Beech Manor Care Home Care Home Service Golf Course Road Rosemount Blairgowrie PH10 6LJ Telephone: 01250 877980 Type of inspection: Unannounced Inspection completed on: 20 January 2017 Service provided by: Renaissance Care (No4) Limited Service provider number: SP2013012056 Care service number: CS2013316792
About the service Beech Manor Care Home is located in the Rosemount area of Blairgowrie. The service is a care home for older people and those with mental health problems. The service consists of 45 bedrooms, all with en suite showers. The aims and objectives of the service's provider state that: "Renaissance Care aim to enhance the quality of life and maximise the potential of each individual, ensuring that dignity and privacy are maintained. The service aims to achieve this by encouraging service users' choice and independence; ensuring safety and equality; ensuring staff are appropriately trained; and encouraging service users to maintain social relationships and links within the community". This service registered with the Care Inspectorate on 4 October 2013. What people told us During the inspection we spoke with 14 people using the service and five relatives. All were happy with the care and support provided at the home. They spoke highly about the staff and the support they received from them. Relatives said they were always welcomed, staff were friendly and they were offered tea and biscuits whenever they visited. Some of their comments included: - "The staff are very, very good." - "We are well looked after." - "Of all of these kinds of places, it's the best." - "Everything is fine." - "The staff really are good." - "I was very lucky to get here, I think." - "I'm very, very happy here." - "Staff are lovely, I have no problems." - "It's great." - "Sometimes staff come quickly when you buzz, sometimes you have to wait a while." - "99.9% of the staff are pleasant, by and large they are all very good." - "It's fine here, no problems." - "Food sometimes not good." - "There are some activities but it can be a long day." - "Staff friendly." page 2 of 10
- "I've visited a lot of homes and this is the best I have been in by far." A resident mentioned something that was a bit of a worry for them. We discussed this with the manager who had already taken steps to resolve this but planned to review the actions again. Self assessment We received a fully completed self assessment document from the service provider. We were satisfied with the way the service provider had completed this and with the relevant information they had given us for each of headings that we grade them under. The service provider identified what they thought they did well, some areas for development and any changes they had planned. The service provider told us how the people who used the care service had taken part in the self assessment process. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 5 - Very Good 5 - Very Good Quality of care and support Findings from the inspection The service encouraged people to give their views on the care provided at the home. Suggestions and comments to improve the service were welcomed and acted on when possible. People were supported to make their own choices and decisions about their day-to-day care. As part of the inspection we visited the home at 6:00am on the first day. We found the home settled and calm. Staff were quietly supporting people who wished to rise early. People were supported to rise when they chose. Staff were friendly and caring. Anyone who requested an early rise was offered tea, toast and cereal to keep them going until breakfast. People's individual level of independence was encouraged and supported. People were using adapted utensils at mealtimes to maintain their abilities and skills. Mealtimes were a sociable experience for people. Staff provided suitable support relevant to the person's choices and preferences. People's care plans provided appropriate information and guidance for staff on the person's abilities and the level of support required from staff. These would benefit from a stronger level of person-centred information. We discussed with the manager some improvements to the administration of medication procedures. This included the use of pain assessments and protocols for 'as required' medication. She planned to act on these immediately. page 3 of 10
We observed a resident who was distressed. Staff provided guidance and support to them. We discussed the outcome of this with the manager and provided further information on the ways staff could assist people who are stressed or distressed. Staff were being trained in the Promoting Excellence Framework training and this will strengthen their skills when supporting people. The Promoting Excellence Framework training is training for health and social care staff working with people with dementia and their relatives/carers. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good Quality of environment Findings from the inspection Beech Manor has a pleasant, well maintained and bright environment. The home has a comfortable and homely atmosphere. Staff had a good awareness of health and safety. There were no obvious slip and trip hazards. People were kept safe by a regular programme of service of equipment, maintenance and repairs which were completed and up to date. Some useful signage was in place to support people's independence in finding their way about the home. The manager planned to increase the level of signage and the use of signifiers to further support people's independence. The lounges had homely, domestic style furnishings which would be familiar to people using the service. People were supported to bring furniture from home to personalise their bedrooms. Notice boards around the home were used to keep people informed about what was happening in the home, activities and any developments with the service. Communal lounges and seated areas had a range of styles and heights of chairs and sofas available to suit people's preferences and abilities. The manager had recently completed an audit of the home environment. This identified areas where the home could be improved for people with memory and sensory support needs. The improvements were being progressed. Once completed, the improvements will increase people's experience of living in the home. page 4 of 10
Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good Quality of staffing Findings from the inspection Staff had a very good understanding and knowledge about people's health and care needs. They provided support at a pace and level suitable for the person's abilities. Staff were friendly and showed patience and warmth when supporting people. A range of training opportunities were available for staff. These were suitable for their role and the support needs of people using the service. A particular strength was the level of training provided for staff on supporting people with dementia. Two staff had been trained in the Promoting Excellence Framework training and were delivering this training to the rest of the staff group. The service protected people's safety by following good practice guidance when recruiting new staff. New staff completed an induction period covering all aspects of the home related to their role and responsibilities. Only on successful completion of this are their posts made permanent. People using the service, relatives and staff said there were enough staff on each shift to support people appropriately. There was a high level of satisfaction from the staff group about the work they do. They felt well supported in their roles and were encouraged to make suggestions on ways to improve the service. Staff were motivated and committed to providing a quality service for people. We discussed with the manager some terminology used by a staff member which did not show respect to people. The manager planned to act on this immediately. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good page 5 of 10
Quality of management and leadership Findings from the inspection The home used a programme of regular audits and reviews to assess and confirm the quality of the service they provided. Completed audits had an action plan to show what improvements had been made. Links had been made with local schools. An intergenerational arts project had been started with the school children working with people using the service. This had been a very positive development in maintaining people's links with the community. The manager provided a strong level of leadership to the staff group. Regular staff supervision sessions were held to support staff in their roles. This included reminding staff of the standards expected in the home. The manager took a proactive approach to any complaints, concerns or suggestions from people. A full record was kept of the actions taken on these and the outcomes. A service development plan was in place. This showed the areas the service had identified they could improve. The focus of this was to improve the experience for people living in the home. We will follow up on the outcomes of this at the next inspection. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 The provider must improve the admission process to ensure that proper provision for the health of new residents is made. In order to do this, you must: - Demonstrate that the needs of people who use the service are regularly assessed and adequately met. - Ensure that the pre-admission/admission process includes a full assessment and how needs will be met. page 6 of 10
- Ensure that people who use the service are provided with a choice in the ways in which the service is provided for them. - Ensure that people who use the service and/or their representative are fully involved in the assessment and care planning process. - Ensure the care plan is in place within acceptable timescales. - Ensure the social, spiritual and recreational needs of service users are fully assessed and that activity is meaningful to the individual service users. - Ensure all risks to the safety, privacy and dignity of individual service users is fully assessed and preventative measures planned and recorded. This is in order to comply with: The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011, (SSI 2011/210) Principle 3 - a requirement about quality, respect and choice; and Regulation 4(1)(a) - a requirement for the health and welfare of service users. Timescale: to commence immediately upon receipt of this report and to show significant improvement within two months. This requirement was made on 8 July 2016. Action taken on previous requirement This requirement was made following an upheld complaint. We looked at a sample of care plan records. We found that people and/or their next of kin had been involved in developing and reviewing the plans. Pre-admission and admission processes had included a full assessment on how the person's needs would be met. During the inspection we saw that people's choices and preferences about their care was supported and respected by staff. People's care plans had been developed and implemented within acceptable timescales. Social, spiritual and recreational support needs had been assessed and a programme of meaningful activity was in place taking these into account. A range of suitable risk assessments had been completed for people. These had been regularly reviewed and updated when changes occurred. Met - within timescales page 7 of 10
What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations There are no outstanding recommendations. Complaints Please see Care Inspectorate website (www.careinspectorate.com) for details of complaints about the service which have been upheld. Enforcement No enforcement action has been taken against this care service since the last inspection. Inspection and grading history Date Type Gradings 18 Nov 2015 Unannounced Care and support Environment Staffing 5 - Very good Management and leadership 5 - Very good 26 Feb 2015 Unannounced Care and support 3 - Adequate Environment Staffing Management and leadership 3 - Adequate 29 Oct 2014 Unannounced Care and support 5 - Very good Environment 5 - Very good Staffing 5 - Very good Management and leadership 5 - Very good page 8 of 10
Date Type Gradings 28 Jan 2014 Unannounced Care and support 3 - Adequate Environment Staffing 3 - Adequate Management and leadership 3 - Adequate page 9 of 10
To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 10 of 10