Inspection on 06/03/06 for Beech House (Binfield)

This inspection was carried out on 6th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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) 24/04/07

Beech House (Binfield) 20/11/06

Beech House (Binfield) 02/05/06

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 Jill Chapman Unannounced Inspection 6th March 2006 9:55 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.V285279.R01.S.doc Version 5.1 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.V285279.R01.S.doc Version 5.1 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.V285279.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th September 2005 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. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an additional inspection the focus of which was to follow up the requirements from the inspection of 27 September 2005. The home has had vacant beds for the past few months. The proprietor has notified CSCI of financial pressures, which affect the business, CSCI is seeking clarification on this position to be assured that the welfare of service users is secure. The day-to-day outcomes for service users do not appear to be affected at present. Discussion took place with the proprietor, manager, a senior support worker, the cook and the laundry assistant. Some informal discussion with service users arose during the tour of the building and some of their morning routine was seen. Inspectors saw some of the communal areas of the home, some bedrooms and the bathrooms. Records related to the requirements were sampled. What the service does well: What has improved since the last inspection? Some redecoration to communal areas, a new bathroom floor and some new bedroom carpets have improved the appearance of these areas. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 6 Work to upgrade the fire safety system has been carried out. 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. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 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.V285279.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this visit. EVIDENCE: Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 & 11 There has been some improvement regarding health care plans but general care plans need further development to show that needs are assessed, met and reviewed formally. Requirements to improve the medication process have been met. Service users wishes about terminal illness and death arrangements have been sought. EVIDENCE: Requirements about the development of care plans and risk assessments for meeting the health care needs of service users including those diagnosed with diabetes have been met. It was noted however that some care plans are not developed from full assessments and consequently, may not include detailed health care and/or daily living programs. Existing care plans are reviewed monthly for permanent service users but on samples seen formal reviews had not been carried out since 2003. One service users care plan did not reflect her rapidly changing Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 10 health and care needs, nor did it evidence that the home could meet those changing needs. There were two requirements regarding medication and both of these are met. A fridge has been purchased for storing medication and the record of medicines returned to the pharmacist is in place. A requirement was made to record service users wishes in the event of terminal illness or death. The registered persons action plan states this has now been recorded and this will be verified at a future inspection. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Service users can have alternative meals to those on the menu and the cook asks service users what food they like. EVIDENCE: A requirement was made to provide a daily record of food provided and consumed by service users. Menus are kept and a diary now records alternatives given. The preparation of the lunchtime meal was underway during the visit. Food appeared appetising and nicely presented. The cook confirmed she speaks with service users regarding their preferences. The manager needs to make sure that the cook’s food hygiene certificate is up to date. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 There is insufficient recorded evidence to show that the registered persons are dealing effectively with complaints about the home. EVIDENCE: There were two requirements about the complaints procedure. Neither of these has been met. The complaints record was seen and was not up to date. Letters regarding two complaints were not available although the manager said they were on the premises. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 21 Redecoration and repairs have improved the environment for service users. Some repairs or replacement to kitchen equipment are needed. The registered persons have made some improvements to the bathrooms but refurbishment is needed to further improve the appearance of these areas. EVIDENCE: There were six requirements regarding the premises from the last inspection. No fire doors were wedged open during the tour of the premises and so this requirement is met. A requirement to re-plaster and redecorate corridors and stairways has been met. New carpets have been laid in bedrooms as required. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 14 The fridge in the storeroom has been replaced as required but this is faulty and needs to be exchanged for a new one. Adequate provision exits for food storage however. The proprietor has asked for more time to replace the stair carpet from the 1st to 2nd floor. An additional timescale will be agreed because it does not currently present a health and safety risk. But wheelchair damage to the carpet on the side of the bottom stair on the ground floor needs to be repaired. The door seal to the fridge in the main kitchen is damaged and needs replacement. Although not subject to requirement from the last inspection this has been pointed out to the proprietor on previous inspections. An extractor fan in the kitchen is not working properly because of a missing part. There were four requirements regarding bathrooms and toilets. Three have been met. New flooring has been laid in the ground floor bathroom and toilet, toilet and baths have been de-scaled and antibacterial soap has been provided. A requirement to provide timescales for the refurbishment of the bathrooms has not been met. The work required is redecoration and minor repairs and does not constitute a health and safety risk. As such it should be included in a future refurbishment plan. A requirement was made to find a safe storage space for walking frames other than in the middle of the lounge and dining room. The manager said she has reviewed this situation and although no alternative space is available they are storing them as safely as possible. