Care Home: Beechwood Residential Home

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What the care home does well The inspector formed the view that this home is run for the residents to facilitate and support them. A poster on the wall in the dining room reminds staff that this is what their job is. The home is resident led. Residents looked relaxed and comfortable in the home. The interaction between them, the manager, staff was warm and supportive. One stakeholder spoken with said that the home is "very supportive and very person centred". "Staff are 99% accessible and any issues (like trip money being lost) are followed up the next day". She said she felt that residents the residents "enjoy being there and they have no complaints about staff or their rooms".The home is well organised and managed so that residents can have structure and security in their lives. The manager and staff observe the residents closely and although they have very different individual needs they are supporting them to live as a happy, fulfilled group of people.There are lots of things which this service does really well.It helps people when they are feeling sad or angry.So that they can work things out.It supports people to attend their day centres.Beechwood Residential HomeDS0000022830.V353966.R01.S.docVersion 5.2Page 7People make their own choices.......and get to do some fun things,like going on holidays. What has improved since the last inspection? The home has responded well to requirements from the previous inspection. The statement of purpose and service user guide have been amended. The chair referred to has been removed and the lace curtains replaced. Person in charge visits have commenced and there is now a business plan. Supervision of staff is not quite frequent enough in all cases but has improved. There were no concerns with the recording of resident`s monies.The manager has updated some documents,and the records of the monies are good. What the care home could do better: The inspection resulted in five legal requirements and two good practice recommendations. The manager needs to expand the risk assessment for two residents specifically. The adult protection policy needs alternation and expansion and the manager should seek out the local social services policy. There are three environmental issues to be addressed in the home and there should be better security for the Control of Substances Hazardous to Health (COSHH) items. The manager has identified in his AQAA, improvements which can be made in the communication support systems. He has also identified that health promotion plans would be a positive development.There are some things the home need to do to improve.Staff need to keep their training up to date,and health promotion plans could be developed. CARE HOME ADULTS 18-65 Beechwood Residential Home Beechwood Residential Home 17 Ismalia Road Forest Gate London E7 9PH Lead Inspector Anne Chamberlain Unannounced Inspection 30th October 2007 10:00 Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beechwood Residential Home Address Beechwood Residential Home 17 Ismalia Road Forest Gate London E7 9PH 020 8472 2771 020 8472 2771 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Pretim Singh Mr Benjamin Arthur Piper Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2007 Brief Description of the Service: Beechwood Residential Home provides accommodation and care for six adults with learning disabilities. Twenty-four hour care is provided. The home has four single rooms and one shared double room. All bedrooms are located upstairs. The home does not have a passenger lift and is therefore not suitable for service users with mobility needs. The ground floor is spacious with sitting and dining rooms, a kitchen and office. There is a garden with good garden furniture. Local amenities include a culturally diverse parade of local shops, post office and food outlets in Upton Lane. Several bus routes serve the home. The nearest underground station is Upton Park, on the District Line. The nearest British Rail station is Forest Gate. Currently the home is full and there are no placement vacancies. Fees in the home are in the region of £1,250 per week. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection the manager kindly completed a Annual Quality Assurance Assessment which provided helpful information. The inspection was of key standards and to monitor compliance with requirements made at the last inspection. It lasted some six and a half hours. The inspector spoke with residents and was assisted in the inspection by the manager. She case-tracked three residents viewing their files and the files of their three keyworkers. In addition she viewed key documentation and the arrangements for the administration of medication and finances (for the three residents selected for case-tracking). The inspector toured the premises including the garden, and with his kind permission, the bedroom of one resident. She spoke on the telephone with a stakeholder. The inspector would like to take this opportunity to thank the residents, manager and staff of the home for their assistance and co-operation with the inspection. What the service does well: The inspector formed the view that this home is run for the residents to facilitate and support them. A poster on the wall in the dining room reminds staff that this is what their job is. The home is resident led. Residents looked relaxed and comfortable in the home. The interaction between them, the manager, staff was warm and supportive. One stakeholder spoken with said that the home is very supportive and very person centred. Staff are 99 accessible and any issues (like trip money being lost) are followed up the next day. She said she felt that residents the residents enjoy being there and they have no complaints about staff or their rooms. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 6 The home is well organised and managed so that residents can have structure and security in their lives. The manager and staff observe the residents closely and although they have very different individual needs they are supporting them to live as a happy, fulfilled group of people. There are lots of things which this service does really well. It helps people when they are feeling sad or angry. So that they can work things out. It supports people to attend their day centres. