Inspection on 23/06/08 for The Beeches

This inspection was carried out on 23rd June 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.

Other inspections for this house

The Beeches 10/06/09

The Beeches 06/06/07

The Beeches 07/09/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE The Beeches 6 Brunswick Terrace Wednesbury West Midlands WS10 9DA Lead Inspector Linda Elsaleh Key Unannounced Inspection 09:30 23 & 25th June 2008 rd 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 The Beeches DS0000066611.V367088.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. The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Beeches Address 6 Brunswick Terrace Wednesbury West Midlands WS10 9DA 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) 0121 556 0435 Asha John Mr Dennis Valentine John Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th June 2007 Brief Description of the Service: The Beeches has been in operation as a care home since 1985 but in May 2006 came under new ownership. It is located in a cul de sac very close to Wednesbury town centre so it is in reach of numerous facilities including shops and main bus routes. The house is a large traditional property that has been extended in the past to its present size and layout. All bedrooms are sited on the first floor of the house and can be accessed by a shaft lift. There are a number of toilets on the ground and first floors with bathrooms (including assisted facilities) on the first floor. The ground floor also houses the lounge, dining room, kitchen, laundry and office. Ramped access is now available to the rear of the property, this a valuable addition to the facilities on offer and greatly assists access in and out of the home for frailer residents. The home is managed on a day-to-day basis by a joint provider/manager who is supported by care staff (some seniors) cook and domestic. The home offers predominately long stay accommodation but has offered some short-term care in the past. The manager should be contacted for information about the fees charged for this service. The Beeches DS0000066611.V367088.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 unannounced inspection was carried out on 23rd & 25th June 2008. The purpose was to assess the home’s performance against the key standards identified in the National Minimum Standards for Care Homes. Our findings are based on the information received by the Commission for Social Care Inspection, (the commission), examination of relevant records and documents kept at the home and discussions with the joint owner/manager, staff and people who live in the home. Comments received by people who live at the home and relatives were generally positive about the service being provided. The staff team was described as “caring” and “helpful”. What the service does well: What has improved since the last inspection? Assessments carried out by the home are more detailed. Prospective service users should be provided with written confirmation that the home is able to meet their needs as part of the assessment process. The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 6 A programme of re-decoration and refurbishment has been implemented to improve the environment for people who live at the home. Work still needs to be carried out to improve the bathing and toilet facilities. A more planned approach is being taken to arranging training for staff. The training provided about meeting dietary requirements has improved the provision in the home for meeting people’s dietary needs and preferences. Entries on dietary records about foods to be avoided when taking certain medication would further ensure the needs of individual is being fully addressed. 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. The Beeches DS0000066611.V367088.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 The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is adequate. Written information is not provided by the home to prospective service users. However, people are able to visit the home before making a decision about where to live. The home has made some improvements to its process for assessing the needs of prospective service users. However, written confirmation stating the home is able to meet their needs and personal preferences is not provided. A copy of the contract agreed with the home stating the terms & conditions of residency is provided to the prospective service user. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 9 Information provided by the joint provider/manager before our visit stated the home’s Statement of Purpose had been produced in a user-friendly brochure. The joint provider/manager informed us this, and the Service User Guide, was being up dated to reflect recent changes. One person who lives at the home told us s/he had not been provided with information about the service before moving in. The senior member of staff on duty told us they had been asked to consider a placement for this person at short notice. The information in the person’s file confirms this and identifies this has a short-term placement. A review of this arrangement is overdue and should be addressed by the home. Other people who live at the home told us they had been provided with information about the home. One relative told us s/he did not receive any information from the home about the service it provides, but had read a copy of our inspection report (Commission for Social Care Inspection) and also took the opportunity to visit the home, on their family member’s behalf. The joint provider/manager and senior member of staff told us a person was moving into the home following day. A visit was made to the home prior to the placement being agreed. The files we looked at contained care assessments from the funding authority. The assessments carried out by the home shows improvements are still being made to this process. Assessments include information about the individual’s past and their current lifestyles. The records show arrangements have been made for staff to attend training in caring of people with dementia and managing diabetes. The assessment for one person, who had recently moved in, included detailed information about their physical needs such as hearing, sight and mobility and dietary requirements/preferences and interests. The service has not provided individuals with written confirmation that it is able to meet their assessed needs. However, a copy of the contract/statement of terms & conditions between the home and the individual is available on the files. The Beeches DS0000066611.V367088.