Care Home: The Beeches

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What the care home does well A temporary management team of three experienced members of staff is now running the home. It was positive to see that there is now a more open culture with residents about the planned closure of the home and that the residents are going to be consulted about where they will live in the future. Work has started on reducing the number of files kept about each person who lives at The Beeches. It was positive to see that one person had recently had a review about their placementand had been asked who they wish to be present and involved. What the care home could do better: The home recognises the significant amount of work that needs to be done to address the outstanding requirements and recommendations made at the key inspection in March 2010. Serious consideration should be given to updating risk assessments in the new files rather than transferring existing risk assessments some of which are several years old and some of which are no longer relevant . Consideration should be given to not transferring duplicated information when setting up the new files. Random inspection report Care homes for adults (18-65 years) Name: Address: The Beeches Fairfield Bungalows Blandford Dorset DT11 7HX zero star poor service 01/03/2010 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Susan Hale Date: 1 9 0 5 2 0 1 0 Information about the care home Name of care home: Address: The Beeches Fairfield Bungalows Blandford Dorset DT11 7HX 01258453436 01258451540 s.j.tuck@dorsetcc.gov.uk www.dorsetforyou.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Susan Joy Tuck Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dorset County Council care home 25 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 25 The maximum number of service users who can be accommodated is 25 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home The Beeches provides accommodation for adults who have a learning disability, providing long-term and short-term care. The home was purpose built in the 1970s. Accommodation is arranged over two floors, with the lounges, dining room and domestic kitchen being on the ground floor. There is a large garden to the rear of the property. The home has good access to the local community and is within walking Care Homes for Adults (18-65 years) Page 2 of 18 0 1 0 3 2 0 1 0 Brief description of the care home distance of the town centre. The Beeches has a bungalow attached to the main home that currently accommodates three service users. The people who live in the bungalow, are supported by two members of staff during the waking day, and one waking night staff. The bungalow has its own kitchen, dining room, lounge and bathroom. The homes service users guide and a copy of the last inspection report is available on request. Details of charges are available on request. Care Homes for Adults (18-65 years) Page 3 of 18 What we found: The inspection took place over the course of one day and was undertaken by two inspectors. The purpose of the visit was to check progress in relation to the outstanding requirements and recommendations that were made at the key inspection in March 2010. There were 13 people living in the home on the day of the visit. The home is currently being managed by a team of three members of staff who all work within day centre learning disability services. The role of these staff is to identify systems to address the serious concerns identified at the key inspection. We looked briefly at two care plans but the majority of the time spent at the home was in discussion with two members of the acting management team. Following this discussion it was clear that a start had been made to improve the service offered at The Beeches. Plans were in place to reduce the number of files containing information about each resident so that they become more accessible to staff and residents. The majority of residents have now been allocated a social worker as part of the reassessment and transition process for residents to be supported during the closure of The Beeches and consideration of where people want to live in the future. People who live in the home are now aware of the planned closure and are becoming involved in the decisions being made about their future. We saw that the number of files that each of the two residents had been reduced. However, some of the information in both of the files were duplicated and some information was out of date and could have been archived. One care file looked at was significantly better than the second file. We discussed with the two members of staff about how consistency of information could be achieved. One person had recently had a review of their placement and had been asked who they wish to attend their meeting. The review had made it clear to the resident that The Beeches is closing and focused on how their needs would continue to be met and how they would become involved in choosing where they wish to live in the future. What the care home does well: A temporary management team of three experienced members of staff is now running the home. It was positive to see that there is now a more open culture with residents about the planned closure of the home and that the residents are going to be consulted about where they will live in the future. Work has started on reducing the number of files kept about each person who lives at The Beeches. It was positive to see that one person had recently had a review about their placement Care Homes for Adults (18-65 years) Page 4 of 18 and had been asked who they wish to be present and involved. 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 2. Care Homes for Adults (18-65 years) Page 5 of 18 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 1 4 The registered provider shall 30/04/2010 compile in relation to the care home a written statement which shall consist of a statement as to the matters listed in Schedule 1. People who are considering using the home need to have accurate information about all aspect of the service being provided including the age range of people using the service. Not looked at during this inspection. 