Care Home: Beeches (The)

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What the care home does well Procedures are in place to ensure that new peoples` needs are assessed in detail before their admission to ensure that these can be met by the home. A key worker system is in place and monthly summaries of care needs and activities are recorded to ensure that responsive care and support are provided. People`s health needs are closely monitored and arrangements are made for them to see appropriate health professionals promptly. A complaints and safeguarding policy and procedure is in place. Staff are receiving the training and support they need to carry out their duties. The home supports people`s access to a variety of leisure, educational and other day activities according to their choices. What the care home could do better: Improvements need to be made to individual care plans and risk assessments. Further training must be undertaken by all staff, managers and the responsible individual to ensure that there is a clear system (whistleblowing) for staff to report concerns about colleagues and managers. The responsible person must ensure that all staff including managers are aware of and fully implement the home`s policies and procedures. The policy and procedures in relation to planning and taking residents on holiday must be available and implemented at all times when arranging holidays. Full-time management arrangements are needed for the home and a competent new manager must be recruited as soon as possible, who is registered with the Care Quality Commission as a fit person. The registered person must ensure that robust quality assurance and monitoring procedures are in place to comply with Regulations and also to enable the Commission to monitor the service. Random inspection report Care homes for adults (18-65 years) Name: Address: Beeches (The) The Beeches 48 The Drive Ilford Essex IG1 3JF two star good service 29/04/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Harina Morzeria Date: 1 0 0 2 2 0 1 0 Information about the care home Name of care home: Address: Beeches (The) The Beeches 48 The Drive Ilford Essex IG1 3JF 02085183704 Telephone number: Fax number: Email address: Provider web address: thebeeches48@onetel.com Name of registered provider(s): Name of registered manager (if applicable) Dr Chanan Singh Sidhu Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 8 The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home The Beeches is registered to care for younger adults with moderate learning disabilities and associated mental health problems. The home is situated on a busy main road in a residential area in the London Borough of Redbridge. It is within easy reach of a park Care Homes for Adults (18-65 years) Page 2 of 11 2 9 0 4 2 0 0 9 Brief description of the care home and the main town centre in Ilford which is accessible by public transport. All service users occupy their own single rooms which are well furnished and decorated. The service users are supported by the manager and staff to maintain their independent living skills, go to the day centres, attend college for various courses as well as accessing community facilities locally. Some residents access day services, others are supported in community based activities by the staff team. Service users are also encouraged to work part time in paid jobs or work as volunteers in charity shops if they wish. Activities are organised both within the home and via various club memberships. Personal care is provided on a 24-hour basis, and all health care needs are met by staff supporting service users to attend appointments with health professionals. The fees for the home range from 700.00 -- 900.00 GBP per week. A copy of the Statement of Purpose and Service User Guide are available in the home, together with a copy of the most recent inspection report. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: This random unannounced inspection was carried out as a result of a number of concerns raised by a whistleblower around the care and treatment received by residents whilst on holiday in Florida in September 2009. During the time of the inspection, the deputy manager as well as the manager from the sister home, Norfolk road, both assisted with the inspection process. The inspection included a tour of the downstairs part of the building, an assessment of residents care files, staff training files, health and safety records, rotas and relevant policies and procedures. No new people have been admitted to the home since the previous inspection. Most of the residents were at home when the visit commenced. They were preparing to go out with staff for various activities during the day. I had the opportunity to talk briefly with some of the people living at the home and later had a group discussion with staff on duty. As a result of the concerns raised, two strategy meetings were held by Redbridge safeguarding adults team on 7th December 2009 and 14th January 2010. Full care reviews of each individual placement were carried out by the relevant Local Authorities as well as an audit around how finances were managed during the holiday. The outcome of these investigations is available in the minutes of the meeting and a full report prepared by the audit team. This inspection was carried out following a management review, to inspect issues around care planning, risk assessment, staffing and recruitment procedures, adult protection protocol and management duties and responsibilities especially protocols around taking residents on holiday as well as a failure by the responsible individual to carry out effective monthly Regulation 26 monitoring of the service. Five peoples care files/plans were inspected and were found to include details of how peoples needs were being met by staff. Risk assessments are also in place. The care plans and risk assessments were generally being reviewed monthly. The inspector noted that the care plans for some people were drawn up since the home became operational more than five years ago and have been reviewed monthly. However all the individual care plans and associated risk assessments must be thoroughly reviewed and redrawn in consultation with the residents, their placement officers, key worker and interested parties involved in the persons care to ensure that an up to date individual and comprehensive plan of care and associated risk assessment is in place for each person living at the home. This document should then be used as a working tool by staff/key worker in order to ensure that staff work towards helping a person meet their individual needs, goals and expectations. The care plan should put a person at the center of service delivery by the care home. At the time of inspection staff were observed to treat people living at the home with respect, maintaining their privacy, dignity and lifestyle choices whilst supporting them with personal, social and emotional care. From viewing files and discussion it was clear that people living at the home are supported to see healthcare professionals on a regular basis. The service has a whistleblowing and safeguarding procedure in place which staff have signed to state they have read and are aware of it. Staff also confirmed that they have received safeguarding adults training. The London Borough of Redbridge, care management team have carried out a review of the homes safeguarding protocol and are planning to arrange further refresher training in the near future. The whistleblowing procedure/protocol was instigated at the time the recent concern was raised, however this issue was poorly