Care Home: Beechwood Place Nursing Home

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What the care home does well People are properly assessed before moving into the home. People told me they had enough information about the home before they moved in. One person told me that family had visited and looked around the home and the manager visited her before she was admitted, to introduce herself and talk to her about the home and what to expect. There are thorough recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. Care and support is delivered by skilled competent staff. New staff are given an excellent induction into care, and on going staff training is of a very good standard. People said they enjoyed the food they were given and said that there was a good choice. One person said `the meals are great, I really enjoy my breakfast, I have it in my bedroom the staff ask me what I want and bring it for me`. There is a varied selection of activities offered to people who live at the home, such as movement to music, outings, aromatherapy and visiting entertainers. In addition to this people also get individual time spent with them by the activities co ordinator to pursue any other interest or activity. People know that they can complain, and that they will be listened to. One person said they would complain to the manger or any of the staff and would be confident that their concerns would be listened to and acted upon. Staff know their responsibilities in passing on any concerns which affect the safety and vulnerability of people. The manager listens to the views of those with an interest in the home. There are regular minuted relative and resident meetings. It was evident that the manager takes positive action to improve the quality of life of people who live at Beechfield Place Nursing Home, often as a result of listening to what people who use the service have to say. The home is well maintained and the garden area is beautiful with level access and outdoor seating. What has improved since the last inspection? At the last inspection we asked the manager to update some risk assessments that were in place in particular the garden pond. The manager identified that work needed to be carried out to make the pond safe.The work has been completed and people can use the garden area safely. Refurbishment and redecoration of the home is ongoing. A new assisted shower room has been created with a ceiling hoist fitted to ensure easy access for people using it. New equipment has been bought such as specialist mattresses to make people who spend long periods of time in bed more comfortable. A new set of weighing scales has been purchased which allows for people who use a wheel chair to be weighed accurately. Enhanced induction training has been introduced for all new staff, and staff training now includes the Mental Capacity Act and Deprivation of Liberty. `Link` nurses havebeen created. This means that the trained staff in the home has some specialist knowledge in areas such as managing continence, caring for the terminally ill and wound management. What the care home could do better: This service provides excellent outcomes for people who use it. The manager and staff team are always looking for opportunities to develop and enhance this service, to ensure a positive experience for people who live and work at Beechfield Place. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beechwood Place Nursing Home 50-52 Welham Road Norton Malton North Yorkshire YO17 9DP     The quality rating for this care home is:   three star excellent 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: Bridgit Stockton     Date: 2 2 0 6 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 Older People 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 Older People Page 2 of 22 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 Older People Page 3 of 22 Information about the care home Name of care home: Address: Beechwood Place Nursing Home 50-52 Welham Road Norton Malton North Yorkshire YO17 9DP 01653692641 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : ann-marie.medd@bleakhouse.org Bleak House Limited care home 35 Number of places (if applicable): Under 65 Over 65 35 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Beechwood Place is a privately owned nursing home for up to thirty five service users who require nursing care. It is situated in a quiet area in the town of Norton. The accommodation is on three floors with lift access. The town of Malton is nearby, where there is access to shops, the post office and cafes. The rooms vary in size and some have en suite facilities. There is parking to the side of the home and pleasant gardens to the rear and side of the property. Care Homes for Older People Page 4 of 22 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The methods I used to gather the information needed included a visit to the home, conversations with the people who live there, their relatives, healthcare professionals and the staff. I looked in detail at the care and records of three people, examined other records and looked around the home. I spent four hours at the home. The manager also completed some paperwork for us called an annual quality assurance assessment (AQAA). This provides valuable information to help me form a judgement about the quality of service offered at the home Care Homes for Older People Page 5 of 22 What the care home does well: What has improved since the last inspection? At the last inspection we asked the manager to update some risk assessments that were in place in particular the garden pond. The manager identified that work needed to be carried out to make the pond safe.The work has been completed and people can use the garden area safely. Refurbishment and redecoration of the home is ongoing. A new assisted shower room has been created with a ceiling hoist fitted to ensure easy access for people using it. New equipment has been bought such as specialist mattresses to make people who spend long periods of time in bed more comfortable. A new set of weighing scales has been purchased which allows for people who use a wheel chair to be weighed accurately. Enhanced induction training has been introduced for all new staff, and staff training now includes the Mental Capacity Act and Deprivation of Liberty. Link nurses have Care Homes for Older People Page 6 of 22 been created. This means that the trained staff in the home has some specialist knowledge in areas such as managing continence, caring for the terminally ill and wound management. 