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Inspection on 06/02/08 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 6th February 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

Assessments and care plans were well written and gave staff clear instruction about how to meet people`s needs. Visitors said, "staff was very good, kind and skilled. They helped to settle their parent into the home and supported the relative through a difficult period". Staff interviewed was clear about their roles and responsibilities and they feel supported by the manager. Staff said training was very good and they wanted to do a good job. Staff had shown a commitment to their own learning and should be commended for their efforts to obtaining NVQ qualifications. Activities were well organised to meet the needs of people who use the service. Mealtimes were managed to ensure people received the support and assistance to eat a healthy well balanced diet. People said they enjoyed the meals, especially the main meal of the day.

What has improved since the last inspection?

The registered providers have made significant improvement to the environment as required at the last inspection. Carpets have been replaced bedrooms and communal areas have been decorated and soft furnishings have been renewed so the bedrooms are more comfortable for people to spend their time.

What the care home could do better:

Medication procedures could be better to ensure people receive their medication as prescribed. Some gaps in the MAR (medication administration records) and changes to the medication prescribed and not administered means that the procedure is unsafe. Signage and colour schemes around the home could be improved to enable people with limited capacity to orientate easily around the home. Nameplates on people`s bedroom doors could be improved, as they would be difficult to read by people who were visually impaired. Recruitment and selection procedures could be improved to make them robust. Some staff had been employed without all the required employment checks, which mean people, were not protected. Staffing levels (nursing) were not sufficient to meet the needs of people who use the service. The manager works on the rota, which means she may not have sufficient time to undertake her management responsibilities. The manager should apply to be the registered manager by submitting an application to CSCI without further delay. The organisation must act in the best interests of people who use the service by ensuring their personal money is not held in the homes pooled bank account. The manager must send notification of any significant events affecting people who use the service, to the CSCI office (Commission for Social Care Inspection).

