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Inspection on 01/10/08 for Benton House Nursing Home

Also see our care home review for Benton House Nursing Home for more information

This inspection was carried out on 1st October 2008.

CSCI found this care home to be providing an Adequate 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.

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

Benton Court was clean and fresh smelling. Staff were knowledgeable about people`s individual needs and personalities. We observed good interaction between the staff and people living at the home. Staff took each opportunity to maintain people`s independence and enable them to exercise choice. People were helped to make use of local amenities. The manager encourages staff to train and extend their knowledge and skills.

What has improved since the last inspection?

People whose rooms had been redecorated and refurbished were happy with the outcome; they were pleased to have been offered a choice of colour scheme. People said they were happy with areas of the home that had been redecorated and refurbished.

What the care home could do better:

Ensure that the ordering storage and administration of medicines is in accordance with pharmacy guidance and good practice. Continue to update and refurbish people`s bedrooms and communal areas. Review and update the laundry and sluice provision to prevent risk of cross infection. Staff needs extra training so that they know about the Mental Capacity Act 2007 this would make sure that they are able to fully protect vulnerable people.

CARE HOMES FOR OLDER PEOPLE Benton House Nursing Home Gattison Lane Rossington Doncaster South Yorkshire DN11 0NQ Lead Inspector Ian Hall Key Unannounced Inspection 1st October 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 Benton House Nursing Home DS0000015851.V372922.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. Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Benton House Nursing Home Address Gattison Lane Rossington Doncaster South Yorkshire DN11 0NQ 01302 864979 01302 863435 None 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) Union Healthcare (North) Limited Manager post vacant Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (36) Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of three persons between the age of 60 years and 65 years may be accommodated to receive Nursing Care or Residential Care, be accommodated in the categories DE(E) and MD(E) within the total of 36 registered beds. One specific service user under the age of 60, named on variation dated 20th November 2006, may reside at the home 6th February 2008 2. Date of last inspection Brief Description of the Service: Benton House Care Home is situated in the village of Rossington near Doncaster. It is within reach of local shops, a post office, church and other local amenities. The home is registered to provide both nursing and personal care for up to 36 service users in the category of older people with dementia and mental disorder. Benton House a detached house which has been extended. It provides accommodation on two floors. There is a passenger lift to provide access between floors. The communal areas are located on the ground floor and comprise two lounges, a smoker’s room and a dining room. The kitchen and laundry facilities and office are also found on the ground floor. There is a garden at the rear of the building with limited parking available at the front of the building. Information about the home and services available is detailed within the home’s Statement of Purpose and Service User Guide. The last published inspection report is available on request and a copy is available for visitors to read. Information gained on the 1st October 2008 indicated the current fees range from £477.05 to £577.05. Additional charges are made for hairdressing and chiropody). These fee charges only applied at the time of inspection, more up to date information may be obtained from the home. Benton House Nursing Home DS0000015851.V372922.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 1 star. This means that the people who use this service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The unannounced site visit undertaken as part of the inspection started at 08:15 and concluded at 15:15 on the 1st October 2008. The inspection was conducted by the link inspector Mr I Hall and the CSCI pharmacy inspector Mr S Baker. The site visit included a tour of the building, reading records, discussions with staff and people who use the service and observation of the meals provided. We also met with the manager and other members of staff. In addition the inspection took account of information received about the service since the last key inspection on 6th February 2008. This included records of telephone conversations with staff, events notified to CSCI and records of management visits to the home. Prior to the site visit the home carried out a self-assessment of the service. This is called the annual quality assurance assessment (AQAA). People spoken with were happy to assist with the inspection. Comments were positive when describing the care and motivation of the staff, these included: “I like it at this home, I feel safe,” “they are good to me”, and “its lovely here the staff are smashing”. At the end of the site visit verbal feedback was given to the manager. What the service does well: Benton Court was clean and fresh smelling. Staff were knowledgeable about people’s individual needs and personalities. Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 6 We observed good interaction between the staff and people living at the home. Staff took each opportunity to maintain people’s independence and enable them to exercise choice. People were helped to make use of local amenities. The manager encourages staff to train and extend their knowledge and skills. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. The service provides people with detailed information to enable them to choose whether the home is the one for them. Detailed assessments ensure that people’s needs could be met prior to offering them a place. EVIDENCE: An information pack is available that provides details of the standard of care and services available at Benton House. This includes useful information about staff, their qualifications, visiting the home, choosing meals, the laundry service and how to raise concerns. We checked three case files. Each contained a detailed needs assessment; this included such things as daily living, personal care, health care, social interests and areas of risk when appropriate. Whenever the need for specialist caring Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 9 equipment had been identified this had been obtained prior to the person moving into the home. The assessment formed the basis for the initial care plan. People said they had been able to discuss their wishes and the type of help they needed before they made the decision to live at Benton House. Whenever possible people had been encouraged to visit and spend time at the home so they could meet members of staff and other people living at the home. This was confirmed by written entries in the case files. Copies of contracts, social work referrals and assessments were available and kept in the case file. Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. People who use the service experience adequate quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. Clear information is provided to guide staff meeting people’s needs. Staff ensure that people are able to access health services as they need them. Staff attitude and approach to care is based on respect for the person, this helps to safeguard and promote people’s rights and dignity. Staff work to the home’s policies for the administration of medication, this promotes the wellbeing of people who live at the home. EVIDENCE: Three people’s care records were examined. People’s care needs had been assessed. A range of recognised assessment documents had been used to measure people’s needs. These included mobility, mental ability, state of nutrition, and areas of risk such as falls. These provided a baseline for staff to measure people’s progress or increasing level of need. This enables staff to Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 11 plan the help and support people need. There were care plans to tell staff how to meet these needs. These had been reviewed regularly. Most people we spoke to knew about their care plan. Relatives said they were kept informed and involved whenever possible. Care plans detailed people’s religious and cultural needs and the gender of staff that they wanted to support them with their personal care. Pen portraits of the person, their lives and interests provide staff with background information to improve the care and service provided. Daily entries were made of care provided. This enables staff to review people’s health and wellbeing and change plans of care as necessary. There were records of visits by the GP, community nurse, occupational therapist, dentist, opticians and chiropodist. All people were registered with a family doctor; there were good relationships with the doctors and the district nurses. There were wheelchairs, aids and equipment provided to meet people’s moving and handling needs. We saw that not all bathing and toilet areas had been provided with aids and adaptations so people can use them independently and safely. We examined the homes medication policy, medication administration record (MAR charts) and the storage & handling arrangements for medicines. We also observed medicines being given to people after breakfast. The medication policy does not provide enough information for staff on current legislation and guidance to make sure that best practices are followed. New locally relevant medication procedures would enable all staff to understand exactly what is expected of them when handling and administering medication. There were very few gaps on the MAR charts. This means there is a record kept of people receiving their medication as prescribed. The quantity of medication from one monthly cycle to another is not recorded on the new MAR chart. This means it is difficult to have a complete record of medication within the home and to check if medication is being administered correctly. There is inconsistency in handwritten entries on MAR charts and in describing changes made to medication. All prescribing details on the pharmacy label, the quantity supplied, the date of entry, the signature of the person making the entry and a witness signature where possible should be included. Similar requirements are needed for a change of dose or cancelled medicines. Details of the person authorising the change should also be included. This makes sure that there is an accurate record of any changes or new medicines. Insufficient information is available in the home to ensure that all medicines prescribed to be given when required are always given consistently according to the prescribers directions. There is no means of checking the temperature of the medication storeroom. This means that staff do not know whether medicines are being kept at the correct temperatures recommended by the manufacturer. We found a box of Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 12 adrenaline injection available for use, which was out of date in July 2008. Bottles of liquid medicines and containers of skin medicines, which have limited use once opened, were not marked with the dates they were first opened. Medicines must not be used beyond their recommended shelf life in case they do not produce the intended effect. Medication administration processes in the home do not completely follow recommended guidance. Pots were used to hand medication to the person and water was offered to help with the taking of medicines. Time was spent with each person and encouragement given to help them take their medication. However, the MAR charts and the persons photograph were not used to help ensure each medicine is always given to the correct person. This process should be changed to reduce the risk of a medication error-taking place. People living at the home said that “staff were caring and helpful” and that “nothing was too much trouble”. People said that the staff promoted their privacy and dignity. We saw staff knocking upon bedroom doors and waiting to be invited to enter. We observed interactions between staff and people living at the home. These were warm relationships with each person showing respect for the other. Benton House Nursing Home DS0000015851.V372922.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): 12,13,14,15. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. Suitable activities were provided at the home to keep people stimulated. Visits from relatives and friends were encouraged so people kept in touch with people who were important to them. There was a good catering service, which met people’s nutritional needs and food preference. People who live at the home were encouraged to eat a healthy and varied diet. EVIDENCE: Three care files and care plans were checked. These show that people were involved in a range of social activities. People were reading, listening to music and watching television. No one currently leaves the home unless accompanied by members of their family or staff. Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 14 Dedicated staff were employed to organise activities that stimulate people and encourage social interaction. Entertainers visit the home for people’s enjoyment. People said that they were able to go to bed and rise as they chose. A multi denominational service is held regularly for people who wish to follow their religious faith. People’s comments included “ the food is good here”, “dads needs are well catered for”, “as a visitor I’m always asked if I’d like a drink which is nice and welcoming, mum says the meals are very nice and I think that’s all that matters”. We saw the cook preparing and baking cakes and buns. She said these were freshly made each day. People said they enjoyed them with their cups of tea and there was always plenty to eat. A list of birthdays had been provided for the cook who said she prepared teas for people’s birthdays. The meals provided were appealing and smelled appetising. People said they enjoy their meals. They can choose other meals if they don’t like the meal provided. People were seen and heard to make choices at dinnertime. Staff were seen to help and encourage people with their drinks and meals. Mealtimes were unhurried with extra portions provided as required. People’s personal likes and dislikes were documented and known by staff. Special diets were available as needed. Staff said they sought the dietician’s advice when necessary. Drinks and snacks were available through both day and nighttime. Adapted cutlery was available to help people to maintain their independence. Benton House Nursing Home DS0000015851.V372922.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): 16,18. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. The complaints procedure enables people to raise any concerns. Concerns and complaints received were dealt with promptly and changes made to improve the quality of people’s lives. Staff had been trained in the recognition and reporting of abuse and relevant checks were made prior to them starting work, this reduced the risk of harm to vulnerable people. EVIDENCE: Visiting relatives and some people living at the home were able to describe how they would raise concerns with staff. They said that any matters they raise however trivial were dealt with promptly by staff and they were satisfied with the outcome. The complaints procedure was available for people living at the home, their relatives and staff. Their comments included: “my mums here for a year now and I’ve never had any complaints”, “the one minor complaint I had was dealt with very well”. Doncaster Metropolitan Borough Council (DMBC) Adult Protection Team had been consulted following a situation that arose at Benton House. The home’s Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 16 manager was found to have dealt with the issue promptly and in accordance with Adult Safeguarding protocols to protect people involved. Two people had brought their concerns to the manager’s attention, three elements of their concerns that were investigated were be founded, and actions had been taken to deal with the deficits. They had been investigated, recorded within the home’s policy and procedure. People who had no advocate or next of kin have been provided with access to advocacy services provided by Age Concern. Staff had been provided with training in adult protection procedures to ensure people were safe, and to inform staff what to do if an allegation was made. The inspector’s discussions with staff confirmed that they felt confident and able to respond to concerns or complaints effectively. Benton House Nursing Home DS0000015851.V372922.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): 19,26. People who use the service experience adequate quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. The home was clean, tidy and generally well maintained ensuring that people live in pleasant and safe surroundings. The bedrooms were clean and reflected personal choice. Redecoration and refurbishment of the home has improved the environment. EVIDENCE: We saw that the home clean and smelt fresh. Soft furnishings, pictures and ornaments were used to provide a homely domestic setting. Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 18 Many bedrooms had been provided with matching curtains, bedding and soft furnishings. A range of colours had been used to individualise and improve the appearance of the bedrooms. A number of families had assisted with personalisation of bedrooms with favourite items and memorabilia. Bedrooms were lockable with keys available for those who wished to exercise the choice to lock their own door. Work in progress at the time of inspection included redecoration and refurbishment of lounge and bedroom areas. New carpeting and furniture had been provided in some bedrooms. Additional carpets and items of furniture were identified that needed early replacement and updating. Bedrooms visited had been personalised reflecting the interests and personality of the person who lives there. Many people had brought treasured possessions and memorabilia from their own homes. Visitors’ comments included: “it’s clean and homely,” “I’m very happy with the cleanliness”. There is level access throughout the home with handrails provided to assist people to maintain their independence and mobility. Refurbishment of some toilet and bathroom areas continues, a new shower wet room is planned. Some toilets need safety aids and grab rails. These are needed to enable people with physical disabilities to maintain their independence. Some commodes were worn and in need of replacement. There was an adequate number of baths, with an assisted bath within each area of the home. Not all extractor fans were working. People living at the home did not have designated indoor smoking area. Appropriate seating has been provided in the enclosed garden area for people wishing to sit outside whenever the weather permitted. The sluice and clean linen storage is in a shared area separated only by a partition wall. This presents a health and safety cross infection risk. The laundry area requires review to separate clean and dirty service areas and reduce risk of cross infection. Staff confirmed that they were provided with protective clothing if they needed it and that equipment was in working order, being serviced as required. Low surface temperature radiators had been provided to reduce risk to people of being burnt. Benton House Nursing Home DS0000015851.V372922.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): 27,28,29,30. People who use the service experience good quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. Staffing levels were maintained to meet people’s care and social needs. Staff had received training to meet general and specific needs. Appropriate support and guidance was provided to new staff, enabling them to safely care for people who lived at the home. Staff files included the required information. The home operated a recruitment policy that promoted people’s protection. EVIDENCE: We met with seven members of staff including the manager during the course of this inspection. We saw staff working with people and noted that there was an atmosphere of mutual respect; their conversations were relaxed and friendly. The staff group were well motivated and enthusiastic about their work. They confirmed that they were supported by the manager and encouraged to train and update their skills. A new member of staff we interviewed was able to provide evidence both written and verbal of their induction training and developing knowledge of the care needs of people at Benton House. They confirmed that they had to Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 20 provide two satisfactory written references and a Criminal Records Bureau check before commencing employment. Personnel files sampled confirmed that the home follows the company staff recruitment procedures. Records of staff supervision and their training needs were examined. We saw the staff training and development plan. Training courses completed and planned were seen. These included health and safety, moving and handling, first aid and dementia care training. Many staff had achieved National Vocational Qualifications; the remaining staff were working to achieve the award. Skills for prevention of infection and fire and health and safety were updated each year. This ensures that staff were trained to meet people’s care needs safely Benton House Nursing Home DS0000015851.V372922.