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 Quality in this outcome area is adequate. Information in care plans about the health, personal and social care needs of people who live at the home have improved. However, for individuals to feel confident their changing needs will be fully met the home needs to apply a more consistent approach to producing care plans and the risk assessment process. The home has suitable procedures for managing people’s routinely prescribed medication. However, protocols should be introduced for monitoring the use of “as required” medication to ensure the health and well being of the individual is fully protected. People are treated with respect and their right to privacy is upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 11 The files we looked at all contained plans for different aspects of the individual’s care and information about the level of support required. The standard to which care plans have been completed vary in quality. However, there is evidence to demonstrate the home is taking action to improve in this area. The assessment for one person showed s/he is generally independent in most tasks. The care plan shows minimal support is required for washing and dressing and identified which areas s/he required assistance. A risk assessment informed staff of the action to be taken to reduce the risk of slips and falls when the person is getting in and out of the bath. This was last reviewed in June 2008. The person told us “Staff are very good; they help me to wash each day and make sure I get in and out of the bath safely.” The mobility plan for another person shows s/he “uses 2 sticks when walking and is unable to negotiate the stairs”. As stated in the plan, staff are aware of the need to provide this person with additional support when moving around the home and using the lift. Plans are also in place for meeting nutritional and incontinence needs. Risk assessments have been carried out and are available on the individual’s file. Staff told us they had attended training in moving and handling. This is recorded on the training files and arrangements are made for newly appointed staff to attend this training. Care plans and risk assessments are being reviewed internally each month by the home. However, we saw no real evidence of the involvement of the individuals this process. Care plans had not been signed by the individual or their representative. Two people spoke clearly to us about their needs and how this is addressed by the home. One relative told us they attended a meeting with their family member four weeks after s/he had moved into to discuss how they had settled. They also confirmed their family member was able to able to make their own decisions, but required support to carry out some physical tasks. The support required is detailed in the person’s care plan. A signed “disclaimer” was seen on some people’s files indicating they have declined staff intervention, for example, advice given for wheelchair and bedrails. Discussions held with individuals and/or their representatives about managing risks should fully recorded and appropriate action identified. Although health & safety training has been provided, staff would benefit from specific training in risk assessing and risk management to ensure health & safety regulations and good practice guidelines are followed. The joint owner/manager and senior member of staff have agreed to take action to address these issues. The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 12 People who live at the home have access to community based health care services, such as chiropodist, dentist and opticians. A record is kept of appointments and outcome of consultations. One person told us s/he did not wish to see a dentist. A note has been made on her/his file for staff to discuss this again with them at a future date. Medication managed by the home is stored appropriately. The medication folder includes a list of six staff authorised to administer medication. This list requires updating and a sample signature and initial should be obtained from the relevant staff for auditing purposes. Since our last visit the home has arranged for night staff to receive medication training. Two people’s files show their medication is being managed by the home at their request. One person living at the home confirmed they are pleased with this arrangement. A relative told us they are also pleased with arrangements for the home to manage their family member’s medication because s/he had become confused and was forgetting to take her/his tablets. The records show suitable arrangements are in place for ordering, receiving and returning medication. The majority of medication is provided in a monitored dose system. The home enters the date medication that is not provided in this way, such as eye drops and creams, is opened to ensure use by dates are adhered to. A photograph of the individual is kept with her/his medication administration record (MAR) sheets. The majority of these sheets are pre-printed by the pharmacist, however some entries have been handwritten by the home. It is advisable for handwritten entries to be witnessed and signed by a second member of staff to reduce the risk of recording errors. The MAR sheets we looked were completed to acceptable standards. There are a number of people living at the home who manage some of their own medication, such as inhalers. This information is not always recorded in their care