Inspection on 31/10/07 for Beech House (Binfield)

This inspection was carried out on 31st October 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) 24/04/07

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 Kerry Kingston and Denise Debieux Unannounced Inspection 10:00 31 October 2007 st 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.V344336.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.V344336.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.V344336.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th April 2007 Brief Description of the Service: Beech House offers accommodation and care 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. The fees charged range from £435 and £490 per week Hairdressing, Chiropody, Papers are additional cost Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a report for the key inspection of the service, which included a routine unannounced site visit. This took place between the hours of 10.00am and 4.00pm, by two inspectors on the 31st October 2007. The information was collected from the Random Inspection report completed in July 2007 (available on request from the Commission for Social care Inspection), the key inspection report completed in April 07 and any other information received by the Commission since the Key Inspection in April. Discussions with three staff members and the Registered Manager took place. Five people who use the service spoke with us during the visit and some observations and further discussions took place throughout the visit. A tour of the home and reviewing residents’ and other records were also used to collect information on the day of the visit. The home has made some improvements to the quality of the care provided but further improvement is necessary to ensure the quality of the outcomes is raised and maintained in all areas. Seven requirements were made at the last inspection (July 2007), four requirements have been met, two requirements have been partially met and one requirement remains outstanding. New requirements have been made as a result of this key inspection. What the service does well: What has improved since the last inspection? The home has had some decorating done, the bathrooms have been partially refurbished and some new carpets have been laid, this has made the premises more homely and comfortable for the people who live there. Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 6 The home makes sure that all staff, including those supplied by an agency have all the right checks to ensure that they are safe to work with the residents. Staff are properly trained so that they are able to meet peoples’ needs effectively. The home has improved its’ ways of ensuring the safety of the people who live there by making sure that water temperatures are safe, routine servicing of equipment is up-to-date and portable appliance testing takes place. What they could do better: 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.V344336.R01.S.doc Version 5.2 Page 7 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.V344336.R01.S.doc Version 5.2 Page 8 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. People who use the service experience good quality outcomes in this area. The home ensures people are properly assessed and are as involved as possible in this process. People are not admitted to the home unless the assessment shows that it can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four pre admission assessments were reviewed for residents admitted to the home since February 2007. All four documents had been completed prior to the residents being offered a room at the home and had been signed and dated by the manager carrying out the assessment, thereby meeting the recommendation made at the last key inspection. The assessments were seen to be comprehensive and included details of health, social and personal care needs. Also included was any specialist equipment that would be needed for the home to be able to meet the Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 9 resident’s identified needs, however this is not always in place prior to admission. The home explores any individual equality and diversity needs at this assessment stage. The residents spoken with confirmed that they had been involved in their preadmission assessment. The home does not offer intermediate care and there were no residents at the home on a ‘short term’ or respite care basis on the day of this visit. Beech House (Binfield) DS0000011071.V344336.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 who use the service experience adequate quality outcomes in this area. The home, generally meet the personal and social care needs of individuals but health care needs are not always met as well as they could be because care plans are not always followed and specialist equipment is not always available prior to a resident’s admission. Medication is administered safely and residents are satisfied with the care they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this visit the care plans of four residents were sampled. These residents had all moved into the home over the past nine months. The health, personal and social care needs identified during there pre-admission assessment visit had been incorporated into their care plans, which were detailed, well laid out and easy to follow. The care plans are kept in a folder in the office with each Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 11 folder containing the pre-admission assessment, the resident’s care plan, records of GP and other health professional visits, risk assessments and any accident or incident reports. However, none of the care plans had been signed or dated by the residents or their representatives to signify their involvement and agreement. During the pre-admission assessment, a note had been made for one resident that they would need a higher chair and a bed of the correct height. Following assessment the resident was offered a place and has now moved into the home. However, this resident still needs to be assessed by a suitably qualified person to identify the specific equipment necessary to meet their needs. Currently the resident is using a normal dining chair with a scatter cushion on the seat to raise the height. Each resident has a daily report sheet, which the staff write each shift. The daily report sheets are not kept with the care plans but kept in a daily report folder. The manager stated that it is easier for the staff to write their reports if these sheets are all in one place rather than in the resident’s own care plan folders. Notes made in these daily reports raised concerns that care plans are not being followed by the staff. For example, for two residents who have diabetes, their care plan contained very clear dietary guidelines. The daily reports indicated that these were not followed, in one file it was seen that the resident routinely has cake, biscuits or jam tarts with their afternoon