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Inspection on 10/04/05 for Benslow Nursing Home

Also see our care home review for Benslow Nursing Home for more information

This inspection was carried out on 10th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home was completely refurbished in 2003, and the building is well decorated and comfortably furnished. Although nursing care is provided, the atmosphere is that of a home designed and run for the benefit of the residents. It provides a comfortable and homely environment for the residents. All the residents who took part in the inspection said that they are happy in the home and that the staff provide a good quality of care. All the care staff spoken to were enthusiastic about their work, and one said that Benslow is the best home she has worked in. The staff were observed to have a good relationship with the residents and to treat them with courtesy and respect. The home provides a good quality of food, with a variety of nutritious meals including cooked breakfasts and suppers for those who want them. The menus reflect the likes and dislikes of the residents. All the residents spoken to praised the food.

What has improved since the last inspection?

The acting manager has provided a period of stability for the home. A good training programme is in place, including training in protection of vulnerable adults. The care plans that were introduced before the last inspection are now in place, and provide good information on the residents` needs. Assessments are now carried out for all residents before they are admitted to the home

What the care home could do better:

The acting manager is aware of the main areas for further development. These are to involve the residents in preparing or agreeing their care plans, and to develop an effective programme of activities. Four requirements from the last inspection report have not been met, and have been repeated. Enforcement action may be considered if they are not met within the new timescales set for compliance. Appropriate risk assessments must be put in place for all residents, and kept under review. A programme of activities must be implemented in consultation with the service users. Service users must be enabled and encouraged to make decisions about their care and about their lives in the home. All substances that are hazardous to health must be stored securely at all times. Good procedures for the administration and recording of medication were implemented before the last inspection. It was therefore disappointing to note that there were several concerns about medication on this occasion, with gaps in recording and poor practice in administration observed. The dining room needed cleaning and the cooker in the kitchen was very dirty. It had been thoroughly cleaned by the time a return visit was made to the home two days later, and it was reported that a procedure had now been put in place for a thorough clean to be carried out every week. Requirements were also made concerning inappropriate notices in the residents` rooms and good practice for the use of bed rails