plans. We found examples where staff have recorded medication “refused” on MAR sheets for people who look after their own inhalers that are prescribed for use “as required”. The home should review its protocols for people who administer their own medication. Individual protocols should also be produced for “as required” medication prescribed for each person that is managed by the home on her/his behalf. Staff practice in this area should be observed to ensure protocols are being followed appropriately. People who live at the home told us staff respect their right to privacy. We observed staff referring to individuals by their preferred names and knocking bedroom doors before entering. Consultations with health care professionals take place in private. Where requested by individuals, a member of staff is available to support them during consultations. The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. People who live at the home are offered a range of activities, but support to participate in group-based activities or to follow individual interests is often dependent on the availability of staff. People living at the home should be provided with more opportunities and support to maintain their independence, wherever possible. The home’s visiting policy supports people to maintain contact with family and friends. Meals and mealtimes are arranged to meet the dietary needs and preferences of people who live at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 14 People who replied to our survey stated suitable activities are provided by the home. One person we spoke to told us they like watching television and playing dominoes, another said they enjoy reading and the company of other people who live in the home. The home provides group activities, such as dominoes, hula-hoops and bingo. Records are kept of the activities individuals choose to participate in, including following their own interests, such as reading & watching television. One person has arranged to go on a day trip with her/his club. We spoke to a resident who was in the garden. S/he told us they enjoyed “pottering” around looking after the flowers. Residents occasional meet to discuss issues about how the home is run. The minutes of a recent meeting includes requests for more board games and shopping trips to be arranged. One resident told us s/he would like more stimulating activities. S/he also said staff have escorted her/him, in the wheelchair, to the local shops. But found the trip uncomfortable due to the poor state of the road. Staff we spoke to said they would like to be able to spend more time supporting residents to participate in group-based and individual activities. The care staff team is responsible for carrying out all laundry tasks and some catering duties. They have, until recently, also been responsible for cleaning. The joint owner/manager is advised to look at the impact these duties may have on meeting the social needs of the residents. There is little evidence to demonstrate how the home supports people to maintain their independence and exercise their right to make their own decisions. The senior member of staff told us a key worker system has recently been introduced. The role will include holding one to one sessions with the resident to discuss their care needs and how they can be supported to maintain her/his independence. The home operates an “open door” policy for visitors. We observed visitors arriving throughout the time of our visit. Comments received from relatives were generally positive about service, but some did feel the home could provide more stimulating activities and outings. Written comments we received were all positive about the meals. People told us during the evening staff ask them for their choice of meals for the following day. However, should they change their mind or request something different this is usually accommodated. Care plans include information about people’s dietary needs and personal preferences. Nutritional assessments are regularly reviewed and a record is kept of meals people have eaten on their individual files. We were told a few residents are able to manage their own diets and “know what they can/cannot eat”. Training is being provided to enable staff to provide good dietary advice to people with diabetes. Information on some medication labels identifies the need to avoid certain foods. A record of this should be included on the individual’s dietary records. The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 15 We were told one resident, who spends a lot of time in their bedroom, chooses to join the other residents for meals in the dining room. Drinks are provided throughout the day and a large bowl of fruit is available in reception. Staff told us snacks are provided on request. A cook is employed to prepare breakfast and mid-day meals. A member of the care staff team is responsible for preparing the evening meals and other meals when the cook is not on duty. Training in Basic Food Hygiene is provided. A food premises inspection visit has been carried out by the Environmental Health Agency. A brief examination of the kitchen facilities show three of the six requirements made have still to be fully addressed. The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. People who live at the home and their relatives are aware of the home’s complaints procedure. They feel staff listen to their concerns and these are usually addressed to their satisfaction. Policies and procedures are available in the home and staff receive training in safeguarding people who live at the home abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure. A comment book is available in the reception area. People living at the home and visitors told us they were familiar with how to make a complaint and would speak to a staff member if they were unhappy or concerned about anything. Residents meetings also provide people with the opportunity to discuss general aspects of the running of the home with staff. Information sent to us by the