Care Home: Beechwood House

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What the care home does well The overall care is planned in a responsible manner, and takes into account interests, preferences, needs and abilities of the people living at the home. The staff support and enable people to maintain their independence in all aspect of their daily lives. The people at the home live in a safe and attractive environment, which is maintained to a good standard and promotes their privacy and independence The home is well managed and has an benefited from an established and experienced staff team The general standard of records and record keeping in respect to the people who live there was good. What has improved since the last inspection? The requirements from the previous inspection have been fully complied with by the time of this inspection. There have been no major service changes. What the care home could do better: There are no major issues for improvement, however the home needs to address any areas outlined in the report. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Beechwood House Devon Drive Brimington Chesterfield Derbyshire S43 1DX     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: Nancy Bradley     Date: 1 7 1 2 2 0 0 8 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 27 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Beechwood House Devon Drive Brimington Chesterfield Derbyshire S43 1DX (01246)476444 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): suedurrant@elmwoodnh.eclipse.co.uk Elm Care Limited Name of registered manager (if applicable) Ms Alison Jane Colledge Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Beechwood House is provides personal care and support for up to 10 younger adults with learning disabilities and who may have some challenging behaviours. The home is well maintained and provides all single room accommodation, each having a wash hand basin provided. There are adequate separate bathing and toilet facilities and a communal lounge and dining room. Catering and provided centrally, although service users are able to access the kitchen with staff support in order to prepare drinks and snacks in accordance with the capabilities. There is a separate laundry room, which service users can also access with staff support. A small garden area is provided, with seating and also car parking spaces. The philosophy of the home is one of `normalisation? with the aim of promoting service users independence, choice and opportunities for personal development, with care planned in accordance with their risk assessed needs and personal lifestyle preferences. Service users have regular access Care Homes for Adults (18-65 years) Page 4 of 27 care home 10 Over 65 0 10 Brief description of the care home to activities - personal, social, recreational and educational- both within and outside the home. The Registered Manager and team of care and hotel services staff, provide twenty-four hour support for the service users accommodated. There are suitable ongoing arrangements for staff training and development. Care Homes for Adults (18-65 years) Page 5 of 27 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: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection and took place over a total of five hours. We spoke with the registered manager, care staff and people living at the home. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. We looked at all the information that we received or asked for, since the last key inspection. This included the following: The annual quality assurance assessment (AQAA) that was sent to us by the home. The AQAA is a self-assessment that focuses on how well outcomes Care Homes for Adults (18-65 years) Page 6 of 27 are being met for people using the service. It also gives us some numerical information about the home. Two people living at the home were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the person. Additionally, time was spent in preparation for the visit, looking at the service history and the previous inspection report. Records were examined relating to the people living there and the general running of the home. There were ten people living at the home on the day of the visit, the home has no vacancies We sent out ten Have Your Say questionnaires to people living at the home and have received all ten back. Completed surveys indicated the people living at the home were very happy there and were supported by the staff on a daily basis. Care staff had assisted the people in completing the questionnaires. Discussions with the care staff on behalf of the people living there did express concerns at the optional questions at the back of the questionnaires. Care staff stated that people were upset about this and did not see why we needed to know this information. We received a warm, friendly and enthusiastic welcome from the people living at the home. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 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 27 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. Arrangements are in place to ensure that peoples needs are fully assessed and met prior to admission. This ensures that peoples holistic needs are appropriately met. Evidence: The majority of the people who are admitted to the home have their needs assessed by social workers or through the care management system. The single assessment then forms part of the planned care people receive. Also the home undertakes their own individual comprehensive needs assessments. This was in accordance with a recognised care model and provides a person centred record of individual needs, including identified strengths and needs, long-term goals, and evaluation. Care management are not always reviewing the care needs assessments. Family and carers interests were also recorded. There have been no new admissions to the home since the last site visit. However there has been a transfer of two people within the Elm Care complex in to Beech House. Reasons for this are always recorded on the care plans. Care Homes for Adults (18-65 years) Page 10 of 27 Care Homes for Adults (18-65 years) Page 11 of 27 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. There is a care planning and review system in place, which ensures that peoples individual needs are met. Evidence: During the visit care plans of two people who live at the home were seen. The registered manager had compiled the care plan and evidence was seen of care plans being reviewed on a monthly and six monthly basis. All of the people case-tracked had a comprehensive care plan, which was in accordance with their assessed need and formulated within a risk assessment framework. All care plans were very detailed and comprehensive including peoples individual lifestyle preferences and choice, the interventions prescribed by outside healthcare professionals were appropriate. Daily records are also maintained on each person. The home has moved into person centred planning and people living at the home were very proud of the work they had undertaken in compiling their care records. The Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: person centred planning runs along side the more formal care planning system in operation. People living at the home had complied their care plan with help from their key worker. Each day both care staff and people living at the home write in the care records. The care records include peoples goals, achievements and aspirations. During the visit care staff were observed discussing with people, choices and arrangements for daily living. Detailed risk assessments were in place and these included actions to be taken by staff. Care Homes for Adults (18-65 years) Page 13 of 27 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. There were arrangements in place to enable people to maintain and develop appropriate relationships and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. Evidence: During the site visit we spoke with people from the home and care staff about the activities they were engaged in and the arrangements for these. The care records of all people provided detailed needs assessment and care planning information regarding their social, recreational, educational and occupational activities both within the home and outside in the community. The peoples personal goals, choices and preferences were identified and there were properly recorded risk assessments in place for each person in relation to the activities Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: they were engaged in. The home takes people from the home on holiday each year to the coast and photograph records were on seen showing how they had spent their time. The holidays are tailored to the individual needs and abilities of the people living at the