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): 31,33,35,38. People who use the service experience adequate quality outcomes in this area. This judgment has been made using available evidence, including a visit to this service. Staff said the manager was supportive and approachable and there was a system of professional supervision. People were involved in making decisions about their care and had control over most issues that affected their lives. Systems were in place to protect people’s financial interests. Checks had been made on the major systems in the home such as fire and gas installations to ensure the home was safe for people. Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 22 EVIDENCE: We saw that there was always a senior member of staff on duty at the home with advice and support readily available. Responsibilities for the day-to- day operation of Benton House were shared between senior members of the team. People said: “I feel the home is very well run, they organise events for residents but these aren’t always well attended by families”, “they have changed my dad’s life, he’s improved since he came here”. Staff said the manager was approachable, very professional and they felt confident in her. The manager had a job description that clearly defines her roles and responsibilities and staff were aware of her role. Staff had received management supervision at regular intervals; this is needed to develop staff and monitor care practices. A senior company manager visits the home to monitor care and standards at the home. A written report of their findings was available at the home. Management use a quality assurance system to measure standards of care and service provided. Questionnaires were used annually to seek the views of people and relatives. Regular meetings are held for staff and people who live at the home. These give people living at the home a voice and chance to say how the home should be run. People felt that their views and opinions were taken into account by the staff. The manager handles money on behalf of some people, account sheets were kept with receipts kept. A second person witnessed each transaction. Policies and procedures met the required standards. Records were mainly up to date and well ordered to ensure the best interest of people. No fire exits were obstructed and hazardous substances were securely stored. Statutory servicing and checks of equipment were complete. Risk assessments had been completed identified areas required review to maintain a safe environment. Service records for the moving and handling equipment, fire safety records and other maintenance records were up to date. The sluice and clean linen storage is in a shared area separated only by a partition wall. This presents a health and safety cross infection risk. The laundry area requires review to separate clean and dirty service areas and reduce risk of cross infection Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 23 The manager had received training in the Mental Capacity Act. This training has not been provided for the staff; it ensures they are aware of the changes needed to fully protect vulnerable people at the home. Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 24 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 3 x 3 X X 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 3 17 X 18 3 2 X X 2 X X x 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 25 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 A system must be in place to check expiry dates of medicines and medication with limited use once opened. This makes sure medication is safe to use at the time it is needed. New carpeting and furniture had been provided in some bedrooms. Additional carpets and items of furniture were identified that needed early replacement and updating. Some toilets need safety aids and grab rails. These are needed to enable people with physical disabilities to maintain their independence. The sluice and clean linen storage is in a shared area separated only by a partition wall. This presents a health and safety cross infection risk. The laundry area requires review to separate clean and dirty service areas and reduce risk of cross infection. Timescale for action 30/11/08 2 OP19 23(2) 30/09/09 3 OP22 23(2) 31/12/08 4 OP38 23(2) 01/02/09 Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 26 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 OP9 Good Practice Recommendations The management team should produce a set of local medication procedures for all staff to use in support of the existing policy. These new local procedures should also be reflect with current professional best practice guidance. A system should be in place to record all medication received in to the home and medication carried over from the previous month. This helps to confirm that medication is being given as prescribed and when checking stock levels. Handwritten entries and changes to MAR charts should be accurately recorded and detailed. This makes sure that the correct information is recorded so a person receives their medication as prescribed. The prescriber or community pharmacist should be asked to provide further information about medication prescribed ‘when required’. This makes sure that the medication is given correctly. The temperature of the medication storage room should be regularly monitored. This makes sure that medicines are being stored at the temperature recommended by the manufacturers. The risk of medication errors should be reduced by using a recent photograph and the current MAR chart to identify people at the time their medicines are being given to them. A manager who is ‘fit to’ be registered should submit an application for registration with the CSCI. 2 OP9 3 OP9 4 OP9 5 OP9 6 OP9 7 OP31 Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Benton House Nursing Home DS0000015851.V372922.R01.S.doc Version 5.2 Page 28 - 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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