home in an Annual Quality Assurance Assessment report (AQAA) shows no complaints about the service has been made directly to the home. During the last twelve months the local authority The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 17 has received two complaints about the service. A local authority representative has made regular visits to the home and discussed the issues with the joint owner/manager. The home has safeguarding adults and prevention of abuse and whistleblowing policies. Staff we spoke to told us they had attended adult protection training. They were clear about their duty to report any suspicion or allegation of abuse. Training certificates are available on the files we looked at. The matrix show arrangements is being made for a further five staff to receive this training. The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 18 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): 29 & 26 Quality in this outcome area is adequate. The home has made some improvements to provide people who live at the home with a safer and better-maintained environment in which to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home continues to carry out work in improving the environment. The lounge and dining room have been re-decorated and new flooring fitted. As previously mentioned, work needs to be carried out in the kitchen to meet the requirements identified in Environmental Health Agency’s report. The ground floor toilets are fitted with grab rails, but are in need of re-decoration. There is a small laundry area to rear of the premises. A pass lock needs to be fitted to The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 19 the staff toilet and suitable facilities should be provided for staff to store their personal items. Bedrooms are situated on the first floor and can be accessed via the shaft lift or staircase. One person used the staircase when showing us her/his bedroom. They told us their room was comfortable. A lock is fitted to their door, but they told us they did not wish to hold the key because staff often ‘pop in’ with a cup of tea, return their laundry and periodically check to see they are all right during the night. A senior member of staff told us most people’s bedrooms doors now have locks fitted, but they do not wish to have their own key. Five bedrooms were seen during this visit and most have been recently decorated. Residents have personalised their rooms with family photographs, ornaments and small pieces of furniture they brought with them. Commodes are provided in most bedrooms. A senior member of staff told us not all people who have commodes in their bedrooms need them. The provision of commodes for individuals should be assessed and rusty commodes replaced to reduce the risk of the spread of infection. A toilet and two bathrooms are located on the first floor. All are in need of redecoration & refurbishment. The lighting in the bathrooms is very dim and needs to be replaced to reduce the risk of accidents occurring. A mobile ramp is fitted to the side exit to enable people to access the garden via a short path. There is a lawn and flowerbeds for people to enjoy in fine weather. The joint owner/manager told us quotes have been obtained for work to be carried out on the patio and walkways. Personal protective clothing & equipment; such as disposable gloves, aprons & bags are provided for staff. The records show five members of staff have completed infection control training and four are in the process of completing the course. The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is adequate. People who live at the home are being care for by a staff team who are being provided with better training opportunities. Further improvements need to be made to recruitment procedures and staffing levels to ensure the standard of care provided to people living at the home continues to improve. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the last twelve months there has been significant changes within the staff team. Due to depleted staffing levels the home has not followed a robust procedure for recruiting new staff. There have been occasions when posts have been taken up following a clear PoVA First (Protection of Vulnerable Adults) check and prior to CRB (Criminal Record Bureau) checks being completed. The joint owner/manager has been advised, except in exceptional circumstances, to follow robust recruitment procedures to ensure the well being of residents are fully protected. We looked at the recruitment files for two staff and found two references on file and satisfactory CRB checks. Staff we spoke to told us a seven day induction process was followed and they work with a senior member of staff at all times. Completed induction checklists are The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 21 available on the files. The content in supervision records have improved and contains details of the discussions held about practice issues and training needs. We were informed nearly all members of the staff team hold the NVQ (National Vocational Qualification) Level 2 training in Health & Social Care. Staff we spoke confirmed they had completed this training and certificates were available on the files we looked at. The home is registered to provide care for a maximum of fifteen older people. A reduced number of people have been cared for during the last twelve months. The rota shows three care staff are on duty during the morning shifts and often includes the joint owner/manager. One person in the home requires the support of two care staff at different times during the day. Until recently cleaning duties have also been carried out by care staff. The domestic post has now been filled and the worker is receiving induction training. During the afternoon/evening two members of staff are on duty. As previously reported, part of the care team’s duties is to prepare the evening meal. One person is on duty at night to meet the needs of the residents. Another member of staff sleeps in on the premises and is