home. A record of peoples individual activities is kept by them and included as part of their person centred care plan Information on peoples records indicated that contact with family and friends were appropriate and that were they play an important part in their lives, the home maintains good contact with them. Restrictions in contact were clearly recorded and were with peoples agreement. From examination of the menus the home is providing a healthy, well-balanced and nutritious diet. The home maintains a record of peoples weight. During the site visit we joined the people for lunch. The people are given a choice if they do not like the options on the menu. The care staff were observed checking with people as to their likes and dislikes. Care Homes for Adults (18-65 years) Page 15 of 27 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. People living at the home receive personal and health care support in a way, which promotes their independence and is in accordance with their preferences and beliefs. Evidence: During the visit it was clear that the peoples privacy and dignity is respected, and where people need supervision during personal care this is recorded in their care plan. From records examined and from discussions with staff, people health and personal needs were being met People were generally healthy and records showed that staff promptly contacted the appropriated medical services. All people attended services within the community including optician, podiatry, and dentist. People at the home receive regular health check from centre at Ash-green. The people a living at the home showed us their My Health Care booklet. This is a record of all medical appointments and health details. Each person completes this and can take it with them on appointments. This is a scheme supported by the National Health Service and the Co Operative for people with additional needs. The home operates and monitors all medication. None of the people are able to Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: administer their own medication. All staff have received training on medication training procedures. The arrangements for receipt, storage, administration and disposal of medication were also examined and found to be satisfactory. All medication is recorded on MAR sheets. Care Homes for Adults (18-65 years) Page 17 of 27 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. There are suitable arrangements in place to safeguard peoples welfare, which enables their concerns and complaints to be listened to and acted upon. Evidence: The home has a complaints procedure, which is included in the service users guide which all pf the people living at the home have a copy of. The complaints procedure is also displayed throughout the home. The home has developed a format which is accessible to people and they are made aware of how to make a complaint and who they can complain to. Records seen indicated that no complaints had been made about the home since the previous site visit. The Commission for Social Care Inspection has not received any concerns about this home. The home also keeps a record of compliments from family and friends. The procedure contains the new complaints address of the Commission for Social Care Inspection and informs the complainants that they are able to contact the Commission at any stage of the complaints process if they wish to do so. The home has good links with the Derbyshire Advocacy Service, and they support the people in making complaints should they wish to do so. From discussions with the care staff and from records examined there has been no reported incidents or allegations under the safeguarding of adults procedure since the Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: last site visit. The staff confirmed they had received training on safeguarding of adults. The home operates to Derbyshire County Councils Social Services policy on Safeguarding of Adults. . As discussed with the staff the policy needs to show contact details for the local social services office or call Derbyshire. Care Homes for Adults (18-65 years) Page 19 of 27 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. People live in a safe and well-maintained home, which suits their needs and promotes their independence, privacy and lifestyle. Evidence: We carried out a full tour of the home, accompanied by the staff on duty and people who live at the home. All communal areas were inspected together with staff facilities. Peoples bedrooms were inspected with their agreement and all rooms had been decorated and furnished to their personal choice and all were personalised. The home was clean, well maintained, well furnished, equipped and well lit and heated. There is a central kitchen and separate laundry and staff facilities. There are no outstanding maintenance issues. The care staff confirmed there is an ongoing programme of refurbishment and decoration, which will commence, in the New Year. There is a small garden and patio area with garden furniture, which is used by people from the home at various times of the year. Several of the people spoken with confirmed they help with the garden maintenance. Care Homes for Adults (18-65 years) Page 20 of 27 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. The home has robust recruitment procedures and practices in place which ensure the safety and protect the people who live there. People are well supported by an effective staff team who are appropriately trained. Evidence: The home operates a key-worker system and the staff spoken with during the visit where aware of the individual needs of the people they care for. From records examined during the visit over 50 of the staff have attained a National Vocational Qualification at level 2 or above. The home has a recruitment and selection policy in place. Several staff records were examined and generally these were well presented. All new staff are required to provide two references, a full employment history, have a clear Criminal Records Bureau clearance and complete a probationary period. However the companies application form does not indicate that a full employment history is required. The form is not requesting the days date, month and year. This was discussed with the registered manager. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Copies of staff qualifications were on file. There has been no change in staffing since the pervious inspection. Staff spoken with during the visit stated there were good training and development opportunities. The AQAA and the homes training records confirmed the training undertaken over the last twelve months together with future training requirements. All staff have a Personal Development Plan. The home has a staff supervision policy place. There was evidence in staff records to show that staff appraisals were being undertaken and staff had received supervision. Care Homes for Adults (18-65 years) Page 22 of 27 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. Systems are in place to ensure that people have a voice and their views are listened to and acted upon. Evidence: The Registered Manager has a Registered Managers Award, NVQ Level 4 in care and management and has a relevant job description. Discussions and completed staff questionnaires stated the manager was approachable and supportive and open to discussion. All of the staff indicated they felt supported by the manager and there is good team support. The home has developed a system for auditing quality and monitoring all services provided by the home. The Registered Manager provided copies of the most resent audits undertaken by the home. These confirmed that the necessary service aspects of the home had been audited. The Regulation 26 visits are under taken by the Registered Managers for the homes within the Elm Care Group these were seen and found to be satisfactory. The registered manager compiles an annual report and Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: reviews the team objectives on a regular basis. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. Evidence of checks having been carried out was provided to us by way of the AQAA. The Registered Manager had completed the AQAA to satisfactory standard and within the required timescale. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 1 2 3 2 23 34 The home should ensure that care managers regular assess peoples care placements. The homes safeguarding policy should show the contact details for the local Social Services office or call Derbyshire. The company should amend its application form to indicate to applicants that a full employment history is required. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 27 of 27 - 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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