tea. In discussion with the cook, there are no special arrangements for separate meals for these two residents that follow the guidelines that are part of their care plans. The care plans for these two residents also stated on admission that diabetic check ups should be arranged with the GP. Despite the residents having been at the home a number of months, these check ups have not been carried out and there has been no other professional guidance sought by the home (such as a dietician or specialist diabetes nurse). The manager advised that one of the people with diabetes, made her own choices with regard to her food and that the G.P supported this, but this was not evident in the care plan. One resident was noted to have lost 4lbs in weight but there was no evidence that this weight loss was being monitored or that suitable action had been taken. Following the last key inspection the home have now purchased a set of weighing scales that can be used on the hoist, enabling the home to monitor the weight of all residents. Similarly, for another resident with Parkinson’s disease, the care plan indicated on admission that a referral to the Parkinson’s nurse specialist should be arranged. This has not yet been done. At the random focussed inspection in July it was identified that one resident should have a risk assessment for falls and moving and handling and that a Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 12 physiotherapist referral should be arranged. It was seen from the file that both these actions had been carried out. A physiotherapist assessment had been arranged and carried out, with the physiotherapist leaving an exercise programme for staff to carry out three times a day with the resident. We were advised, however, that the manager felt these exercises were too dangerous for the care home staff to follow and the exercise routine was not being followed. The manager has also identified that the home need additional equipment for the safe transfer of this resident. To date, this equipment has not been obtained and the report of the occupational therapy assessment has not been received. It was noted from the accident records that one resident had fallen a number of times. This resident had fallen a number of times before the home assessed the risk and identified that moving the resident to a different room would reduce the risk (See requirement standard 38). It was noted that the falls stopped in August, after the resident moved rooms. As part of the care planning system at the home, risk assessments for bathing and fire evacuation are routinely carried out for all services users. However, the home does not routinely carry out nutritional assessments or risk assessments for falls and moving and handling with all residents on admission followed by regular ongoing reviews. Documented reviews of the care plans take place on a monthly basis. However, the care plans are not always amended to reflect any new problems or changes to the actions staff need to take to meet the residents’ needs. Medication administration record sheets, medication storage and the lunchtime medication round were all observed during this visit and seen to be in line with current guidance and with the home’s policy. At present no residents are prescribed controlled drugs and there are none stored at the home. Residents spoken with all praised the staff and said they were kind and caring. One resident said ‘I have everything I need’ with another saying that ‘the staff are very kind and look after me well.’ Residents confirmed that they felt the staff respected their rights to privacy and dignity and that staff always knocked before entering their private rooms. Two relatives spoken with were happy with the care their relative receives at the home and said that they are always made to feel very welcome when they visit. One relative added that ‘the staff are all lovely’. Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 13 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 who use the service experience good quality outcomes in this area. People have access to varied activities and are satisfied that they have enough to do, the frequency of activities is not always documented. Residents are enabled to have contact with family and friends and receive a nutritious and well balanced diet, although the choices are limited. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager stated that afternoon activities take place approximately every other day. There are no dedicated activity staff employed and activities are carried out by the care staff with a musical entertainer coming in once a month plus a trainer coming in monthly to run an exercise class. Afternoon activities mostly comprise of board and word games run by the care staff. Residents spoken with said how much they enjoyed these activities although one resident said they would like more quizzes. One resident attends a day centre twice a week and enjoys these outings. At present there is no weekly schedule of activities planned or advertised and the log of activities Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 14 kept by the home does not reflect the activities that actually take place. However, residents spoken with were happy with the level of activities provided. Residents that wish to do so are enabled to attend the church of their choice. There are no restrictions to visiting and the staff encourage residents to maintain family contact. As stated earlier in this report, relatives feel welcomed at the home and this was observed during this visit. The residents’ bedrooms seen were all highly personalised with their own mementos and some personal items of furniture. Residents were coming and going as they wished about the home, with staff being seen to offer help and assistance as needed. The main, hot meal of the day is at lunchtime, with a smaller meal in the evening. The menu for the current week was seen and offered a range of meals with desert each day. Residents spoken with all praised the food at the home with one resident saying ‘there is almost too much!’ At present there is only one choice at each meal. The chef stated that she will provide an alternative if a resident requests one, for example, it was known that one resident did not like the lunch that day so they had been provided with an alternative of their choice. The lunchtime meal was taking place during this visit. It was sausage meat plait with new potatoes and mixed vegetables. The atmosphere in the dining room was pleasant and homely with ample staff seen to be offering help and assistance where needed. The meal was presented in an appetising manner and the majority of residents spoken with said how much they were enjoying their meal. It was noted that three residents had carefully cut out their sausage meat and left it at the side of their plate. When asked they said that they did not like the sausage meat but had enjoyed everything else. This was mentioned to the manager later, who said she would reiterate to staff that they should be checking if residents are not eating and pass the information on. Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 15 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 who use the service experience good quality outcomes in this area. The home ensures residents are listened to, complaints are taken seriously and people are protected from all forms of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure in place that is available to all residents and their relatives. The complaint’s book was seen and there have been no complaints recorded by the home since the last key inspection. A complaint was made to The Commission for Social Care Inspection in June of this year and was explored at a random focussed inspection carried out on the 16th July 2007. A copy of that report can be obtained on request to the Commission. Residents spoken with all said they would talk to the manager if they had any concerns. The manager is aware of the local multi-agency procedure for safeguarding adults and confirmed that all staff have now received or are about to receive training updates in the procedure, this was confirmed by staff training records. Beech House (Binfield) DS0000011071.V344336.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, 22 and 26. People who use the service experience adequate quality outcomes in this area. The premises are homely, clean and hygienic. Carpets have been replaced and bathrooms have been refurbished to a good standard, some areas need further refurbishment and people are not always provided with the specialist equipment required to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has had new carpets fitted in several areas, decorating has been completed and the bathrooms have been refurbished, some still require flooring and tiles. Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 17 The home was odour free and generally seen to be clean and hygienic, the laundry was in good order with a specialist system to ensure clothing and all laundry is properly sterilised/cleaned. Some areas of the home and some furniture look ‘tired’ (top landing) and there are areas where wallpaper is peeling and gloss paint is chipped (mainly corridors). There are three radiator covers that need painting and one bedroom has a boiler in the en-suite situated in a cupboard where the door would not shut, the pipes and the boiler casing was very hot and presented a hazard to the resident of the room, the manager advised that the en-suite is never used by the resident alone and rarely used at all. The en-suite door was locked to ensure the safety of the resident and the door to the boiler cupboard will be repaired as a matter of urgency. (See standard 38) Some people do not have the appropriate equipment to ensure their diverse needs are met some hoisting equipment is not adequate, makeshift cushions are used to higher seats for people who need ‘higher chairs’ and inappropriate bed rails are used to assist someone to get out of bed. The bed is low and use is made of a mattress to higher it and add comfort, the bed may need to be replaced. There is no maintenance schedule or plan in place to show an ongoing decorating /refurbishment programme for the home. Beech House (Binfield) DS0000011071.V344336.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 who use the service experience good quality outcomes in this area. That the residents needs are met by a competent and properly trained staff team. The recruitment process ensures that residents are protected by the necessary information and checks being completed for all staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rotas showed a minimum of five staff on duty from 8am to 2pm, four from 2pm to 6pm, three from 6pm to 8pm and two from 8pm to 8am. Agency staff are not being used, currently any shortfalls are covered by the manager, bank staff and staff on overtime. The manager said this did not cause any problems with staff cover currently. Residents said there was always staff to help them if necessary and one staff member said there were enough staff to complete all the tasks, the manager confirmed that in her opinion there were enough staff to meet the needs of the residents. A concern about the lifting and handling of one resident resulted in an assessment by an Occupational therapist but the report has not been received as yet. Staff do not feel they have the ability/equipment etc. to meet this person’s needs and the manager agreed with this. Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 19 Recruitment records were seen for the three newest staff, all the necessary paperwork is in place. Application forms are not detailed with regard to past work history, however the manager has asked the most recent applicant for a detailed, separate work history to correct this omission from the existing application forms and confirmed that this will be standard in the future. When used, the agency supply details of their staffs’ recruitment checks, training and professional qualifications along with a clear photograph of the worker, this meets a requirement from the last key inspection. Mandatory health and safety training has been completed by most staff and up-dates are being booked as necessary. Some certificates from training held in 2006 have not been received as the proprietor did not pay the trainers but invoices were seen and the manager agreed to cross reference in supervisions and complete a detailed list of those who attended. Training records note the training completed, some staff have paid for their own certificates and some have completed further training provided by the local authority. Eleven of the fourteen staff have National Vocational Qualitification (N.V.Q) 2 or above qualifications, a small sample of certificates were seen, the manager confirmed the numbers. A resident spoken to said ‘the staff are very kind and look after me well.’ Two relatives spoken to said they were ‘happy with the care’ their relative receives at the home. Staff supervision and appraisals are still not being completed regularly and staff meetings are approximately twice a year. The last meeting was in August 2007, minutes were taken and the content was good referring to good practice and information giving to staff. The home does not have a laundry assistant or full time domestic help at this time, which puts additional tasks on the carers and detracts form the care role. The home is an old building and requires a lot of cleaning to ensure it remains up to adequate cleanliness standards Beech House (Binfield) DS0000011071.V344336.