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 Older People Page 7 of 22 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 22 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. People are properly assessed to ensure their needs could be fully met, prior to being offered a permanent placement at the home. Evidence: The care plans I looked at showed that comprehensive pre-admission assessments had been carried out before offering someone a place. This is to make sure that the home can meet the persons needs. A senior member of staff, usually the manager visits the person at home, or in hospital to discuss their care needs. Social Services assessments are also used to determine this as well; these were also available to look at. On the afternoon of the inspection the manager had planned to go and visit the local hospital in Malton to assess a person who was wanting to come and stay at the home. People are welcome to visit the home before reaching a decision. The family of one person had visited the home prior to the person being admitted and arranged the Care Homes for Older People Page 9 of 22 Evidence: room with small items of furniture, and hung pictures and photographs on the wall, to make the room look homely. The home does not provide intermediate care. Care Homes for Older People Page 10 of 22 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are treat with the utmost dignity and respect, and they can be assured that their health and personal care needs are met. Evidence: People using this service receive a high standard of care. Observations in communal areas and peoples rooms showed people looking clean and well cared for with hair brushed, teeth cleaned and nails cut or manicured. People where treat in a respectful and dignified manner. I looked at three care plans in detail, to make sure that peoples health and personal care needs are being met in the way the person prefers. I found the plans to be comprehensive and well written. Careful and thoughtful strategies to address particular needs or problems were well documented and sensitively written. The plans demonstrated that people are in receipt of individual planned care and support. Care staff spoken to during the inspection were very knowledgeable about the care they were delivering to people, they spoke of individual needs of each person and described peoples routines, and how personal choices were met. Care Homes for Older People Page 11 of 22 Evidence: One person said I have really improved over the past few weeks, another said the care is wonderful and the staff really know how to care for me. Risk assessments were in place relating to moving and handling, nutrition, the prevention of pressure sores and the risk of falls. The manager wrote in the AQAA Along with the plan of care, we commence risk assessments to identify any risk. For example malnutrition, pressure sores, choking, falling. We reduce this risk to a minimum via our care plan, training, pressure relieving aids, appropriate diet and liaising with specialists if required. These all ensure that people know their limitations in a risk assessed environment. Staff are aware of what equipment to use and aware of how to promote independence in a safe setting. Privacy and dignity is maintained. All personal care is administered in a private room and visiting healthcare professionals are aware that this practice takes place and see people within their own bedrooms. People were observed being addressed in a pleasant manner by staff and were generally called by their first names. The medication system was inspected. The home has clear policies in place regarding staff administering medication and self administration. There was a clear audit trail of peoples and stock medication could be reconciled to the medication administration record. Staff need to be reminded on how medication is disposed of safely, as some tablets that should have been destroyed were found in the medication trolley. Care Homes for Older People Page 12 of 22 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recreational and social needs of people are very well catered for, which enables people to make daily choices and promotes independence. Evidence: During my visit the atmosphere in the home was friendly and welcoming, with visitors coming and going throughout the day. the visitors who spoke to me said they were always made to feel welcome and it was evident that families could speak to the manager and staff easily and that they were approachable. An activities program was on display. The program was varied and included church services, bingo and sing-alongs. A picnic in the grounds of the home had taken place at the weekend and people told me that they had really enjoyed themselves, and that family and friends were welcome to attend this as well. People told me that the food was lovely another person said I have a cooked breakfast each morning, it sets me up for the day. The cook was knowledgeable about what people liked and disliked. On the day of inspection people had a choice at lunch time of silverside of beef with creamed and roast potatoes served with cauliflower, carrots and broccoli with fresh fruit salad for dessert. There was also an alternative if people did not want this for lunch and a vegetarian option served. People told me the food was excellant and another person Care Homes for Older People Page 13 of 22 Evidence: wrote we