Inspection on 21/11/05 for Beechcare Care Centre

This inspection was carried out on 21st November 2005.

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 02/05/06

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 21st November 2005 09:30 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.V264070.R01.S.doc Version 5.0 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.V264070.R01.S.doc Version 5.0 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) BetterCare Group 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.V264070.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7 July 2005 Brief Description of the Service: Beechcare Care Centre, 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. BetterCare Beechcare Limited is the registered provider. The home is situated within a five-acre site of well-maintained 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. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over seven hours on the 21 November 2005 and over three hours on the 22 November 2005. Lead inspector Elizabeth Baker carried out the inspection with support from Pharmacy Inspector Jane Vaughan on the 21 November 2005. A partial tour of the home was carried out. Some residents were spoken with including three who were interviewed in private. One visitor and members of staff were spoken with. Two members of staff were also interviewed in private. At the time of the visit 63 residents requiring nursing care were resident at the home, comprising 39 on the Beechcare Unit and 24 on the Peter Gidney Unit. The inspection was carried out with assistance from peripatetic manager Anne Cooke and the Senior Nurses of both units. Some judgements about the quality of care, life and choices were taken from conversations with residents, as well as direct and indirect observations. Some records were seen as part of case tracking and to assess work on the requirements made at the last inspection. Following the last unannounced visit, a total of 41 comment cards have been received by the Commission from relatives/visitors (12), residents (25), GP (1), Care Managers (2) and Health and Social Care Professional (1). This is the third unannounced inspection of this home for the inspection year 2005/06. The inspection focused mainly on the standards not met at the last visit and key standards, which were not inspected. This report should be read in conjunction with unannounced inspection report dated 13 April 2005 and additional inspection visit report dated 7 July 2005. What the service does well: What has improved since the last inspection? Nine of the 14 requirements made at the last unannounced inspection visit have been complied with. The main reception lounge on Beechcare has been redecorated and the seating renewed. Residents indicated meals have got better. Indeed residents said “food is good”, “food is usually very good” and “meals are very good”. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 6 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. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 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.V264070.R01.S.doc Version 5.0 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, 2, 3, 5 and 6 Prospective residents are provided with lots of information, although the Service User Guide does not totally reflect the individuality of the home. Prospective residents cannot be sure appropriate nursing equipment is in place at the point of admission. EVIDENCE: To reflect the change of ownership in May 2005 new documentation including Statement of Purpose, Service User Guide/Brochure and Terms and Condition of residence has been published. Although the revised Service User Guide generally follows the principles set out in the Commission’s guidance, some aspects do not adequately reflect the individuality of the home, including actual bedroom sizes and details of arrangements for residents to attend religious services of their choice. These could be important factors for prospective residents considering this home. All residents, regardless of how they are funded, are provided with terms and conditions of residence. This is good practice as it ensures all residents are aware of the rights and responsibilities of both parties while living at the home. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 9 A newly admitted resident said they had visited the home, with assistance from their care manager, prior to admission. The resident said they were glad they chose the home. Prospective residents are usually pre assessed in their current environment by a registered nurse to ensure the home is suitable for their individual assessed needs. A form is used to record the information gathered during the process. However there was some confusion as to the actual pressure area condition of a recently admitted resident due to the pre admission assessment indicating there was no pressure sore, but subsequent records inferring there was. Pre admission documents and admission records must contain accurate details of residents’ condition so that appropriate action is taken and equipment provided at the time of the admission. The home is not registered for intermediate care. Standard 6 is not applicable. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 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 11 Care records are not clear to adequately provide staff with information they need to satisfactorily meet residents’ needs. Whilst current systems support many of the pharmaceutical needs of the residents, procedures for medication reviews and improved drug storage would benefit residents. EVIDENCE: Seven care plans were inspected as part of the case tracking process. The model of care records is currently in the process of changing to that of the new organisation. Some care records were complete of this transition whereas others contained a mix and in one case a duplication of certain forms. There was evidence that some care records had been composed with input from residents and or their advocates. In one case there was confusion as to the resident’s actual pressure area condition on admission and the actual pressure relief/ preventative equipment they were provided with. The new admission assessment does not specifically require the nurse completing the document to record this important information. Although a pressure relieving/preventative mattress had been provided for a particular resident the alarm light was showing. Staff had no knowledge of this until the matter was pointed out. For another resident who likes to chain smoke, the risk assessment and care plan Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 11 component did not correspond accurately with the measures to be taken to maximise the resident’s safety. Both records were incomplete of comprehensive information including reference to the resident having a left side paralysis and their preference for keeping a tissue box on their lap. This matter has been reported on in a previous inspection report. All records contained information in respect of moving and handling. In one case the type of hoist to be used was described as the “big” hoist. The home has a number of “big” hoists. To prevent confusion, the actual hoist model should be stated. A particular resident was interviewed while sitting in their wheelchair. The resident’s corresponding care records did not state they required a wheelchair. Care records contain weight charts. In some cases the frequency of weighing was indicated as weekly, although the charts indicated they were being weighed monthly. Skin check charts are kept and require daily checks. A review of these indicated numerous gaps. An incorrect skin integrity score had been recorded. Daily statements are maintained. However some contained more information than others regarding residents’ quality of day experiences. As care records are used to provide care staff with current, comprehensive and concise information of residents’ condition and care they must be accurately maintained. Social activities sheets are maintained on all residents. In all cases the last recorded entries of residents receiving social care were dated 7 November 2005. Storage of medication was poor. There are two clinical rooms, one was cluttered and dirty and one was small with insufficient lockable storage. Locks were not sufficiently robust. Oxygen cylinders were not stored safely to prevent them falling. Controlled Drugs were recorded correctly, with storage of some items not complying with current legislation. Medication Administration Records were completed appropriately with no gaps noted and handwritten entries were double signed to indicate accuracy. Medication entering and leaving the home was recorded. The administration of homely remedies was recorded but there were no central records of their use. Registered nurses noted that prescribed doses of some medication were no longer appropriate, yet medication reviews were not requested. Several drugs were prescribed “as directed”. Disposal of waste medicines complied with current legislation but procedures and record keeping were not robust. Creams and liquid medication were not marked with the date of opening. Residents receive input from community health care professionals when their assessed needs require this. This includes input from the tissue viability nurse and speech and language therapist. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 12 None of the seven care records contained details of residents’ preferences in respect of death, dying and last rites. One resident had been specifically admitted for palliative care. There was also confusion as to the resident’s next of kin and marital status. This information was missing from their records, although a daily entry for the 20 November 2005 referred to the resident having been visited by her husband. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Residents have some choices about their daily lives and are able to include visits from friends and family into their day. The meals at the home have improved giving residents more choice. EVIDENCE: Residents spoken with indicated meals had improved. At this visit comments included “food is good”, “food is usually very good” and meals are very good”; Despite social activity input now totalling 75 hours per week, residents said they sometimes have activities but not often. However residents said they were looking forward to going Christmas shopping at Bluewater, having a meal at a nearby Harvester Restaurant and seeing a pantomime at the Orchard Theatre. Other seasonal activities including carols, Christmas fete and a band. Some residents were enjoying playing bingo during the afternoon of the first inspection day visit on the Beechcare Unit. Some Peter Gidney residents had joined them for this activity. A resident described her daily routine of getting up at their preferred time, having a daily shower and dressing as they wished to. Residents are supported in attending day centres if they choose to do so. Another resident described how they had been able to go on holiday with support from the Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 14 home. The resident also mentioned the enjoyment they receive from watching wildlife from the home’s lounges and that they spend much time on this occupation. Bedrooms visited had been individualised with personal effects. A resident said how pleased they were with their room and it had been decorated to their colour choice. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Systems are in place for residents and others to make a complaint, but not everyone who needs to know is aware of the procedure. EVIDENCE: The home maintains a record of complaints. Details of the home’s complaints procedure is displayed in the main reception hall. Despite this seven of the twelve comment card respondents from relatives/visitors indicated they do not know how to make a complaint. The training matrix identified that not all staff have received recent adult protection training. The two members of staff interviewed described appropriately what they would do if they with they witnessed poor care. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 Improvements to the environment would improve the residents’ quality of life. EVIDENCE: Since the last inspection the reception lounge has been redecorated and the seating has been renewed. This makes for a pleasing entrance into the home. However corridors, walls and doors to residents’ bedroom and ensuite rooms are badly scored and damaged, and in some places plaster is missing from the walls. A radiator has been replaced in a particular bedroom. The wall has not been made good. The reception room carpet on Beechcare and the main lounge carpet in Peter Gidney have been damaged in places by cigarette burns. Some bedroom carpets are stained. All this presents a tired and scruffy appearance and does not promote a homely and comfortably place for residents to live. The main kitchen and kitchenette on Peter Gidney were in a better state on this occasion. However cereal containers were again noted to be dirty and sticky and the metal frame waste sack holder on the Peter Gidney unit required Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 17 a thorough clean. The waste disposal unit in the Beechcare kitchen is still out of order. Undated and expired use by dates were again noted on plated sandwiches and processed meat in the small refrigerator in the dining room. The standard of cleaning in this dining room was not adequate in that areas under the drinks vending machine and around the skirting board/wall junctions were dirty. All bedrooms on the Beechcare unit have ensuite showers and WCs. In addition there are two communal bathrooms. However it was again noted that residents do not have easy access to these facilities because of the practice of storing equipment, such as hoists and over-toilet portable chairs, in these rooms. This situation prevents residents using these facilities and the rooms being properly cleaned. Corridors on both units are wide and are fitted with handrails. This situation promotes residents independence. Following a previous requirement, the provider indicated a separate smoking room would be provided. At this visit a number of residents were seen smoking on each unit in lounge areas. This was in the presence of nonsmokers. There is still no separate smoking room. Some residents may find this situation a nuisance as well as a potential health hazard. Adjustable beds are provided to residents when they are assessed as requiring them. Bedrooms contain a variety of furniture. In two bedrooms visited it was noted that doorknobs were missing from the chest of drawers, making it difficult for residents to open them. A number of carpets in residents bedrooms had been stained damaged and did not promote a homely environment. It was again noted that additional pillows and duvets were being stored in a resident’s ensuite room. This is practice is not hygienic and must cease. Residents must be provided with sufficient appropriate storage facilities for their need. Hand washing facilities are provided throughout the home for staff to use to minimise cross infection. A member of staff interviewed said they are provided with adequate protective clothing to carryout their duties in a safe manner. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 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 Current vetting practises to not ensure residents are adequately protected. Staff morale has improved allowing for improved level of care and support. EVIDENCE: Care records inspected contained dependency assessments, which are used to determine the staffing levels of current residents needs. Staffing rotas reviewed indicated the home runs more or less to the staffing level requirements set by the original regulatory authority in 2001. Despite this nine of the 12 comment card respondents from relatives/visitors indicated in their opinion there are not always sufficient staff on duty. Fourteen percent of health care assistants are now trained to NVQ level II care. Others are due to commence and some are now training for NVQ level III. Two staff files were inspected. This demonstrated that the home’s system for appointing and vetting staff has improved. However a review of the application forms identified that there was no employment history stated for an overseas member of staff. There was an explained gap for another member of staff between them leaving school and starting work. The two members of staff interviewed said they have received recent training including protection of vulnerable adults, fire and moving and handling. Both indicated they enjoyed their roles, even though they had not previously worked in a care home. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 19 Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 The peripatetic manager has a clear understanding of what needs to be done but will not be in post to ensure it is delivered. EVIDENCE: Residents indicated the running of the home has improved since the return of peripatetic manager Mrs Cooke. Whilst acknowledging the home has appointed two home managers since the departure of Mrs Swan in December 2003, neither manager stayed long enough to be processed by the Commission for the position of Registered Manager. Mrs Cooke advised during this inspection of her intention to leave the organisation’s employment in the middle of February 2006. The Commission has not been formally informed of this. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 21 Residents and staff spoken with indicated they would speak to the manager if they had a problem or a concern. Staff were seen interacting with residents and each other in a professional manner on this occasion. However it was identified on this visit that not all members of staff have their own copy of the General Social Care Council’s code of practice. A review of the home’s fire safety record book identified that although weekly fire tests are carried out, other tests requiring monthly checks are not always undertaken as frequently as required. During a conversation with a resident who was sitting in a wheelchair it was noted that the footplate rubber mat was missing. It is not the home’s practice to keep a separate wheelchair maintenance logbook. Having such a book may provide a quick audit of the condition of wheelchairs in use. Staff interviewed said they receive supervision and records supported this. Residents and staff meetings have been reintroduced. However there have no recent satisfaction surveys carried out to obtain residents and/or their advocates views on the home’s facilities and services. Records are maintained of monies held and transactions made on behalf of residents. Their monies are kept separately. A revised system is being introduced in line with the new organisation’s policy. The organisation’s regional administrator regularly audits the records to reconcile cash balances. This is good practice. The manager reported that maintenance and servicing of the home’s equipment is up to date. A resident was seen smoking unsupervised and without the protection of a fire blanket. The resident’s risk assessment was not comprehensive of all known risks and limitations. This situation places the resident at risk. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 22 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 2 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 2 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 2 2 2 2 2 3 2 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 3 X 2 Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 23 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 OP7 Regulation 15 Requirement Care plans must be complete and current of residents wishes, needs and problems, and composed with input from service users and advocates. (Timescale 31/07/05 partially met) Contact damage to bedroom doors and frames must been made good. (Previous timescale of 30/11/04 and 30/06/05 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. (Timescale 30/06/05 and previous timescale of 30/11/04 not met). A Suitably qualified and experienced Manager must be employed. This was the same situation at the previous inspection. (Timescale 30/09/05 not met) DS0000026147.V264070.R01.S.doc Timescale for action 28/02/06 2 OP19 23 31/03/06 3 OP19 16 30/11/05 4 OP20 23 31/03/06 5 OP31 9 28/02/06 Beechcare Care Centre Version 5.0 Page 24 6 OP1 4 7 OP4 14 8 OP9 13(2) 9 OP9 13(2) 10 11 12 OP9 OP21 OP22 13(2) 23 23 13 14 15 16 OP29 OP33 OP38 OP38 19 24 13 23(4) The home’s new Service User Guide/Statement of Purpose must reflect the facilities of Beechcare Care Centre. Pre admission and assessment forms must include full details of pressure sores and preventative equipment Robust procedures must be produced to support the safe management of waste medication. Medicine storage must be reviewed, improved and updated in accordance with guidelines from the Royal Pharmaceutical Society. All drug storage facilities to be fitted with BS 5 level locks. Bathrooms and WCs must be easily accessible to residents at all times Storage facilities must be available for nursing aids and equipment currently stored in bathrooms (Beechcare) and a particular ensuite room (Peter Gidney Unit) All employment gaps must be investigated and full employment histories obtained A system of obtaining residents and their advocates views must instigated. Comprehensive risk assessments must be available for residents who smoke. Fire fighting equipment and precautions must be suitably tested at regular intervals. 31/03/06 30/11/05 31/12/05 31/03/06 31/12/05 31/12/05 31/03/06 30/11/05 28/02/06 30/11/05 30/11/05 Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 25 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 Refer to Standard OP7 OP8 OP9 OP9 OP11 OP18 OP24 OP28 Good Practice Recommendations Moving and handling assessments should contain precise details of the moving and transferring equipment to be used. Pressure sore risk assessments must be accurately completed. Central records are maintained for the control and audit of homely remedies administered. Staff monitor the condition of residents and prompt the review of medication as necessary. Information in respect of resident’s wishes for death, dying and last rites must be obtained and recorded. All staff must received Adult Protection training. Residents’ bedroom furniture must be kept in a good condition. 50 of unqualified care staff must trained to NVQ level II care. Beechcare Care Centre DS0000026147.V264070.R01.S.doc Version 5.0 Page 26 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.V264070.R01.S.doc Version 5.0 Page 27 - 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!