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 A thorough recruitment process is not in place to ensure the protection of the service users. EVIDENCE: A requirement to make sure that new staff are not employed unless references and CRB/POVA checks are carried out has been mostly met. The files of three new staff were sampled and show that these checks have been carried out. Two showed that CRB checks and POVA checks had been received and a third had a POVA check but no CRB had been received yet. There is further evidence however that a thorough recruitment process is not in place to ensure the protection of the service users. The homes recruitment policy states that references should include one from a recent employer. Although all three files showed that two references had been sought, the validity of some references was not clear. Some from previous employment were clearly from work colleagues and not the employer. Although the homes recruitment policy states that proof of identity is sought these were not evident on files sampled. There were no copies of passport, birth certificate or photograph. One file of an overseas student did have an up to date copy of visa entitlement with photograph. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 16 Three induction packs were seen and had not been completed in the timescales stated in the homes recruitment policy and as recommended in the standard. A requirement to put the full names of staff on the rota has been met. A requirement was made to ensure that adequate numbers of staff are employed in the home at all times in such numbers as appropriate for the needs of the health and welfare of the service users. It was not possible to fully follow this up on this visit and will be a focus for the next inspection. A requirement about inducting night staff into the homes policy on 2 hour breaks could not be followed up on this day time visit. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35 & 38 Service users cannot be sure that their money and valuables are kept safely and they do not have easy access to this. Although requirements about health and safety have been met, the registered persons are not making sure that hot water is regularly checked to keep service users safe. Service users are potentially at risk because of the financial pressures on the service. EVIDENCE: Requirements to ensure that financial records are provided have been met. Whilst records were available these could not be verified because the monies were not kept in the home. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 18 The proprietor said he had removed money for safekeeping because he had several incidents of internal thefts. The registered person is required to provide a safe place where the money and valuables of service users may be deposited for safekeeping, and make arrangements for service users to acknowledge in writing the return to them of any money and valuables so deposited. These thefts should have been notified to CSCI under Regulation 37. The manager of the home said she has no access to service users monies. The manager does not have access to any petty cash funds when the proprietor is away from the home. She said that in emergencies she rings the proprietor or uses her own money. A requirement about the servicing of hoists and lifting equipment has been met. A requirement about the testing and recording of hot water outlets used by service users has not been met and is subject to an immediate requirement. All outlets are not being tested weekly and no tests have been carried out since 1/2/06. A requirement to keep the COSHH cupboard locked has been met. Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 19 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 x 18 x 2 X 2 x x x x x STAFFING Standard No Score 27 x 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x 1 1 x x 2 Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 20 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 37 Requirement The Registered Person to provide to the CSCI without delay written notifications as required within Regulation 37. ORIGINAL TIMESCALE FOR COMPLIANCE WAS 12/04/05 Complaints records to detail the timescales taken to investigate complaints and detail outcomes. ORIGINAL TIMESCALE FOR COMPLIANCE 1/12/05 Concerns and complaints letters to be maintained on the premises and available for inspection. ORIGINAL TIMESCALE FOR COMPLIANCE 1/12/05 The registered Person must ensure that adequate numbers of staff are employed in the home at all times in such numbers as appropriate for the health and welfare of service users. This was not followed up on this visit. The registered person is required to provide a safe place where the DS0000011071.V285279.R01.S.doc Timescale for action 06/03/06 2. OP16 17, 22 20/03/06 4. OP16 22 20/03/06 5. OP27 18 01/11/05 6. OP35 16(2)l 20/03/06 Beech House (Binfield) Version 5.1 Page 21 money and valuables of service users may be deposited for safekeeping, and make arrangements for service users to acknowledge in writing the return to them of any money and valuables so deposited. 7. 8. OP19 OP27 23 18 Stair carpeting from the 1st to the 2nd floor to be replaced. Night staff to be inducted and trained into the homes policy on the taking of 2 hour breaks during the night shift. Water temperatures from all water outlets accessed by service users to be tested weekly and recorded. ORIGIONAL TIMESCALE FOR COMPLIANCE 01/11/05 The registered persons should operate a thorough recruitment procedure ensuring the protection of service users. The registered persons should make sure Food Hygiene Training is up to date. Make safe the damage to the carpet on the bottom stair The door seal to the fridge in the main kitchen is damaged and needs replacement. To ensure that a written care plan is developed from a detailed assessment of individual service users needs and that the plan is reviewed to ensure changing needs are met. Repair the broken extractor fan in the kitchen. 06/09/06 01/11/05 9. OP38 13 (4) 10/03/06 10. OP29 19 Schedule 2&4 16 (2)j 23 23 15 06/05/06 11. 12. 13. 14. OP15 OP19 OP19 OP7 06/05/06 06/04/06 06/04/06 06/05/06 15. OP19 23 06/04/06 Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Beech House (Binfield) DS0000011071.V285279.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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