Inspection on 24/04/07 for Beech House (Binfield)

This inspection was carried out on 24th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Beech House (Binfield) 22/10/08

Beech House (Binfield) 31/10/07

Beech House (Binfield) 20/11/06

Beech House (Binfield) 02/05/06

Beech House (Binfield) 06/03/06

Beech House (Binfield) 27/09/05

Beech House (Binfield) 12/04/05

Beech House (Binfield) 05/10/04

Beech House (Binfield) 06/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Beech House (Binfield) London Road Binfield Bracknell Berkshire RG42 4AB Lead Inspector Chris Schwarz Unannounced Inspection 10:00 24th April 2007 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 Beech House (Binfield) DS0000011071.V330645.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. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech House (Binfield) Address London Road Binfield Bracknell Berkshire RG42 4AB 01344 451949 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) Charnley Care Limited Mrs Gill Kirk Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th November 2006 Brief Description of the Service: Beech House offers accommodation and care for up to 28 older people. The home has 25 bedrooms 3 of which are double-bedded rooms. The home is located close to the town centre of Bracknell and within close proximity to rail, bus routes and the M4 motorway. Fees for the service are £430 to £480 per week. Hair £8 - £29 Chiropody £11 Newspapers -Various - Some papers provided by the home. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was conducted over the course of a day and covered all of the key National Minimum Standards for older people. Two inspectors undertook the visit between 10.00 am and 3.15 pm. Prior to the visit, a questionnaire was sent to the manager for completion alongside comment cards for distribution to service users, relatives and visiting professionals. No replies were received back from the comment cards but these were seen available in the home during the visit. The inspection consisted of discussion with the manager, provider and other staff, opportunities to meet with service users, examination of some of the home’s required records, observation of practice, joining residents for lunch and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the manager and provider at the end of the inspection. The manager, provider, staff and service users are thanked for their cooperation and hospitality during this unannounced visit. What the service does well: Every resident has a comprehensive pre-admission assessment prior to admission to the home. Prospective residents have the necessary information about the home and the service it provides prior to making a decision to be admitted. The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. Residents have access to varied activities and are enabled to have contact with family, friends and the community. They are provided with nourishing and well presented meals to meet nutritional needs. Complaints and adult protection are effectively managed to listen to views of people who live at the home and reducing the risk of harm to them. The home provides staff cover to meet needs and undertakes thorough recruitment procedures of staff to ensure that people working with residents have the right qualities and abilities to meet care needs. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: All staff need to have attended up-to-date training on adult protection to supplement the practices and procedures in place at the home, to reduce risk of harm. The premises are generally clean but décor and poor condition of carpets in some parts of the building and condition of bathrooms detracts from the homeliness that could be created for residents. Some efforts were observed being made to rectify this and improve standards at the home. The manager and provider need to make sure that agencies provide them with details of recruitment and background checks undertaken for staff they supply to the home. Evidence of up-to-date staff training is needed to ensure staff have the right skills and competencies to support the people who live at the home. Health and safety needs improving in the following ways to make sure that no one living, visiting or working at the home is put at risk of injury: Temperature of hot water accessible to users needs to be maintained at a safe temperature (43 degrees Celsius) to eliminate the risk of scalding. Routine servicing of equipment needs to take place in accordance with any manufacturer’s or engineer’s instruction, and remedial works completed in a timely manner, to ensure the health and safety of residents. Electrical safety needs to be improved through regular hard wiring and portable appliance testing, to safeguard against the risk of fire or electrocution. Good practice advice has been given in the following areas, to supplement practice at the home: Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 7 A set of weighing scales should be purchased that can be used to monitor the weights of all users. Any assessment carried out should be signed and dated at the time it was carried out, to provide a clear account of when needs were assessed and by whom. All risk assessments should be reviewed on a periodic basis and any changes documented, so that they reflect current needs. Staff administering controlled medications should complete the medication administration record as well as the controlled drug register, to provide a clear audit trail of medicines. The home should obtain written agreement to the taking and holding of photographs of individual residents, to show that consent has been given. Staff who have not attended Protection of Vulnerable Adults training within the past twelve months should do so, to ensure that their skills are refreshed in this area of practice. References should to be addressed to managers of other work places rather than peers, to obtain a more realistic account of work history and performance. 