CARE HOMES FOR OLDER PEOPLE Benton House Nursing Home Gattison Lane Rossington Doncaster South Yorkshire DN11 0NQ Lead Inspector Val Hoyle Unannounced Inspection 09:45 6 February 2008 th 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.V356155.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.V356155.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 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.V356155.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 12th March 2007 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 homes 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 6th February 2008 indicated the current fees range from £417.05 for personal care to £477.05 ( nursing care top ups) for nursing care. Additional charges are made for hairdressing (£6 - £20) and chiropody (£7). 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.V356155.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. This key unannounced inspection took place over 7.5 hours starting at 9:45 to 17:15, this included a partial inspection of the home. Three people who use the service, two relatives and five staff were spoken to during the visit; their views are included throughout the report. Occupancy at the home remains high with 31 of the 36 beds occupied. The manager said 25 people were assessed as requiring nursing care, while 6 people were assessed as needing residential care. Two peoples care plans were examined and policies relating to medication, complaints, protection of vulnerable adults and handling of people’s monies were looked at. Four staff recruitment and training records were examined to assess how people were protected. The manager Marguerite Law was appointed approximately twelve months ago, she has not submitted an application to CSCI for registration. She was sent the AQAA on 12th September 2007 (Annual Quality Assurance Assessment) to complete and sent back to the local CSCI office by 10th October 2007. The completion of this document (AQAA) is a legal requirement and forms part of all regulatory inspections. The AQAA had not been returned at the time of writing the report, therefore CSCI ‘Have your say…. Surveys have not been sent to people who use the service. What the service does well: Assessments and care plans were well written and gave staff clear instruction about how to meet people’s needs. Visitors said, “staff was very good, kind and skilled. They helped to settle their parent into the home and supported the relative through a difficult period”. Staff interviewed was clear about their roles and responsibilities and they feel supported by the manager. Staff said training was very good and they wanted to do a good job. Staff had shown a commitment to their own learning and should be commended for their efforts to obtaining NVQ qualifications. Activities were well organised to meet the needs of people who use the service. Mealtimes were managed to ensure people received the support and assistance Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 6 to eat a healthy well balanced diet. People said they enjoyed the meals, especially the main meal of the day. 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.V356155.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.V356155.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): 3 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were assessed before moving into the home to ensure their needs could be met. EVIDENCE: All new people received a full comprehensive needs assessment before admission. The manager who had the required skills and competencies carried this out. The service was efficient in obtaining a summary of any assessment undertaken by the placing authority, and insists on receiving a copy of the care plan before admission. Staff confirmed that information contained in the assessment was essential to understand what they needed to do to ensure people’s needs were met. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 9 Two assessments were examined; they focused on achieving positive outcomes for people who use the service. Before agreeing admission the manager and staff carefully consider the needs assessment for each individual prospective person and the capacity of the home to meet their needs. Relatives said they were fully involved in the admission of their family member into Benton House. They said staff were very supportive through a difficult time, and helped their relative move into the home. Benton House Nursing Home DS0000015851.V356155.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. We have made this judgement using a range of evidence, including a visit to this service. Care plans provided sufficient information to protect people who use the service. Medication policies and procedures were generally well managed, although some aspects require attention to make them safe. EVIDENCE: Two care plans were examined; these were well written and provided sufficient information to enable staff to meet the needs of the people who use the service. The care plans include regular evaluations, and daily records assess the individual’s progress. Comprehensive risk assessments ensure people can maintain their independence, while remaining safe. One member of staff interviewed was able to describe in detail the care needs of the people case tracked. Visitors said staff were very good, and they knew how to care for their relative. They said they always kept them informed about any concerns and always made them feel welcome. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 11 Records examined and discussion with the staff confirmed people’s healthcare needs were met. The senior carer said doctors provide a good service, and staff were trained to recognise health problems and report them to the nurse in charge of the shift. An audit of medication stocks and records found some gaps in the MAR chart (Medication Administration Record), where medication had been administered but not signed for. One person’s medication had been changed following a stay in hospital although the monitored dosage system had not been changed to reflect the new dosage of new medication prescribed. Some medication was not on site although staff had signed to say they had administered the medication. One person’s medication label said administer as prescribed by the doctor but it was unclear when the medication should be administered. This means that the medication arrangements were unsafe and could pose significant risk to people, who may not receive medication as prescribed. There had been some medication that had been discontinued but there was no reference to say when the medication had been stopped or who had authorised the change. Eye drops for people did not have a date of opening. Once opened eye drops must be used within 28 days. If they are used beyond this date they may be unsafe. The local pharmacist is contracted to undertake periodic checks to ensure the stock levels were maintained and procedures followed. Medication was stored securely; there was a separate, locked room for storing medication that contained a medication fridge, although it was not locked and there was no record to confirm that the temperature of the fridge was taken daily. There was a controlled drugs cabinet and medication was appropriately store and recorded. Observations during this inspection confirmed people were treated with respect. People were addressed and spoken to in an appropriate manner. Staff were very good when caring for people who were agitated, by speaking calmly and quietly to them to give reassurance about their surroundings. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 12 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. We have made this judgement using a range of evidence, including a visit to this service. People are able to socialise with family and friends and mealtimes are well managed. EVIDENCE: Activities were arranged to meet the needs of people who use the service. The activity co-ordinator was very motivated, and was able to describe activities organised, which included trips to the local pub, and walks to the local shop. There was a designated activity room; used for small group activities, and the co-ordinator said she found the room better for small group work for people with limited capacity. People were actively encouraged to keep in contact with family and friends living in the community. Visitors were welcome at any time and facilities were available for them to have a drink or a meal with the people who use the service. People can choose to entertain visitors in their own rooms or perhaps a lounge or garden areas, as they prefer. Visitors to the home said they were made to feel welcome, and the atmosphere was always pleasant and homely. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 13 People were able to exercise choice, by having freedom to move around the communal areas freely. However bedrooms were not easily accessible, as they would need to ask staff to open locked doors. This was discussed with the manager who said it ensured the privacy of people who stayed in their bedroom. Mealtimes were well managed, staff were aware of the needs of people ensuring that people with limited capacity was supported to the dining area. The cook gave examples of the menus provided and said alternatives were always available. The cook said nutritional assessments had been undertaken to ensure people receive additional supplements where needed. Staff were seen giving assistance in an unobtrusive way, and people said they had enjoyed their meal of sausages and mash, while others had home made soup. One relative said she often visited around meal times so that she could have her lunch and offer assistance to her husband. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 14 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. We have made this judgement using a range of evidence, including a visit to this service. People who use the service could access the complaints procedures and the manager ensures any concerns were recorded and investigated appropriately. Adult protection policies, procedures and training of staff promote the protection of people from abuse. EVIDENCE: There was a complaints procedure that was available to people who use the service and visitors. The procedure was also referred to in the service users guide, identifying the stages to follow; this included the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection was included in the procedure, although this should now be amended to reflect the change of address and telephone number. The manager said no complaints had been recorded since the last inspection at the home. Visitors said they were confident that the manager would deal with any concerns they may have. There was a comprehensive Safeguarding Adults and Whistleblowing policy and staff follows the procedures to those standards. The manager would investigate fully any allegations of abuse and would follow the necessary procedures if any were substantiated. The manager holds discussions with staff to talk over issues and how to recognise different forms of abuse. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered provider continues their refurbishment of the home to ensure it is fit for purpose and is safe and suitable for people to spend their time. EVIDENCE: The registered provider continues their refurbishment of the home to ensure the environment was comfortable and suitable for people to spend their time. A partial tour of the building found good standards of cleanliness and hygiene. New carpets and none slip floor coverings have been fitted in communal areas and corridors had been painted. A number of bedrooms had been decorated and new bedding and curtains made the rooms homely and welcoming. The signage around the home could be improved to orientate people who use the service. Nameplates on bedroom doors were poor, staff said decorating was continuing in some of the areas. This would be a good time to improve the Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 16 signage, including considering introducing different colours to the corridors and bedroom doors. All corridors were painted the same colour, making it difficult for people with limited capacity to find their way to their bedroom. People can easily access a safe garden area and there was appropriate seating. One relative said her husband liked to sit in the garden when the weather was better. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 17 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff had the skills and knowledge to fulfil their roles within the home, and there was a stable staff group. Recruitment policies were not sufficiently robust to ensure the safety and protection of people who live at the home. EVIDENCE: Staff rotas were examined and there were sufficient carers to meet the needs of people who use the service. However the nursing levels were insufficient to meet the complex needs of people with nursing needs. There was only one nurse on duty with responsibility for twenty-five people with high complex mental health needs. The staffing levels must sufficient to meet the needs of people who use the service, in order to safeguard their wellbeing. Four staff recruitment files were examined; two files only contained one written reference. One file did not have a POVA 1st check or CRB (Criminal Record Bureau) check. This means the recruitment procedures were not sufficiently robust to protect people who use the service. The manager should check the date on the CRB as good practise suggests that a new CRB check should be carried out every three years, to ensure the information is up to date. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 18 The staff training and development plan was examined and was seen to identify staff training needs, courses completed and courses being undertaken. Staff spoken with confirmed they had undertaken statutory training and updates e.g. moving and handling, fire prevention. They were involved in National Vocational Qualification (NVQ) training and dementia care training. The numbers of staff trained to level 2 NVQ in care exceeded the minimum 50 required by The National Care Standards Act 2000 and the associated Regulations. The manager said the nurses continue to develop their own knowledge, by attending relevant training courses. PIN numbers for the registered nurses were examined and were current. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 19 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. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home needs attention to ensure people who use the service, which looks after their financial interests. EVIDENCE: The manager has been in post for over 12 months, although she had not submitted an application to CSCI to become the registered manager. She said she was undertaking the RMA (Registered Managers Award) and has also attended training arranged by the organisation. She is a Registered Mental Health Nurse and maintains her professional status. She is respected by staff and liked by relatives and people who use the service. Relatives said, “she is very kind and always treats people with respect”. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 20 Examination of rotas confirmed that the manager was not supernumerary and often works as the lead, and only, nurse on duty. This means that she would find it difficult to complete her managerial duties. The manager was able to demonstrate how the organisation gains the views of people who use the service. A quality survey is sent to relatives to complete, as people living at the home had limited capacity. She also spends time speaking to people to find out what they like about living at the home. One relative said she felt that the home always asked if they were satisfied with the service. The manager said the laundry service was identified as needing some improvement. They addressed this by employing a laundry assistant. People were unable to manage their own finances due to limited capacity; some relatives hold responsibility for this. The administrator told the inspector how bank accounts were held on behalf of people who use the service. Records examined were accurate to moneys held on behalf of people. Bank statements show money was held in a pooled bank account, which was non-interest baring. This means that the organisation was not acting in the best interests of people. Some people had large amounts of money, which could have been put into individual interest bearing accounts. Accident reports were analysed by the manager to ensure risk assessments were developed where required, and to protect people who use the service. However notifications of death, illness and other events were not send to CSCI as required under Regulation 37 of the Care Homes Regulations. Maintenance and service records examined were up to date and current to the services provided. The manager had the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures were in place and service records were examined and were current, ensuring the safety of people who use the service. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 21 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 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 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 X X 3 Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 22 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 Requirement Medication must be administered on a regular basis in accordance with the directions of the prescriber. This means that people would get their medication correctly. The administration of all medicines must be recorded on the MAR chart. This makes sure that there is an accurate record of the medication administered and that it demonstrates it is being administered as prescribed. Timescale for action 01/03/08 2. OP9 13 01/03/08 3. OP9 13 There must be enough stock of 01/03/08 medication to administer to a person. This ensures that people do not go without their medication, which may adversely affect their medical condition. There must be sufficient nursing staff to meet the needs of people who use the service. The manager must work supernumery to the staff providing care. A copy of the DS0000015851.V356155.R01.S.doc 4. OP27 18 01/03/08 Benton House Nursing Home Version 5.2 Page 23 revised rota showing the new staffing levels must be sent to the CSCI office. 5. OP29 18 Staff must not work unsupervised until they have received a POVA 1st check and satisfactory Criminal Records Bureau (CRB) Check and two satisfactory employment references. A manager who is ‘fit to’ be registered must submit an application for registration with the CSCI. 31/03/08 6. OP31 8 31/03/08 7. OP35 20 Money held on behalf of people 31/05/08 who use the service must be banked in accounts in their own name, and must not be pooled to ensure people’s money is protected. Notifications of death, illness and other events must be sent to the Commission for Social Care Inspection. 01/03/08 8. OP38 37 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. 2. Refer to Standard OP9 OP9 Good Practice Recommendations Eye drops should state the date they were opened to ensure they are not used beyond the 28 days. The medication fridge should be kept locked and a record should be kept of the temperature of the fridge. Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 24 3. OP19 Signage and colour schemes around the home should be improved to enable people with limited capacity to orientate around the home. CRB checks should be renewed after 3 years to ensure the information is up to date. 4. OP29 Benton House Nursing Home DS0000015851.V356155.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas House 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.V356155.R01.S.doc Version 5.2 Page 26 - 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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