Inspection on 28/06/06 for Bennett House

This inspection was carried out on 28th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Bennett House 18/12/06

Bennett House 21/12/05

Bennett House 22/06/05

Bennett House 23/01/05

Bennett House 10/09/04

Bennett House 16/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Bennett House Park Lane Woodside Telford Shropshire TF7 5HR Lead Inspector Janet Adams Key Announced Inspection 28th June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bennett House DS0000020538.V294004.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. Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bennett House Address Park Lane Woodside Telford Shropshire TF7 5HR 01952 582588 01952 582080 lynf@accordha.org.uk 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) Accord Housing Association Limited Mrs Stephanie Matthews Care Home 45 Category(ies) of Dementia (26), Old age, not falling within any registration, with number other category (19) of places Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home may accommodate a maximum of 45 service users. The home may accommodate a maximum of 45 Elderly Persons of whom 26 may be suffering from Dementia and 1 may have physically disabilities under 65 years of age. The home may from time to time admit persons between the ages of 60 and 65 years of age, upon consultation with the Commission for Social Care Inspection. 21st December 2005 3. Date of last inspection Brief Description of the Service: Bennett House is registered as a care home for up to 45 older people requiring personal care, which may include up to 26 older people designated as having dementia. Some people come to live at the facility on a short term respite basis. Many people move into the home after attending the day care centre, which is also on the site of Bennett House. The Accord Housing Association owns the home, and the Registered Manager, Stephanie Matthews, transferred within the Accord Group to be in charge of Bennett House in July 2005.The home, situated in the Woodside area of Telford, is a purpose-built bungalow style building, which during the past year has been subject to a lot of financial investment, refurbishment and team effort to improve the living accommodation provided there. It is divided into four separate units, each unit comprises of single bedrooms, bathroom, separate toilets, a lounge area and a kitchen/dining area. As the home is in the centre of the extensive regeneration project, which is ongoing within the locality, it is anticipated it will benefit from the local community facilities, which are currently being upgraded. The ranges of fees currently charged are between £348.88 and £390.28 per week. Day centre fees are £35.78 per day. Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection by one inspector lasting eight hours. Since the last unannounced inspection in December 2005, the home has had three other inspection visits, on January 19, March 3, and April 6 2006.These were carried out to monitor the management of concerns and complaints CSCI (The Commission for Social Care Inspection) had received about the service since the end of last year. The reports for these visits are available on request from CSCI. This inspection included observing activity within the home, inspecting the premises, an ‘in depth look’ at records for residents and staff, observing, talking and listening to nearly all of the 45 people living there, a few visitors, and the staff on duty at the time of the inspection. Discussions were carried out in private with people on their own, or together in groups in the lounges. Everyone was happy to share valid comments, which are included in the main body of the report. Nine residents also made some written comments for the inspector. All of these were complimentary and had some good ideas how to make the home even better. The Registered Manager Mrs Matthews was on duty at the time of the inspection. Everyone, including residents and staff were very welcoming and helpful throughout. A total of 31 out of a possible 38 National Minimum Standards for Older People were assessed on this occasion. What the service does well: It was impressive to see that despite recent challenges, the home has continued to more than meet National Minimum Standards for some parts of the service and support it provides for its residents. The home meets most of the individual personal and health care needs of the elderly people living at Bennett house on a long-term basis in a most desirable manner. Many residents spoken to stated they were happy to be living at Bennett House felt safe, and were well cared for. Others who were not able to confirm this as a result of their medical conditions all expressed feelings of well being when observed during their daily pastimes. One resident commented that the staff were ‘Marvellous from the ground upward!’ Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 6 It is obvious that Accord Housing who owns the home focus very much on involving and empowering people to have their say about life at Bennett House. Many of the systems seen in place make sure they involve and explore peoples’ choices and opinions before going ahead to make changes. Keeping all residents busy in a variety of daily life and social activities is considered to be vital at Bennett House. The whole care team embrace the issue of activities to make sure people have the support they need to live as full a life as possible. Despite the staffing challenges, a variety of activities seen being held and planned were as a result of people living there being involved in deciding what they were interested in and enjoyed doing. Accord Housing have been very supportive in enabling the home team have time to find the ‘right people for the right job’ and have provided extra funding for agency staff to be used on a long term contract basis to maximise care delivery while the vacancies have been filled and new staff settled in. The current staff members also deserve recognition for supporting the home during recent challenging times. A core of committed staff have enabled resident care to be a priority despite working with and supporting a variety agency personnel as part of their day to day duties. What has improved since the last inspection? As a result of the recent inspection visits to the home, the staff team have been working hard to improve systems so that as many statutory requirements made by CSCI have now been fully met. The