Care Home: Beulah House

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What the care home does well The manager and the staff find out what people like to do and try to make sure that they can do it and they find out what they like to eat and try to make sure that is what they get. If somebody is ill they make sure that they get treatment. If somebody doesn`t like something they can complain to the manager or any of the other staff. The home is clean and well decorated. It is in Market Drayton and it is very easy to get to local shops and there is plenty of transport so that people who live in the home can get to other things like cinemas and cafes. The staff are cheerful, friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. The managers are also cheerful, friendly and helpful and organise things that help the staff to do their jobs and makes sure that the home is a safe place to be. What has improved since the last inspection? There were no requirements or recommendations made at the last inspection. However, improvements have been made to the care planning system that shows the system to be `person centred`. What the care home could do better: No requirements recommendations have been made as a result of this inspection. CARE HOME ADULTS 18-65 Beulah House 5 Cemetery Road Market Drayton Shropshire TF9 3BD Lead Inspector Mike Moloney Key Unannounced Inspection 24th September 2008 08:00 Beulah House DS0000020703.V372315.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 Beulah House DS0000020703.V372315.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. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beulah House Address 5 Cemetery Road Market Drayton Shropshire TF9 3BD 01630 652451 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) www.macintyrecharity.org MacIntyre Care Mrs Carol Fay Groome Care Home 5 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (1) of places Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2006 Brief Description of the Service: Beulah House is a detached property situated in Market Drayton, Shropshire. The home offers access to local amenities and is in keeping with the local community. The home is part of the MacIntyre Care Services organisation and is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation and personal care for a maximum of four people with a learning disability under the age of 65 and one person with a learning disability over the age of 65. Service users are provided with a single room. En-suite facilities are not provided. Shared space includes a lounge/dining room and a fully fitted kitchen. The garden at the back of the property provides privacy and security and the service users have access to a large fully furnished heated summer house. The home has its own transport and service users regularly access the local community. Ms Carol Groom is the Registered Manager and Head of service. Further information is available from the home’s service user guide. The fees are paid by the local authority on a ‘block contract’ basis. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. A range of evidence was used to make judgements about this service. This includes: information from the provider, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service. What the service does well: What has improved since the last inspection? What they could do better: No requirements recommendations have been made as a result of this inspection. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 6 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. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 7 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 Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 8 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): There have been no new service users admitted to the home since the last inspection therefore it was not possible to evaluate the admissions procedures. EVIDENCE: Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 9 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. Individuals are involved in decisions about their lives and play an active role in planning the care and support they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care records for two of the people living in the home were looked at and were seen to contain information about the reviews of their care that had taken place in the last twelve months. The records also showed that reviews of their ‘Person Centred Plans’ which contain information about a persons likes, dislikes and hopes had taken place within the same period. When talking with the staff they also confirmed that they had been involved in these reviews. Staff also explained that various risk assessments and behaviour management plans had also been reviewed as part of this process and could be seen in the individuals’ files. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 10 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. People who use services are able to make choices about their life style and are supported to develop their life skills. Social and recreational activities are developed to meet individual’s expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of two of the service users were looked. They were both seen to have detailed care plans and ‘Person Centred’ plans that contained the likes, dislikes and wishes of each individual. Talking to the staff confirmed that these had been drawn up by observing which activities the person liked or disliked or asking other people such as friends or relatives for input. Each individual person was also asked and they were able to respond in different ways depending on their communication skills. Copies of these plans were found in each person’s bedroom either in a folder or on the wall and staff were seen using them to explain what activities were Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 11 to take place. They also explained that some of the plans had been ‘laminated’ otherwise they did not last long because of wear and tear. Daily activity sheets were also seen in each person’s file and looking at these showed that activities take place that are to the liking of the person concerned. An example of this was seen during the morning of the inspection when one person who had been identified as liking having her hair done hurried into the sitting area after she had her hair washed and she was carrying her hair dryer. She then sat smiling waiting for the member of staff who was helping her to dry her hair for her. During the inspection it was seen that activity summary sheet for each of the daily activities was marked as completed by the staff and sheets such as these for each previous day were seen in the records giving a quick reference when checking that people were taking part in the activities that they either enjoyed or needed. Records of what each person had eaten were seen. Checking these records against individual ‘Person Centred Plans’ showed that people are being offered food that they are known to enjoy. The records also said what name each person liked to be known as. Throughout the inspection staff were seen to treat everyone with dignity and respect and explained what they were doing as they did it. The people that they were talking to gave the impression that they were used to this and expected it. The home was seen to have two vehicles that were available to transport people to the activities or appointments that had been arranged for them. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 12 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 good. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records looked at showed when each person had either visited or been visited by a healthcare professional, what for and what the outcome was. Talking with the staff showed that they were aware of the contents of each person’s health action plan. The arrangements for the storage and administration of people’s medication were looked at. Storage was seen to be appropriate and records correctly maintained. Although no controlled drugs were kept at the home one particularly powerful drug was treated as such by the staff in both the way it was stored and the way its administration was recorded. Staff said that they receive training in the safe handling of medication before they are allowed to give them to people and their records confirmed this. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 13 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): 22 and 23 Quality in this outcome area is good. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager and the senior carer on duty at the time of the inspection stated that no complaints or any allegations of abuse had been made since the last inspection. The home had a copy of their complaints procedure and policies which complied with the local policies and procedures for the protection of vulnerable adults, both being part of the systems that ensures that the service users are listened to and protected from abuse, neglect and self-harm. The senior member of staff on duty explained the system for recording of residents personal cash transactions and these were seen to be clear in the way that they were recorded and checked by other staff and senior managers. The level of the disabilities of the service users means that most are unlikely to be able to access these formal policies but observation of the staff interacting with them and communicating between themselves indicated that they would be aware of any dissatisfaction expressed. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 14 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. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is situated in Market Drayton and is an older property that has been converted to its present use in a sensitive and practical manner. The home has its main laundry area situated so that access is through areas that are not used for food preparation or consumption thereby reducing the risk of cross contamination. Walking around the home it was seen that everywhere was clean and well maintained with the grounds providing a similarly pleasant but secure area for the people and their pets to be. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 15 The service users’ bedrooms were all seen and these were all pleasantly decorated and, according to those that could express their views, were very much to their liking. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 16 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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions and to support the smooth running of the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection staff were seen and heard constantly chatting with service users and explaining what they were doing and why. They responded straight away if a service user indicated they wanted something. An example of this was when one person saw someone else having her breakfast and indicated that she wanted a slice of toast as well. The member of staff acknowledged her and went to get one straight away and the person who wanted the toast sat at the table and waited in a way that suggested that she was used to being treated in such a manner. During the inspection there were enough staff on duty to meet the needs of the people living in the home. Looking at the rotas and talking with the staff established that appropriate numbers of staff were available at other times with numbers being increased should the need arise. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 17 The manager also said that any vacancies are covered by the existing staff team or specially employed ‘bank’ staff who have undergone training at the home and know the people who live there well. The staff that were on duty confirmed that they meet with their line manager once a month on a one to one basis to discuss issues about themselves or the home and that they receive the training that enables them to meet the needs of the people that they look after. Looking at the staff records and talking with the manager confirmed what they had said. The records also showed that 13 of 19 staff have gained National Vocational Qualification level 3 in care. Records of the recruitment of any new staff were not looked at. These are kept at the company’s area office along with those of sister homes. Another of the homes records had been inspected recently and their records were found to be in order. These checks are carried out to ensure that people who wish to work with vulnerable people are fit to do so. The provider has three further services that are registered locally and, in recent years, no errors have been found in any of their recruitment records. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 18 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 and 42 Quality in this outcome area is excellent. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by qualified, competent managers. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been running this home for a number of years and gained her Registered Managers Award some time ago. This is a qualification that is considered appropriate for someone in this position. Since the last inspection she had also temporarily managed another of the provider’s homes in a nearby town whilst it was without a manager. In order to help her with this arrangement and to ensure that the service provided to the people living at Beulah House was maintained a senior member of the staff Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 19 took on some of the day to day management tasks. This was all with the knowledge of the Commission for Social Care Inspection. A list of which of the provider’s other home managers could be contacted and how was available to the staff should the home’s own manager not be available. Records showed that senior managers visited the home on a regular basis to monitor how well the needs of the service users were being met. Copies of the records of actions taken by the manager that are sent the senior managers of the organisation were seen. These records contain information about such things as staff training and formal professional supervision sessions. A number of records were seen showing that safety checks had been carried out on such things as portable electrical appliances and fire safety equipment Records of fridge and freezer temperatures were also seen to have been kept. The home was also seen to have secure storage for hazardous materials and have developed instructions for their safe use. Records showed that the staff team receive appropriate safety training in infection control, the safe handling of medicines, first aid, food hygiene, manual handling and fire prevention. Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 20 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 x 2 x 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 3 ENVIRONMENT Standard No Score 24 3 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 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 x 3 x x 3 x Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 21 no Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Beulah House DS0000020703.V372315.R01.S.doc Version 5.2 Page 23 - 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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