Inspection on 02/05/06 for Beechcare Care Centre

This inspection was carried out on 2nd May 2006.

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

Beechcare Care Centre 02/09/08

Beechcare Care Centre 04/09/07

Beechcare Care Centre 05/02/07

Beechcare Care Centre 21/11/05

Beechcare Care Centre 13/04/05

Beechcare Care Centre 07/09/04

Beechcare Care Centre 01/06/04

Beechcare Care Centre 20/04/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

Thorndene

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Beechcare Care Centre Darenth Road South Darenth Dartford Kent DA2 7QT Lead Inspector Elizabeth Baker Unannounced Inspection 2nd May 2006 10:00 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 Beechcare Care Centre DS0000026147.V291637.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. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beechcare Care Centre Address Darenth Road South Darenth Dartford Kent DA2 7QT 01322 628000 01322 628001 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) www.fshc.co.uk Four Seasons Beechcare Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Vacant Care Home 74 Category(ies) of Old age, not falling within any other category registration, with number (48), Physical disability (26) of places Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st November 2005 Brief Description of the Service: Beechcare Care Home, incorporating the Peter Gidney Unit, is a purpose built single storey facility. Following the registration of the Peter Gidney Unit as a special spinal unit in 1997, the home increased its registered numbers to 74 beds providing nursing care. Four Seasons Healthcare Limited in May 2005 acquired the home. The home is situated within a five-acre site of wellmaintained grounds in a rural area. Public transport is limited. The main A2/M25 junction is easily accessible by car from the home. Dartford town centre is approximately two miles to the north and is served by a regular train service to and from London, the Medway Towns and Kent Coast. There are ample car parking facilities. Bedroom accommodation comprises 58 single and eight double rooms. All bedrooms have ensuite WCs and wash hand basins. A number of ensuite rooms also have a shower. Day space consists of three lounges, a large reception room and two separate dining rooms. A large gym is currently sited on the Peter Gidney Unit. All bedrooms used by Service Users are connected to the nurse call system. Fees currently range from £407.12 to £1135.98 per week, exclusive of hairdressing, newspapers, toiletries and chiropody charges. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first key unannounced visit to the home for the inspection period 2006/07. The inspection took over seven hours and was carried out by lead inspector Elizabeth Baker and Registered Nurse inspector Justine Williams. The main purpose of the visit to check the Provider’s compliance against the requirements made at the last visit to the home on 21 November 2005. A partial tour of the home took place. A number of residents, two visitors and staff were interviewed in private. Other residents and staff were spoken with throughout the visit. The newly appointed Manager, Miss K Kempson assisted throughout the visit. At the time of the visit 64 residents requiring nursing care were residing at the home. Some judgements about the quality of care, life and choices were taken from conversations with residents, visitors and staff, as well as direct and indirect observations. Some care records were seen as part of case tracking. What the service does well: What has improved since the last inspection? What they could do better: Care records do not clearly demonstrate that all care has been assessed, delivered and reviewed. Registered Nurses must improve their record keeping skills, as the available care record information does not reflect the actual condition of some residents. The decorative state of the home and standard of cleaning, including the kitchens must be improved. Broken equipment including waste disposal units and assisted baths must be repaired or replaced. Only four of the fifteen outstanding requirements assessed on this visit had Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 6 been fully complied with. This was despite the Provider’s action plan indicating the majority would be completed by 31 March 2006. 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. Beechcare Care Centre DS0000026147.V291637.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 Beechcare Care Centre DS0000026147.V291637.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): 1, 3, 4 and 6. Quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The current assessment process does not ensure all residents will be properly cared for. EVIDENCE: A review of two new residents assessments included dementia as part of the residents’ overall condition. This was also mentioned in the joint assessment in one particular case. The home is not registered for dementia care. Indeed the manager confirmed care staff are not trained in dementia care. Admitting out of category residents may result in regulatory action being taken. It was also noted that the assessments were incomplete of all pertinent information to enable staff to properly complete the resultant care plans. Since the last inspection the home has produced supplementary information reflecting the facilities and services provided by this home in its entirety to reflect its actual registration as one service. This information is inserted into the Organisation’s colour brochures of each unit. This is an attempt to prevent prospective residents in thinking there are two separate registered services on this site. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 9 The home is not registered for intermediate care. Standard 6 is not applicable. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality of this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents remain at risk because their needs are not comprehensively set out in their plans of care. Personal care is offered in a way to protect residents’ privacy and dignity. EVIDENCE: Two care plans were inspected from Peter Gidney Unit and two from Beechcare. None of the residents had been fully assessed, thus a comprehensive plan of care had not been generated. Some residents had been involved in the drawing up of their care plans. One resident had been admitted over 20 days ago and did not have a care plan despite having some complex nursing needs. The moving and handling assessment in respect of this resident had not been signed or dated and was incomplete. The nutrition risk assessment was also incomplete and the resident had not been weighed despite the resident being obviously underweight. The pressure sore risk assessment (Waterlow) and continence assessments were also incomplete. Another resident had recently spent time in hospital to treat a non-healing large necrotic wound. There was good evidence to suggest close liaison with the Tissue Viability Nurse. However the most recent advice from the Tissue Viability Nurse had not been recorded in the care plan, thus it was unclear as Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 11 to what the wound was being dressed with and how frequently. This resident also had a seizure chart, but no mention as to how to manage this was in the care plan. The care plan had not been reviewed for some five months. The third resident’s care plan failed to detail how the resident’s confusion was to be managed and more concerning was the total absence of information on how to treat the resident’s pressure sore, which was mentioned in the daily events and on the admission records. Again the moving and handling assessment was not fully completed. The final care plan was satisfactory. Care records evidenced frequent and timely visits by the GP. Equipment for the prevention and treatment of pressure sores was seen. The requirements regarding medication made at the last inspection have been partly met. However there is still no clear detailed procedure for the disposal of medicines since the introduction of waste management companies disposing of medicines. The storage of medicines has improved partly with regard to oxygen cylinders. The homely remedies are now recorded in a book on each unit. However the information is by drug and not by resident. To ensure residents do not receive more than the recommended dose or for longer than is agreed with the GP and in accordance with manufacturer’s guidelines, it is recommended this practice be reviewed. Medicines were stored by resident and by type of drug. It is recommended medicines be stored by resident only to minimise risks to residents. Residents spoken with stated that staff are caring and always act with due regard for their right to privacy and their dignity upheld. Residents said they were able to make telephone calls in private, and received their personal mail unopened. Staff were observed to address residents appropriately and in a caring, friendly manner. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 12 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): 12, 13, 14 and 15 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents continue to enjoy their activites but there are anxieties that the provision will be reduced to reflect the budget cut. EVIDENCE: Efforts are made to assist residents to get up in the morning, wash, shower or bathe at a time they prefer. However residents are assisted with bathing or showering only once a week, despite some residents’ records stating they liked to shower three or four times per week. Residents are able to choose from the menu and where to eat, though meal times are set. Residents spoken with said meals are good and the new chef is trying hard to accommodate their specific needs and wishes. Information about forthcoming activities and planned trips were on display on notice boards. Residents spoken with said they were broadly satisfied with the range of activities on offer, although some were involved in a recent fund raising event for the provision of activities. Residents said that the funding for activities had been reduced and they were trying to supplement this. To bolster funds staff and advocates are also asked to partake in sponsoring events. Although some participants have willing done so, others are not so keen and feel under pressure to provide this time. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 13 Residents are able to meet visitors in private and choose whom they do and don’t wish to see. During the afternoon of the visit a number of residents were preparing to go out to a local pub. A resident described the outings they had previously been on and to a forthcoming trip to Hastings, which they were really looking forward to. A special coach has been booked so the maximum number of residents can go on this trip. Other residents in the home were seen sitting in their rooms listening to the radio, reading or watching TV. In the Beechcare lounge radio music competed with the TV programme, which was being broadcast at the same time. The two activities coordinators spoke enthusiastically about their role and spoke of their plans for developing the range and scope of activities currently provided. However they expressed concern at having the activity budget cut by two thirds and the impact this may have in the provision of activities and other treats for residents. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 14 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 and 18 Quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The current method of complaint investigation does not ensure the complainant knows the outcome. EVIDENCE: Details of the home’s complaint route are displayed in the reception hall and included in the service user guide. The address of the Commission’s area office is stated, although the local telephone number is not. One resident has recently complained of losing money. The resident said the Manager had informed the Police and the resident was now waiting to hear the outcome. The complaint was not recorded in the complaints file although a previous similar occurrence was. The Manager said the resident had been informed and the matter recorded somewhere in the care records. The current situation does not provide for an easy audit of complaints or incidents for quality assurance purposes. During the visit it transpired that not all staff have received Adult Protection training. The new manager could not recall seeing copies of Kent and Medway Adult Protection procedures at the home. The manager has agreed to contact the County’s Adult Protection co-ordinator in order to obtain current documents and enquire as to available training. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 15 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, 20, 21, 22, 24 and 26 Quality of this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There has been no significant change in the décor or furnishings since the last inspection. This situation does not create a pleasant environment for residents to live. The standards of hygiene are still inadequate and continue to place residents at risk. EVIDENCE: Extensive grounds surround the home. Some residents said they like to selfpropel themselves around the grounds during good weather. Other residents spoke of their enjoyment of watching the different wildlife from bedroom and lounge windows. However they also mentioned the grounds are not so well maintained now as the gardener has recently left. Indeed boarders and grass banks were looking overgrown. The manager said a new gardener is about to be employed. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 16 Despite 26 bedrooms having been redecorated and the flooring replaced in five bedrooms over the last year, the environment of the home is deteriorating. Stained carpets were seen in some communal areas and bedrooms; carpets in lounges used by smokers are damaged by cigarette burns; some ceilings are dirty and/or damaged; wallpaper is peeling and a large piece is missing in the main Beechcare lounge; doors and doorframes throughout the home, including bedrooms and ensuite rooms are damaged. The provider’s action plan to the last inspection indicated that the Regional Estates Department has undertaken a review of the contact damage to doors and door frames and metal door coverings had been ordered. The completion date to this is stated as 31 March 2006. This is not the case. Indeed visitors spoken with said how disappointed they are that despite the new owners announcing at a meeting that the home would be refurbished, to date nothing seems to have happened. An Inspecting Officer (Health Premises Technical Adviser) of Kent Fire and Rescue Service carried out a fire safety compliance re-visit of the Peter Gidney Unit on 23 February 2006. The unit was found to comply with the Workplace Fire Precautions Legislation. Clean hard towels were seen in the laundry room, linen rooms and residents’ bedrooms. Hard towels may damage residents’ skin integrity because of the coarseness. Although the home was odour free and looked generally clean, attention to detail in certain places was poor. The dining room chairs in the Beechcare unit and some armchairs and settee in the PGU were dirty; many kitchen appliances in the main kitchen were sticky to touch; the new cereal containers in the Peter Gidney unit kitchenette were dirty, the metal pedal in this room was dirty; spillages were seen on the walls in the PGU kitchenette and the visitor’s kitchen in the small lounge on Beechcare; the top of the fridge in this room