are blessed in having such an excellent cook she cooks us lovely meals The manager told me in the AQAA Many of our service users require assistance with meals. Staff breaks are co-ordinated to enable all staff availability at meal times. Meals are never rushed and we ensure that eating is an enjoyable experience. All staff have obtained training with regard to nutrition and diet both in house via NVQ and by speech therapist and dietician. One person said they could have a sleep in when ever they liked and another person said the staff are champion, I get on with them all they help me get up and ready on a morning, if Iwant a walk out they will take me, nothing is a trouble. Care Homes for Older People Page 14 of 22 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 can be confidant that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse Evidence: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staff knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. Any concerns raised by people who live at the home are dealt with immediately. People who live at the home told me they would speak to the manager or any of the staff if they had any concerns or complaints. The complaints file was looked at and procedure is followed with regard to how complaints are dealt with. Staff told me that training has taken place in the protection of vulnerable adults in abuse. I looked at four personnel files and found that staff recruitment procedures were adequate and staff were employed and deployed following appropriate checks. The manager and staff team were clear and confident in the protection of vulnerable adult procedures. Care Homes for Older People Page 15 of 22 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, 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. 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 clean, comfortable and safe home Evidence: All the bedrooms that I saw reflect the persons individual preferences and taste. The family of one person had visited the home prior to the person being admitted and arranged the room with small items of furniture, and hung pictures and photographs on the wall, to make the room look more like home from home. There is a programme of redecoration for the bedrooms, as well as for the rest of the home. One person told me that they were looking forward to having the room redecorated and had chosen the colour for the walls and had matching bed linen. A bathroom has recently been refurbished to make an assisted shower room with ceiling hoist so people could have a choice of how they bathe. The bedroom doors all have locks, and there is a lockable storage space in the rooms. This means that people can keep their belongings private and secure. The fire risk assessment has been updated on the home and the fire and rescue service visit the home to inspect it for fire safety. They have not made any requirements from the last visit. Care Homes for Older People Page 16 of 22 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that staff are trained and on duty in sufficient numbers to meet their assessed needs Evidence: The rotas and staff numbers suggest that there are enough staff on duty at all times to meet the needs of the people who live at the home. The manager makes sure that staff have the necessary training to help them do their work as well as possible. There is a wide range of courses available and the records confirmed that the staff are allowed the time to attend. During the inspection the deputy manager was away from the home attending a course. Records demonstrated that staff had been recruited properly and appropriate checks had taken place before they were accepted to work at the home. Staff complete a thorough induction programme and then continue on the skills for care course. Staff told me they receive regular supervision and that they training the receive is excellent. Care Homes for Older People Page 17 of 22 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe and well managed and people who live and work at the home can contribute to the decision making processes. Evidence: The manager has the qualifications and the skills to manage the home effectively. Staff said that the manager was lovely and very supportive. The people who live at the home all new who the manager was and it was evident that people would raise concerns with her. The manager makes sure that things are being done properly and that people are happy with their care. Medication audits, accident analysis and regular supervision of staff take place. The manager receives regular supervision from the homes owner. The manager told us in the AQAA that We have effective quality assurance and monitoring system ensuring that aims and objectives reflect service users wishes. Internal audits take place on a monthly, three monthly or yearly basis. The results of Care Homes for Older People Page 18 of 22 Evidence: the service users survey will be published and available for service users, staff, family members and stakeholders. The registered manager demonstrates a commitment to development for each service user which is incorporated in their plan of care. The home looks after small amounts of personal money for some people, transactions are recoreded properly and money is kept safe. Policies and procedures are kept up to date; to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. Staff have basic health and safety training. All these measures make sure that the health, safety and welfare of the people who live at the home is promoted and safeguarded. Care Homes for Older People Page 19 of 22 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 Older People Page 20 of 22 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 9 All staff should be reminded on the homes policy and procedure for the safe disposal and destruction of medication. Care Homes for Older People Page 21 of 22 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. 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