home has met 17 out of 25 requirements, which is good considering that 14 of these were only made at the last visit in April by the pharmacy inspector. Systems to manage the care of people admitted to the home for short-term care have vastly improved. This is as a result of new paperwork, and continued team effort especially from the laundry, care and management teams in the home. Efforts to improve the quality of staff recruited to the home were also reflected in many comments received by the inspector, and improvements to the way staff are supervised and supported showed how the management team are working together to improve staff morale and competence. The home is to be commended on newly updated processes, which now reflect excellent complaints and accident management systems. On the day of the inspection when many of the residents were asked what had improved in the last six months, they were all unanimous that the continued refurbishment in the home meant the provision of new armchairs and more new carpets in many parts of the home had complimented the extensive refurbishment carried out at Bennett House last year. Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 7 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. Bennett House DS0000020538.V294004.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 Bennett House DS0000020538.V294004.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 &4 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Bennett House’s admission procedures show there is sufficient information to clearly demonstrate they can meet the long term and short term needs of people thinking about moving in there. EVIDENCE: Since last December, the management team have worked hard to improve the whole admission process for short and long term residents. Examination of five sets of residents records show that people have a detailed assessment completed prior to, and upon admission to make sure the home knows how to look after that individual person from the time they move into the home. Assessments are been carried out in enough detail to assure residents, their relatives and staff that the home can meet their needs. Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 10 Bennett House also has a system in place to make sure any additional information provided from assessments by professionals such as social workers is recent, especially in the case of people coming into the home for short- term care. Anyone who returns for another spell of ‘respite’ has their records updated on the day of admission, so that any changes in their needs and support required is noted and shared with the staff on the unit they are staying on. A simple but effective form introduced when people are admitted to the home makes sure all property they arrive with is accounted for when they go home. All records checked showed that people knew the terms of residency of living at Bennett House by signing their own copy of this information. From four sets of resident’s records looked at it was noteworthy to see that appropriate details were in their files. Observations and discussions with many of the residents confirmed they were very happy living at Bennett House. Since the last inspection, the home has been receiving regular letters of thanks from relatives of people who have been staying at the home. Social workers have also passed on several positive comments about Bennett House that people have shared with them. One relative wrote in the home to especially say thank you, and to comment ‘how nice her Mums hair and nails looked’. Similar responses were received at in March this year when CSCI carried out their own survey to check whether the people moving into the home for shortterm care were happy with the service the home provided. Bennett House DS0000020538.V294004.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The care planning and medication management systems need extra details to mirror the entire professional, individual, standards of care residents receive and need to get. EVIDENCE: Comments received from the residents living at the home all agreed that they liked living at Bennett House, felt well cared for and the staff respected their privacy. One written comment received from a resident reflected at least half a dozen others. It stated: ‘I am very happy with the care I receive, I always feel and look clean and I enjoy the meals.’ Although some people who live at the home are not fully able to answer questions and write their opinions about Bennett House down, the inspector spent over two hours in the unit where people with dementia related conditions live. Observations of the care delivery and behaviours of these individuals during this time showed that the people living there appeared to be happy, Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 12 were well groomed and had the support of plenty of knowledgeable staff on duty to give them the personal attention they needed. The home only allocates staff that know the residents to that particular unit, and although two of the carers seen were agency staff, they had been working at the home for some time, and obviously had a good working knowledge people’s individual preferences and needs. Improvements to care plan records have meant this information has improved a great deal since December. The details seen in the easy to understand paperwork shows residents or their representative understand and participate in their care. Care records contain noteworthy attention to detail about the person’s key Worker and how that person takes ‘special responsibility’ of individual residents needs. This was seen to be working most effectively - staff were seen engaged in their key worker roles make sure residents got the help they need. One resident was seen being prepared for a hospital visit with his key worker, and good record keeping also showed how the individual was involved in the new NHS ‘Choose and Book’ initiative for hospital referrals. This shows the home had adaptable systems ‘to keep up with the times’. Whether the resident was living at the home for two weeks or had been there two years, care records were seen to have been updated to contain most of the detailed information how people preferred and needed to be looked after. However, the change of design of the corporate care plan forms has resulted in some important information being missed out. This means all records looked at lacked guidance for staff how to safely move