Inspection on 14/02/06 for Benham Lodge

This inspection was carried out on 14th February 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Benham Lodge 16/05/07

Benham Lodge 19/08/05

Benham Lodge 14/10/04

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

CARE HOME ADULTS 18-65 Benham Lodge 42 Pelham Road Gravesend Kent DA11 0HZ Lead Inspector Helen Martin Unannounced Inspection 14th February 2006 15:30 Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 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 Benham Lodge DS0000059579.V281331.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 Adults 18-65. 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. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Benham Lodge Address 42 Pelham Road Gravesend Kent DA11 0HZ 01474 533108 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) DGSM Limited Miss Sarah Ann Aldous Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care of two service users with a Learning disability is restricted to two persons whose dates of births are 06/07/1924 and 21/02/1933 19th August 2005 Date of last inspection Brief Description of the Service: The home provides accommodation and residential care for up to 9 people with learning disabilities. Twenty-four hour supervision is provided. The premises are close to local facilities and public transport. The house is owned by Hyde Housing and leased to DGSM Ltd. The premises were purpose built and service users have their own bedrooms. At the rear is a conservatory and garden. There is car parking space at the front of the home. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 14th February 2006 between 15.30 and 17.45 hours. The visit included talking with the Acting Manager, support workers and five residents. Some judgements about the quality of life within the home were taken from observation and conversations. Some records were looked at. A tour of the home and garden was undertaken. Residents were happy to talk to the inspector about their life within the home. Benham Lodge currently has nine residents with no vacancies. What the service does well: What has improved since the last inspection? What they could do better: Residents would be better protected by additional senior staff and improvements to the systems for staff recruitment and training and the administration of medication. They would benefit from some additional refurbishment of the home. Residents’ changing needs could be better reflected by improvements to some record keeping, contracts, care plans and risk assessments. Their interests could be better promoted by the training and registration of the acting manager and a review of record keeping and written Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 6 policies and procedures. Residents would benefit from additional pre-admission information and care plans and risk assessments that they could easily understand. They would also benefit from the full cost of a holiday included in the contract price. 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. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard 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 Prospective residents know that the home will meet their needs, although they would benefit from some additional, easily understandable information before they decide to move in. Residents’ contracts could be better reflected in documentation. EVIDENCE: Previous inspection identified that, although the pre-admission information available for prospective residents and their representatives contained some useful information, it did not contain full details about the home’s services and facilities. The acting manager said that they were currently in the process of reviewing the documentation available. Information is now contained within one document, designed to include the combined required details of the statement of purpose and service users’ guide. All the information is present with the exception of the number, qualifications and experience of staff, the organisational structure of the home, the number and size of the rooms, a copy of a standard contract including terms and conditions of accommodation and contact details of the CSCI. The information is not available in a format that would be easy for residents to understand. Residents benefit from an assessment prior to their admission to the home, to ensure that their needs can be met. The acting manager said that the format for pre-admission assessments was under review. The acting manager Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 9 demonstrated a good understanding of the range of needs that the home could and could not meet. Previous inspection identified shortfalls in the personal contract for residents; these should contain more specific information regarding the service provision for individual residents; the acting manager undertook to review this and to have a revised contract available for any new residents. At the time of this inspection, the acting manager explained that they continued to be in the process of reviewing contracts. Interim documentation was seen. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 Residents are supported to make their own choices and decisions about their lives. Their changing needs could be better reflected in care plans and risk assessments that they could easily understand. EVIDENCE: A written plan of care for each resident is prepared from a pre-admission assessment. Previous inspection identified that care plans were in need of updating; the acting manager outlined how this would be done. This inspection identified that care plans continue to be in the process of review, some had been updated and some had not. The acting manager said that most had been reviewed. One revised care plan was seen which more accurately reflects the resident’s changing needs and goals. This care plan gives staff guidance about action to be taken to meet the health and welfare needs of the resident. Daily notes are recorded in individual books, although it was noted that only staff on duty in the afternoons record these for the whole day. Staff on duty during the mornings and at night do not routinely make any entries. One care plan seen for a resident who arrived at the home in September 