CARE HOMES FOR OLDER PEOPLE Benslow Rise Hitchin Hertfordshire SG4 9QY Lead Inspector Claire Farrier Unannounced 10 & 13 April 2005 8:15 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 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. Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Benslow Nursing Home Address Benslow RiseHitchinHertfordshireSG4 9QY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01462 459773 01462 438678 Benslow Management Company Limited Care Home with Nursing 33 Category(ies) of OP Old Age 33 registration, with number of places Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Registered numbers shall remain at 33 subject to the continued occupancy by a married couple. When one permanently leaves, for any reason, numbers will reduce to 32. Date of last inspection 16 December 2004 Brief Description of the Service: Benslow Nursing Home is a care home providing personal care and nursing care and accommodation for 33 older people. It is owned by Benslow Management Company Limited, which is a private company. It was first registered under the Registered Homes Act (1984) in January 1996. The home is situated in a quiet residential neighbourhood just over a mile from the centre of Hitchin. It consists of a three storey building and the interior is decorated to a high standard. All the home’s bedrooms have en-suite facilities. There are three double rooms, one of which is below the standard size. It is occupied by choice by a married couple, and it is a condition of registration that the room should revert to single occupancy if either of the couple permanently leaves the home for any reason. There is a passenger lift. The home has a garden at the side, accessed through the front door, with lawn and shrubs, a patio and sheltered sitting places. Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of the inspection year and took place over one Sunday, with a return visit two days later. Two inspectors visited the home, and the majority of time was spent observing and talking to residents and staff. Some time was also spent looking at records and care plans, and the results of the inspection were discussed with the acting manager. The inspectors spoke to eighteen residents and ten members of staff during the inspection, and several relatives and visitors gave their comments during the inspection and contacted the inspector following the inspection. This was generally a positive inspection, and the majority of the standards were met or partially met. The home is continuing to make improvements, but requirements were repeated from the previous inspection report on risk assessments, activities, the involvement of residents and storage of hazardous substances. Enforcement action may be considered if these requirements are not met within the new timescales provided What the service does well: The home was completely refurbished in 2003, and the building is well decorated and comfortably furnished. Although nursing care is provided, the atmosphere is that of a home designed and run for the benefit of the residents. It provides a comfortable and homely environment for the residents. All the residents who took part in the inspection said that they are happy in the home and that the staff provide a good quality of care. All the care staff spoken to were enthusiastic about their work, and one said that Benslow is the best home she has worked in. The staff were observed to have a good relationship with the residents and to treat them with courtesy and respect. The home provides a good quality of food, with a variety of nutritious meals including cooked breakfasts and suppers for those who want them. The menus reflect the likes and dislikes of the residents. All the residents spoken to praised the food. Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: The acting manager is aware of the main areas for further development. These are to involve the residents in preparing or agreeing their care plans, and to develop an effective programme of activities. Four requirements from the last inspection report have not been met, and have been repeated. Enforcement action may be considered if they are not met within the new timescales set for compliance. Appropriate risk assessments must be put in place for all residents, and kept under review. A programme of activities must be implemented in consultation with the service users. Service users must be enabled and encouraged to make decisions about their care and about their lives in the home. All substances that are hazardous to health must be stored securely at all times. Good procedures for the administration and recording of medication were implemented before the last inspection. It was therefore disappointing to note that there were several concerns about medication on this occasion, with gaps in recording and poor practice in administration observed. The dining room needed cleaning and the cooker in the kitchen was very dirty. It had been thoroughly cleaned by the time a return visit was made to the home two days later, and it was reported that a procedure had now been put in place for a thorough clean to be carried out every week. Requirements were also made concerning inappropriate notices in the residents’ rooms and good practice for the use of bed rails Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 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. Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 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 standard(s) 3 and 4 A comprehensive assessment of the needs of the residents was seen to be in place. Adequate and appropriate risk assessments are needed to ensure that the residents live in a safe environment. The home had sufficient information on residents’ needs and access to appropriate services to enable the needs to be met EVIDENCE: Each resident has an assessment file that contains a personal profile and an assessment carried out before they are admitted to the home. The assessments seen include physical and mental health, behaviour, falls, pressure sores and nutrition. There are details of the person’s needs under each heading and a numerical score to provide a measure of their dependence. The personal profiles give a picture of the person’s family history and interests, but those seen were not in the words of the resident, and showed little evidence of the input of the resident or their family (see Standard 7). Some appropriate risk assessments were in place, but one resident had no risk assessment for the use of bed rails on her bed, and another had a bed assessment for being “bedridden” which was no longer applicable but this had not been reviewed. Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 10 The home employs sufficient nurses to meet the resident’s nursing needs, and the care staff have appropriate training. Some of the residents spoken to felt that there were not sufficient staff (see Standard 27), but they all said that the care they receive is good, and that the staff are polite and pleasant Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10 The individual needs of residents are clearly set out in care plans to ensure that all their needs are identified and can be met. Several errors were seen in the administartion and recording of medication, which could cause a risk to the health of the residents. Residents said that staff treat them with respect, but this is compromised by the display of some inappropriate notices in their rooms. EVIDENCE: Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 12 The care plans of four residents were inspected. They contain clear and easily accessible information on the resident’s health and personal care needs, with comprehensive procedures for meeting the needs. Appropriate goals are identified for each person. However there is no indication that the resident has been involved in drawing up the care plan and personal profile (see Standard 3), and setting their own goals. Several of the residents spoken to said that the staff never ask their opinions (see Standard 14). None of the care plans seen were signed