and handle residents at all times. Although ‘risk reduction tools’ are in place, there is not enough information about all risks residents may encounter. When the old records of a resident who had lived at the home for two years were looked at – this important information had been included, and it is only since the changeover to the otherwise very good ‘Getting to Know You’ information that this has been omitted. This was looked into by the manager during the inspection, which confirmed Accord is currently working on this issue. Communication between the local GP practice and the home has not been favourable recently, which has had an impact on the care and professional support provided for the residents in the home. This is currently being looked into by a variety of professionals including CSCI and Telford and Wrekin Social Care services to make sure the people living at Bennett House get permanent changes to make sure they get the appropriate professional care necessary at all times. Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 13 As there are several medication management issues, which need to be resolved, The CSCI Pharmacist inspector carried out a random unannounced inspection in April of this year with a judgement that this part of this service was of poor quality. It is noteworthy in a relatively short period of time over half of the requirements made have been met. The home management team are currently having talks with experts to get permanent changes underway by this September. Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 14 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 &15 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. The Bennett House team work in close liaison with residents and their relatives to promote choice and control over individual lifestyles and preferences in order that these can be continued or further enhanced when they live at the home. EVIDENCE: Although the home has taken some time to appoint their new activity organiser to make sure they found the right person for the job, it is evident the care team have tried very hard to keep residents involved and stimulated in their day to day lifestyle. It was good to see that this part of the service Bennett House provides continues to be carried out well despite some long term staffing challenges it has experienced. As Accord Housing have another home in the Telford area, residents have enjoyed the opportunity of an outing across town to join in the exercise classes held there. One resident who had attended the day before the inspection said he had thoroughly enjoyed himself when he went. Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 15 Established systems seen in place confirm there are daily written details about the activities people are involved in. An activity tracker form seen in all records looked at also described individuals’ moods and behaviours on the unit where people with dementia live in response to some activities. The home team have been involved in more changes to improve the lifestyle of individuals with dementia in the home. Pioneered by one of the senior care team members, the home now has a monthly meeting with a Community Mental Health Nurse, relatives and residents look at how to improve their well being. This has been so successful, it is now expanding to other units in the home. Links with the branch of the local Alzheimer’s Society has meant staff are accessing lots of ideas and information to encourage meaningful pastimes for residents. The content of the minutes of the regular monthly resident meetings also confirmed that residents were fully involved in making decisions and choices about a variety of issues in the home. As a result of a recent meeting, each separate unit of the home have designed an activity plan of what they would like to do in between getting out and about on trips. These large posters were seen on display in all of the four units where people live. All of them were different, showing this was entirely led by residents’ choice and interests. The minutes of a meeting held in May for one set of residents confirmed that the meal provision at the home was improving. The home is proud of its ‘gold’ Healthy Eating Award from Telford and Wrekin Council, and changes in the catering team have meant further improvements. The recent hot weather has made the availability of a variety of ice creams from the kitchen to be very popular. Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 16 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 &18 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Resident’s well-being is now fully protected through the home’s complaints procedure, which compliments the home’s other systems to protect residents from abuse. EVIDENCE: Very clear, easy to understand complaints information is available in the reception area, and is backed up by a good system for the manager to record, investigate and monitor any complaints. The manager supplied information at the time of the inspection to confirm that there had been four complaints about the ‘home part’ of the service since December 2005.These issues had all been thoroughly investigated and had been very well managed. The home is to be commended on the newly updated processes, which now reflect excellent complaints management systems. As a result of one of the complaints, a multi agency adult protection agency investigation is in progress. The most professional way Accord Housing and key members of the home management team have carried out their responsibilities, in relation to this investigation has been most noteworthy. The home has demonstrated to CSCI that improvements to many of its day to day management systems are robust and working well to make sure resident well being is being promoted. Bennett House DS0000020538.V294004.