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Inspection on 27/07/05 for St Benedict`s Nursing Home

Also see our care home review for St Benedict`s Nursing Home for more information

This inspection was carried out on 27th July 2005.

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

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

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

What the care home does well

The location of this home is generally suitable for its stated purpose, convenient for visitors and an adequate level of compliance with the National Minimum Standards in respect of the building had been generally maintained. With the exception of one or two bedrooms, all areas inspected were odour free. Records indicate that the health and personal care needs of the residents are generally adequately provided for. There is input from a range of healthcare professionals and evidence of equipment and adaptations throughout the home. There is a choice of meals and some special dietary needs can be catered for, and the standard of catering and kitchen maintenance was judged very satisfactory. Feedback from the residents, and relatives confirmed that staff generally treated the residents well. Reported lapses were addressed decisively.

What has improved since the last inspection?

Some progress had been made with matters raised for attention by the last inspection, and the new acting manager has made a positive impact on all aspects of the running of this home. Record keeping is more systematic and properly accountable, and staff present as generally very motivated.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE St Benedicts Nursing Home 22 - 23 St Georges Terrace Herne Bay Kent CT6 8RH Lead Inspector Jenny McGookin Announced 27 & 28/07/05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Benedicts Nursing Home Address 22 - 23 St Georges Terrace, Herne Bay, Kent, CT6 8RH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01227 362398 01227 362398 Macari Homes Limited Mrs Gillian Dawn Wren Registered Care Home 25 Category(ies) of Care Home for Older People registration, with number of places St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Of the 25 nursing beds 8 are also registered for the admission of residential clients Date of last inspection 11/11/04 Brief Description of the Service: St Benedict’s Nursing Home is situated in a residential area of Herne Bay overlooking the sea and is close to local amenities including local pubs, shops and churches. The building is a large detached house, which has been extended and converted. There is a car park at the rear of the building, accessed from the front by a driveway to one side of the building, which can accommodate up to eight vehicles. There are twenty-one single bedrooms, four of which have en-suite facilities, and two shared rooms, one of which has an en-suite facility. The Home has four communal areas and there is a shaft lift to the first floor. There is a ramp from the rear lounge into a conservatory area, and at the entrance of the front door, all of which enables Service Users with limited mobility to have access to most areas of the Home. The Home has several aids and adaptations in place. There is a call-bell system in operation and TV points in every bedroom. The garden has a paved patio area with garden furniture. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which was used to introduce the new inspector to residents and the staff; to check progress with matters raised from the last inspection (November 2004); and to reach a preliminary view on other aspects of the day-to day running of the home. The inspection process took just over fifteen hours, spread over two days, and involved meetings with eight residents, two relatives, nine staff (representing the nursing side, care, housekeeping and catering) and the acting manager and the proprietor. The inspection also involved an examination of comment cards from fourteen residents, seven relatives / visitors, a range of records and policy documents and the selection of two residents’ case files, to track their care. Fourteen bedrooms were inspected for compliance with the National Minimum Standards, and the inspector also checked some communal areas. Interactions between staff and residents were observed throughout the day. What the service does well: What has improved since the last inspection? Some progress had been made with matters raised for attention by the last inspection, and the new acting manager has made a positive impact on all aspects of the running of this home. Record keeping is more systematic and properly accountable, and staff present as generally very motivated. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 6 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. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 4, 5, 6 1. The home has a Statement of Purpose and Service User Guide but they do not provide Service Users and prospective Service Users with all the information they need to make a decision about moving into the home. 2. There are contracts governing each placement between the home and the resident, or their representative, but they do not have all the elements recommended to protect residents’ interests. 3, 4. Prospective residents are assessed prior to admission to establish the extent to which their needs can be met by the home, and how potential risks will be managed. Service users are generally content with the way they are supported by the home. 5. Prospective residents, or their representatives, have the opportunity to visit the home before proceeding with the admission and there is a trial stay to further inform their choice. 6. The home does not provide intermediate care. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 9 EVIDENCE: There is a Statement of Purpose and Service User Guide, which usefully describe the facilities, services and principles of care but a number of elements listed by this standard were not there. Feedback on the day of this inspection indicated that the decision to apply to this home was influenced more by its locality (i.e. close to where the resident or their friends or relatives lived) and by personal recommendation, than by any public information produced by the home itself. There are contracts governing each placement (whether self funded or funded by a third party). A number of recommendations were made to improve the contract document. See schedule of recommended action. The home carries out a preadmission assessment, and the prospective resident or representative is invited to visit the home. The residents were generally able to confirm this process, though, with one or two exceptions, they did not visit the home themselves, either because they trusted the judgement of their representatives or because they had already gained a positive impression of it. Two relatives recalled there being an assessment to make sure the home could meet their needs. Records confirm there is a standard preadmission assessment form to ensure a consistent approach. Each resident is offered a trial stay, and two relatives confirmed this was the practice. On their admission, the home carries out further assessments. . The home does not provide intermediate care. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 10 7. The assessment and care planning processes cover a range of health and personal care needs, as well as some social care needs 8. The home is served by a range of healthcare professionals, to promote good health and has generally adequate facilities for privacy. 10. Residents confirmed that staff treat them well, and that their privacy is respected. EVIDENCE: The care planning process starts on admission, and records confirm care plans are underpinned by risk assessments and are reviewed monthly – in each case counter signed by the staff reviewing them. However, records of reviews often showed no change overall, and there were gaps in the records in respect of follow-up of some social care needs (interests, activities). Some details were amended or deleted with correction fluid, which is not advisable practice None of the residents or relatives spoken to showed any recognition of an active care planning review process, which included them. But some did generally recall being asked questions about their care needs right at the start. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 11 With two exceptions, all the bedrooms in this home are single occupancy, which means personal care and treatments can be given in privacy. Shared rooms have screening to afford occupants some privacy. However, in each case, the drawing of curtains around the bed closest to the window effectively deprives the other of all, or almost all, natural sunlight. This is not an ideal arrangement. Feedback from the residents confirmed that their privacy was respected and that staff generally treated them well, though there have been occasional lapses, which were addressed decisively when reported. The home accesses a range of healthcare professionals, but residents would need to pay for chiropody, physiotherapy of any special or private treatment or medication themselves. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 12. Most residents are generally content with their lifestyles in this home, and the home has been able to match their expectations. This home offers a very limited range of activities inside and outside the home, and one or two residents would like the home to organise more. 13. There are open visiting arrangements, and the home is well placed for access to local shopping outlets and the sea front activities. 14. There is choice and control over most aspects of daily routines. Personal care is offered in a way, which generally protects residents’ privacy and dignity, though there have been reported lapses. 15. The meals in this home are generally very satisfactory, offering both choice and variety and catering for personal preferences. Residents can also opt to eat where they eat and at different times. EVIDENCE: Residents and relatives were not able to give many examples of any particular interests and hobbies being actively promoted by the home. However, staff said there were occasional walks, painting or craft sessions, games such as dominoes, support with activities such as knitting and the home has its own library room, supplemented by the local Mobile Library. Most residents indicated that they were generally content with their lifestyles in this home, St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 13 though one or two wished the home would organise more activities or outings. The re-introduction of an Activities Co-ordinator would be of benefit. The Statement of Purpose states that the home can arrange for visits by clergy or for staff to accompany residents to church if friends or relatives cannot, but there was no information for prospective residents on local religious resources or services to the home. The home has open visiting arrangements, and feedback from residents and relatives as well from questionnaires received from seven relatives / visitors invariably confirmed that they were always made welcome whenever they visited. The daily routines are as flexible as healthcare needs will allow. Residents confirmed that they can choose when to get up and go to bed. They can choose where to take their meals (though there is a dedicated communal dining room, albeit cramped), and also have some choice over meal times. There is a 6-week menu cycle, based on the residents’ expressed preferences. Menus supplied for inspection indicated that the meals in this home tend to be traditional English, though the cook is also catering for one diabetic resident. There is a choice of two options at lunchtime and more at suppertime and the two weeks’ menus showed no duplications The home gets all its food provision fresh from local outlets, and is keeping records of the meal options actually consumed by individuals, as required. Questionnaires from twelve residents confirmed they enjoyed the meals, and this was confirmed by three residents during the inspection. One singled this aspect of the home as its key strength. Two other residents, however, said they sometimes did not enjoy the meals, in one case partly because lunch time meals were being left in her room without being cut into manageable portions. Meals sampled on both days of this inspection were well prepared and presented, and residents were observed being assisted by staff in a respectful and unhurried way. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 16. There is a complaints procedure readily available, though this will require amendment to fully comply with this standard, and residents feel that any complaints they had would be listened to and acted on. The home relies on staff, or the residents’ families and friends to raise issues and represent the interests of the less able residents. There are no independent advocacy services. 18. Residents generally feel well cared for and safe. Staff expressed a commitment to protect residents from abuse, and previous lapses in care were decisively acted on when reported. EVIDENCE: The home’s complaints procedure is detailed in the Statement of Purpose and Service User Guide, and describes the process and timeframes involved, in general compliance with the provisions of Regulation 22. However, it gives the CSCI as an option only if the complainant feels the complaint has not been dealt with properly or wishes to take the matter further. This is not a correct interpretation of the National Minimum Standard or Regulation 22 and the registered person will need to correct all copies. One version still refers to the Commission by its old title, which is liable to confuse the reader. The residents generally confirmed that they would know who to talk to if they had a complaint and felt safe. The home does not use any independent advocacy services but relies on staff, or the residents’ families and friends to raise issues and represent the interests of the less able residents. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 15 During the inspection, however, allegations were made about past lapses in care, which were immediately reported to the registered person and acted on decisively. Staff training in adult protection is a matter raised by the last inspection and found to be still outstanding. The registered person is also reminded that this is the kind of event to which the duty to make formal notifications to the CSCI applies (Reg 37). See Schedule of Required Action. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26 19, 25. The location of this home is generally suitable for its stated purpose, and residents confirm this is a homely place to live. Pre-Inspection information indicates it is being maintained and regularly inspected for safety. 20. Residents have a choice of communal areas, and furnishings tend to be domestic in character. There are homely touches throughout. 21. Lavatories and washing facilities are generally accessible to bedrooms and communal areas. 22. There is a range of equipment and adaptations to support residents and staff in safety in their daily routines and to maximise residents’ independence. 23, 24. Most residents have access to the privacy of their own bedrooms and five rooms have en-suite facilities. Residents can personalise their rooms with their own possessions and items of furniture 26. The home is generally adequately maintained and, with the exception of two bedrooms, all areas inspected were free of any unpleasant odours. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 17 EVIDENCE: The site of this home is generally suitable for access to the sea front and local community (although the reported level of take-up was disappointing) and it is generally adequately maintained. Some matters were, however, raised for attention on this occasion. See schedules for details. There are 22 single bedrooms, all of which are at least 10 square metres. In fact, only three are between 10-11 sq metres, the others are larger. Five of these single rooms have en-suite facilities. There are also two shared rooms, one of which is 16 square metres and the other, although below the National Minimum Standard at 14 square metres has its own en-suite facilities. Fourteen bedrooms were assessed against the National Minimum Standards and had almost all the furniture and fitments required. All were generally well maintained and most were in satisfactory decorative order. It was noted, however, that if the curtains in the shared rooms were drawn around the bed closest to the windows, then the second bed was effectively deprived of almost all light from the window. Consideration should be given to an alternative configuration. Some matters were raised for attention. Each room had been personalised with the residents’ possessions and, in some cases, pieces of their own furniture and there were homely touches throughout. Although several residents said they did not want locks on their doors or any lockable facilities these should be installed as standard. The home provides a choice of communal space for each resident. There is a main lounge area, a conservatory plus a dining room on the ground floor and a second lounge on the first floor (which is known as the “Quiet Room” and has a library which is kept replenished by Canterbury library). All furnishings within the communal areas are domestic in character and of reasonable quality, suitable for the service users needs. All areas seen were adequately maintained although the décor was in need of investment. Some communal areas were cramped with furniture or mobility equipment, thereby reducing the amount of useable floor space, and staff were observed struggling to manoeuvre wheelchairs and assist residents with mobility equipment on several occasions. Lack of available storage facilities was identified as a problem. The Home has a shaft lift to access all floors and all areas are linked with a call bell system. Specialist equipment includes special mattresses, raised toilet seats, grab rails and corridor rails, hoists. Access to the front door and patio is good. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 18 There is one communal WC and two communal bathroom / WCs on the ground floor, and three communal bathrooms / WCs on the first floor i.e. within reasonable access to bedrooms and communal areas. There were adaptations in each case. The home has one domestic washing machine a second washing machine with a sluice cycle, plus one dryer. Clinical waste is appropriately managed – there are weekly collections under contract by Canterbury City Council. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 27. Staffing rotas show a detailed staffing arrangement, designed to meet the number of residents and their dependency levels, and this is a workforce which reports working flexibly and co-operatively to maintain the residents’ quality of life. However, there were some fluctuations over the period examined. 28. Residents generally feel safe and well cared for. Mandatory health and safety training is in train, although cycles have yet to be completed or repeated. 29. There is a systematic recruitment process in place now, which includes a range of checks, to protect residents, and efforts are being made to address gaps in records for long-standing staff. 30. Staff are multi skilled to provide to address the care and support needs of residents. Limited progress has been made with the introduction of NVQ training, and most staff have not had any systematic supervision or appraisals to oversee and manage their further skills development. EVIDENCE: Staffing rotas were submitted for inspection for the two-week period 18-31 July 2005. These showed that the waking / working day has been interpreted as a 12-hour period from 8am to 8pm. During this period there was at least one qualified nurse (RGN) on duty, and usually a second for the first or latter six hours. The acting manager’s hours in the office are detailed separately as are nursing assistants’ hours spent on kitchen duties, as required. On St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 20 weekends, however, there was only one qualified nurse on duty during the waking day. It was not clear why this should be so. There would, moreover, be six or seven nursing assistants on duty for the first six hours and four or five (but occasionally only three – again, it was not clear why this should be so) for the latter. The maintenance of consistent staffing levels has been raised as a concern by one anonymous caller this year and must be addressed as a matter of priority. At night there was invariably one RGN and one nursing assistant on duty and there was a designated RGN on call throughout the period. Considerable progress has been made with the systematising of personnel records required to be kept by the Regulations (matter raised by the last inspection), but this process was by no means complete. Some references are, for example, having to be sought in retrospect for long-standing staff; some key documents were not on file (e.g. contracts, interview records, proof of identification, including photographs) or not signed (e.g. policies); and there were no overall checklists to manage the recruitment. This is judged a major shortfall. This home has seven first level registered nurses, sixteen care staff and twelve ancillary staff, with all the skills-mix that implies. Records indicate a longstanding core group of staff - about a half have been working at the home since 2000 or before, and there were no staff under the age of eighteen years of age, as required. However only four care staff (excluding registered nurses) are reported to have NVQ level 2 accreditation or above i.e. 25 . This falls short of the National Minimum Standard. Records confirm only one completed cycle of mandatory training investment for staff. Only one of the staff reported having had formal documented supervision sessions and there was only one such record on file in the records selected at random for inspection. This is judged a major shortfall. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) This standard was not assessed on this occasion, as there is an acting manager in place following the voluntary standing down of the registered manager. EVIDENCE: St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 2 2 3 2 3 3 STAFFING Standard No Score 27 2 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x x x x x x St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4& Schedule 1 Requirement Timescale for action 31 12 05 2. OP1 3. OP16 4. OP18 The Statement of Purpose must be amended to comply with all the elements of National Minimum Standard 1, Regulation 4 and Schedule 1. 5, 6 The Service User Guide must be amended to comply with all the elements of National Mimimum Standard 1, Regulations 5, 6. 22 & Each version of the homes Schedule complaints procedure gives the 4 CSCI as an option only if the complainant feels the complaint has not been dealt with properly or wishes to take the matter further. This is not a correct interpretation of the National Minimum Standard or Regulation 22 and the registered person will need to correct all copies. One version still refers to the Commission by its old title, which is liable to confuse the reader. 12, 13, 37 The registered person needs to ensure that residents and staff are actively encouraged to report any perceived lapses in care as they occur so that they can be investigated and resolved without delay. Staff training in H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc 31 12 05 31 12 05 Immediate and ongoing St Benedicts Nursing Home Version 1.40 Page 24 5. OP19 13(4) 6. 7. 8. 9. OP19.2 OP19.2 OP19.2 OP22.7 23(2)(d) 23(2)(d) 23(2)(d) 23(2)(l)( m)(n) 10. 11. OP24.2 OP24.2 16(2) 16(2) 12. 