2005 contained mostly information from a previous placement, some of which was dated June 2005, 2004 and 2002. Benham Lodge had provided behavioural guidelines, dated Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 11 September 2005, but these have now been superseded together with the review date. No updated records are available. The acting manager explained that a new keyworker for this resident was in the process of building rapport and recording current guidelines. Care planning information is not available to residents in a format that is easy for them to understand. Residents are supported to take risks as part of maximising their independence. It was identified that recorded risk assessments continue to be in the process of review, some had been updated and some had not. The acting manager said that most had been reviewed. One updated care plan contained risk assessments for activities. Another contained none at all for a resident who posed the greatest potential risk to themselves and others. The acting manager explained that they continued to be in the process of reviewing all recorded risk assessments for residents. Residents are encouraged to make choices. They receive continuity of care by having individual key workers. There is evidence that considerable attention is given to helping residents to make decisions about how to spend their time and to avoid the development of very rigid routines. They are able to choose what time to get up, go to bed, and eat and the colour schemes of their rooms. Residents are involved as far as possible in decisions regarding the running of the home. They are involved in some cleaning, laundry, cooking and menu planning. A weekly residents’ meeting is held about choices such as meals, activities or holidays. Residents have recently chosen a new television. Some residents described aspects of their aspirations and goals. These were diverse as the group of residents have differing support needs. Information regarding residents in dealt with appropriately and documents are kept securely. Staff demonstrated an understanding of confidentiality issues. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Residents enjoy individual lifestyles, which include opportunities for social, educational and recreational experiences. They would benefit from the full cost of a holiday included in the contract price. EVIDENCE: Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 13 Residents are supported towards independent living skills, dependant on their capacity, and also have the opportunity for personal, emotional and social development. Residents are treated as individuals who have different interests and aspirations. Activities and development opportunities are provided accordingly. Personal development is progressed through attendance at college, paid employment/voluntary work, attendance at day centres and clubs and maintenance of relationships with friends and family. Residents also receive guidance with the development of skills within the home with the support of staff. All resident spoken with clearly enjoyed the activities that they were involved with. Residents are part of the local community. During weekdays residents enjoy attending day centres, drop-ins and evening clubs, participating in social events and activities that personally interest them or to further develop their life skills. Transport is provided. An activities co-ordinator is also provided once a week. Activities available to residents include squash, art and craft, cooking, bowling and swimming. One resident enjoyed making and receiving a Valentine’s card today. Residents regularly enjoy attending nightclubs and some enjoyed a Valentine’s party yesterday. Opportunities are available for residents to undertake paid or voluntary work. Two residents are currently employed, both in catering and one in work for a charity. Residents spend time at the home in the evening, weekends and on the days when they do not attend day centres or work. They are able to relax watching television or videos or doing activities within the home. Residents’ individual interests are encouraged. Staff support residents with one-to-one time and trips out locally such as lunch. They are able to assist residents to continue their education or training and to continue taking part in planned activities. The support needs of one resident were discussed; the acting manager said that currently additional staff are provided for activities outside of the home. Residents are encouraged and supported with shopping, cooking, cleaning and laundry tasks wherever possible. Day centres provide support for cooking and sport. Residents are able to see their family and friends as often as they wish. Residents spoken with confirmed this. Individuals can visit the home at any reasonable time. Some visit their families on occasions. Residents have been able to maintain friendships outside of the home. All residents currently have the opportunity to go on holiday. From comments made by residents, they are supported to choose and plan holidays, and were enthusiastic about their plans. The acting manager said that organisation does not pay for the cost of the holidays. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 14 Residents enjoy privacy in their rooms and staff respect this. Staff talk to residents in a friendly and polite way. Residents are able to receive visitors in private. Residents have meals in accordance with agreed menus, known choices and nutritional needs or preferences. Residents are supported in cooking and menu planning. A weekly meeting is held about choice of food and each resident can choose a meal. Good pictorial food choices were seen to enable residents to choose their meals. Residents can choose what time to eat. The main meal is usually at teatime and consisted of cheese and potato pie with tuna and salad on the day of inspection. The acting manager indicated that staff support residents who need it with any special diet. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 Residents benefit from support which meets their individual needs. They would be better protected by improvement to the system for the administration of medication. EVIDENCE: Residents are given the personal support they need to maximise their independence, while respecting their dignity and privacy. Residents are able to exercise choice. They have individual clothing and hairstyles. Staff have an understanding of the preferred routines of each resident. Residents have access to social and health care professionals. They are supported with any specialist appointments. One resident said that they had an appointment with the dentist soon. The new format for care plans has the facility to document all medical visits. The social and health care needs of one resident were discussed in some detail at the time of inspection. Changes have been made, following behavioural guidelines, to which the resident has reacted positively. The acting manager said that another more suitable placement was being sought following a multi-disciplinary review. Arrangements are in place for the storage and administration of medication. A monitored dosage system is used. Storage is secure. Medication Administration Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 16 Record (MAR) sheets seen were completed appropriately with the exception of handwritten entries that are not countersigned by a second member of staff or the prescribing GP as accurate. Receipt and return of medication to and from the pharmacy are checked and signed for by staff, although records of returns did not contain a signature from the pharmacy. Records are kept with photographs of residents and a staff signature list. Signed records of GP’s approval for the use of homely remedies was seen with MAR sheets, although one care plan seen showed out of date medication information signed by a resident’s previous GP. The acting manager said that all the necessary staff had undertaken training in the administration of medication. The acting manager demonstrated a good understanding of the challenges of aging faced by residents and regarding the death of a person close to them. It was mentioned that residents could stay at the home for as long as possible as long as their needs could be met. Residents have been supported to come to terms with loss according to their individual capacity. Specialist counselling is available through DGSM. The home has a written policy and procedure regarding death and dying. Some staff have undertaken bereavement training. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Improvements to the staff recruitment system would enhance the protection of residents. EVIDENCE: Previous inspection identified that the home follows the Kent & Medway Policy for Adult Protection. The acting manager demonstrated a good understanding of the procedures involved. Some staff have undertaken adult protection training. The social and health care needs of one resident were discussed in some detail at the time of inspection. Changes have been made, following behavioural guidelines, to which the resident has reacted positively. The acting manager indicated that this had been undertaken in order to protect this individual and the remaining resident group. It was mentioned that another more suitable placement was being sought following a multi-disciplinary review. There was no evidence that up to date Criminal Records Bureau (CRB)/ Protection of Vulnerable Adults (POVA) checks had been undertaken for all staff. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Residents benefit from living in a clean, comfortable and homely environment. This would be enhanced by some additional refurbishment. The premises are best suited to people with few mobility difficulties. EVIDENCE: The building fits in with the local community and has a style and atmosphere that meets individuals’ needs. Residents benefit from living in a clean and comfortable accommodation. The premises are generally suitable for their current needs. The house is maintained and decorated by Hyde Housing Association. The acting manager said that since the last inspection, a new pump had been fitted to the hot water system. The flooring in the conservatory is in need of repair and maintenance. The acting manager said that Hyde Housing had been informed and that they were awaiting a date for the commencement of work. The inspection also identified that tiling in one bathroom was in need of refurbishment. Residents have recently chosen a new television. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 19 Adequate recreational, dining, toilet, bathing and individual accommodation are available to residents. The home provides a lounge and dining area, a conservatory and garden. All residents have their own rooms. Bedrooms are comfortable, very well equipped and each reflects the interests of its occupant. Residents clearly like their rooms, which are all individual and highly personalised. They are able to choose the colour schemes and how their furniture should be arranged. There are no passenger or stair lifts within the home. A manual hoist is fitted in a bathroom. The acting manager indicated that some additional equipment would be provided if a resident’s review determined a need. It was mentioned that current residents have few mobility problems. Bedrooms and communal areas are equipped with staff call-bells. The premises are clean and hygienic. There is a laundry room used by residents with support from staff. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 34, 35, 36 Residents benefit from staff who have a good understanding of their needs. Residents would be better protected by additional senior staff and improvements to the systems for staff recruitment and training. EVIDENCE: Staff showed a good understanding of residents’ needs. Residents benefit from good support and interaction. The acting manager said that all staff have job descriptions and contracts of employment. Induction training is provided and signed records were seen. It was mentioned that the home does not currently provide any foundation course or training linked to the Learning Disability Award Framework. The acting manager said that this would be discussed with DGSM centrally and that the home’s induction training would be reviewed. Staff have undertaken ongoing training in food hygiene, health and safety, first aid, manual handling, medication, challenging behaviour, care planning, signing, learning disability, mental health, bereavement, Dementia, Epilepsy, adult