Care Home: Beechwood Care Home

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What the care home does well The people who live at the home indicated that they liked living there. There is a welltrained and established staff group, who are supportive to people and treat them with respect. People are able to make choices about their daily lives, such as what they want to eat, how and where they want to spend their time and what activities they want to pursue. The manager has worked hard to develop a comprehensive training plan for staff. She has also developed good person centered care plans for all the people living there. What has improved since the last inspection? A refurbishment of the bathrooms has been undertaken. Staff rotas are now checked to ensure they are accurate. Fire records are completed regularly by a designated fire warden. Care plans are in more depth and are person-centered. Menus have been reviewed to include more choices. The medication procedures have been revised. Quality assurance systems have been developed. What the care home could do better: No issues of concern were identified at this inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Beechwood Care Home 60 Burlington Road Sherwood Nottingham NG5 2GS     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Western     Date: 1 9 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Beechwood Care Home 60 Burlington Road Sherwood Nottingham NG5 2GS 01159245893 01159609077 kathyg@norsaca.org.uk www.norsca.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Nottingham Regional Society for Adults and Children with Autism care home 8 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 8. The registered persons 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 are within the following category: Learning disability - Code LD Date of last inspection Brief description of the care home Beechwood was opened in 2000. It is situated in the Sherwood area of Nottingham and is a large older adapted property, with much of its original character maintained. Arranged on 2 floors, the accommodation consists of 7 single bedrooms with shared bathing facilities, one single en-suite room and communal lounge and dining rooms. A single storey exension provided in 2006 houses the office and staff sleeping-in room. It is close to local amenities and bus routes into the city centre, less than 2 miles away. The mission statement says the service focuses on assisting service users to attain Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 8 Brief description of the care home maximum personal development. The fees charged are 1,141.90 pounds weekly and this information together with information about the homes facilities is available form the managers office. Care Homes for Adults (18-65 years) Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Commission for Social Care Inspection [CSCI]. The visit lasted approximately three hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection.Before we made our visit the provider had returned the Annual Quality Assurance Assessment [AQAA]. This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent out surveys to people before we visited the service.The main method used to carry out the inspection is called case tracking; this includes following the care of a sample of people through their records and assessing their care. We spoke with five people who use the service and saw rooms of those people who Care Homes for Adults (18-65 years) Page 6 of 25 gave us permission. We spoke with three staff members. The manager and the deputy manager were present at the time of the inspection and the general outcomes of the visit were discussed with them.At the time of the inspection the home confirmed that the weekly fees were around 1141 pounds, depending on the assessed needs of the resident. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report is available in the office. What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information provided is freely available to residents and clearly sets out what is available for them. A comprehensive initial assessment ensures that the needs of residents can be met. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. Evidence: The manager told us that she or the deputy manager always visited prospective residents at home or in another care setting to undertake a thorough assessment of all their care needs. We saw records confirming this. NoRSACA has its own admission panel where all new admissions are discussed fully. The deputy manager attended several meetings concerning the latest person to be admitted and records showed that he had an extended admission period before both he and the service were sure that the placement was suitable. The statement of purpose and service user guide we saw were both easy to read and gave people all they needed to make an informed choice; the service user guide contained pictures of the home and facilities. We saw admission records for people that were clear and gave staff enough information to meet their needs.Terms and conditions and contracts we saw were up to date. We spoke to a Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: resident who said she had visited before she was sure she wanted to move in permanently. Records we saw confirmed this. We spoke to a staff member who described the admission process and the importance of making new residents and their families welcomed. Care Homes for Adults (18-65 years) Page 11 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans accurately describe support needs for people and they are fully consulted. People are regularly asked for their opinions on the running of the home and what their wishes and preferences are. There are good assessments in place to minimise risks to people. Evidence: We saw person centred care plans selected from people living in the home. They had a wide range of information about peoples daily support needs. We saw evidence of peoples participation, including their signatures where possible. The assessments included those of other professionals such as the Primary Care Trust, psychiatrists and specialists in autism. We saw evidence of input from relatives and advocates throughout. Reviews were held on a six-monthly basis and included questionnaires completed by residents. We saw several examples of people making individual choices, including a male and female resident who were in a relationship. This was being managed with sensitivity and in a responsible way by staff. Two residents told us that they could choose what they ate and when they went to bed. There were clear Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: risk assessments for various activities and the Mental Capacity Act and Deprivation of Liberties were included throughout care planning.We saw that staff treated people with dignity and respect for their wishes. Care Homes for Adults (18-65 years) Page 13 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A good variety of leisure activities and outings are provided to ensure that service users have an enjoyable stay. Service users have a choice of meals from a balanced and varied menu. Evidence: We saw a printed list of activities and a daily routine for each individual. On the day of the inspection, two people were tidying their rooms and doing their laundry, three were attending