13. OP24.2 OP24.6 16(2) 12(4)(a) 14. OP24.6 12(4)(a) adult protection is a matter raised by the last inspection and found to be still outstanding. The registered person is also reminded that this is the kind of event to which the duty to make formal notifications to the CSCI applies (Reg 37). One ground floor WC had an ill fitting lid which was cracked and requires replacing. The bath had unsightly marks / stained where the hoist has damaged surface Scuffed paintwork requires refreshing in Rooms 10, 16. Rooms 21, 23. Damaged wall paper requires redcoration. Room 18 had damage to the ceiling due to leak, which must be addressed and made good There needs to be adequate storage facilities for equipment within the home to be readily accessible to staff. The storage of equipment in bedrooms is not apropriate. Action Plan to be submitted Each bedroom needs to have comfortable seating for two people. Room 20. Resident requires a longer mattress, and would also want the bed lowered after breakfast, so as to be able to rest. Room 21 requires a table or bed tray All bedroom doors must be fitted with locks suited to the residents’ capabilities (and accessible to staff in emergencies. Action plan to be submitted All residents must be provided with keys (e.g. to front door, bedroom doors and lockable facilities in bedrooms) unless 30 09 05 30 11 05 31 12 05 31 12 05 30 09 05 31`12 05 31 12 05 30 11 05 31`12 05 31 12 05 St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 25 15. OP26 16. OP26.6 17. OP28.1 18. OP28.2 non-provision can be justified by properly documented consultation or risk assessment 12(1)(a) Kitchen. One ceiling light requires a 2nd fluorescent strip and diffuser. Seal on fridge door requires replacing 16(2)(j)(k Sluice areas. ) Edges to flooring require sealing or coving to prevent their becoming dirt traps. Ceiling lights should have diffusers. Taps should be wrist or elbow operated Action plan to be submiited 18(1)(a-c) The registered person must submit an action plan to show how he intends to obtain a minimum ratio of 50 of staff trained to NVQ level 2 or above, excluding registered nurses 18(1) The registered person must submit an action plan to show how he intends to meet the standard for induction of new staff 30 09 05 31`12 05 30 10 05 30 10 05 19. 31 12 05 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 OP2 Good Practice Recommendations Placement Contract. The following matters are raised for consideration: · Although the room to be occupied is identified by number, there needs to be information about it – status (single or shared), whether en-suite, furniture and fittings provided etc so that the resident knows what to expect. The contract should also make it clear that anything brought in by the resident must be subject to safety H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 26 St Benedicts Nursing Home 2. OP7 3. 4. 5. 6. OP12, 13 OP13 OP19 OP19.3 7. 8. OP21 OP21 checks and who would bear the charge for these checks. · The home reserves right to vacate a room or bed on formal written notice but the notice period is left blank for hand-written completion – which may leave the home / proprietor open to charges of inconsistent practice · The contract should indicate how fees are calculated. Fees are subject to review “from time to time” – the contract should indicate the likely frequency or circumstances warranting reviews, so as not to attract charges of frequent or arbitrary increases in fees · The home’s insurance cover is left blank and needs to be set so that residents can make appropriate and enduring top-up arrangements · There is a very legalistic section in small font at end after the signatories and dates - to be entered into where a third party is to be responsible for payment of the home fees. This needs to be in plain language, and in an appropriate font size and style so as not to alienate the resident. · The contract includes a clause giving the resident the option to insist (or not) on having a lock fitted to their bedroom door. This needs to be standard provision – nonprovision of keys must be subject to properly consulted and documented risk assessment, and subject to periodic review. Care Planning reviews should routinely record who participates in each case; include the recorded views of resident and/or their representative, and any unmet needs, so that anyone authorised to inspect them can evaluate their ownership. More attention could be given to exploring each resident’s interests, aspirations and social needs in a practical way One or two residents wished the home would organise more activities or outings. The re-introduction of an Activities Co-ordinator would be of benefit. The information provided for prospective residents should include local religious resources or services to the home. Some communal areas were very cluttered with equipment and furniture, and had limited useable floor space. alternative configuration or provision should be considered. Shared rooms. If curtains are drawn around the bed closest to the windows, then the second bed is deprived of almost all light from the window. consideration should be given to an alternative configuration Bathroom and WC windows should have blinds or curtains to ensure privacy and provide homely touches Bathroom areas would benefit by the provision of a chair for assisted dressing / undressing where there is sufficient H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 27 St Benedicts Nursing Home useable floor space, and 9. 10. 11. 12. 13. OP22.3 OP22.6 OP24.2 provision for clothing and personal effects. There should be handrails down both sides of 1st floor corridor, to cater for all residents The registered person should consider whether the installation of Loop systems would benefit residents with hearing aids Electrical sockets in bedrooms need to be accessible. Double rooms should\have at least three double electrical sockets. St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 28 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Benedicts Nursing Home H56-H05 S26118 St Benedicts NH V230774 270705 Stage 4.doc Version 1.40 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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