protection, fire and break away techniques. The staff training matrix was seen and although most core courses had been undertaken, there were some gaps. The acting manager assured the inspector that courses were planned to fill the gaps. Training certificates are kept in staff files. The acting manager said that currently all Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 21 support workers, except two have obtained an NVQ qualification. The remaining two staff have applied for a course. At the time of inspection, the number of staff on duty met residents’ needs. There are usually two support workers during the day with one ‘sleeping-in’ at night. An on-call system is in place. Staff support residents with cooking, cleaning and laundry tasks wherever possible. No domestic staff are employed. An activities co-ordinator is available weekly. Staffing hours worked on the roster showed no surnames of individuals recorded. The acting manager said that currently the home did not have any senior support workers; two posts are vacant. It was mentioned that recruitment was currently in process and that appointments should be made shortly. The acting manager said that longstanding and experienced staff were present on every shift. The support needs of one resident were discussed; the acting manager said that currently additional staff are provided for activities outside of the home. The acting manager assured the inspector that sufficient staff are available to meet the needs of all residents at all times. A procedure is in place that aims to appoint suitable staff who can support the needs of residents. Staff files did not evidence that all pre-employment checks had been undertaken. There was no evidence that up to date Criminal Records Bureau (CRB)/ Protection of Vulnerable Adults (POVA) checks had been undertaken for all staff. A list was seen for applications and receipts, although this was not up to date. Evidence of some ‘portable’ CRBs from previous employment was seen for some staff, although this is not sufficient. One staff member confirmed that they had been employed at the home with a ‘portable’ CRB and were about to make a fresh application. One staff file contained only one reference and no written record of gaps in employment. The acting manager said that the second reference would be at the head office of DGSM. Not all files included proof of identity or a recent photograph. One staff file identified the need for a work permit, the acting manager was unsure whether this had been checked and no written evidence was available. The home’s application form did not contain the facility for the self-disclosure of any cautions. Staff files did not include copies of job descriptions or staff contracts of employment. The acting manager said that they aimed to provide monthly supervision for staff together with annual appraisals, which included the identification of training needs. Supervision records were seen within staff files. It was mentioned that the acting manager had completed supervision and appraisal training. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42, 43 Residents benefit from a well run home, although their interests would be better promoted by the training and registration of the acting manager and a review of record keeping and written policies and procedures. EVIDENCE: The acting manager said that the previous manager was no longer in post, that they had recently been appointed as permanent manager and would be applying for registration with the CSCI shortly. The acting manager has relevant experience of service provision for older people and for people with learning disabilities. It was mentioned that they had achieved an NVQ level 3 qualification and were planning to commence an NVQ level 4 in both management and care in 2006. The acting manager has undertaken a course that provides the underpinning knowledge of the NVQ level 4. The acting manager said that they would be undertaking a shorter management course in March of this year. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 23 There is an open and inclusive atmosphere in the home. Residents are comfortable chatting and spending time with staff. Residents’ meetings are held weekly. Residents were happy to speak about life within the home. The acting manager said that the home had won a quality assurance award regarding independent living skills. Good pictorial food choices were seen to enable residents to choose their meals. The home’s quality assurance system was assessed during previous inspection. The home has comprehensive recorded policies and procedures that are available for staff. These were last reviewed in 2002/2003. The acting manager explained that these are currently in the process of review by DGSM to ensure that they are specific to the home and should be available in April 2006. Records are stored securely. Records seen were completed appropriately with the exception of some care plans, risk assessments and staff recruitment files; staffing hours worked on the roster showed no surnames of individuals recorded. Accidents and incidents are recorded appropriately. Previous inspection identified that records and certificates indicated the regular testing and maintenance of systems and equipment within the home. The acting manager said that since the last inspection, a new pump had been fitted to the hot water system. It was mentioned that the temperatures of hot water outlets were controlled by pre-set valves throughout and were tested and recorded on a regular basis. COSHH (safety for storage of chemicals and cleaning materials) assessments have been made and it was mentioned that all chemicals are stored securely. The acting manager stated that the home is financially viable. Appropriate certificates for insurance and registration are displayed. The home’s business accounts were not inspected on this occasion. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 3 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 1 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 2 3 3 2 2 3 3 Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 25 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 YA1 Regulation 4 & 5 Sch 1 Requirement The registered person shall produce a written guide to the care home. In that, the reviewed combined statement of purpose and service users’ guide must include the number, qualifications and experience of staff, the organisational structure of the home, the number and size of the rooms, a copy of a standard contract including terms and conditions of accommodation and contact details of the CSCI. This requirement has been repeated from inspection dated 19th August 2005. 2 YA6 YA9 YA20 YA41 15(1)(2)(b) Unless it is impracticable to 09/04/06 carry out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (‘the service user’s plan’) as to how the service user’s needs in respect of his health and DS0000059579.V281331.R01.S.doc Version 5.1 Page 26 Timescale for action 09/04/06 Benham Lodge welfare are to be met. The registered person shall keep the service user’s plan under review. In that, the acting manager must complete their stated intention to complete the updating and review of all care plan and risk assessment records. Issues regarding care plans have been repeated from previous inspection dated 19th August 2005. 3 YA23 YA34 YA41 19(1)(a)(b) Sch. 2 The registered person shall not employ a person to work at the care home unless the person is fit to work at the care home; subject to paragraphs (6), (8) and (9), he has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2. In that, proof of identity, including a recent photograph, up to date CRB/POVA checks, two written references and a satisfactory written record of any gaps in employment must be obtained for all staff. 4 YA23 YA34 YA41 17(3)(b) Sch 4:6(f) The registered person shall ensure that the records referred to in Schedule 4 are at all times available for inspection in the home by any person authorised by the Commission to enter and inspect the care home: A record of all persons employed at the care home, Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 27 09/04/06 09/04/06 including: Correspondence, reports, records of disciplinary action and any other records in relation to their employment. In that, proof of identity, including a recent photograph, up to date CRB/POVA checks, two written references, a satisfactory written record of any gaps in employment and proof of eligibility to work in the UK must be made available for inspection in order to evidence a thorough recruitment procedure. 5 YA33 YA41 17(2)Sch4:7 The registered person shall maintain in the care home the records specified in Schedule 4: A copy of the duty roster of persons working at the care home, and a record of whether the roster was actually worked. In that, details shown on the staffing roster must include the surnames of those individuals working at the home. 6 YA35 18(1)(c)(i) The registered person shall 30/04/06 ensure that staff working at the home receive training appropriate to the work they are to perform. In that, appropriate training must be provided for all staff to meet the needs of residents. 7 YA37 8(a)(b) The registered person shall appoint an individual to manage the care home where there is no registered manager DS0000059579.V281331.R01.S.doc 15/02/06 30/04/06 Benham Lodge Version 5.1 Page 28 in respect of the care home and the registered provider is an organisation. In that, although a permanent manager is now in post, they must apply for registration with the CSCI. 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 Refer to Standard YA1 Good Practice Recommendations It is recommended that the information contained within the combined statement of purpose and service users’ guide should be available in a format that is easily understood by service users. Revised personal contracts should contain more specific information regarding the service provision for individual service users. In that, the acting manager explained that they continued to be in the process of reviewing contracts. Interim documentation was seen. This recommendation has been repeated from previous inspection dated 19th August 2005. 3 YA6 With regard to care plans: • It is strongly recommended that staff on duty during the mornings and at night routinely make entries in residents’ daily notes, in addition to those in the afternoons. It is recommended that care planning information is available to residents in a format that is easy for them to understand. 2 YA5 • 4 YA14 It is recommended that the cost of residents’ holidays DS0000059579.V281331.R01.S.doc Version 5.1 Page 29 Benham Lodge should be included in the basic contract price. 5 YA20 It is strongly recommended that, with regard to medication: • A second member of staff or the prescribing GP should countersign as accurate handwritten MAR sheet entries, not provided by the supplying pharmacy. Records of the return of medication should be countersigned by the supplying pharmacy as accurate. All records of residents’ current medication and GP approval for the use of homely remedies should be up to date in care plans to be in line with those kept with MAR sheets. • • 6 YA24 It is recommended that, with regard to repair and maintenance: • • The conservatory floor should be completed as soon as possible. The tiling in one bathroom should be refurbished. 7 8 YA33 YA34 It is strongly recommended that senior support workers should be in post as soon as possible after appointment. It is strongly recommended that, with regard to staff recruitment files: • • The application form should contain the facility for the self-disclosure of any police cautions. Staff files should contain copies of job descriptions and employment contracts. 9 YA35 It is strongly recommended that the system for induction, foundation and ongoing training courses should be reviewed to ensure that they are linked to the Learning Disability Award Framework. It is recommended that the acting manager should commence and complete an NVQ level 4 qualification in management and care as soon as possible. 10 YA37 Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 30 11 YA40 It is recommended that DGSM complete the review of policies and procedures to ensure that they are up to date and specific to the home. Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 31 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 Benham Lodge DS0000059579.V281331.R01.S.doc Version 5.1 Page 32 - 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!