2 3 12 The registered person shall 30/04/2010 make suitable arrangements to ensure that the care home is conducted with due regard to the sex, religious persuasion, racial origin and cultural and linguistic background and any disability of service users. It is important that the home is able to demonstrate they are meeting the needs and preferences of individuals with diverse cultural backgrounds. Not looked at during this Care Homes for Adults (18-65 years) Page 6 of 18 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action inspection. 3 6 15 The registered person shall 30/04/2010 after consultation with the service user,or a representative of his, prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. It is important that peoples changing needs, aspirations and goals are clearly recorded and reviewed as part of their person centred plan. Goals must be specific, measurable and time specific. Plans must state who is responsible for for supporting the individual achieve their goals and how will it be monitored. Previous timescale of 30/04/2010 not met. 4 7 12 The registered person shall, for the purpose of providing care to service users, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings. Proper support plans must be in place when people are being moved. There must be clear evidence of the action taken to prepare people. Not looked at during this inspection. Care Homes for Adults (18-65 years) Page 7 of 18 30/04/2010 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 5 9 13 The registered person shall, 28/05/2010 ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. It is important that people are supported to take risks in their daily life through robust risk management of situations and the development of positive action to facilitate this. Not looked at during this inspection. 6 19 12 The registered person shall 30/04/2010 ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service suers. Where individuals have ongoing serious health conditions there must be detailed plans in place so that staff know exactly what to do and what to record. Not looked at during this inspection. 7 23 13 The registered person shall make arrangements by training staff or by other measures to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. 30/04/2010 Care Homes for Adults (18-65 years) Page 8 of 18 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action It is important that staff put their training into practice and ensure people who use the service are safe at all times. Not looked at during this inspection. 8 32 18 The registered person shall, 31/05/2010 having regard to the size of the care home , the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. It is important that staff working in the home receive the training they need to understand the complex needs of people using the service. Not looked at during this inspection. 9 35 18 The registered person shall 30/04/2010 ensure that the persons employed to work at the care home receive training appropriate to the work they are to perform. It is important that there a training needs assessment is carried out on the staff team Care Homes for Adults (18-65 years) Page 9 of 18 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action linked to the services needs and the needs of individual living in the home. Not looked at during this inspection. 10 39 26 Where the registered provider is an organisation the care home shall be visited in accordance with this regulation. It is important that the process of conducting monthly visits to the home are meaningful and ensure the people using the service are protected. Not looked at during this inspection. 11 42 13 The registered person shall 30/04/2010 ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. When hot water temperatures are recorded and they are higher than they should be it must be evidenced what action has been taken to ensure people are protected. Not looked at during this inspection. 12 42 37 The registered person shall give notice to the commission without delay of 30/04/2010 31/05/2010 Care Homes for Adults (18-65 years) Page 10 of 18 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action the occurance of any areas detailed in the regulation. It is important the commission is aware of how people are supported when ill through accidents and when injured, in order to be clear how the home is protecting vulnerable people. Not looked at during this inspection. 13 42 13 The registered person shall 30/06/2010 make suitable arrangements for the training of staff in first aid, moving and handling, infection control, food hygiene and fire safety. It is important that all staff receive training and refresher training in safe working practices to ensure people who use the service are safe at all times. Not looked at during this inspection. Care Homes for Adults (18-65 years) Page 11 of 18 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, 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 1 The registered person should ensure that the service user guide and statement of purpose are available in a format suitable for the people for whom the home is intended. First recommended in the inspection report 1st March 2010 Not looked at during this inspection. 2 5 The registered person should ensure that the contract is in a format and language appropriate to each individual residents needs. First recommended in the inspection report 1st March 2010. Not looked at during this inspection. 3 6 The registered person should ensure that people are involved in their reviews and if a person lacks capacity as defined in the Mental Capacity Act code of practice, the care plan should record how this decision has been reached. Page 12 of 18 Care Homes for Adults (18-65 years) 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 First recommended in the inspection report 1st March 2010. Not looked that during this inspection. 4 6 The registered person should ensure that plans establish individualised procedures for service user is likely to be aggressive or cause harm, focusing on positive behaviours, ability and willingness. First recommended in the inspection reports 1st March 2010. Not looked at during this inspection . 5 6 The registered person should ensure that the plans (known as help lists) are available in the language and format that individuals can understand. Their plans should be held by them unless clear reasons not to do so are recorded. First recommended in the inspection report 1st March 2010. 