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. Beech House (Binfield) DS0000011071.V330645.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 Beech House (Binfield) DS0000011071.V330645.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 Quality in this outcome area is good. Every resident has a comprehensive pre-admission assessment prior to admission to the home. Prospective residents have the necessary information about the home and the service it provides prior to making a decision to be admitted. The service does not provide intermediate care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector examined a sample of care plans and a pre-admission assessment was found in each. The assessments were very thorough and clearly outlined the individual’s care needs. One of the care plans examined had a copy of a “reason for admission document” which gave a very clear picture of the person and their immediate needs. This was in addition to the assessment documentation. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 10 The inspector noted that the assessments had been clearly signed by the registered manager who had carried them out but the date was missing. It is a good practice recommendation that any assessment carried out should be signed and dated at the time it was carried out. Following the pre-admission assessment prospective residents and their family are invited to visit the home, and if possible a short stay visit (respite care) is arranged prior to any decision to be admitted is made. The home’s statement of purpose document is provided to all prospective residents and an up to date copy was presented to the inspectors for examination. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 11 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): 7,8,9,10 Quality in this outcome area is good. The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector examined a meeting with the individual were being met. On each person’s care needs and the sample of care plans and followed this up by resident to ascertain if the care needs identified occasion the care plan had clearly identified the action required to meet them. There was good evidence of care provided and residents and relatives spoken to said that the care at the home was consistently good, and that the care staff were excellent. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 12 A doctor visited the home during the inspection and met with the inspector and expressed that there was a very good working relationship with the practice, district nursing team and the home. The care plans are regularly reviewed and changes documented. Risk assessments were in place but there was little evidence of these being reviewed on a periodic basis. It is recommended that all risk assessments should be reviewed on a periodic basis and any changes documented. The inspector noted that residents’ weight had been recorded on a regular basis and any changes noted. The registered manager said that the community dieticians were readily accessible should they be required. The weighing scales are of a small domestic type and not suitable for use with frail elderly residents. This issue was raised at a previous inspection and needs to be remedied. One of the residents was rather distressed concerning a letter received. The registered manager phoned the relative who visited within the hour and was able to alleviate the problem. This is commendable practice. The inspector observed staff assisting residents with their activities of daily living and noted that on every occasion the resident was treated in a kindly and appropriate manner, with dignity and respect. Residents spoken to said that the staff always treated them as individuals. The inspector found little evidence of the resident’s previous lifestyle, and interest, in the care plans. This was discussed with the registered manager who said that they had previously asked relatives to supply the information for them but had little response. It was agreed that perhaps asking for this information, as part of the admission process would be a good idea. The registered manager is going to progress this. The medication system was examined and overall found to be in good order. The supplying chemist is very supportive and the pharmacist makes periodic visits to the home to check compliance with the system. Staff who administer medication each have training and the registered manager informed the inspector of further updates that are being arranged at the present time. None of the present group of residents is able to administer their own medication. The home has a “homely remedies” policy in place that has been drawn up and agreed by the doctors. This enables staff to administer certain agreed over the counter medication should it be required, without consultation with a doctor. The inspector checked the controlled drugs held in the home with the registered manager. The correct number was recorded in the controlled drugs register, and when this was checked with the medication administration record Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 13 sheet, the last entry had not been completed. It is recommended that all of the staff that administer medication should be informed of the necessity to make a complete and accurate record of all medication given, by ensuring that they complete the medication administration record as well as the register. Photographs are taken of all residents and these are kept in the medication cupboard. The inspector did not see any written agreement to individual photographs being taken. It is recommended that the home should obtain written agreement to the taking and holding of photographs of individual residents. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 14 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, 15 Quality in this outcome area is good. Residents have access to varied activities and are enabled to have contact with family, friends and the community. They are provided with nourishing and well presented meals to meet nutritional needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an activities programme in place and this was displayed in the main lounge. This included keep fit, a visit of farm animals and outside entertainer providing a very popular sing a long. This entertainer was visiting the home during the inspection and the residents and staff were seen to be thoroughly enjoying themselves. A couple of residents were dancing to the music, and others tapping their fingers or toes to the beat of the music. Newspapers are purchased by the home and left in the sitting room for anybody wishing to read them. Residents spoken to say that they would like more activities to choose from. The musical entertainer is a very popular visitor with a number of residents. There is no designated person responsible for the activities provision and this Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 15 makes it difficult to provide one-to-one quality time to those residents who are less able to take part or do not wish to take part in group activities. One visitor spoken to said ”this is a nice home for my Mum and I am always made very welcome.” Residents have a cat called “Fudge”. The inspector joined the residents for lunch in the most attractive dining room. The dining room tables were laid with colourful tablecloths and napkins, and a vase of flowers. The tables are well spaced out to provide ease of access for all the residents and for staff assisting residents with their meals. There was a good relaxed atmosphere during the meal and the inspector noted staff serving and assisting residents with their meals in a kindly and appropriate manner. A member of staff was available at all times during the meal. Lunch was served on an individual basis and was well presented and looked appealing and appetising. The residents clearly enjoyed the meal and told the inspector that generally the food was good. The inspector noted that the timing of meals in the home appeared to be quite close together. The cook told the inspector that this had been discussed with the residents and a survey was carried out and the residents asked for the times to be retained. The inspector met with cook and examined the menus, and discussed the availability of food, as there had at the time of the previous inspection been a problem with the supplier, as monies were owed. This has now been rectified but the delivery has not yet recommenced. Food has been obtained from local supermarkets meantime. The cook is very experienced in the catering field and takes great pride in producing good quality meals for the residents, and has found the period without a regular supply of foodstuffs particularly difficult. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 16 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, 18 Quality in this outcome area is good. Complaints and adult protection are effectively managed to listen to views of people who live at the home and reducing the risk of harm to them. Ensuring that all staff have attended up-to-date training on adult protection will supplement the practices and procedures in place to reduce risk of harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a complaints procedure in place and a log was being maintained of any issues raised by residents or other parties. Six matters were recorded since the last inspection, five relating to water temperature in bedrooms being unsatisfactory or residents feeling cold in their rooms. These issues had been responded to and inspectors noted that heating was on around the building on a low setting despite it being a warm day, but in response to cold mornings and evenings. The Commission had received an anonymous concern in December 2006 about finances at the home and how this may be impacting on service users. This is still of some concern and pertinent to some of the findings resulting from this inspection. An adult protection procedure was in place and the manager had a copy of the local Bracknell Forest interagency guidelines and reporting forms for any allegations of abusive practice. Practice at the home was supportive of residents and staff were kind and respectful to residents. There was a lack of evidence to show that formal adult protection training had been undertaken by all staff and this would be beneficial, to make sure that they are fully able to Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 17 minimise the risk of harm to residents. It is recommended that staff who have not attended Protection of Vulnerable Adults training within the past twelve months attend a course on protection. The home’s service users guide includes contacts details of Social Services in the area and Age Concern in Bracknell, as well as contact details of the Commission for Social Care Inspection in the complaints procedure contained within it. The manager may wish to consider displaying these important contact details in the home so that residents and visitors can see them. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 18 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, 26 Quality in this outcome area is poor. The premises are generally clean but décor and poor condition of carpets in some parts of the building and condition of bathrooms detracts from the homeliness that could be created for residents. Some efforts were observed being made to rectify this and improve standards at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the bedrooms at the home were single occupancy and residents had been enabled to personalise these to different tastes. Odour control was generally being managed around the building although a urine type smell was present in one room which the manager said would be shampooed. Following the last inspection, the provider gave assurance that various matters would be attended to to improve the quality of the environment at the home. Carpets had not been replaced within the timescale he gave but fitters were Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 19 said to be coming out a couple of days after the inspection to replace carpets in all identified areas. Some redecoration had very recently been undertaken in one of the corridors and the provider said that he is intending to carry out painting to whichever areas need freshening up, including areas of chipped or worn gloss paint. The dishwasher had been replaced and was seen working. Bathrooms had not been upgraded within the provider’s stated timescale but he said the work could be achieved by the end of May this year. Until agreed works/refurbishment have been completed, the relevant standards cannot be scored as met and will be a focus of the next inspection of the home. Parts of the home were attractively presented such as the dining areas and most bedrooms. The garden is maintained in an attractive condition and a nesting box had been put on the tree, providing interest for residents. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 20 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, 30 Quality in this outcome area is adequate. The home provides staff cover to meet needs and undertakes thorough recruitment procedures although needs to ensure that agencies provide details of checks undertaken for staff they supply. Evidence of up-to-date training is needed to ensure staff have the right skills and competencies to support the people who live at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of this visit the manager was on duty plus five carers, a cook and a domestic worker. The atmosphere within the building was unrushed and call bells were being answered within reasonable times and inspectors could see that requests made by residents, such as someone requesting a drink, were responded to promptly. There was no laundry assistant at the home. The provider said that recruitment could go ahead for a laundry worker to ease burden on a carers. Recruitment files of three staff were looked at and found to contain evidence of all required checks, including Criminal Records Bureau clearance, before staff commenced working at the home. One reference had been written by a carer’s previous work colleague. As a good practice, it is recommended that references from peers are not taken up but that the manager of the workplace is approached, to ensure that a more realistic account is given. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 21 Some agency staff were being used, supplied by one local agency. The manager was not being supplied with individual details to confirm that satisfactory recruitment checks had been undertaken for each person, plus an account of their work history and training. It is required that these details be obtained individually, for each person being supplied to the home, and ideally before any new agency staff work at the home in future. There was good progress with National Vocational Qualifications at the home and all but one person either already had a National Vocational Qualification or was completing one. Records of mandatory training were a mixed picture. Some courses had been attended by staff but proof of attendance was restricted as certificates had not been issued due to trainers not being paid. The courses will need to be repeated if verification cannot be obtained and a requirement is made for the home to provide evidence that all mandatory training is up-to-date for staff. The manager had been informed of some forthcoming training events and was intending to get as many staff as possible onto them. Staff supervision and staff meetings had not been taking place on a regular basis, which the manager was open about and recognised needed to be developed. Progress will be reviewed at the next inspection. Evidence of induction was in place for a new member of staff whose file was looked at. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 22 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, 38 Quality in this outcome area is poor. The management and administration of the home does not consistently promote continuity and quality of care for the people who live there and does not ensure that risk is safely managed to reduce the likelihood of injury or harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has worked at the home a number of years and has the necessary experience to run the home. She has the Registered Managers Award and National Vocational Qualification level 4 and has been registered with the Commission. She is restricted in the extent of her management role by financial constraints placed upon her and matters which are outside of her control, such as maintenance of the building. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 23 The financial viability of the service was a concern at the last inspection and evidence of continuing problems was evident on this occasion. Inspectors overheard a member of staff telephoning to say her wages had not been paid and staff had concerns that their wage slips were insufficient to prove they are in regular employment for, say, purposes of obtaining loans or renting accommodation. Whilst these specific issues are outside of the remit of the Commission they do have a bearing on the fitness and capability of the provider and have the potential to impinge on staff morale and their willingness to continue to be employed at the home. In this sense they cause concern and reflect poorly on how the home is being managed and administrated. Improvement was noted to management of residents’ money with records and cash now kept at the home and in good order. Petty cash was now being kept at the home. Quality assurance surveys had been given out to residents and to relatives if residents were unable to understand these, but none had been returned. A suggestion was made that an occasional get together with relatives and residents may provide a forum for people to express views about the service and for management to share information about any developments of the home. The home had a current clinical waste disposal contract in place. The passenger lift had been repaired since the last inspection and the fire log showed that routine checks are being carried out. Other health and safety records at the home were looked at and showed that important safety checks are not being consistently maintained at the home and pose risks for residents, staff and visitors. Portable electrical appliances were last checked in October 2005. The need for annual checking was discussed with the provider, who had arranged for retesting to take place shortly after this inspection. The person who would be doing the checks was on the premises and verified this. Certificates of hoist servicing showed that an engineer last came out in May 2006, with a reexamination date of November 2006 noted on the record sheet. No arrangement had been made for re-testing therefore servicing was five months overdue. There was no evidence of any electrical hardwiring check at the home. The fire log showed that an engineer visited in October 2006 to service the alarm system and ticked “fail” on the work sheet, with remedial actions recommended. The provider could not produce evidence to demonstrate that this work had been completed. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 24 Records of hot water temperature checks showed that generally water is within safe ranges so as not to scald residents. Bedroom nine had a temperature of 49°Celsius noted on 11/4/07, which was thought to be an error. Water was tested in this room by the inspector and found to be 51°Celsius - too high and of immediate concern if a resident had been occupying the room. As the room was vacant, the manager will need to ensure that the temperature is reduced to no more that 43°Celsius before anyone uses the room and inspectors overheard a plumber being contacted to remedy matters during the inspection. Requirements are made in respect of the health and safety deficiencies at the home. Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 25 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 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 1 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 1 Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? yes 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. 1 Standard OP29 Regulation 19 Timescale for action Evidence of satisfactory 01/06/07 recruitment checks is to be obtained for all agency staff working at the home. Evidence of up-to-date 01/10/07 mandatory training is needed for all staff, to ensure that people providing support to residents have the necessary skills and competencies to meet needs. Temperature of hot water 01/06/07 accessible to users is to be maintained at a safe temperature (43 degrees Celsius) to eliminate the risk of scalding. Previous timescale of 24/11/06 not met. Routine servicing of equipment is 01/06/07 to take place in accordance with any manufacturer’s or engineer’s instruction, and remedial works completed in a timely manner, to ensure the health and safety of residents. Electrical safety is to be 01/06/07 improved through regular hard wiring and portable appliance testing, to safeguard against the risk of fire or electrocution. DS0000011071.V330645.R01.S.doc Version 5.2 Page 27 Requirement 2 OP30 18(1) 3 OP38 13 (4) 4 OP38 13(4) 5 OP38 13(4) Beech House (Binfield) 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 4 Refer to Standard OP8 OP3 Good Practice Recommendations A set of weighing scales should be purchased that can be used to monitor the weights of all users. Any assessment carried out should be signed and dated at the time it was carried out, to provide a clear account of when needs were assessed and by whom. All risk assessments should be reviewed on a periodic basis and any changes documented, so that they reflect current needs. Staff administering controlled medications are to complete the medication administration record as well as the controlled drug register, to provide a clear audit trail of medicines. The home should obtain written agreement to the taking and holding of photographs of individual residents, to show that consent has been given. Staff who have not attended Protection of Vulnerable Adults training within the past twelve months should do so, to ensure that their skills are refreshed in this area of practice. References are to be addressed to managers of other work places rather than peers, to obtain a more realistic account of work history and performance. OP7 OP9 5 6 OP9 OP18 7 OP29 Beech House (Binfield) DS0000011071.V330645.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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. 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