Care Home: The Park Beck

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What the care home does well The registered manager ensures that she obtains as much information relating to a prospective resident prior to them moving into the home, this involves carrying out a pre-admission assessment by visiting prospective residents in their own homes or in hospital and obtaining a care manager plan of care as well as other information available from other health care professionals who have worked with the prospective resident. Residents health care needs are well met, with evidence that referrals are made to appropriate health care professionals as and when the need arises. Resident are offered a variety of activities to participate in if they wish, and there is good contact with the local community, as well as trips out to the theatre, and places of interest. Meals in the home are good, and menus have been published in written and picture format, that the residents with dementia type illness can relate more easily to. Park Beck Care Home provides a comfortable, homely atmosphere, and there is good evidence that there is a continuing programme of maintenance, decorating, refurbishing and renewal. There is good evidence that the home adheres to their infection control policy and procedure to prevent residents being placed at risk. The staff levels and staff training in this home is good, ensuring that residents received care from staff who have the skills and knowledge to meet the residents assessed needs. All prospective staff are appropriately vetted prior to working in the home, to help residents from being placed at risk. The registered manager is approachable and her top priority is the standard of care that residents received. She has developed an excellent quality assurance system in the home, where she seeks the views of residents, relatives, stakeholders and staff and also carries out regular monitoring checks of all systems used in the home. A quality assurance summary is published of these findings and is posted on the notice board in the main hallway of the home. Health and safety, and fire risk assessments are considered to be of paramount importance in the home to protect residents and staff from harm. Residents spoke highly of the care they receive, they were full of praise for the care staff. Each of the six residents spoken to during this inspection said how much they liked the food in the home. At least three of the residents said that they enjoyed the activities on offer in the home. One relative spoken to said that he was more than happy with the care that his mother receives. What has improved since the last inspection? Care plans are now reviewed on a monthly basis and are signed off and have the date when the review took place. The registered manager has worked hard to try and involve residents relatives in the reviewing process and there was evidence available in some care plans to show that relatives had been present at review and agreed to the changes made. The home has a programme of planned decorating, refurbishment and renewal, and there is evidence that a lot of work has been done in the last two years to provide a comfortable home for the residents to live in. There was evidence through staff personnel files, and staff themselves that all new staff receive initial induction as well as Skills for Care related induction pack. Evidence was available that all staff receive at least six formal supervision per year. The manager places strong emphasis on staff gaining their NVQ qualifications and at this inspection 7 members of staff have gained the NVQ level 2 or 3 and a further four staff are working towards this qualification What the care home could do better: The registered manager must ensure that the complaints policy and procedure that is displayed in the main hallway, and available in the service user guide contains the correct information. Complaints must be properly logged when received with a thorough recorded investigation and outcomes. Key inspection report Care homes for older people Name: Address: The Park Beck 21 Upper Maze Hill St Leonards on Sea East Sussex TN38 0LG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: June Davies     Date: 2 7 0 5 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: The Park Beck 21 Upper Maze Hill St Leonards on Sea East Sussex TN38 0LG 01424445855 01424420812 manager.parkbeck@regalcarehomes.com www.regalhomes.com Regal Care Homes Ltd care home 37 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 37. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE(E). Date of last inspection Brief description of the care home The Park Beck is registered to provide accommodation for up to 37 older people and admits people with low to medium dependency needs. The premises is a large detached property in St Leonards on Sea with thirty-three single and two double rooms, many with en-suite on the ground and two other floors. Access can be gained to floors via a shaft lift. Residents have the use of three separate lounge areas and a dining room. The home has a good-sized well-maintained rear garden with covered patio area for residents who smoke and other seating areas for residents, lawn areas and established borders. There is some car parking within the grounds or alternatively Care Homes for Older People Page 4 of 24 37 0 Over 65 0 37 Brief description of the care home street parking is usually available outside. Regal Care Homes Ltd owns the business and also another within walking distance. Some joint activities and social events are carried with the other home. The home is near bus routes and Warrior Square railway station. The fees at present are #322 - #450. Additional costs are charged for hairdressing, toiletries and newspapers. The last inspection report is available to prospective residents from the home. There were twenty-six residents living at the home at the time of inspection. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection took place on Wednesday 27th May 2009 over a period of 7 hours. During the inspection the inspector talked to the registered manager, four members of staff, six residents and one relative. An audit was carried out of medication, and a tour of the home took place. The inspector observed care staff working with residents, and viewed all documentation relating to the key standards inspected. Some information in the report was obtained from Annual Quality Assurance Assessment sent to CQC by the registered manager of Park Beck Care Home. People who use this service experience GOOD quality outcomes. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? Care plans are now reviewed on a monthly basis and are signed off and have the date when the review took place. The registered manager has worked hard to try and Care Homes for Older People Page 7 of 24 involve residents relatives in the reviewing process and there was evidence available in some care plans to show that relatives had been present at review and agreed to the changes made. The home has a programme of planned decorating, refurbishment and renewal, and there is evidence that a lot of work has been done in the last two years to provide a comfortable home for the residents to live in. There was evidence through staff personnel files, and staff themselves that all new staff receive initial induction as well as Skills for Care related induction pack. Evidence was available that all staff receive at least six formal supervision per year. The manager places strong emphasis on staff gaining their NVQ qualifications and at this inspection 7 members of staff have gained the NVQ level 2 or 3 and a further four staff are working towards this qualification 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All prospective residents have detailed pre-admission assessments carried out prior to moving into the home so that the registered manager can determine that the home can meet their needs. Evidence: The registered manager visits all prospective residents and carries out an assessment of their pysical, personal and social care needs. This was evidenced from three preadmission assessments viewed. These pre-admission assessments gave clear details of residents, physical state, what care they require, their social interests, choices and likes and dislikes. The registered manager also gains further information from other health care professionals and care managers prior to the resident moving into the home. This helps the registered manager to determine if the staff have the knowledge and skills to meet the residents needs. All residents move into the home for a four week trial period prior to their residency being made permanent. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning is clear and consistent and provides staff with the information they need to meet the residents needs. Personal care is offered in a way that protects residents privacy and dignity and promotes independence. The medication at this home is well managed promoting good health. Evidence: Three care plans were viewed and found that information contained within these plans is detailed in respect of health, personal and social care needs. Each care plan had risk assessments in place and while some were generic others related to specific risk issues for individuals. Care plans and risk assessments have been reviewed on a monthly basis, and where possible the resident or their relative has signed up to the review and any changes made. There was evidence in these care plans that residents have access to a variety of Care Homes for Older People Page 11 of 24 Evidence: health care professionals as and when required and that they are assisted to attend hospital appointments. It was noted that while there is a need in the home there is no evidence that the continence nurse visits to carry out periodical assessments. Daily reports are adequate, and daily report sheets also contain a personal hygiene matrix, that staff sign when personal hygiene tasks are carried out. During the inspection staff were observed talking to residents in a professional and friendly manner, and staff respect the residents rights to privacy and dignity when personal hygiene needs are being carried out. For a short period a staff member was observed administering lunch time medication, this was carried out using the correct procedures. Medication administration records and the controlled drugs register were appropriately signed when medication had been administered. Any medication not used is entered into the returned medication book at returned to the pharmacy in a timely manner. Appropriate medication policies and procedures are in place including the administration of PRN as required medication. All staff who administer medication have received the appropriate training which is due to be updated this year. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a variety of activities as well as frequent trips into the community, which all the residents enjoy. The meals in this home are good offering both choice and variety and catering for special diets. Evidence: From care plans viewed there is evidence that residents are able to make some personal choices in regard to their day to day living routines. At present time the newly promoted deputy manager carries out, in house activities with residents, and organises outings. There was sufficient evidence that residents have a good programme of activities on offer, and are able to access the local community for trips to the local pubs for lunch, the threatre, and places of special interest. Residents are also taken on one to one outings into the town shopping and for coffee or lunch, or a walk along the sea front, and to the local park. Outside entertainment is brought into the home from time to time. Residents birthdays are celebrated if residents chooses to. The home organises summer fetes, Care Homes for Older People Page 13 of 24 Evidence: and celebrations for special days. The local church holds Holy Communion in the home once a month and residents are able to attend if they wish to. Visitors are made welcome in the home at all times. When residents move into the home they are able to bring personal belongings in with them. Many of the residents have made arrangements for relatives or powers of attorney to manage their fianancial affairs. Resident can have access to their own private telephone and can also seek assistance of advocacy services should they wish to. Residents are offered a varied and nutritious menu, and specialised diets can be catered for as and when required. Menus are produced in written and pictorial format and the menu book is displayed in the main dining room. Residents said that they like the pictorial menus, and find it much easier to make a choice. When required staff give assistance to residents in a sensitive manner respecting the residents dignity. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints process in the home needs to be updated to ensure that residents, relatives and representatives have up to date information, and to show that complaints are acted on. Staff have good knowledge and understanding of Safeguarding Vulnerable Adult issues which protects residents from abuse. Evidence: The home has a complaints policy and procedure available in written and pictorial format, but this was out of date and gave the wrong contact and address details for CQC. The complaints file viewed showed that in some cases, a record had not been kept of the investigation that took place in regard to the complaints and a copy of the response letters to the complainants were not available. Two residents said that they would know who to complain to, but were not sure what the complaints process was. There are clear policies and procedures available in the home for Safeguarding Vulnerable Adults and whistleblowing. Sussex Multi Agency guidelines procedures and protocols are also available in the home. There has been one safeguarding referral since the last key inspection that has been properly investigated and closed. All new staff are appropriately vetted prior to be employed by the home. Staff working in the home have received Safeguarding Vulnerable Adults training, with exception of one new member of staff. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is ongoing investment into decoration, renewal and refurbishment, creating a comfortable, safe and pleasing environment to live in. Infection control procedures are closely followed to prevent residents being placed at risk of cross infection. Evidence: Park Beck has a homely atmosphere, with well decorated, maintained and good quality domestic style furniture and fittings, giving residents a comfortable and homely place to live. Residents are able to have choice of which communal lounge and dining room they would prefer to use. Some bedrooms have en suite facilities, while other bedrooms have close access to communal toilets and wash basins. There is an ongoing programme of maintenance and refurbishment that ensures the home is kept in good repair. Where necessary mobility aids are available for resident to use. The rear garden of the home is maintained and attractive, with seating and patio areas, and a built up flower bed, that residents and their relatives enjoy planting up. There is a ramp access from the large communal lounge via the smokers patio to the garden. The laundry room is situated in the basement of the home, and this was found to be well fitted out with an industrial washing machine providing a sluicing facility. Throughout the home all communal toilet and bathrooms have liquid soap and paper Care Homes for Older People Page 16 of 24 Evidence: towels. Staff are provided with disposable plastic aprons, and gloves. Infection control procedures in the home are good, to ensure that residents are not placed at risk of cross infection. The home is clean and fresh and there are no offensive odours. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good match of well qualified staff offering a consistency of care within the home. Recruitment policies are consistently followed resulting in residents receiving care from staff that have been appropriately vetted. Evidence: An appropriate number of staff are employed at the home to meet the health, personal and social needs of the residents. Many staff have gained their Social Care qualification, NVQ level 2 or 3, and have undertaken mandatory training as well as work related training. The manager ensures that recruitment processes are followed and that new staff are not employed until they at least have a Protection of Vulnerable Adults register check prior to taking up employment in the home. Staff files examined showed that all staff have Criminal Receords Bureau and Protection of Vulnerable Adults register checks. With the exception of one new member of staff the majority of staff have completed their mandatory training, with further courses arranged for new staff and for other staff to update their knowledge. Care Homes for Older People Page 18 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has a good understanding of what needs to improve in the home, and is supported in this by senior management. There are good records available for the management of residents personal allowances, to ensure that residents financial interests are protected. Health and Safety is well managed in the home to ensure that residents live and staff work in a safe environment. Evidence: The registered manager has been in this post for two years, she has obtained her NVQ level 4 and updates her skills and knowledge by attending training courses. She has an open door policy and is available to residents and staff at any time when she is on duty. There is good evidence that the registered manager has worked hard in ensuring that residents receive a good standard of care in the home, and that the environment is well maintained and provides a comfortable and homely place for the residents to Care Homes for Older People Page 19 of 24 Evidence: live in. The registered manager has worked hard at producing an excellent quality assurance system in the home. Residents, relatives, stakeholders and staff complete quality assurance questionnaires, and the manager carries out regular monitoring of systems used in the home. The results of questionnaires and monitoring are then produced into a summary and are posted on the notice board in the main hallway. Evidence was available to show that where the manager looks after residents personal allowances the appropriate documentation is kept of all incoming and outgoing monies, together with receipts. Money and documentation is kept safely and securely. From viewing the supervision timetable, discussion with staff and evidence on staff personnel files there is evidence that each member of staff receives at least six supervisions per year. All staff have completed core training in Health and Safety issues. Health and Safety in the home is of paramount importance for the residents and staff. There is evidence that health and safety and fire safety environmental checks take place regularly and that all equipment used in the home has up to date maintenance certificates. All accidents are recorded onto accident sheets, and these are monitored by the registered manager, where a residents has more than three falls in a short space of time referral is made to their General Practitioner for a health check. Care Homes for Older People Page 20 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 16 20 The registered person shall 30/06/2009 establish a procedure, the complaints procedure, for considering complaints made to the registerd person by a service user or person acting on the service users behalf. The complaints procedure shall be appropriate to the needs of the service user. The registered person shall ensure that any complaint made under the complaints procedure is fully investigate. The registered person shall, within 28 days after the date on which the complaint is made, or such shorter priod as may be reasonable in the circumstances, inform the person who made the complaint of the action if any that is to be taken The complaints policy and procedure must be kept up Page 22 of 24 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action to date with correct details. Records must be kept in complaints file of all investigations and outcomes. 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 Care Homes for Older People Page 23 of 24 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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