available to provide additional support, if/when required. The deployment of staff means there are times throughout the day when some residents are left without any staff support. This was discussed with the joint owner/manager. He stated an additional member of staff has been rota-ed for duty since our last key inspection and arrangements have been made to recruit more care staff. An experienced manager is due to commence work in the very near future and an application will be made to the commission for her to become the registered manager for the home. The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 22 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 Quality in this outcome area is adequate. The management and administration of home has continued to be reactive rather than planned. The home needs to fully implement a comprehensive quality assurance system in order to identify a systematic approach for the development of the service. A satisfactory system is in place recording the small amounts of money the home manages on some people’s behalf. The health, safety and welfare of people living in the home is promoted and protected by regular routine checks and servicing of appliances and equipment and training provided to staff on matters of health & safety. This judgement has been made using available evidence including a visit to this service. The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 23 EVIDENCE: The home continues to be managed by one of the two owners. During the last twelve months the manager has made some improvements to the environment, such as replacing floor coverings and re-decoration of communal areas. Progress made to improve care practices within the home has been slow. A robust quality assurance system has not been implemented. Information gathered by the home about the service it provides have not been analysed and a development plan for the service has not been produced. The home manages a small amount of money for a few people. Suitable arrangements have been made to obtain their personal allowance on a regular basis. Records are kept of all transactions made on their behalf. The records and money held by the home for the two people we checked was found to be correct. Staff told us individual supervision sessions are normally once every two months. As previously stated, the quality of the recordings for these sessions have improved. Team meetings are also arranged throughout the year. Two have been held this year. Staff unable to attend a meeting read and sign the minutes. Certificates were seen for the servicing of appliances and equipment, such as the fire alarm & detection system, passenger lift, hoist and portable electrical appliances. The gas appliances and heating system are due for a service in August. The home has made progress in providing training for staff in different aspects of health & safety to ensure safe working practices are followed, such as basic first aid, fire safety, moving & handling and infection control. The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 2 2 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 X X 3 The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 12(3) Timescale for action Discussions held with individuals, 30/09/08 their relatives and/or other significant people about health & safety matters, which affect the safety of the individual and others and how the matter is to be addressed, must be fully recorded. Medical advise about the need to 30/09/08 avoid certain food should be included on the individual’s dietary information. Protocols must be produced for 30/09/08 all medication prescribed, “as required” to ensure the health and well being of the individual is fully promoted. Requirement 2. OP9 13(2) 3. OP9 13(2) 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 The home’s statement of purpose and service user’s guide DS0000066611.V367088.R01.S.doc Version 5.2 Page 26 The Beeches 2. 3. OP4 OP7 4. OP9 should be provided to prospective service users, their relatives and other interested parties. Prospective service users should be provided with written confirmation from the home that it is able to meet her/his needs. Information should be included in care plans and daily recording of how the home encourages and supports individuals to participate in planning for her/his care and maintaining their independence, wherever possible. The list of staff responsible for managing medication should be kept up to date, with a sample of the staff member’s signature and initial, to enable effective auditing of the records to take place. Handwritten entries by staff on a person’s medication administration record sheet should be witnessed and signed by a second member of staff to reduce the risk of recording errors. A review should be held into the availability of staff to support people to participate in more activities. Arrangements should be made to address all the issues identified in the report of the visit made to the home by the Environmental Health Agency. The programme for redecoration and refurbishment should continue with particular attention being given to the kitchen, toilets & bathrooms. An assessment of the need to provide commodes should be carried out and, where applicable, replacement commodes provided. Suitable staffing levels should be maintained at all times to ensure the needs of the people living at the home are being fully met. Robust procedures for recruiting new staff should be followed to ensure the safety and well being of people living in the home is fully protected. A comprehensive quality assurance/monitoring system should be implemented. A development plan for the service should be provided to people who live at the home in order for them to be confident the service will continue to improve. 5. 6. 7. OP12 OP15 OP19 8. 9. 10. OP27 OP29 OP33 The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 The Beeches DS0000066611.V367088.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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