handled by the management team and the responsible individual. A Care Homes for Adults (18-65 years) Page 4 of 11 requirement is made that further training is undertaken by all staff, manager and the responsible individual to ensure that there is a clear system for staff to report concerns about colleagues and managers. Staff that blow the whistle on bad practice must be supported by the service. The manager is aware that staff must be trained and competent to meet residents needs consistently. During the inspection two newly recruited staff files were examined. These contained evidence of two references, ISA check and an application for a CRB check. The management team are aware that residents must be protected by following the homes recruitment policies and procedures. The rota was examined which indicated that there are consistently enough staff available to meet residents needs and more permanent staff are being recruited. Staff training certificates were examined which indicated a range of training undertaken by staff including relevant learning disabilities training. The manager is aware that newly recruited staff must also undertake all relevant and mandatory training. Staff supervision records were checked which showed that the management team have begun to provide regular recorded supervision to them. However, it was not always easy to track records in relation to these. At the time of writing this report the deputy manager confirmed that supervision has been provided to all the staff now. The manager is aware that residents benefit from well supported and supervised staff. The staff team must be effective and available in sufficient numbers and skill mix, to support residents assessed needs at all times. Management The previous registered manager for the home has resigned, following concerns raised around the planning, treatment of residents and conduct during the holiday in Florida. The deputy manager and a manager of the sister home in Norfolk road, were responsible for the day to day managment of the home. However, on the day of this inspection, the inspector was informed that the deputy manager will be resigning. Sufficient arrangements have been made to provide interim cover. A potential candidate for the management post has been interviewed and the proprietor is waiting for the required paperwork and processes to be completed prior to making the appointment. Concerns raised around the implementation of the homes policies and procedures, by the previous manager, have been addressed separately at a meeting (03/02/2010), with the responsible individual, following a management review. The responsible individual is required to ensure that all staff including managers are aware of and fully implement the homes policies and procedures. There must be a strong ethos of being open and transparent in all areas of running of the home. There must be effective systems in place to monitor staff adherence to policies and procedures during their practice. Historically the home have arranged group holidays abroad when the whole house goes away together. However, this has not always considered peoples individual needs and capacity to travel. The manager and staff need to review their approach to holidays and look at providing small group holidays for individual residents, so that their individual needs and capacity to travel can be fully taken into account at the planning stage of a holiday so that an appropriate holiday is arranged for them. A requirement has been made regarding the policies and procedures relating to holidays which must be reviewed, updated and followed when planning holidays in the future. The responsible individual must ensure that there is individual and appropriate care planning, risk management, and that health and safety issues are fully taken into account when planning future holidays. Appropriately trained, experienced and fully competent staff must be available to partake in future holidays. The responsible individual must play a proactive role in the management of the service to ensure that the service fulfills its stated purpose and objectives and meets the needs of Care Homes for Adults (18-65 years) Page 5 of 11 the people who live there. A requirement has been made that there is a robust quality assurance and quality monitoring system in place. The responsible individual must ensure that thorough monitoring of the service is carried out as required and that residents health, safety, welfare, rights and best interests are safeguarded by staff implementing the homes policies and procedures at all times. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 11 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 14 16 The responsible person to 12/05/2010 review and update the homes policy and procedure relating to holidays. This must be fully implemented by staff when planning future holidays. So that residents health, safety and best interests are safeguarded. 2 23 13 Robust procedures and training for responding to suspicion or evidence of abuse or neglect including whistleblowing, to be undertaken by all staff managers and the responsible individual to ensure the safety and protection of service users. So that there is a clear system for staff to report concerns about colleagues and managers. Staff that blow the whistle on bad practice must be supported by the service. 12/05/2010 Care Homes for Adults (18-65 years) Page 8 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 3 37 9 The registered person must 09/06/2010 ensure that a new full-time manager is recruited for the home who registers with the Care Quality Commission as a fit person. So that residents benefit from a well run home which is operated by a person who is qualified, competent and experienced to manage the home and meet its stated purpose, aims and objectives. 4 39 26 The responsible individual or 12/05/2010 a nominated independent individual to carry out monthly visits to the care home in accordance with the Regulation. So that residents benefit from robust quality assurance and quality monitoring of the service to ensure that the care home fulfills its stated purpose and objectives and meets the needs of the people who live there. 5 39 24 The registered person must 12/05/2010 ensure that effective quality assurance and quality monitoring systems are established and that there is continuous self monitoring, and an internal audit at least annually. The results of the findings to be explained to the residents in a suitable format to all the residents. Page 9 of 11 Care Homes for Adults (18-65 years) Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action So that residents are confident that their views underpin all self-monitoring, review and development by the home. 6 40 17 The registered person to ensure that staff and managers receive support and training to fully implement the homes policies and procedures. So that residents rights and best interests are safeguarded and so that staff are aware of ,understand and apply all policies,procedures and codes of practice. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 12/05/2010 1 6 The registered person to review each existing care plan and risk assessment in consultation with the residents and other interested parties involved in the residents care to ensure that residents know their assessed and changing needs and personal goals are reflected in their individual plan and how these will be met by the home. Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 11 of 11 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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