6 6 People should be supported to develop life history plans including details and photographs of their life, family, friends, where they grew up, who they know. This is especially important to know in the future of the service where many of the people of live to a number of years is due to close. First recommended in the inspection report 1st March 2010. 7 7 The registered person shall be to demonstrate how individual choices are made entirely record when decisions have been made by others and why. First recommended in the inspection report 1st March 2010. Not looked at during this inspection. 8 8 The registered person should ensure that people using the service are consulted about changes to the homes Page 13 of 18 Care Homes for Adults (18-65 years) 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 statement of purpose. First recommended in the inspection report 1st March 2010. Not looked at during this inspection. 9 10 The registered person should ensure that all information handed about people using service is kept in accordance with the homes written policies and procedures and in line with the Data Protection Act 1998. First recommended in the inspection report 1st March 2010. Not looked at during this inspection. 10 13 The registered person should ensure that people are supported to make use of services, facilities and activities in the local community. First recommended in the inspection report 1st March 2010. Not looked at during this inspection. 11 14 The registered person should insure that group trips are planned and chosen by people who share the same interests. First recommended in the inspection report 1st March 2010. Not looked at during this inspection. 12 16 The registered person should ensure that staff use the individuals preferred form of address which is recorded in the individuals plan. First recommended in inspection report 1st March 2010. Not looked at during this inspection. 13 18 The registered person should ensure that people who use the service have some choice of staff who work with them such as staff from the same ethnic, religious, gender or Page 14 of 18 Care Homes for Adults (18-65 years) 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 cultural background. First recommended in inspection report 1st March 2010. Not looked at during this inspection. 14 19 People who use the service should be offered annual health checks. First recommended inspection report 1st March 2010. Not looked at during this inspection. 15 19 The registered person should ensure that individuals are facilitated to have health action plans. First recommended inspection report 1st March 2010. Not looked at during this inspection. 16 22 The registered person should be proactive in ensuring that people who use the service know what a complaint is, how they can make one if they were unhappy all concerned. This should be considered a priority. First recommended in the inspection report first of March 2010. Not looked at during this inspection. 17 23 The registered person should develop a pictorial/photographic guide so that people know who they can speak to if they dont feel safe or if they are concerned about abuse. First recommended in inspection report 1st March 2010. Not looked at during this inspection. 18 24 The registered provider should ensure that people who use the service have safe access to the home. The ramp at the back of the home should be made safe, as it is currently a trip hazard. First recommended in the inspection report 1st March 2010. Care Homes for Adults (18-65 years) Page 15 of 18 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 Not looked at during this inspection. 19 32 The registered person should make significant efforts to ensure that they increase the number of staff qualified to NVQ level II or above. First recommended in the inspection report 1st March 2010. Not looked at during this inspection. 20 33 The registered person should ensure that there is staff on duty at all times who can communicate with service users in their first language including sign and have skills in other communication methods relevant to service users identified needs. First recommended in the inspection report 1st March 2010. Not looked at during this inspection. 21 33 The registered person should ensure that the staff rota includes the full names of staff. First recommended in the inspection report 1st March 2010. Not looked at doing this inspection. 22 33 The registered person should complete a first aid risk assessment to determine how many first aider should be on duty on each shift and the level of training they were quiet. The assessment should include the needs is people who live in the service, how likely first aid will be needed and what kind of first aid will be required. If the provider does not carry out a risk assessment first aid will need to be provided at all times by properly trained staff. First recommended in the inspection reports 1st March 2010. Not looked at during this inspection. Care Homes for Adults (18-65 years) Page 16 of 18 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 23 37 The registered manager should undertake periodic training to maintain and update her knowledge, skills and competency while managing the home. First recommended in the inspection report 1st March 2010. Not looked at during this inspection. 24 38 The registered manager should communicate a clear sense of direction and leadership which staff and people who use the service understand and are able to relate to the aims and purpose of the home. First recommended in the inspection report 1st March 2010. Not looked at during this inspection. 25 40 The registered person should ensure that policies and procedures are regularly reviewed and updated to make sure they reflect current good practice advice and legislation. First recommended in the inspection report first of March 2010. Not looked at during this inspection. Care Homes for Adults (18-65 years) Page 17 of 18 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 18 of 18 - 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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