Inspection on 08/05/08 for Benham Nursing Home

This inspection was carried out on 8th May 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Benham Nursing Home 13/04/07

Benham Nursing Home 31/07/06

Benham Nursing Home 26/01/06

Benham Nursing Home 16/08/05

Benham Nursing Home 23/09/04

Benham Nursing Home 04/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Benham Nursing Home 217-219 Spital Road Bromborough Wirral CH62 2AF Lead Inspector Julie Garrity Unannounced Inspection 8th May 2008 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 Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Benham Nursing Home Address 217-219 Spital Road Bromborough Wirral CH62 2AF 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) 0151 334 8533 F/P 0151 334 8533 Mr Michael Richard McGowan Unregistered manager Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 29 OP (N) and 1 named adult (N) under 65, 13 OP (PC) within an overall number of 43 13th April 2007 Date of last inspection Brief Description of the Service: Benham is a care home that provides care for individuals with both personal and nursing care needs. The home is made up of two former dwelling that have been adapted and extended to provide accommodation in a mixture of single and double bedrooms and with communal lounge and dining room areas. A conservatory and a pleasant, well-tended garden are situated at the rear of the building. There is parking at the front of the building. The service has sufficient bedrooms for up to 43 people. Benham is located in a main road Spital. Wirral as easy to locate. The service is close to the facilities of Bromborough. Local amenities such as shops, cafes and a library are within a ten-minute walk and the home has its own minibus. Public transport links are easily reachable in particular the local bus service. Fees range from £352 to £408 according to individual needs. Personal items are charged as each individual needs them. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. The inspection was carried out over a period of one day. The inspector arrived at the home at 10:40 and left at 20:10. The inspector spoke with 9 people who live in the home, 4 relatives, 6 staff and the manager. The inspector completed the inspection by a site visit to Benham, a review of records available in the service, these included care plans, medications, staff training, staff recruitment, policies and procedures, daily records and maintenance records. Records held in CSCI offices were also looked at. The main emphasis was discussions with the people who live in the home, staff and management. Questionnaires were sent to the home for people who live in the home and seven were returned prior to completion of this report. The inspector followed an inspection plan written before the start of the inspection to ensure that all areas identified in need of review were covered. All of the Key standards were covered in this inspection, these are detailed in the report. Feedback was given to the manager during and at the end of the inspection. The arrangements for equality and diversity were reviewed throughout the visit and are detailed in this report. Particular emphasis was placed on the methods that the home used to determine individual needs and the practices that they put into place to meeting those needs. What the service does well: There is a high level of commitment from the management team the owners have only the one home and are available in Benham frequently. The manager has completed training in care home management and often works in the home supporting the people who live in the home, staff and relatives. A friendly, welcoming atmosphere is encouraged by a staff team that have spent many years working in the home. One relative commented “it is nice that its mainly the mainly the same staff, they get to know you and you get to know them. It helps when you want to talk to them about what’s happening with my mum and makes me feel that she is really being well cared for”. All of the people who live in the home spoken with or received questionnaires from the Commission were very positive about the care that they received. This included comments such as “staff are fantastic”, “I am very happy here”, Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 6 “Can’t fault the home, the staff or the managers” and “I couldn’t ask for better”. What has improved since the last inspection? What they could do better: The management team has done a lot of work in the last 12 months and they have addressed all the requirements made. There are still areas that they need to improve. This includes updating and making available information available to people who may wish to move into the home. The management of medications is not sufficient to make sure that all staff are competent and all people who live in the home receive their medications as prescribed. The policy and procedure is being updated by the manager in this area in order to make sure that staff are aware of good practice and work to that standard at all times. Not all complaints are recognised and dealt with under the homes own complaints policy and procedure. The policy and procedure in this area is in need of updating, this also needs to include information to the staff as to what happens when a complaint is made in particular a complaint of a serious nature. The manager has been in post for over 12 months as yet we have not received an application for her to become the registered manager. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 8 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 Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed were 1, 3 and 5. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. As all individuals are assessed before they move in the home, this helps the manager and staff decide if they can meet the needs of the individual. Individuals only come to live in the home when they feel confident that the home can meet their needs. EVIDENCE: The manager make sure that all people who may want to move into the home have an assessment before they move in. The assessments look at the individual’s needs and in some cases include social needs. The manager explained that she will not accept individuals to move into the home unless she has been able to do a full assessment this is good practice and makes sure that individual needs can be determined before they move in. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 10 All the people who live in the home and those who returned questionnaires to the commission, said that they had received enough information to help them make a decision as to the suitability of the home. The service offers a trail period to all newly admitted individuals. This is good practice as it supports people to make a decision about moving into the home. The written information know as a statement of purpose and service users guide that describes the services and how Benham will meet individual needs was not available at this site visit. The manager explained that the owner is currently reviewing this and will forward a copy to the commission when completed. The plans include making sure that it is available in forms that meet individual needs such as large print or pictures. This is good practice as it meets people’s individual equality and diversity needs and helps them make informed choices about whether the home will be for them. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service makes sure that all health care needs are identified and appropriate actions put into place to meet individual needs. The management of medications is in need of further development in order to maintain safety. People who live in the home feel that they are treated with dignity and respect at all times. EVIDENCE: We looked at the care records of five people who live in the home. A new system has been developed that looks at all individual needs and makes sure that instructions are available to staff as to how to meet those needs. As this is still being developed the opportunity to have the people who live in the home read and sign that they agree to the care described has not occurred. The manager explained that they intend to continue to review how they do care plans and this will include looking at how to reduce the levels of paperwork to Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 12 make them more readable by the people who live in the home or their representatives. People who live in the home said that “ the staff here are very good they know what we need and make sure that we get it” and “they are very good, the staff have worked here for years so they learn what I like”. We looked at medications managed by the home. There were examples of good practice such as auditing medications and photographs of individuals to make giving out medications safer. All people who managed their own medications had a risk assessment in place and an agreement that they wished to do this. We looked at two risk assessment for people managing their own medications, these had not been reviewed for sometime and did not include how the home was to monitor that individual had the correct support. The manager detailed that she intends to include risk assessments for selfmedicating in the monthly reviews that are occurring for other risk assessments such as moving and handling. There are areas of medications that are in need of further development. Evidence showed that not all staff are following the correct procedures for giving out medications. We looked at eight individuals medications, five of these viewed had medications that when audited showed that they had not been given correctly. Examples included , painkillers for one individual who had more painkillers available than they should have. Another individual’s painkillers had less available than they should have. One person living in the home had started to run out of medications, the staff member had tried to get more medication to make sure there was enough. On the advice of an external professional they had not given five prescribed doses. The advice was not from the GP prescribing the medications and as such the staff had not given the medications in accordance with the prescriber’s instructions. Other areas of development include maintaining good standards such as making sure all medications were logged in when received by the home and making sure that all medications were returned to the correct place for disposal. The manager does do audits to make sure that medications are managed properly. It is clear that these audits need to be reviewed in order that they can make sure that all staff are skilled in giving out medications, following the process and make sure that all people who live in the home receive their medications as they should do. All the people who live in the home told how staff did maintain their dignity and privacy. This included comments such as “I prefer to say in my own room, I don’t like mixing with other people”, “staff always knock on doors before they come into my room” and “I always have nice clothes available”. Relatives spoken with said, “mum always looks lovely, happy, her hair is done her teeth are clean and her clothes are always pressed”. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed were 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of daily living are in place to meet individual needs. There is a strong activities programme that reflect their needs and of the people who live in the home. The people who live in the home receive a variety of meals, which the majority of individuals enjoy. EVIDENCE: People who live in the home and relatives were very positive about the variety of activities available, comments included “we have shows, dancers, games its entertaining and fun” and “its nice to have something interesting to do at some point during the day.” Relatives spoken with said, “there’s always something happening, some days you get here and it’s like a party going on”. The activities co-ordinator was observed during the day undertaking a variety of activities with the people who live in the home including, playing the organ, a quiz and exercise games. She records what activities have been done, what individuals liked and has a programme available to reflect what is happening. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 14 There is no regular menu plan that is available to the people who live in the home. The staff stated that the people who live in the home are offered a choice at each meal and they tell the kitchen staff what individuals like. There is no full record that is updated regular as to what individual choices or preferences in this area maybe. Observations of meals showed that choices was available. Individuals spoken with said that, “if I don’t like something I can ask for something else”, “most of the time the food is good but I don’t always like what is available” and “generally tasty”. When individuals are admitted part of the initial assessment asks what their likes and dislikes are. This is not updated as it is with activities, nor are these preferences recorded as it is with activities. As such staff are relying on their memories both in planning menus and offering choices. For those individuals able to express an opinion this is not an issue. For those individuals less able to express an opinion a reliance on memory may mean that vital choices are missed or misinterpreted. To make sure that food meets the individual nutritional needs of the people who live in the home staff regularly weigh individuals changes in weight are monitored. When an individual has gained or lost weight this is reported to the individuals GP. The manager has attempted to run “residents and relatives” meetings. These have not been well attended and as such have not given the home the opportunity to use individual views in the daily routine. In the past the manager did go to individuals and record their views about a variety of aspects of the care home with them. This has not happened for a while, the manager does discuss individual needs with people who live in the home on a regular basis as do the majority of the staff. Relatives spoken with detailed that they are encouraged to visit. All relatives spoken with said that they were “ always welcomed,” in the home”. They find it a very “friendly, inviting place, with lovely staff”. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home have been informed of their rights and feel confident to raise their concerns. Staff training supports them to raise concerns of a serious nature and help safeguard the people who live in the home. EVIDENCE: Questionnaires returned from the people who live in the home showed that they all felt confident in raising any concerns and knew how to make a complaint. Comments included “any things that needed fixing were always done very quickly”, “staff listen and try to make sure that I get what I need” and “Never had any cause to complaint but if I did I am sure the manager would fix it”. There has been one concern raised with the Commission about this home this was discussed with manager at the site visit. Although not raised with her the manager was aware that the family had concerns. Complaint records viewed for other concerns raised showed clearly what the issue is and what the manager has done to investigate and resolve the issue. A meeting with relatives had highlighted a concern that the manager addressed in the discussion. Although this had not been logged and dealt with under the complaints procedure of the home the concern had been acknowledged and addressed. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 16 Discussions with staff detailed that they understood how to raise concerns, they were also able to explain what they saw as a potential abuse of the people who live in the home Records showed that the majority of staff have received training in recognising and reporting potential abuse. Discussions with staff showed that they were not aware of how these areas would be investigated and it is likely without this information they would incorrectly deal with an allegation in this area. There is a policy on how the home would deal with complaint raised, the manager is intending to review this and also to develop the homes own policy on raising concerns with social services. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed were 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Benham is a warm and welcoming home that is maintained to a good standard. There are a variety of communal and private areas that support the people who live in the home to choose where they would wish to spend their day. EVIDENCE: We looked at the environment and noted that it is decorated in a homely manner, all areas looked well maintained with pictures and ornaments that help make it feel more like an individuals home. There is a variety of lounges and dining areas that support people who live in the home to sit where they choose. There is also a quieter lounge that relatives can use to socialise with their relative as well as individual bedrooms. The home has a conservatory and well maintained gardens that are well used by the people who live in the home. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 18 We looked at individual bedrooms and found that they had been personalised and included individual items such as pictures and ornaments. All the individuals we spoke with said, “the home is lovely”, “I’m very comfortable here” and “it’s nice to have my own things here”. Although adaptations such as ramps have been made through out the home in some areas individuals need to be able to climb a few stairs. This occurs more in the area of the home that does not support nursing clients. During the site visit we observed several staff members helping individuals up these stairs. They gave full and proper support at all times. We also noticed that there are aids to moving individuals about the home such as wheelchairs, hoists and bathing equipment. These have been recently checked and a fault noted on one piece of equipment was being attended to. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed were 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are protected by good recruitment, training and staffing levels. EVIDENCE: We looked at five staff files all had two references, one of which was from the staff member’s last employer. This is done to make sure that references are of value and provide the manager with a good idea of the staff member’s ability to work in the service. In all but one case police checks were seen in staff personnel files both the staff member and manager were sure that a police check had been requested and received as such it is likely to have been filed incorrectly. Training for staff was discussed with staff members and records reviewed. The manager makes sure that all staff area aware of the training that they need and logs their attendance to make sure that they get the correct training. Staff were able to describe a number of areas of training that they had undertaken. records viewed were up to date and covered mandatory training such as moving and handling. A new member of staff had not received moving and handling training and had been instructed not to move. Observations during Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 20 the day showed that the member of staff was moving and handling items such as mattresses. It was not possible to evidence that all staff that dealt with medications had, had up to date training or were competent to undertake this task. Audits and supervision were in place that would highlight areas of practice that need to be developed. This is good practice, however the actions that needed to be taken to address any areas were not monitored in and as such staffs competency in this area was not clearly determined. A number of training courses such as the protection of vulnerable adults have questions attached that the staff have to answer before they receive their certificate. This is good practice as it determines staff understanding of the training that they have received. People who live in the home were complementary about the staff comments such “unbelievably kind, supportive and welcoming”, “exceptionally good at their jobs” and “you can’t ask for better caring staff”. Relatives spoken with were also complimentary saying “very welcoming, kind, caring and just very nice girls” and “I feel perfectly happy to leave my mum here as I know she is safe. I come everyday and am always welcomed and encouraged to be part of the team. I can’t ask for anything better”. All individuals, relatives and staff said that in their opinion there was sufficient staff available to meet their needs. The manager explained that they do look at individual needs and if more staff are needed they are available. As yet there is no formal monitoring for this but it is being consider for the future as to how they can best make sure that staffing levels are available to meet individual needs. The service does have other support staff such as laundry, cleaning, cooking and an activities co-ordinator that supports the care staff to make sure that they are able to commit the majority of their time in delivering care and support to the people who live in the home. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard reviewed were 31, 32, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home, staff and relatives have confidence in the manager and the staff. The service does not have a formal quality assurance system in place and is unable to recognise areas that need development. This needs to be in place in order to maintain and develop quality within the service. EVIDENCE: The manager has completed her NVQ4 Registered Manager’s Award, and has, in conjunction with her staff team continued to make improvements to this service. As yet the manager is not registered with CSCI a check on the records in CSCI showed that a managers application had not been received. All Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 22 services must return an Annual Quality Assurance Assessment to CSCI before a key inspection. The one received from this service was incomplete in particular the areas that told us what the homes plans were to improve quality were blank. The management team needs to be able to identify and plan how to make improvements in order to increase and maintain the quality of the service. The people who live in the home were complimentary about the manager and the homes’ owners describing them as “always happy to help”, “very easy to get on with”, and “friendly and very kind”. Relatives spoken with said, “if I need to understand something or simply want to discuss the care the manager is happy to take the time to explain things to me”. Some of the policies and procedures available in the home were in need of updating examples would include the medications policy that the manager is currently updating and the complaints policy that does not detail the amount of time that the home would take to respond to a complainant. The manager has 18 hours a week allocated for management duties and as such updating policies and procedures, maintaining staff files and supervision are not easy for her to address in the amount of time available. The manager does do audits on areas such as care plans, environment and medications and this helps her recognise issues as they arise. There is no plan that utilises these audits in order to monitor that they have been addressed and increased the quality of the service. Without a plan the service runs the risk of not maintaining or increasing the quality of the service that they provide. We looked at the supervision available for the staff. The manager has purchased a video to help her and other senior staff to supervise staff appropriately. The manager explained that she has not had the time to keep all of these up to date, but is considering making sure that other staff such as senior carers and nurses also undertake supervision for junior staff. The format for supervision looks at how staff are developing ad what training they need. This is good practice as it will support staff to develop and maintain the skills that they need to appropriately support the people who live in the home. Required health and safety certificates and service contracts were in place, valid and up to date. Individual risk assessments for people who live in the home were available. The majority of these were detailed and reviewed on a monthly basis. The risk assessments for self medicating individuals were not reviewed monthly and in some cases there was no monitoring to make sure that the individual remained safe to manage their medications. The home does not hold any money for individuals preferring that families manage their finances. If an individual needs something this is purchased and the families billed at a later date. This makes sure that all the people who live in the home get items as needed. Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 4 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 3 X 2 Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 OP9 Regulation 13 (2) Requirement All staff that give out medications need to be fully aware of the policy and procedure. Staff need to meet the policy and procedure at all times in order for them to give out medications safely. All staff that give out medications need to have suitable training and their competency to manager medications appropriately determined. An application for registration needs to be submitted to the commission central registration team. Timescale for action 08/06/08 2. OP27 18 (1) (a) (2) 08/06/08 3. OP31 9 (1) (2) (a) (b) (c) 08/08/08 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 OP7 Good Practice Recommendations The process for care planning would benefit from a review DS0000020931.V363039.R01.S.doc Version 5.2 Page 25 Benham Nursing Home 2. OP17 and any means that reduces the amount of paperwork implemented. Care plans are currently overly complicated and as such prevent both staff and the people who live in the home from accessing them as needed. Consideration as to making the contents of care plans specific to the needs of the individual and writing daily records that reflect the care and support needed would benefit the people who live in the home. People who live in the home or their representatives need to be included in the care plans. Staff need to be made aware of whistle blowing and the role of external agencies such as social services in reference to the protection of vulnerable adults. Staffing files need reviewing in order to identify miss-filed items and make sure that all staff have full recruitment details including PIN numbers of the nursing staff. Self-medicating risk assessments need to contain monitoring arrangements, evidence based practice as to how the decision that the individual is safe to manager their on medication, monitoring arrangements in order that the individual can remain safe. Risk assessments need to be reviewed monthly. When the commission requests an AQAA all areas need to be completed and advice sought if needed. 3. 4. OP29 OP38 5. RCN Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Benham Nursing Home DS0000020931.V363039.R01.S.doc Version 5.2 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. 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