by the resident or their representative. All the residents said that the staff treat them with respect and provide a good quality of care. One person said that they are extremely polite and efficient, and another said that they are all nice, helpful and pleasant. Notices were seen on the en-suite bathroom doors in some of the resident’s rooms, stating what size incontinence pad they require. This practice provides an inappropriate display of personal information and does not respect service users privacy and dignity. The home employs sufficient qualified nurses to meet the needs of the residents who need nursing care. All the residents are monitored for the possibility of pressure sores. The wound care for one resident was fully recorded in her care plan, including pictures of the pressure area. The home has a good relationship with the GP, and evidence was seen that residents are referred for mental health assessments when required. The home is not registered for dementia care, but it is inevitable that some residents will develop a measure of dementia. Appropriate referrals have been made when this has occurred, and one resident was recently admitted to hospital for a mental health assessment. Several areas of poor practice were observed in the administration of medication: 1. A nurse was observed putting medication into the mouth of one resident, then going to the next resident and putting medication into their mouth without either washing her hands or using gloves. 2. There were gaps in recording on several MAR (medicines administration record) charts. A check of the medication showed that in most cases the medication had probably been administered but not recorded. For one resident there were 40 epilim in a packet, but if they had been administered properly there should have been 36 remaining. This indicates that on four occasions the medication was not administered. 3. Several bottles of medication were not dated when they were opened. A tube of rectal diazepam was left on top of a medication trolley in the unlocked medication cupboard, easily accessible, and not labelled with the name of the person for whom it was prescribed Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 13 Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 and 15 Social activities and the involvement of service users in decision making were again assessed to be an areas for development. Residents said that staff provide a good quality of care, but their quality of life would be enhanced by prioritising a regular programme of social activities, and by enabling them to feel involved in decisions about their care and their lives in the home. Residents benefit from and enjoy the whiolesome and varied meals provided in the home. EVIDENCE: Relatives can visit the residents at any time, and several visitors were seen in the home during the inspection. All the residents spoken to said that the food provided is very good. Most residents have breakfast served in their room. Lunch was observed during the inspection. It was roast chicken, with no alternative as it was reported, and observed, that all the residents enjoy roast chicken. No residents need a soft diet, but meat is minced or cut into small pieces for some residents at their request. The chef talks to the residents regularly and changes the menus to meet their wishes. The minutes of a residents’ meeting in January 2005 Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 15 showed that there was a discussion about food and drink, and as a result there is a choice of a cooked breakfast twice a week, and cooked suppers, such as cauliflower cheese or fishcakes, are now provided. Little evidence was seen of a programme of activities in the home. Some residents said that bingo takes place on some afternoons “when staff can spare the time”, one mentioned a general knowledge quiz and one mentioned an exercise group. However there is no plan of activities, and those that do take place seem to be sporadic and dependent on staff having spare time. One resident would like access to library books, and one would like outings into the community. Currently residents only go out if their relatives take them. There is a daily activities record in each resident’s care plan, but the only activities seen recorded were “sitting in the front lounge, have a chat with other residents” and “stayed in bed, watch TV”. There was no evidence of any improvement in the involvement of residents in decisions about their care (see Standard 7), or in decisions about their lives in the home, for example in the provision of activities (see Standard 12). Most of the residents spoken to during the inspection said that they were not consulted about their lives in the home. Residents meetings take place, but residents do not feel involved in decisions about their personal needs and wishes. Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 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 standard(s) 16 and 18 Policies and procedures are in place to safeguard the residents from abuse. Residents and relatives are confident that any complaints will be properly investigated EVIDENCE: Several of the residents spoken to were not aware of the complaints policy, but they felt confident about making a complaint to the staff or the manager if they were unhappy. The complaints record showed that several residents and family members have made complaints, and that the home has investigated and dealt with them appropriately. One complaint was referred to CSCI by a relative, but it was found that the home had dealt with it appropriately. However the complaints procedure states that complaints should only be referred to CSCI when all internal procedures have been exhausted. It should state that complaints can be referred to CSCI at any stage of the proceedings. The home has comprehensive procedures for prevention of abuse, and the staff spoken to were aware of their responsibilities for whistle blowing. Some members of staff were not aware of the procedures for prevention of abuse, but they felt confident about reporting any concerns to the manager. An investigation has recently taken place that resulted in disciplinary action against a member of staff. Training in prevention of abuse has been arranged, and was due to take place shortly after this inspection. Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 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 standard(s) 19 and 26 The home and gardens are well maintained and provide a comfortable and attractive environment for the residents. The home is generally clean, but the dining room must be cleaned properly after meals and the kitchen must be cleaned regularly and effectively for the maintenance of food hygiene (see Standard 38). EVIDENCE: Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 18 Benslow Nursing Home is a three storey building, The building is owned by a property company, Acrame Properties Ltd, which is responsible for the upkeep of the fabric of the home and the garden. The home is well maintained both inside and out. It has a garden at the side, accessed through the front door, with lawn and shrubs, a patio and sheltered sitting places. The home is situated in a quiet residential neighbourhood just over a mile from the centre of Hitchin. The home was generally clean, but some areas of cleaning could be improved. The inspection began at 8.15 on a Sunday morning, before any residents were in the dining room. The carpet in the dining room needed vacuuming, and some stains were visible. Several of the tables and chairs in the dining room were dirty, with crumbs on some of the tables and dried food residue on some chairs. In the toilet near the dining room the floor and surfaces needed cleaning. The cooker and hot food trolley in the kitchen were both very dirty, with burned on food and grease (see Standard 38). The kitchen had been cleaned by the time of the return visit to the home two days later. Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Staff numbers in the home are generally adequate to ensure that all the residents’ needs are met, and staff receive appropriate training. Good recruitment procedures and staff training make sure that, as far as possible, service users are supported and protected in the home. EVIDENCE: The home’s regular levels of staff are eight for the early part of the day, six for the later part of the day and three during the night, including two registered nurses on each shift. The staffing rotas showed that on some occasions there was only one registered nurse in the home, but the total number of staff was maintained. On the day of the inspection the only nurse was an agency nurse, and the manager came to the home without delay to ensure that the agency nurse was not left in charge of the home. Many of the residents who were spoken to felt that there are not sufficient staff in the home. A complaint about staffing levels was also made to CSCI by a relative. When this was discussed further, most people agreed that there are generally sufficient numbers of staff in the home, but the use of agency staff means that they lack confidence that all the staff know and can meet their needs. Recruitment of permanent staff is an ongoing process. The home has robust policies and procedures for recruitment. One staff file was seen for a recently Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 20 recruited member of staff. It contained all the required information, including good references and a satisfactory CRB (Criminal Record Bureau) disclosure. All the members of the care staff and domestic staff spoken to during the inspection were enthusiastic about their work in the home. One domestic said that although it is hard work, she enjoys working in the home, especially talking to the residents while she cleans their rooms. One member of the care staff who had worked in other homes said that there is a good staff team and a good atmosphere. There was some concern amongst the nursing staff about their role within the home, and they were advised to discuss this further with the acting manager. The company provides a comprehensive training programme that covers all the statutory training and other training as required for the specific needs of the service users. The staff confirmed that they have appropriate training. Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Adequate records are maintained for the effective management of the home and monitoring of heath and safety procedures. The practices in some areas must be tightened up to ensure that there is no risk to the health and safety of the residents EVIDENCE: The home has policies and procedures in place to ensure that the health, safety and welfare of service users and staff are promoted and protected, and appropriate records are maintained. Three health and safety concerns were noticed during the inspection:1. The kitchen was generally clean. The floor and working surfaces were clean and the food store appeared to be satisfactory. However there was a large amount of burnt on food on the hob and in the oven and in the hot food trolley, and the cooker hood was very greasy. A requirement was made that the cooker and hot trolley must be cleaned without Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 22 delay. A return visit was made to the home two days later, and the cooker and hot trolley were seen to be clean. It was reported that a procedure had now been put in place for a thorough clean to be carried out every week. 2. The cleaning cupboard on the top floor was observed to be unlocked, providing easy access to hazardous items. All the beds in the home have bed rails that can be used if needed for the safety of the resident. Several bed rails were seen to be in use, but without the use of the covers that are required to prevent the risk of injury. Appropriate risk assessments were not in place for all residents for whom bed rails were in place (see Standard 3). Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 x x x x x x x 2 Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 24 YES Are there any outstanding requirements from the last inspection? 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 3 Regulation 13(4)(c) Requirement One resident did not have a risk assessment for the use of bed rails, and a risk assessment that was no longer current had not been reviewed. Appropriate risk assessments must be put in place for all residents, and kept under review. Previous timescale of 31/03/05 not met. Enforcement action may be considered if this requirement is not met within the new timescale. Poor practice was observed in the administration of medication. Effective measures must be put into place to ensure that all medication is stored, administered and recorded according to the home’s procedures. In particular:1. Effective hygiene procedures must be followed when handling medication.2. All medications must be administered as prescribed and recorded when administered. Any reasons for not administering the medication must be recorded.3. The date that each container of Timescale for action 31 August 2005 2. 9 13(2) 10 April 2005 Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 25 3. 10 12(4)(a) 4. 12 16(2)(m) &(n) 5. 14 12(2)&(3) 6. 19 & 38 13(3)&(4) (c)16(2)(j ) medication is opened must be clearly recorded.4. All medication must be stored securely at all times. Notices were seen on the ensuite bathroom doors in some of the resident’s rooms, stating what size incontinence pad they require.Personal information should not on open display in residents’ rooms. There was no evidence of any activities within the home. A programme of activities must be implemented in consultation with the service users.Previous timescale of 31/03/05 not met. Enforcement action may be considered if this requirement is not met within the new timescale. There was no evidence of the involvement of service users in decisions about their care, or in decisions about their lives in the home.Service users must be enabled and encouraged to make decisions about their care and about their lives in the home.Previous timescale of 31/03/05 not met. Enforcement action may be considered if this requirement is not met within the new timescale. The cooker and hot food trolley in the kitchen were very dirty, with burned on food residue and grease. The kitchen was fully cleaned within forty-eight hours of the inspection. Evidence of food residue from the previous day was seen in the dining room.The registered person must ensure that appropriate procedures are implemented for the maintenance of food hygiene. 31 August 2005 31 August 2005 31 August 2005 10 April 2005 Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 26 7. 38 13(4)(a) 8. 38 13(4)(c ) The cleaning cupboard on the top floor was observed to be unlocked, providing easy access to hazardous items.All substances that are hazardous to health must be stored securely at all times.Previous timescale of 31/03/05 not met. Enforcement action may be considered if this requirement is not met within the new timescale. The bed rails on several beds were in use, but appropriate covers for the rails were not in place.Appropriate procedures for the use of bed rails must be followed at all times. 31 August 2005 31 August 2005 9. 10. 11. 12. 13. 14. 15. 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 7 Good Practice Recommendations Residents should be involved in drawing up their care plans, and the care plans should be signed by the service user or their representative. Repeated from the previous inspection report The complaints procedure should be amended to state that complaints may be referred to CSCI at any stage of the proceedings. Repeated from the previous inspection report 2. 3. 4. 5. 6. 7. 16 Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 27 Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 28 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City HertsAL7 3BQ 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 Benslow Rise v220655 i52 s19288 benslow v220655 100405 stage 4.doc Version 1.40 Page 29 - 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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