was dirty. The waste disposal unit in the main kitchen has still not been replaced or repaired; the main cooker and cooking utensils are scorched damaged. Opened cooked meat packets were in use. The date of opening had not been stated; the fridge in the small lounge on Beechcare unit contained a container of fresh whole milk still in use despite a use by date of 30 April. The fridge also contained a dirty mug with dried up contents; and three partly frozen cooked chicken drumsticks wrapped in foil. There was no date or description label on the foil. Fridge and freezer temperature records did not evidence temperatures had been taken over the bank holiday period. The flooring in bathrooms, ensuite rooms and sluice rooms is a non-slip type. However with the passage of time and continuous wear and tear, the indented surface of this flooring now looks dirty. Access to sluice rooms and one bathroom on Beechcare is limited as these rooms continue to be used to store excess nursing aids and equipment. It was also noted that the gym on the Peter Gidney Unit is now being used to store beds and a range of wheelchairs. A particular resident said they have been given a new room with a larger Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 17 ensuite room with a shower, which they are very pleased with. However the ensuite room is being used to store additional nursing sundries required by this resident. This practice was identified in the resident’s previous room and reported on a number of occasions. The provider’s last response to this was that the room had been cleared and a review of all necessary equipment made and excess removed. Sadly this is not the case. A resident said they could not have their preferred bath because the bath’s adjustable mechanism was broke. The manager was not aware of this. The bath had been out of use for some time. The home admits residents who smoke. However there are no separate facilities. Because of this certain areas of the two main lounges are used for smokers’ use. However one resident said although they like to go to the lounge to mix with other residents, they don’t like to stay too long because the atmosphere gets smoky. This unit does not have another sitting room for residents to use. Dirty footplates were seen on wheelchairs being used by residents. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recruitment practices are still not sufficiently robust to minimise potential risks to residents. EVIDENCE: Staff were seen carrying out their duties in an unhurried manner. In addition to care staff, staff are employed for administration, activities, cooking, cleaning, laundry and maintenance. Only 13 of healthcare assistants employed are trained to NVQ level II care. This is well below the fifty percent now expected. Three staff files were inspected. References had been sought and received. However in one case, both references were sought and obtained from employees of the applicant’s last place of employment, as opposed to the Manager of the home. In another case, an employment gap was noted. There was no recorded evidence the reason for the gap had been investigated. A new employee described her initial induction programme and said that they are now working through a more detailed programme. The returned pre inspection questionnaire form indicates staff have received training for wound care, compression hosiery and bandaging and supra pubic catheter care update. The Organisation’s colour brochure for the Peter Gidney unit infers the home can care for residents with various medical conditions including Huntington’s disease. The form does not evidence staff have received such training. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 19 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): 31, 33, 35, 37 and 38 Quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The new manager has an understanding of what needs to be done to improve the home and is currently supported in this by the Organisation’s Regional Manager. EVIDENCE: Since the last inspection a new permanent manager has been appointed. A resident said the new manager makes time to speak to all of them [residents] regularly and seems to know all their names already. The resident added “the home has a number of new care staff, who are very good, a new chef and manager and things are getting better”. Residents and visitors said they could not recall having been requested to complete satisfaction surveys. Indeed the manager confirmed there have been Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 20 no surveys since she commenced in February 2006. However, meetings have taken place for both residents and staff. A visitor said they had accessed a copy of the home’s last inspection report and found the contents interesting, particularly the references to medicine administration. The home has a range of policies and procedures. However two staff members interviewed did not know for sure where the documents are located. The home is responsible for maintaining small amounts of money on behalf of some residents. The provider’s representative audits the records and cash balances regularly. However on this visit it was identified that access to resident’s monies