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 who use the service experience adequate quality outcomes in this area. Some improvements have been made in this outcome area but more work is needed to ensure consistent good quality outcomes for the people who live in the home. The management is not always effective, as the manager has no financial control, which is reflected by her inability to access vital pieces of equipment, or fully control the day to day running of the home. Health and Safety matters are taken seriously but further improvement is needed to ensure that residents are kept as safe as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 21 The manager is experienced and qualified and has worked in the home for a number of years. Residents are happy to be living in the home but there is no evidence to show their involvement in the development or running of the home. The manager advised that there is no specific quality assurance process and no annual development plan, at this time. The manager has some concerns with regard to the financial status of the home as her requests for what she considers to be essential items such as the wiring check, door guards for bedrooms 23 and 5 and proper cushions to raise the height of chairs in the lounge have not been supplied (these were first requested in April 2007). The manager confirmed that residents have adequate heating, lighting, food and other essential items and the only difficulty has been with the supply of uniforms for staff. The proprietor assumes responsibility for residents monies, the home does not act as appointee for any residents and hold only personal allowance monies for individuals. Appointees are either residents’ family members or the local authority. The records for four peoples’ personal monies were seen and were accurate with appropriate receipts in place. The proprietor was advised that if there was any difficulties in accessing personal allowances from family members, when people need it, consideration should be given to asking for the care managers assistance as it could constitute financial abuse. Health and safety checks seen and are now up-to-date, which meets the requirement from the last key inspection. Records were seen for water temperatures, bath seat, mobile hoist, bath hoist , the controlled waste certificate, the boilers service, Portable electrical appliance testing, wheelchairs and fire alarms and appliances. The home does not have any evidence of a ‘wiring’ check and the proprietor confirmed that he does not think he has ever had the major electrical circuits tested, this was part of a requirement from the last key inspection report. A broken socket was noted in the sitting room, whilst it was not in a place that could be hazardous this should be attended to. The proprietor agreed to ensure that the wiring test takes place imminently. The hot water is tested weekly and all temperatures recorded are under 43°c, the proprietor tested the two rooms which caused concern at the random inspection in July and for which the Commission issued a Statutory Notice, both were at a safe temperature. The proprietor confirmed the accuracy of the weekly hot water temperature recordings and the accuracy of the newly purchased water temperature probe as required at the last key inspection. Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 22 The home has not sought an environmental health officer’s advice about the water temperatures in the kitchen and laundry, which was required at the last key inspection. Incident accident forms were seen, 27 accidents/incidents were recorded between 01/01/07 and 23/06/07 The accident/incident forms do not detail what the home is going to do to minimise the risk of recurrence and do not have detailed risk assessments with regard to falling and moving and handling prior to admission. Action is not taken quickly to stop incidents recurring for instance one person had eight falls during this period and was later moved to another room which the manager advised had reduced her falls. There was discussion about the manager accessing expertise, in this area from the local ‘falls’ clinic /nurse or hospital. Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 23 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 2 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 2 X X 2 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 2 X 2 X 3 X X 2 Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 24 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 OP38 Regulation 13(4) Requirement Electrical safety is to be improved through regular hard wiring and portable appliance testing, to safeguard against the risk of fire or electrocution. (Partially met should have been met 01/06/07) 2 OP7 13(4) c The registered persons must make sure that the risks from falling and moving and handling are fully documented, to ensure the physical safety of service users. A referral to the Physiotherapist for assessment must be made to identify service users current moving and handling needs and the type of equipment needed. (Partially met should have been met 16/08/07) 01/12/07 Timescale for action 01/12/07 3. OP8 12 (1)(a) To undertake nutritional screening for each resident on admission and on a periodic DS0000011071.V344336.R01.S.doc 01/12/07 Beech House (Binfield) Version 5.2 Page 25 basis, advice and guidance must be promptly sought where concerns are identified such as unexplained weight loss or specific dietary needs. To pursue and obtain referrals, in a timely fashion, to clinical specialists when identified in the residents’ pre-admission assessments and care plans (Such as Parkinson’s or Diabetes nurse specialists.) To ensure that residents are supported to remain as healthy as possible. 4. OP22 23 .2 (n) Service users assessed as needing specialist equipment must be supplied with it, preferably prior to admission or when the need arises, so that they are helped to remain as independent and safe as is possible. To develop Quality Assurance processes, which involve service users, to ensure the home is being run in their best interests and that it is offering them good quality outcomes. To ensure that all risks are identified and minimised, as far as possible to include recording how the risk of falls and accidents will be dealt with and the immediate repair of any areas of the home that could constitute a risk to the service users. 01/12/07 5. OP33 24 01/02/08 6. OP38 13.4 and .5 21/11/07 Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 26 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 OP7 OP19 OP31 OP38 Good Practice Recommendations To evidence that residents and/or their representatives have been involved in and agree to their individual care plan. To produce a maintenance and refurbishment plan for the home to ensure proper standards of décor and comfort are maintained. To ensure that the manager has enough financial resources to exert day – to –day control of the home. To seek advice from the local ‘falls’ specialist with regard to effective risk assessing and minimising the recurrence of falls at an early stage. Beech House (Binfield) DS0000011071.V344336.R01.S.doc Version 5.2 Page 27 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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