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,24,25, & 26 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service The ongoing commitment of Accord Housing ensures the standard of the environment continues to be improved and adjusted to provide residents with a clean, comfortable and well maintained home to live in. EVIDENCE: During the past 18 months Bennett House has had considerable refurbishment, which has included major redecoration project as well as the provision of new furniture and carpets. This extensive facelift has made a huge difference. Several noticeable changes since the last inspection include the provision of many new armchairs and more new carpets, which residents agreed had ‘brightened the home up no end’. Following full involvement of the residents in connection with their continence and independence assessments, the home have replaced all of their wooden commodes with new models which are suited to peoples needs as well as Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 18 improving good infection control practice. A new hoist has also been provided to improve moving and handling systems at Bennett House. Many bedrooms were seen during the home tour. It was also very good practice to see written information in the residents’ records to confirm if they were satisfied with their accommodation, and any matters such as one gentleman requesting his wallpaper border to be replaced were reported to be in hand. One bedroom used by a person on a short term stay in the home was observed to have an unpleasant smell due to his continence challenges. This was discussed during the inspection and the manager requested this be investigated immediately. Random checks of hot water outlets confirmed the recently installed thermostats were doing their job and keeping temperatures within safe limits. The new specialist baths have continued to enhance the lifestyle of people living there. Staff and residents all reported that ‘they’re great’. The system the home uses for clinical waste disposal was seen to need improving on Bluebell Unit – as a result of equipment break down; there was not a specific bin available in the sluice to safely dispose of this waste. The manager reported this would be replaced as a priority. Observations in the laundry and an in depth discussion with the laundry assistant confirmed the home has noteworthy practices to make sure infection control procedures are met and people’s personal clothing are looked after properly. The laundry team have a simple but effective system to make sure lost property is kept to a minimum, and works very well to make sure the laundry of at least four different people who move into the home a week for short term care is returned safely to its owner. Bennett House DS0000020538.V294004.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 29 & 30 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service Robust team allocation and recruitment systems makes sure show the home offers protection to the people living there, by being adequately staffed with appropriate personnel. However, the mandatory training needs of the staff team need action to keep the home up to date with current health and safety issues to safely meet peoples needs. EVIDENCE: During the last six months Bennett House have had major challenges with their staff team. At the unannounced inspection in December 2005, 19 care team members, including the majority of the management team were absent due to sickness. This was further challenged due to the number of vacancies in the home care team. This posed to be an enormous challenge to keep satisfactory standards of care maintained. It is obvious that staff morale has been affected by these events; therefore it is commendable to observe the professionalism of the team to ensure this has not been made apparent to the residents. Following the investment of commendable financial and personnel commitment, Accord Housing has ‘weathered the storm’ and continues to improve day to day care delivery. Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 20 It is noteworthy to see that systems, which make sure all necessary jobs get done during such times, were effective. • A system to monitor care delivery was established - senior care team members complete a quality checklist twice daily to ensure residents needs have been met. Duty rotas and staff on duty reflected that although a lot of agency staff still worked at the home, long term contracts were in place between Bennett House and reputable agencies to make sure there was consistency in care provided. An excellent induction checklist completed with agency staff on their first shifts at the home meant they were well supported in their roles. Some agency staff members have also undertaken additional training with Accord to enhance resident care. Additional staff are rostered as ‘ floaters’ to work as extras in the parts of the home that need it. • • • • This has meant the management team have had the time to look for suitable staff to be permanent team members at the home. Inspection of records of two newly appointed individuals show that the qualifications and experience they already have will enhance the standards of care already at the home, and the very thorough recruitment procedures observed since last December, continue. The manager commented that following rigorous recruitment, most positions had been filled with staff of a similar high calibre as those whose records were inspected. In addition, Accord Housing has seconded staff from other schemes to support the core of permanent staff at Bennett House, and one person who has personally demonstrated a lot of commitment and innovation to prove she is an asset to the home was pleased to tell the inspector she was now a permanent staff member at Bennett House. As part of the improvements to monitor the staff team, a training chart was developed so that the manager could see at a glance what training her team have already had and would need to take in order to comply with legislation as well as meeting peoples needs. It is commendable that 70 of the carers at the home are NVQ qualified.However, it was seen that additional necessary training such as fire safety was needed. The manager confirmed this was in hand. Bennett House DS0000020538.V294004.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37, & 39 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service The registered providers have supported the day to day management at the home with a strategy to enhance the safe working systems already in place at Bennett House. EVIDENCE: CSCI recognise the professionalism and effort by Accord Housing during recent months to make sure the well being of the people who live, work and visit the home have been prioritised. Evidence seen shows this work will continue to permanently improve care standards at the home. Accord is actively engaged with the GP’s the home is registered with to address some of these matters. Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 22 It is noteworthy to comment that the registered manager and her deputy are building a professional rapport and are working closely together to support the team whilst all vacancies have been filled and new staff are settled in. Supervision records for staff seen on the inspection day show a lot of work and effort has been invested to make sure people are appropriately supervised both formally and informally. The annual satisfaction survey carried out by Accord was reported to be due to start in the near future, and there was a wealth of activities in the home to show that resident and relative involvement was welcomed and suggestions researched and acted upon, - records of residents and staff meeting were a testament to this. Catering staff spoken to were full of ideas how to improve the way they get comments about the meals there to make sure everyone is happy. In addition, a recent success story in the home, which evolved to improve the lifestyle of the people with dementia related conditions, has been so positive it has now been opened out to the home. The home holds what is known as a ‘monthly clinic’ with residents, relatives Bennett House staff and the local community mental health nurse. Guests such as hospital consultants and organisations such as the Alzheimer’s Society have proved popular, and a ‘Bennett House Best practice group is emerging as a result of this. Examination of routine service records and certificates show the home has good systems to make sure all tests and equipment servicing is carried out appropriately – these were all in order and up to date. Although the home currently has a vacancy for a maintenance man, the systems already in place will enable the new person to step in the shoes of the previous one without any problems. Improvements to the way the home manages its accidents shows the home now has a very reliable system to show all accidents and incidents are fully looked into to make sure they do not happen again. Bennett House DS0000020538.V294004.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 X 3 3 3 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 4 29 4 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 4 4 3 3 Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 24 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 Rag 15 Requirement The care records for residents must show all assessment of risks is included including moving and handling assessments. The home must demonstrate that staff are aware of the current medication procedures document and ensure that staff adhere to it. Following the documents review the staff must be made aware of the changes made. (Previous timescales of 30/06/06) All “as directed” doses must be confirmed in writing by the prescriber and the MAR sheets must be amended accordingly. (Previous timescales of 13/04/06 not met) The prescriber’s’ administration directions must be followed at all times. Where the home feels that the directions are not appropriate, the home must consult with the GP to seek new written directions. (Previous timescales of DS0000020538.V294004.R01.S.doc Timescale for action 10/08/06 2 OP9 13(2) 10/09/06 3 OP9 13(2) 10/09/06 4 OP9 13(2) 10/09/06 Bennett House Version 5.2 Page 25 5 OP9 13(2) 6 OP9 13(2) 7 OP9 13(2) 8 OP9 13(2) 9 OP9 13(2) 05/06/06 not met) Where possible the home must ensure that the residents’ doctor confirms any changes to the residents medication in writing. If this is not possible then the home must have a protocol in place to ensure accurate recording, doublechecking and the safety of the resident. (Previous timescales of 10/06/06 not met) When residents wish to stay away from the home an accurate record must be made of the medication released to them and returned to the home so that compliance to take the medication whilst away from the home can be monitored. (Previous timescales of 05/06/06 not met) The home must review the administration process, taking place, within the home to take into account the views of the staff and eradicate the bad practices witnessed during the inspection. (Previous timescales of 05/06/06 not met) The homes’ MDS system must not be released to residents when they wish to stay away from the home. The home must either make arrangements with the Pharmacy to have the required medication packed into alternative containers or if very little warning is given by the resident, instigate a secondary dispensing procedure. (Previous timescales of 30/06/06) When residents wish to stay away from the home an accurate record must be made DS0000020538.V294004.R01.S.doc 10/09/06 10/09/06 10/09/06 10/09/06 10/09/06 Bennett House Version 5.2 Page 26 10 11 12 OP26 OP26 OP30 13 (3), 16(2)(k), 23 (2) (d) 16(2)(k), 18 (1) of the medication released to them and returned to the home so that compliance to take the medication whilst away from the home can be monitored. (Previous timescales of 05/06/06 not met) Arrangements for the disposal 10/08/06 of clinical waste on Bluebell Unit must to be improved. All parts of the home must be 10/07/06 free from unpleasant odours. All staff must meet necessary 10/09/06 mandatory training as required by Health and safety legislation, including fire, moving & handling etc. 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 OP26 Good Practice Recommendations It is strongly recommended that each unit have an automatic sluicing disinfector available to ensure the safe disposal of bodily waste, to reduce the risk from contamination and to control the spread of infection, and to check that the chemicals used to disinfect equipment are effective at low water temperatures. It is recommended that the MAR charts for each unit be placed into separate A4 ring files. It is also recommended that a photograph of each resident be attached to a cardboard divider placed in front of his or her corresponding Medicine Administration Record (MAR) charts so that each resident can be readily identified. It is recommended that the storage cupboards be reorganised so that each of the resident’s medication is kept separate from other resident’s medication. It is recommended that a Controlled Drugs cabinet is obtained and securely fixed on to a solid wall using rag bolts. 2 OP9 3 OP9 4 OP9 Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 27 5 OP9 It is recommended that appropriate training be undertaken on how to accurately complete the Controlled Drugs register. Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Bennett House DS0000020538.V294004.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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