is not available “out of hours” including weekends and bank holidays. This may prevent some residents accessing their funds at short notice during these periods. Details of these restrictions could not be found in the service user guide. The care records of two residents who smoke were inspected. Although both care records contained a risk assessment in respect of this activity, the level of information was still not adequate. Indeed in one case the information said cigarettes and lighter must be kept locked away. The cigarettes and lighter had actually been left on top of a small side table. The area was unattended. The resident was later seen sitting in their wheelchair smoking with a handful of paper tissues placed on their lap. The resident has reduced dexterity. The resident was not being supervised nor were they wearing protective clothing. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 21 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 3 X 2 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 1 2 2 2 X 2 X 1 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X 2 2 Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 22 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 OP3 Regulation 14 Requirement Pre admission assessments must contain comprehensive information on all residents’ needs and wishes. New residents must be admitted to the home as per the home’s registration categories. All residents must be provided with a comprehensive care plan and must be reviewed at least monthly. Residents’ moving and handling assessments must complete, signed and dated. Pressure sore risk assessments must be complete and accurate of all details. Comprehensive nutritional assessments must be kept on those residents assessed as requiring them. Robust procedures must be produced to support the safe management of waste medication. (Timescale 31/12/05 not met). Medicine storage must be reviewed, improved and updated DS0000026147.V291637.R01.S.doc Timescale for action 31/05/06 2 3 OP4 OP7 14 15 02/05/06 09/05/06 4 5 6 OP7 OP8 OP8 13(4) 17(3) 17(3) 31/05/06 31/05/06 31/05/06 7 OP9 13(2) 31/08/06 8 OP9 13(2) 31/08/06 Beechcare Care Centre Version 5.1 Page 23 in accordance with guidelines from the Royal Pharmaceutical Society. (Timescale 31/03/06 not met). 9 10 OP9 OP19 13(2) 23 All drug storage facilities to be fitted with BS 5 level locks. Not inspected Contact damage to bedroom doors and frames must been made good. Previous timescale 30/11/04 and 30/06/05 (BetterCare ownership) and 31/03/06 (Four Seasons) not met. The standard of cleaning in the Peter Gidney Unit kitchenette, including storage containers. (Timescale 07/07/05 partially met) The provision of a separate smoking room for service users has not yet been provided. Previous timescale 30/11/04 and 30/06/05 (BetterCare ownership) and 31/03/06 (Four Seasons) not met. Bathrooms and WCs must be easily accessible to residents at all times. (Timescale 31/12/05 not met). Storage facilities must be available for nursing aids and equipment currently stored in bathrooms (Beechcare) and a particular ensuite room (Peter Gidney Unit) (Timescale 31/03/06 not met). 31/08/06 31/08/06 11 OP19 16 31/05/06 12 OP20 23 31/08/06 13 OP21 23 30/06/06 14 OP22 23 30/06/06 15 16 OP22 OP29 23 19 17 OP33 24 Assisted baths must be kept in 30/06/06 working order. All employment gaps must be 31/05/06 investigated and full employment histories obtained. (Timescale 30/11/05 not totally met). A system of obtaining residents 31/08/06 and their advocates views must DS0000026147.V291637.R01.S.doc Version 5.1 Page 24 Beechcare Care Centre instigated. (Timescale 28/02/06 not totally met). 18 OP38 13 Comprehensive risk assessments must be available for residents who smoke. (Timescale 30/11/05 not totally met). 31/05/06 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 5 6 7 8 9 10 11 12 13 14 Refer to Standard OP8 OP9 OP9 OP11 OP14 OP16 OP18 OP21 OP24 OP28 OP29 OP33 OP35 OP37 Good Practice Recommendations Continence assessments must be kept up to date. Residents’ medicines should be stored individually as opposed to medicines being stored by type. Each resident must have individual records in respect of homely remedies. Information in respect of resident’s wishes for death, dying and last rites must be obtained and recorded. Care records not inspected for this care element. Residents should be able to have showers and baths as frequently as they wish. The complaints file must be kept up to date. All staff must received Adult Protection training. Towels must be kept to a standard, which does not compromise residents’ skin integrity. Residents’ bedroom furniture must be kept in a good condition. 50 of unqualified care staff must trained to NVQ level II care. References must not be sought from ex colleagues. All staff should know and have ready access to the home’s policies and procedures. Restrictive access by residents to their personal monies must be recorded. Prospective residents should be informed of such restrictions. All records must be kept up to date. Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Beechcare Care Centre DS0000026147.V291637.R01.S.doc Version 5.1 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!