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 7 People make their own choices……. and get to do some fun things, like going on holidays. What has improved since the last inspection? The home has responded well to requirements from the previous inspection. The statement of purpose and service user guide have been amended. The chair referred to has been removed and the lace curtains replaced. Person in charge visits have commenced and there is now a business plan. Supervision of staff is not quite frequent enough in all cases but has improved. There were no concerns with the recording of residents monies. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 8 The manager has updated some documents, and the records of the monies are good. What they could do better: The inspection resulted in five legal requirements and two good practice recommendations. The manager needs to expand the risk assessment for two residents specifically. The adult protection policy needs alternation and expansion and the manager should seek out the local social services policy. There are three environmental issues to be addressed in the home and there should be better security for the Control of Substances Hazardous to Health (COSHH) items. The manager has identified in his AQAA, improvements which can be made in the communication support systems. He has also identified that health promotion plans would be a positive development. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 9 There are some things the home need to do to improve. Staff need to keep their training up to date, and health promotion plans could be developed. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 10 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 11 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 1 and 2. This judgement has been made using available evidence including a visit to this service. The home has produced helpful information to guide any prospective resident. Assessment of new residents is pro-active and thorough. EVIDENCE: The home has prepared a statement of purpose and service user guide. Both documents have been updated to reflect the fact that the home now has six residents. The most recent admission to the home was about eighteen months ago and the new resident has settled well. The manager said that it was really important not to unsettle the existing residents, and he feels that the new person contributes very positively to the group dynamics. The manager explained to the inspector the process he would follow in assessing a prospective resident. The inspector was quite satisfied with it. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 12 Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 13 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user plans are individualised and kept up to date. Residents make their own decisions wherever possible and risk assessment underpins the process. Some further risk assessment has been identified. EVIDENCE: The inspector viewed the service user plans for three residents. She was satisfied that these were individualised, comprehensive and pertinent. The manager stated that plans would be reviewed at least annually and updated after any substantial change. The inspector noted on viewing three files, that regular reviews of the care plans had been undertaken, and they were initialled to evidence this. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 14 One resident uses Makaton but the manager and staff had observed that she never initiates a conversation with it, but mirrors what she sees. The inspector was quite impressed that this subtlety had been picked up. It shows that the staff are monitoring things closely and sharing their observations. The manager was able to give many examples of residents making their own decisions. He explained that although some of the residents are non-verbal they have a range of communication strategies to indicate their choices. One can be hard to understand but writes and types. Residents also use body language to communicate. One resident points to his choice in shops. The inspector noted that a lot of documents are supported with pictures to help residents understand the information. The home also uses picture cards. Having met the residents the inspector felt quite happy that they would make their preferences clear under most circumstances. The manager stated that residents have a meeting every couple of months. The inspector viewed the minutes of the last one. She was impressed that the minute taker had not just recorded what was said, but other responses, for example head nodding and pointing to pictures. The residents usually holiday together at Warner Breaks where they have a choice of activities. One resident chooses not to go with the others and the home is looking into a separate holiday for him. Two residents had a trip to Belgium recently with their day centre. The inspector was concerned to hear that under a scheme called In Control (a Newham pilot scheme) a resident had been offered supported tenancy accommodation. The manager listed a number of concerns he has about this person living in that kind of independent setting, all of which sounded well grounded to the inspector. The manager said that his main frustration had been that the professionals orchestrating this move had not allowed him to contribute to the assessment process, which is apparently purist. The residents files evidenced risk assessment. There were individualised assessments and generic assessments. Actions to reduce risks had been identified. The inspector noted that although two residents are diagnosed as epileptic and take medication for this, neither of them had a bathing assessment around their epilepsy. The manager stated that the epilepsy is very well controlled and neither resident has had a seizure for years. One resident always has assistance in the bath anyway because of his physical difficulties. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 15 Obviously the manager has already made a mental risk assessment and the inspector asked him to make this explicit on a risk assessment form, to be placed in each residents file (see requirements). Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 16 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home supports residents to take part in a range of activities, in the home, in the community and over their social and family networks. Their rights are respected and they enjoy their meals and mealtimes. EVIDENCE: The residents undertake a range of activities inside and outside of the house. Five out of the six residents attend day centres. The residents have a choice of centre based and community based activities. A contact at the day centre said that residents always come prepared for activities and the home managed to obtain passports so that two could go on a trip to Belgium. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 17 The sixth resident has an individual programme with something to do each day. This represents a significant achievement and improvement in his level of confidence and interaction. The resident was in the home on the day of the inspection. He was interested in it and was very helpful, passing books and papers between the manager and the inspector. The manager mentioned a list of activities and places attended by residents, including Bubble Club, Poetry in Wood, local churches and shopping. The manager of Poetry in Wood apparently said that one of the residents is very artistic indeed. The manager noted when she met her, the lovely colours and choice of jewellery she was wearing. The inspector trusts that there will be many opportunities for this resident to develop her talent. Most of the residents have some family contact and they are all supported with friendships among their social network. The inspector viewed the log books to evidence the above information. She was pleased to see that in addition to personal care and meals being noted staff had recorded that people had been shopping or made a visit home etc. Residents in the home have different levels of independence. They have keys to their room if they want them and can use them. One resident has a keypad which works well for him. Two residents are almost independent in personal care. There are two staff on duty in the mornings, but a lot of preparation is done the night before to save time when people are getting ready for their day centres. The inspector noted on a large noticeboard in the dining room, day plans and timetables for people, some with pictures. She felt that these were very helpful to residents. One resident was enjoying discussing his weekly timetable with the manager. On the board were also instructions to staff and guidelines for working with residents. This all speaks of good care practice. The inspector noted, on her tour of the premises, board games and colouring materials in the sitting room. The manager said that one of the residents likes to play her own invented game, making patterns with the scrabble tiles. He said that the two female residents enjoy colouring together. One resident enjoys reading newspapers and keeps a collection in a drawer in the sitting room. The inspector was told that meals are chosen by residents. A menu plan for the week is usually made on a Sunday evening with people choosing a dish for each day. The manager said that he usually does the shopping on Fridays and one resident particularly likes to come along. The inspector noted that the dining table is large enough for everyone to sit round together. She also noted that when residents came in from day centre they were asked if they would Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 18 like a hot drink and made their choices. Two or three sat around the table with their drinks and biscuits and everyone appeared quite relaxed and at home. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 19 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported in an individual and personal way. Their physical and emotional needs are studied and met and the medication practice in the home is sound. EVIDENCE: As previously mentioned, everyones personal care needs are different according to their level of independence. One resident can paint her own finger nails, another likes her to be done for her. A contact at a day centre said that both women always wear nice clothes. Two residents have chiropody and two have succeeded in losing some excess weight. Two service users are epileptic and one is diabetic. The manager feels that all three are very well managed on their medication. As previously mentioned no seizures have been observed with the epileptic residents. The diabetic resident takes medication and has her blood sugar checked regularly. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 20 The home tries to steer her into healthy eating habits and to limit her intake of sugar. The medication and this approach seem to keep the diabetes well under control. Some of the residents at the home have had input from psychology services in the past, but are not having it currently. There is some challenging behaviour at times and there has been damage to property at the home. Risk assessments reflected the need to keep people safe in the community where they can become unsettled by the public. Two residents are on the autistic spectrum. Notwithstanding this the group at the home seems reasonably compatible and their individual needs for personal care and health care are being met. The inspector viewed the health files for the three residents she was casetracking. They are very useful with a section for each discipline e.g. psychiatry, optician, dentist etc. The manager said that whoever escorts a person to an appointment will take responsibility for making sure there is follow up, if necessary. He said he keeps an overview himself anyway. The AQAA talks of developing health promotion plans. The inspector viewed the arrangements for the administration of medication. Most medications come in blister packs from the pharmacy. The initials of all staff who administer medication are listed at the front of the medication folder. She noted that each resident has their photograph in the folder along with their Medication Administration Record (MAR) sheet, and information about their medications. The inspector balanced a medication for each of the three residents she was case-tracking. There were no discrepancies. The manager said that he does audit the medications periodically and showed the inspector the audit sheet, which listed medications along with other checks. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 21 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 22 and 23. This judgement has been made using available evidence including a visit to this service. Residents views are sought and considered. They are protected from abuse but the adult protection policy needs amendment. EVIDENCE: The inspector viewed the complaints policy which gave timescales for responses. It had been reviewed this year. The manager showed the inspector a user friendly version of the information which he had just taken down from the wall to amend. The manager stated that a log is kept for complaints, but currently it has nothing in it. The AQAA states that residents are encouraged to express any dissatisfactions at residents meetings so that formal complaints are avoided. The home assists residents to manager their finances and keeps balances of their monies for safekeeping. Account books of expenditure are kept and the cash balances are checked at each handover. The inspector counted the cash balances for the three residents she was case-tracking and there were no discrepancies. The inspector viewed the adult protection policy. In fact there were two. The inspector concentrated on the newer version and asked the manager to Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 22 combine the two policies into one and destroy the older policy. The policy made many useful points around good practice. However it did not make clear that in the event of an allegation or suspicion of abuse the home must inform the local social services straightaway. The inspector explained that social services should take the lead and will possibly call a multi-agency strategy meeting. The homes policy should refer to the local social services policy and state that it will be followed in conjunction. It is also useful for the home to have a copy of the local social services policy and the manager has been asked to seek one (see requirements). Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 23 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment at the home is homely, comfortable and quite spacious. The condition is clean but there are some decor issues which need attention. EVIDENCE: In his AQAA the manager speaks of the home as a safe space for residents to relax and call their own. The inspector viewed the premises of the home. It has a small, well-kept garden with good garden furniture and an umbrella. The kitchen in the home is large and well fitted. It was clean and tidy. Different coloured chopping boards for different types of food were in evidence. Also fresh fruit. The inspector checked the refrigerator, most opened foods were labelled with the opened on date with the exception of a box of margarine. The inspector noted that there was plenty of canned and dried foods in the cupboards. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 24 The dining room is a good size and adjoins the office and kitchen. It seems to be the hub of the house. There is a small utility room off the dining room where laundry is done. Off the hallway downstairs is a bathroom with hand shower. The bathroom is finished to a high standard but the hand shower is broken and needs repair (see requirements). The sitting room is a good size and has enough comfortable seating for everyone to sit together and watch TV if they want to. One resident has no interest in TV and her favourite chair has no view of the screen. The inspector noted photographs of the residents on the mantelpiece, there was also a bit of their artwork displayed around the house. The second floor of the house has five bedrooms and the inspector viewed two. One was a shared room and she was told that the residents like sharing. They have a close relationship. They were offered the option to separate when the loft bedroom was developed but declined. The room is certainly large, light and airy. It contained some personal items for one resident, but the other likes to keep his side very minimalistic. There is a bathroom on this floor. It is again well fitted, but the window frame has been partly replaced and not finished with varnish or paint (see requirements). The loft has been developed with another bedroom. This is a really nice, square room with no ceiling slopes, and lots of light. However there has been a leak in the roof which has damaged the ceiling. The manager said that this has been repaired and no longer leaks, but the redecoration has not been done (see requirements). There were no issues in the home around hygiene and infection control. Two residents at the home have occasional incontinence. The floor of the laundry area is not impermeable so staff must take care to load any soiled laundry straight into the machine. The manager stated that the machine has a high temperature wash. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 25 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager stated in his AQAA that the staff team are diverse in age, gender, and culture, as are the residents. He said that equality and diversity are incorporated into staff training. The inspector met three members of staff. They all interacted well with residents. The manager has a very caring approach and apparently residents tend to compete for his attention. This has been positively used to encourage residents. All the staff have NVQ level 2 in care except one who almost has it. Two staff now want to do Learning Disabilities Award Framework (LDAF) training. The manager explained to the inspector the recruitment process and she verified this in the staff personnel files. The recruitment at the home is sound and the manager said that the staff group are stable, most having worked there for some years. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 26 The inspector noted that staff have had various training. A list is kept in each individual file of training undertaken and certificates are also retained. The manager and inspector agreed that it would be reasonable for staff to renew core basics annually, as follows: First Aid Fire Health and Safety Food Hygiene Safeguarding Adults Any additional training staff undertake will benefit them and the residents (see requirements). The manager said that he assesses the medication practice of each staff member once a year. They are all trained to administer medication. The inspector recommended to the manager that he devise a matrix for staff training and make a training plan based on this (see recommendations). The inspector viewed evidence of regular and frequent staff supervision. The home also have team meetings where staff are encouraged to discuss any issues regarding the running of the home. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 27 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 and 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is very well run. This was evidenced in the stable management structures and systems, and in the quality and scope of documentation and recording. Residents at the home need consistency and predictability in their care. The feedback from a day centre was that residents are always prepared for whatever activity is planned. Also staff are accessible and responsive. The contact said that residents are supported to take up the opportunities which come their way, attending lot of parties and social events. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 28 As previously mentioned the manager undertakes his own mini audit regularly and the form for this was seen by the inspector. The proprieter also does, person in charge visits. The manager stated that in addition a feedback form is sent to stakeholders and residents sit down with a staff member to complete theirs. The inspector suggested that next time the residents are asked for quality feedback they are assisted by someone outside of the house, for example a day centre worker. This should improve objectivity. One service user has an advocate who helps her to express her views. The inspector viewed the arrangements for health and safety in the home. She viewed the health and safety policy. There are two and the inspector recommended that one which has been succeeded be destroyed (see recommendations). The inspector viewed the Landlords Gas Safety certificate dated 22/8/07 and the Electrical Wiring check dated 18/10/06 - the latter lasts for three years. The portable appliances were checked on 22/9/07 and the inspector noted a sticker confirming this date. The water quality was checked on 3/11/05 when the shower heads were inspected. The inspector viewed the record of temperature checks for the taps and also ran water over her hand at a basin. The home has a combination boiler so the risk of Legionella is greatly reduced. The inspector viewed the temperature checks for refrigerator and freezer which were satisfactory. The inspector checked on the fire protection arrangements. The home has a fire safety policy and a fire risk assessment. They have fire drills every three months and different staff are involved. The manager stated that the alarms and emergency lighting are tested every week. A fire alarm inspection was carried out on 16/8/07 by an outside contractor. The manager stated that the extinguishers were checked recently and this was verified as an extinguisher had been inspected on September 2007 and was dated. A fire blanket was noted in the kitchen and a Fire Actions sign is posted there. The inspector viewed the arrangements for the storage of COSHH items. The items are stored in a cupboard in the laundry room. It has childproof plastic ties which have to be both pressed together to open the door. However the plastic has become slack and the door was easily opened without any pressure on the ties. The manager needs to replace these ties but should use a lock and key system for better security (see requirements). The home keeps data sheets for all COSHH products used. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 29 The inspector was satisfied that health and safety are taken seriously at the home with efforts made to reduce and eliminate unnecessary risks and hazards. The inspector viewed the business plan for the home for 2007 - 2008. It was centred around the residents. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 30 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 2 3 Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 31 Are there any outstanding requirements from the last inspection? NO NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA9 Regulation 13(4) Requirement The manager must ensure that bathing risk assessments are undertaken for the two epileptic residents. The manager must ensure that the adult protection policy is amended to state: that in the event of a suspicion or allegation of abuse the local social services must be advised. that the homes policy will be followed in conjunction with the local social services policy. The manager must attempt to obtain a copy of the local social services Safeguarding Adults policy. The manager must ensure that: The shower head in the downstairs bathroom is repaired. The window frame is the middle floor bathroom is properly finished. The ceiling in the loft bedroom is Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 32 Timescale for action 01/01/08 2. YA23 13(6) 01/01/08 3. YA24 23 01/01/08 redecorated. 4. YA35 18(1)(c)(i) The manager must ensure that staff keep core basic training up to date by refreshing them annually e.g.: First Aid Fire Health and Safety Food Hygiene Adult Protection The manager must ensure that COSHH products are stored securely under lock and key. 01/03/08 5. YA42 13(4)(c) 01/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA35 YA42 Good Practice Recommendations The manager should devise a training matrix and make a training plan. The health and safety policy which has been succeeded by another should be destroyed. Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Beechwood Residential Home DS0000022830.V353966.R01.S.doc Version 5.2 Page 34 - 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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