Inspection on 11/05/06 for Bexton Court

This inspection was carried out on 11th May 2006.

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

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

Other inspections for this house

Bexton Court 21/09/09

Bexton Court 31/10/08

Bexton Court 25/09/08

Bexton Court 10/09/07

Bexton Court 28/09/05

Bexton Court 18/05/05

Bexton Court 12/10/04

Bexton Court 24/05/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOMES FOR OLDER PEOPLE Bexton Court Bexton Court Bexton Road Knutsford Cheshire WA16 OBZ Lead Inspector Sue Dolley Key Unannounced Inspection 11th May 2006 09:50 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 Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 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. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bexton Court Address Bexton Court Bexton Road Knutsford Cheshire WA16 OBZ 01565 651725 01565 755750 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) http/www.cheshire.gov.uk Cheshire County Council Mrs Jill Phillips Care Home 23 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (22), Learning disability over 65 years of age (1) of places Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 23 service users to include: Up to 22 service users in the category DE (E) (Dementia over 65 years of age) * Within the 22 DE (E) service users 5 may be in the category DE (Dementia aged between 55 and 65 years) * No more than 1 service user may be accommodated in the category LD (E) (Learning disability over 65 years of age) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection 28th September 2005 * 2. 3. Date of last inspection Brief Description of the Service: Bexton Court is a purpose built community support centre owned and managed by Cheshire County Council. It is near to Knutsford Town Centre, where there are a wide range of shops and other amenities. The fees at Bexton Court are based on a financial assessment of the individual. Bexton Court provides accommodation on a single floor with some office accommodation sited on a second floor. The premises are physically linked to a ward in the adjoining hospital. The home is registered to provide care to a maximum of 23 service users. Bexton Court is a developing provision. It is a well-equipped facility offering a range of short- term respite services for people with dementia, which are tailored to an individual’s needs. Care can include short breaks, flexible day and overnight care. There is a day care unit, which provides 5 places each day from Monday to Friday. In Bexton Court, all rooms are easily accessible to wheelchair users. All bedrooms have wash hand basin facilities, with hot and cold water, door locks and facilities for calling staff should assistance be needed. There are several specially equipped bathrooms with bath and shower facilities. There is a secure garden area for service users and visitors to use. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 11th May 2006 over almost 7 hours to assess if service users’ needs were being met. A partial tour of the premises included 4 bedrooms, shared areas such as the bathrooms, the lounges and dining area and the service users safe kitchen, known as a ‘smart kitchen’. What the service does well: What has improved since the last inspection? The service has continued to establish itself as a valuable resource within the area. There has been an increasing demand for short stay and day care places, as the standard of care at Bexton Court has become more widely known. Community groups within the area are being encouraged to get involved with the centre, to volunteer help and support and to sponsor particular projects for the benefit of service users and to foster community spirit. The staff team are motivated and continue to undertake training appropriate to their work to build upon their skills and experience. The premises have been enhanced by redecoration. New furnishings in some areas have helped to create a more homely yet practical environment. New bed covers have made bedrooms more appropriate for day- time use. One specialist bathroom has been completely refurbished and equipped and a small kitchen area has been Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 6 made into a usable safe kitchen for service users to enable them to maintain their daily living skills whilst receiving respite. 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. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 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 Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 6 Quality in this outcome area is good.This judgement has been made using available evidence including a visit to this service.Service users and their carers are provided with useful information about Bexton Court to enable them to make an informed choice about using the service. Management and staff provide much information, reassurance and support and share the caring role with the supporters of service users. EVIDENCE: Bexton Court offers varied and flexible services to dementia sufferers and their carers in the area. A statement of purpose is available to each service user setting out the aims, objectives, philosophy of care, services and facilities, and terms and conditions of the provision. One service user file contained an outdated copy. This did not show the name of the current registered manager, the telephone number of the complaints officer or the contact number of the Commission for Social Care Inspection. A more recent statement of purpose dated January 2006 was found on another service users file but again this did not show the name and contact number of the complaints officer. See Recommendation 1. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 9 A separate service user guide has been produced in colour, which is presented in a clear, concise, easy to read format with picture symbols to complement the text. The document provides useful information to explain the service, the accommodation and care provided. All service users’ needs are assessed before they receive care at the centre. Bexton Court gathers information from the potential service users, their relatives, social services and health care representatives to ensure individual needs can be met. Significant time and effort is spent making admission to the service personal and well managed. 4 service users’ files were checked. These files related to individuals new to the service. All of these service users had been admitted following a full and thorough assessment of need and each had an individual plan of care including information from various sources. Health and social services had contributed information via, assessment documents, hospital discharge notes, patient transfer notes, copies of G.P letters, psychiatric assessments and communication from a local memory clinic. Valuable written information provided by family carers had helped to build these thorough assessments of needs and abilities and were enabling care staff to understand and care appropriately for each individual. A great deal of social history information was provided and the circumstances prior to admission were explained to ensure staff had sufficient detail to get to know service users well. Three of four files contained a good quality photograph of the service user to aid identification. One photograph was awaited for a service user admitted on the previous day. Each file contained a service users property sheet to record each item brought into the centre. At feedback to the site visit a suggestion was made to the registered manager about the possible use of an admission and discharge sheet on individual files to indicate frequency of stays. Bexton Court does not provide intermediate care, therefore National Minimum Standard six does not apply. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good.This judgement has been made using available evidence including a visit to this service. Health and personal care needs are fully assessed, addressed and met and service users are referred to health professionals as appropriate.Service users receive attentive, sensitve and courteous care. Further improvements to the recording of medication need to be made to ensure service users receive their medication as prescribed. EVIDENCE: Each of four service user files checked contained a plan of care which set out in detail the action to be taken by care staff to ensure all aspects of service users health, personal and social care needs were met. The care records provided information regarding medical history and ongoing investigations. There was evidence of careful health monitoring and of staff promptly seeking medical help and advice to address the existing and changing needs of service users. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 11 Significant event sheets were completed at least twice daily during each planned short stay. These evidenced constant reassurance/ assistance given as needed. The actual words spoken by service users were sometimes recorded on the significant event sheets and this provided useful insight for care workers and supporters. The care records checked accurately reflected the care given throughout the day and night. Night -time activity was well recorded. There was evidence of service users being referred to the nurse practitioner for some health problems including constipation, inappropriate urination and skin viability and of appropriate action taken as a result. The high standard of recording in the significant events sheets helped to build a complete picture of care necessary and the difficulties experienced by the service user. Detailed records of discussions with social workers were kept and provided evidence of frequent liaison and contact .The records of health visits were completed fully and were informative, outlining all the care necessary. When one service user was asked about the care received, the reply was “It’s as good as being at home, if not better. The staff here are wonderful, the food is excellent. Staff can’t do enough for you. You get waited on. Anyone who grumbles at this, must have something wrong with them”. During the site visit a discussion took place with a visiting psychiatric nurse advisor who usually attends on Mondays or on other part days. He had commenced at the centre 2 weeks prior and undertakes assessments for long term care and completes risk assessments. He explained that he wants to develop person centred care and support within the centre. A nurse assessor attends Bexton Court on Fridays. Both provide a valuable resource to service users and staff. The psychiatric nurse advisor and the registered manager are meeting with the Alzhiemers group locally to promote the service. In the four care files checked. Two functional ability sheets were dated but not signed by the person completing the assessments. One safer handling risk assessment had not been completed and one medication sheet to record medication on admission had been left blank on a file without any indication that the person did not have medication upon admission. See Recommendation 2. Awareness and Social Interaction Forms were completed daily. These provided very limited comment and were of very little value in their current form. They did not record which activities had been offered and therefore service users preferences and choices could not be established. The registered manager plans to devise a more useful record of participation and activity. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 12 All the medication administration records were checked and contained photographs of each service user to aid identification. Information relating to care for people with diabetes and any known allergies was highlighted. Some improvement had been made regarding recording and stock keeping and storage. Further improvements must be made in the recording of medication to ensure service users receive their medication as prescribed. There were several unexplained gaps in the recording of medication. One start date was wrongly recorded. Omission code ‘F’ was used several times, indicating medication not given .The reason for not giving was not defined. One service user had received one item of medication once on one day instead of twice as prescribed. Medication consent forms were included but only partially completed due to lack of capacity within the service user group. A discussion took place at feedback to the site visit regarding how these forms could be better used. The medication administration records indicated medication weeks and days of the week. These records could be improved by recording each day and date. The controlled drugs book was checked and was accurate. 1 record did however show an unopened box of 28 tablets plus remaining tablets recorded as 28 4,28 3,28 2,28 1 etc, instead of totals of tablets shown. See Requirement 1. Details of outpatients appointments were usefully kept on the medication files. Helpful typed information about the taking of medication was stored on file from family members. This provided evidence of good working relationship with families, of sharing care , of trusting relationships built and of appreciation of staff and family members. The supplying pharmacy intends to complete quarterly stock checks. The registered manager and a group leader have attended Halton College for comprehensive medication training. There is a new medications policy being introduced across the county. Distance learning is to be cascaded to seniors. Two care staff now complete each medication administration session. All care staff responsible for administering medication are to receive refresher training. The group leaders undertake spot checks once a week. In depth training will be necessary regarding the introduction of the new medication policy, and a training group will present the new policy and procedure to staff members. During the site visit, all personal care was given discreetly in the privacy of service users bedrooms. All observed interactions between staff members and service users were respectful and courteous and staff members demonstrated an ability to anticipate need and took prompt action to ensure the comfort of service users. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including visits to the service. The service is flexible and changed to meet individual wishes. Mealtimes are treated as social occasions and a wide variety of foods are presented and enjoyed. EVIDENCE: Time is taken to gather much social history information prior to a service user having a first stay to establish their interests and recreational/social needs. Sufficient staff resources are provided to allow time for activities and stimulation and staff are relaxed and motivated and help service users to maintain their interests. Usual daily routines are maintained as far as possible and service users are enabled to keep contact with those important to them. One group leader spoke of a person, visiting monthly with her dog, which she said seemed to relax the service users. One care file recorded that a member of staff had read to a service user from his book. There was a high level of staff and service user interaction observed during the site visit. There was evidence of visiting entertainers and of carers organising one to one activities and group activities. During this site visit the weather was sunny and a large group of service users and staff were enjoying a game of skittles outdoors and were happy to be competing and encouraging one another. Service users wore Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 14 sun hats and had sun cream applied. They sat watching events, whilst being served tea and biscuits and later iced lollies. Occasionally a carer would escort a service user indoors to sit beside fans to keep cool. Each care file contains a service users activity sheet to provide evidence of participation, interaction and willingness. It is suggested that a clearer more purposeful record is developed to include the type of activity offered so that personal preferences may be determined. Knutsford Lions have purchased a canopy for the garden patio area and this is awaiting fitting. The registered manager is encouraging donations to fund a brightly coloured and heavily scented sensory garden for service users to relax in. Local companies and individuals have already made substantial donations. Knutsford Guardian recently printed an article to try to encourage monetary donations and to encourage volunteers to join a community ground force to help create this special garden space. A range of activities are organised daily, some regular activities include having coffee in Knutsford, having current affairs discussions, baking, bingo, hand and nail therapy, shopping, watching films from the video library, flower-arranging, reading, target mat activity and beetle drives. A high level of liaison was witnessed during the site visit between caring family members and senior staff members who communicated by telephone. Staff members demonstrated that they had a good