college, one was attending an IT workshop and two had gone horse riding. We saw that other activities recently had included going to local pubs, swimming and bowling, trips to the theatre, walks, shopping and visiting the local supermarket. There is a mini-bus for transport. NoRSACA operate their own day centres in Nottingham, which people attend if they wish. Television, books and games were also available. A resident spoken with described going home to visit her mother, which she Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: did regularly and most people had regular contact with their families. The home has a mini-bus. People were asked where they wished to go for holidays and last year this included Filey, Iceland and Fuerteventura, with staff accompaniment. We saw people eating the mid-day meal; one said Its fine and another gave a thumbs-up sign and a big smile. We saw that menus were balanced and varied, with a choice of meals and fresh vegetables and fruit used. The manager said that people could prepare their own meals if they wished, but that normally a main meal was served at 5pm. The kitchen was being completely refurbished on the day of the inspection. We saw that people had daily tasks to carry out if they wanted to, including setting dining tables, washing up and cleaning. People were weighed regularly but diets were only started if people wanted to. Care Homes for Adults (18-65 years) Page 15 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are in sufficient depth and detail to ensure that residents health care needs can be met. Evidence: We saw medication records which showed that people are well supported by a staff group who knows their needs well. The Boots blister pack system is used and drugs are kept in a secured trolley. The GP and other health care professionals are contacted as and when needed. We saw that monthly reviews were held by the staff. We spoke to a senior staff member who said all senior staff had recently received update training in medication. Medication policies were clear and the pharmacist visited regularly. Her last last visit in December 2008 raised no issues of concern. Behaviour management plans were clear and up to date and written in the first person, showing that people were involved throughout their care planning.. Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes procedures for addressing complaints and for protection from abuse are clear. Residents and their families are confident that their comments and concerns will be listened to. Evidence: The complaints procedure is available in writing and symbols to enable service users to understand it where possible. There is one safeguarding allegation which is currently being addressed. Since the last inspection in 2006 there has been one complaint concerning personal care and this was fully addressed by the home. A returned survey form commented There is nothing I would wish to complain about; my son is well cared for. There was a copy of the latest Local Authority safeguarding adults document and we spoke to staff who knew what to do in the event of a serious concern.The deputy manager said that all staff members had received either in-house or external training in safeguarding adults. Care Homes for Adults (18-65 years) Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a safe, comfortable and pleasant environment that is suitable for their needs. Evidence: We saw that the standard of decoration externally was good, with well tended areas for people to sit out in. Internally, rooms were well personalised and decorated to the wishes of each individual. Each bedroom door had the name of its owner displayed. Recent improvements had included the refurbishment of the shower/bathrooms and toilets. On the day of the inspection the kitchen was in the middle of being completely refurbished, but temperature tests and cleaning rotas were still being carried out. The manager said that carpeting and decoration of the corridor areas was the next on the maintenance list for improvements. The home smelled clean and fresh throughout. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent to meet the needs of residents. Evidence: The daily staff rota showed that there were usually 2 staff members during the day and the manager or deputy manager were present Monday to Friday. In addition to the care staff the home employed a cook, a domestic and a maintenance/gardener staff. Staff members said that there were enough staff to complete their tasks in time and people we spoke with indicated that they liked the staff. Staff members we spoke with had been working at the home for many years. Staff training records we saw showed that 4 staff members had completed the National Vocational Qualification [a nationally recognised qualification] at level two with 2 working towards it and 3 staff members were working towards NVQ at level 3. The manager said that staff training needs were identified though supervision and we saw a very clear training programme. This showed that there was a rolling mandatory training plan and induction programme. Training included the Mental Capacity Act and specialist training in autism, epilepsy and behaviour management. Staff files were kept at the organisations headquarters but all necessary information was available. Staff members we spoke with confirmed that they had interviews, gave references, Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: underwent an induction course and had CRB/POVA checks carried out. Records demonstrated that staff received regular supervision staff meetings. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the health, safety and welfare of the residents are promoted. The views of the residents are listened to and they are involved in decisions affecting them. Evidence: The registered manager of the home has been in post for two years. She has 20 years experience in the care profession, 8 of these with NoRSACA. She has the Registered Managers Award, a professional qualification. The deputy manager, who was present at the inspection, has 28 years experience in caring, 7 of these as deputy. Staff spoken with said that the management team were approachable and accessible.The assistant director visits the home on a monthly basis and these visits are recorded. The home is shortly to carry out a self-assessment manual of all CSCI standards. We saw a questionnaire for people and their families to give their opinions about the running of the home. In addition there is an annual review specifically designed for people with autism and overseen by BILD, a specialist learning disability organisation. One of the residents is also part of a study group looking at the running of the home, including staff recruitment. We saw fire records that showed full checks were made Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: regularly by an appointed fire warden. Other maintenance and safety records we saw included water, electricity and heating. Care Homes for Adults (18-65 years) Page 22 of 25 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 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, Care Homes 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 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 Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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