Care Home: The Beeches

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What the care home does well To make sure the service can meet peoples` care and support needs, these are assessed before they come to live in the home. The home is well decorated and well maintained, homely comfortable and clean. People say they like their bedrooms and they are surrounded by their own possessions. One person said they "like their room" and have "everything they need". Another said their room is "lovely" and enjoys living in the home. People enjoy a varied and balanced diet and are offered a choice of menu. One person said they "get plenty to eat" and the "food is great". Another said themeals are "very good", however, they "like Fridays best" as they "like a bit of fish". A sample of the lunchtime meal found it to be well cooked, well presented and tasty. People are cared for by staff that are trained and qualified. One person said "the staff are very good", and another said "the staff are very caring". Throughout the visit there appeared to be enough staff on duty to meet people`s care needs in a relaxed and unhurried manner. People are protected by the way staff are recruited and selected as they include taking up references and police checks before they are employed. One carer said they feel "supported in their work". The returned satisfaction surveys show that people and their relatives have a say in the running of the home and the quality of services provided. The action plan provided by the service shows that changes are made to the way the home runs as a result of what people say. What has improved since the last inspection? To make sure people get the support they need, their care plans are now looked at every month and changed to reflect their changing needs. The way medicines are dealt with has changed and is now looked at regularly to make sure people are safe. Unused medicines are recorded and sent back to the pharmacist for disposal. A new quiet lounge has been created for people living in the home by moving the office. The new office means there is somewhere private for people to talk without been interrupted. What the care home could do better: Throughout the visit people were observed being treated with dignity and having their wishes respected. But the daily records do not contain descriptive words to show and reflect the choices people make. People and their relatives are asked their opinion about the quality of care and services provided, but the views of other visitors such as District Nurses and Social Workers are not asked for or recorded. CARE HOMES FOR OLDER PEOPLE The Beeches 59 Ferrybridge Road Castleford West Yorks WF10 4JW Lead Inspector Tony Railton Key Unannounced Inspection 10:15 23rd April 2008 X10015.doc Version 1.40 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 The Beeches DS0000060847.V362423.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 Older People. 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. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Beeches Address 59 Ferrybridge Road Castleford West Yorks WF10 4JW 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) 01977 517685 01977 517685 carecarecareltd@btconnect.com Care Care Care Ltd Mrs Karen Elaine Smith Care Home 23 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (23), Old age, of places not falling within any other category (23), Physical disability over 65 years of age (23) The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th September 2007 Brief Description of the Service: The Beeches provides accommodation and personal and nursing care for up to 23 older persons who may have additional physical disabilities or enduring mental health problems. The accommodation is on two floors with a passenger lift between the floors. Ground floor accommodation can accommodate those with a physical disability. Not all the rooms are single and only a few have en-suite facilities. The home is sited on a main road close to the centre of Castleford. The home has a garden to the front and a car park to the side and rear of the building. The Deputy Manager informed the Commission for Social Care Inspection on 23rd April 2008 that fees at the home range from £388 to £526 per week and there are extra charges for hairdressing (from £3) and for chiropody (from £10). Further information about service and the role of the CSCI is available on request from the home of by e-mailing carecarecareltd@btconnect.com The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This service has been given a 2 star rating, which means people living in the home experience good quality outcomes. This visit to the home started at 10.15 and ended at 14.30. During this visit there was the opportunity to speak to most people living in the home, the Deputy Manager, Registered Manager, the owner, nurses, care staff, cook and domestic. The records of six people living in the home were seen and included pre admission assessments, care plans, reviews, daily records, and record of activities. A sample of three peoples medical records and medicines and three peoples finances were checked. The homes menu was seen and the lunchtime meal sampled. Other information provided by the service before the visit was considered as was the service history, record of complaints and the minutes of Safeguarding meetings. The homes satisfaction surveys returned from people living in the home and their relatives were also considered. Six staff records were seen and included application forms, references, Police and POVA (Protection of Vulnerable Adult List) checks, and staff training records. This was a very positive visit and a number of improvements were noted. The inspector would like to take the opportunity to thank the people living in the home; the deputy manager, registered manager, owner and her staff team for their hospitality, patience and co-operation throughout the visit. What the service does well: To make sure the service can meet peoples’ care and support needs, these are assessed before they come to live in the home. The home is well decorated and well maintained, homely comfortable and clean. People say they like their