knowledge of service users and their circumstances and were able to encourage meaningful conversation to engage and interest service users. A pay phone is available in a quiet corridor area and a comfortable chair has been placed nearby to encourage service users to sit and converse. Service users are enabled to return to their bedrooms when they wish. Quilted bedcovers have recently been provided to all bedrooms to cover duvets and to make rooms more appealing and appropriate for day- time use. Meal choices were displayed on daily menus on dining tables and sample menus indicated a wide range of traditional foods available. A number of service users said that the food was plentiful and much enjoyed. The lunchtime menu during the site visit was boiled bacon, parsley sauce, potatoes and vegetables or an omelette. For dessert there was chocolate pudding and chocolate sauce. The tea- time meal offered was beans on toast or sandwiches, with melting moments to follow. Staff members shared mealtimes with service users and provided service users with discreet help with eating when necessary. The mealtimes were observed to be unhurried and social events and the meals provided were enjoyed. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 15 A service user kitchen has been made available for staff and service users to use. This kitchen has been specially adapted and made as safe as possible to use under the supervision of staff. The area has been made safe to use under the supervision of staff. There was evidence of service users baking in here and helping to set tables and washing up, to maintain their independence and to promote wellbeing. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including visits to this service.Complaints are well recorded and receive prompt attention to reach a resolution. Staff are alert to the potential for abuse and are receiving training to raise their awareness to help protect service users. EVIDENCE: 2 complaints had been made and substantiated within the last twelve months. Both complaints had been well recorded and dealt with promptly. Protection of vulnerable adults training is being provided for staff. 3 members of staff are to attend this training on 19th May 2006 and 2 senior staff are to attend this training in August 2006. Bexton Court uses Cheshire County Council’s Complaints procedure and this is well advertised throught the centre and in the information supplied to carers. The Department of Health guidance ‘No Secrets’ was available for staff to refer to and a whistle blowing policy is available to staff to enable them to respond appropriately to any suspicions or evidence of abuse. Staff members are aware of various forms of abuse and have received written information on the various ways service users can be safeguarded and protected. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including visits to this service. Bexton Court is well maintained and clean. The premises are bright and airy, are decorated and furnished to a good standard which helps to create a comfortable and welcoming environment for the benefit of service users, staff and visitors. EVIDENCE: Bexton Court provides ground floor accommodation for service users. There is some office accommodation on the second floor. Service users’ rooms are in two wings. There are twelve rooms in wing 1 and eleven rooms in wing 2. Bedroom sizes are adequate and bedrooms are well equipped. There are various layout options to suit individual needs. The premises are well maintained clean, fresh, bright and airy. The decoration and furnishing is of a good standard. Ample communal space is provided for various social activities and there is a large secure garden available for both service users and visitors. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 18 The quiet room and the lounges are to be redecorated. Bedroom doors are to have beading and door knockers added. Many recent improvements to the premises have been made.One bathroom has been completely refurbished and now has a walk in shower an Aqua Nova bath and toilet. New lounge armchairs have been purchased. Taller coffee tables which are at an easier height to use have been provided. A mantlepiece has been put in place in the lounge to create a homely focal point, with a clock placed on the mantle and a mirror placed over it. The wall where the mantlepiece is placed is to be wallpapered in the near future.The ceiling to the main lounge needs repainting due to staining in three areas and this is to be addressed.All other lounge and shared areas were fresh and clean. New cleaning equipment has been provided and includes new cleaning trolleys for general assistants and new vacuum cleaners. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including visits to this service. Staffing levels are generous and staff members are well trained to care for service users. The recruitment checks need to be more thorough to ensure service users are protected. EVIDENCE: Staffing levels are generous to ensure staff members have time to spend with individual service users and to complete all necessary care and support. The staffing levels and skill mix of staff are appropriate to meet the needs of the service user group and staff members can take necessary breaks when they have experienced caring challenges. An Outreach service has been started at the centre and a ‘Take a Break’ service for residents known to Bexton Court and Santune House is underway , so that main family carers can use the service for a maximum of 3 hours and leave their relative at the centre in safe hands whilst they attend personal appointments etc. Every Tuesday the registered manager has an open surgery for staff between 11 and 12. Currently there is a 25 hour staff vacancy, 10 hours of this vacancy has already been appointed. A relief bank is now underway. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 20 The recruitment files of three new staff members were checked. One file contained only 1 partial reference and employment commenced before this reference was received .Another file did not contain evidence of a Protection of Vulnerable Adults First check being completed and contained only one written reference.See Requirement 2. Cheshire County Council are committed to providing training opportunities to ensure staff have the appropriate skills and knowledge to deliver the necessary level of care to service users. Recent staff training has included person centred training, carer link training, and training related to care standards, computer systems, protection of vulnerable adults, standard assessment documentation and fire awareness. Planned training is to take place regarding medication, person centred planning and understanding the various types of dementia. The staff team are motivated and continue to undertake training appropriate to their work to build upon their skills and experience. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including visits to this service. The registered manager is well qualified and experienced with the ability and enthusiasm to discharge her responsibilities fully. Bexton Court runs in the best interests of service users and promotes and protects their health, safety and welfare. EVIDENCE: The registered manager has worked in various caring environments for a period of nineteen years and has previously managed domiciliary care services and a specialist home for people with dementia. The registered manager and other senior staff are familiar with the conditions and diseases associated with old age and share their knowledge and experience with the staff group. There are clear lines of accountability within the home and with external management and there are good organisational systems in place. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 22 A file of allocations meetings minutes was checked. The registered manager and two group leaders meet regularly to discuss management issues. Allocations meetings are now to take place weekly to ensure the smooth running of the provision. Records of allocations meetings provided evidence of regular planning/working together/good organisation and management /identifying shared responsibilities and provided clarity of roles. The group leaders, alternate between supporting senior carers and working in the office. One group leader has responsibility for medication and another group leader takes responsibility for risk assessments, reviews and health and safety. Each member of staff now has a clearly defined role and their responsibilities have been clearly outlined. A format for recording supervision notes was seen. A carers group has commenced and is to be encouraged through the local Alzheimers group. Suitable accounting and financial procedures are in place to safeguard service users money. A sample of four, service users personal allowances balance sheets and money were checked and were accurate. Receipts were available for all transactions. Reports of the last 2 inspections and other literature was available in reception. Other useful information was available in the reception area regarding advocacy services. A quality standards questionnaire was on each service users file and ready for use. The results of a recent quality survey were posted on the reception notice board. Cheshire County Council Performance Assurance Information Development Unit had collated the following results. During the period Period- January 2005 to December 2005 a total of 94 questionnaires were received,of those 93 felt they had enough information to make a decision about accepting a service. 84 said they felt confident about leaving the person they cared for at the centre. 96 found staff always polite and respectful. 87 were satisfied with the service provided for the person they cared for. 91 thought the service definitely helped them. During the site visit all appropriate environmental risk assessments were in place and there were no health and safety concerns. Lots of health and safety guidance was available to staff and staff members had been appropriately trained to recognise and report any health and safety issues. The accident records were fully completed and all maintenance records were up to date. Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 Requirement Arrangements must be made for the accurate recording and administration and stock control of medication. (Previous timescales of 23 May 2005 and 28 November 2005 not met) The registered person must not employ a person to work at the care home unless two satisfactory written references and a first Protection of Vulnerable Adults check have been obtained. Timescale for action 30/06/06 2 OP29 19 30/06/06 Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 25 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 OP1 Good Practice Recommendations Ensure the statement of purpose contains up to date information and contains the name and telephone number of the complaints officer and the contact telephone number of the Commission for Social Care Inspection. Ensure that the person completing the functional ability assessments signs the assessment document. Ensure that safer handling risk assessments are completed and information relating to medication upon admission is recorded fully. 2. OP8 Bexton Court DS0000036255.V289524.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. 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