bedrooms and they are surrounded by their own possessions. One person said they “like their room” and have “everything they need”. Another said their room is “lovely” and enjoys living in the home. People enjoy a varied and balanced diet and are offered a choice of menu. One person said they “get plenty to eat” and the “food is great”. Another said the The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 6 meals are “very good”, however, they “like Fridays best” as they “like a bit of fish”. A sample of the lunchtime meal found it to be well cooked, well presented and tasty. People are cared for by staff that are trained and qualified. One person said “the staff are very good”, and another said “the staff are very caring”. Throughout the visit there appeared to be enough staff on duty to meet people’s care needs in a relaxed and unhurried manner. People are protected by the way staff are recruited and selected as they include taking up references and police checks before they are employed. One carer said they feel “supported in their work”. The returned satisfaction surveys show that people and their relatives have a say in the running of the home and the quality of services provided. The action plan provided by the service shows that changes are made to the way the home runs as a result of what people say. What has improved since the last inspection? What they could do better: Throughout the visit people were observed being treated with dignity and having their wishes respected. But the daily records do not contain descriptive words to show and reflect the choices people make. People and their relatives are asked their opinion about the quality of care and services provided, but the views of other visitors such as District Nurses and Social Workers are not asked for or recorded. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 7 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. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. To make sure people choose the right service their care needs are assessed before moving into the home. The home does not provide specialist services for intermediate care. EVIDENCE: The Deputy Manager said people’s personal care and healthcare needs are assessed before they come to live in the home. They said this is to make sure that the home can meet their personal care needs. A sample of six people’s records including pre-admission assessments confirmed this. The signatures on the assessments show that people and their relatives are involved and have a say in how they would like to be cared for. The Deputy Manager confirmed the home does not provide special services for intermediate care. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People’s personal and healthcare needs are met and they are protected by the way medicines are dealt with. EVIDENCE: A sample of six people’s records show that their care needs are written down in a plan of care telling staff what they must do to make sure their needs are met. The reviews show that the care plans are now looked at on a monthly basis and if needed is changed reflect peoples changing personal and healthcare needs. Throughout the visit people were observed being treated with dignity and having their wishes respected, however, the daily records do not contain descriptive words to reflect and show peoples choices. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 11 The homes returned satisfaction surveys show that people and their relatives feel that the home meets people’s personal care needs. One person said they are “very happy” living in the home and they have “everything they need”. The returned satisfaction surveys also show that people and their relatives feel involved and have a say in what happens to them and what happens to them. The Deputy Manager said to make them safer the medicines in the home are now checked regularly and that medicines not used are now recorded and returned to the pharmacists. The medicine returns book confirmed this. People are protected by the way medicines are dealt with as a sample of four people’s medicines were checked and found to be correct. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People’s lifestyles match their experience and people enjoy their meals. EVIDENCE: The Deputy Manager said activities are arranged and people join in if they choose. The daily records confirmed that activities take place on a regular basis. However, the daily records do not contain descriptive words to show and reflect people’s choices and preferences. The returned satisfaction surveys show people and their relatives are generally happy with life in the home and with the services provided. The menus show people are offered a varied and balanced diet. The cook said all the ingredients including meat and vegetables are bought locally and people usually enjoy their meals. One person said “they meals are great” and they “get plenty to eat”. Another said they have “put on lots of weight” because the “foods so good”. One person said the meals are “very good” but they like Fridays best, as they “like a bit of fish”. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 13 The home’s returned satisfaction surveys show people living in the home and their relatives are very pleased with the homes menu and the quality of the meals provided. A sample of the lunchtime meal found it to be well cooked, well presented and tasty. The menu choice checklists show people are given a choice of menu. To make sure people are safe and protected a sample of six staff records show they have Food Hygiene Training. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People’s complaints are taking seriously and acted upon and they are protected from abuse. EVIDENCE: The Deputy manager said the home has received one complaint since the previous visit. The record of complaint and previous information provided by the service confirmed this. The record of complaint and complaint investigation letter show that the complaint was properly investigated and acted upon. The Deputy Manager said as a result of the complaint further Palliative Care training has been arranged for staff. A copy of the complaints policy and procedure is displayed in the home. The Deputy Manager said all residents and their relatives have access to the complaints policy, which is included in the Service User Guide in people’s bedrooms. The returned satisfaction surveys shows people and their relatives are generally happy with the services provided and the homes ‘ability to deal with complaints and concerns effectively’. The Deputy Manager said to make sure people are safe all staff have Safeguarding training as part of their induction and annual update training. A The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 15 sample of six staff records including induction and training records show they have Safeguarding training. To protect people living in the home the records show there have been three Safeguarding referrals. The minutes of the Safeguarding meetings show that these were properly dealt with and that appropriate action was taken by the home to make sure people remain safe. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People live in a well decorated, well maintained home that is comfortable, clean and safe. EVIDENCE: People were observed throughout the visit relaxing in the lounges, dining room and their own bedrooms. Everyone appeared to be happy and comfortable. One person relaxing in their bedroom said they “have everything they need” and are “happy” with their room. Another said they “like their room” and in particular the “pictures of their family and grandchildren”. A tour of the premises found it to be clean and free from any unpleasant odours. Discussion with the Domestic found they have everything they need to keep everything clean for people living in the home. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 17 The sixteen returned satisfaction surveys show that people and their relatives are happy with the environment provided and cleanliness of the home. The maintenance records show that to keep people safe regular checks of the fire alarm and emergency lighting equipment are carried out. To make sure people are safe staff training records show they have Health and Safety, Infection Control and Control of Substances Hazardous to Health training. The Deputy manager said the new office has provided a place to speak to people confidentially and enabled the provision of a new quiet lounge for people to relax in. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. The numbers and skill mix of staff meets people’s needs and they are protected by the way staff are selected and recruited. EVIDENCE: People are protected by the way staff are selected as a sample of six staff records show that references, police and POVA, (Protection of Vulnerable Adults List), checks are taken up before they are employed. Records also show people are in safe hands and staff have Moving and Handling, Health and Safety, Infection Control, Food Hygiene and Control of Substances Hazardous to Health (COSHH), training. The Deputy manager said there is always enough staff planned to be on duty to meet residents care needs. The staff rota confirmed this. Throughout the visit there appeared to be enough staff available to meet peoples care needs in a relaxed and unhurried manner. The Sixteen returned satisfaction surveys show that people are very happy with the staff in the home saying they are “courteous and polite”, and the attitude of staff is “usually very good” and very “professional”. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 19 One person said, “Staff are very good” and “very helpful”. Another said staff are “very caring”. People’s needs are met by qualified staff as information sent before the visit shows that over half of the staff have a National Vocational Qualification Level 2 or above. This was confirmed by the Deputy manager and staff training records. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People live in a home that is run in their best interests and their health safety and welfare is promoted and protected. EVIDENCE: The care management systems have improved and in particular the reviewing of care plans and medication administration systems to protect people using the service. The satisfaction surveys show people and their relatives have the opportunity to comment on the quality of care and services provided. The Quality Assurance Action Plan shows the home is prepared to listen to what people say and change the way things are done as a result of their comments. However, The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 21 records show that the views of other visitors such as District Nurses or Social Workers are not sought on the quality of care provided. People are protected by the way their finances are dealt with as three peoples finances were checked and found to be correct, kept safely and recorded properly. Peoples health, safety and welfare is promoted and protected as the maintenance records show that proper checks are carried out on emergency equipment, hoists, passenger lift, and safe water temperatures are maintained. Staff training records show they have Health and Safety, Moving and Handling, Food Hygiene, Infection Control and First Aid training. The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? 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. 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. 1. 2. 3. Refer to Standard OP7 OP12 OP14 Good Practice Recommendations Descriptive words should be used in the daily records to show and reflect people’s choices and preferences. People’s involvement and choices with regard to activities should be reflected in the daily records and record of activities. The daily records would benefit from the use of descriptive words to reflect and show people’s choices and preferences and any decisions they make about how they live their daily lives. The views of other visitors such as GPs, District Nurses and Social Workers should be sought on the quality of services provided. 4 OP33 The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 The Beeches DS0000060847.V362423.R01.S.doc Version 5.2 Page 25 - 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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