Inspection on 23/05/07 for The Beeches Residential Care Home

This inspection was carried out on 23rd May 2007.

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 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 Residential Care Home 14/10/08

The Beeches Residential Care Home 01/10/07

The Beeches Residential Care Home 10/05/06

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Beeches Residential Care Home 12 Higham Road Rushden Northamptonshire NN10 6DZ Lead Inspector Sarah Jenkins Key Unannounced Inspection 23rd May 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Beeches Residential Care Home DS0000066337.V341085.R02.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 Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Beeches Residential Care Home Address 12 Higham Road Rushden Northamptonshire NN10 6DZ 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) 01933 318498 01933 386811 Mrs Manonmany Wragg Vacant Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24), of places Physical disability over 65 years of age (4) The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total numbers of service users must not exceed 24 No service users with a physical disability may be admitted to the home when there are already 4 such service users in the home No service user with dementia may be admitted to the home when there are already 24 such service users within the home 10th May 2006 Date of last inspection Brief Description of the Service: The Beeches home is centrally located in Rushden with easy access to shops and services. The home is a converted older property with character, and has a large and pleasant garden area. One wing of the home was built after the original building and is more modern. There are several areas where service users can spend their time during the day including a conservatory. The home cares for elderly people some of whom have a physical disability and a large number who suffer from confusion, or diagnosed Dementia conditions. There is mixture of single and shared room facilities, some of which have en suite toilet and bathroom. At the time of the inspection, the fees charged at the home ranged from £375 £420 per week with extra charges for hairdressing, chiropody and newspapers. Further information is available from the home in the form of the Statement of Purpose and Service Users Guide and the most recent “key” inspection report is displayed on the homes notice board. The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 3 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. The Inspector visited during the early morning to observe practices by staff and to meet with the night staff as well as the day staff and service users. A number of Service users have diagnosed dementia conditions and thereby communication for many is difficult. Establishing Service Users choices and informed decisions is dependant to some extent upon the consistency of staff, service users relationships with staff, and the quality of communication. Feedback obtained from Service Users in this report was in part through observations of their relationships with staff, and also through interpretations of their general levels of happiness with their routines. The Inspector reviewed the history of the home prior to the site visit and the inspection was informed by this, and also by written feedback from some of the service users and from a number of service users’ relatives. No selfassessment questionnaire was available at this Inspection. What the service does well: Staff are caring and responsive to the perceived needs of service users, and welcome visitors. Service users relatives are encouraged to visit and become involved in the social activities of the home. Staff were helpful and cooperative with the inspection process. Recently admitted service users felt that they had been warmly welcomed to the home and enabled to settle in quickly. Service users were complimentary about the provision of food at the home, and discussion with the cook on duty at the time of the inspection showed the The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 6 individual thought and care that went into ensuring service users were well nourished. What has improved since the last inspection? What they could do better: The management of the home must consider all the shortfalls identified on this report and ensure that an effective response to shortfalls is delivered. Some of the issues, such as Health and Safety and the supervision and occupation of service users with dementia needs have arisen in previous reports, and it is disappointing that the response to these issues has not been sufficient to ensure a lasting improvement. The registered facilities of the home e.g. upstairs bathroom must not be taken out of action without proper planning and discussion with the Commission for Social Care Inspection as the Registration Authority. Equipment must be properly and promptly serviced. Care should be taken to ensure that staff and management are fully familiar and up to date with good practice issues in relation to all aspects of care. It is important not to inadvertently bypass professional processes that protect service users, such as the process for administration of covert medicines, or the assessment of bedsides by the District Nurse. Care Plans should be improved to serve the function for which they are designed. Particular attention must be given to safeguarding and protection issues. The lack of proper supervision of service users with dementia has led to incidents between service users, and the failure of senior staff to recognize this as the serious issue that it is, is of great concern. The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 7 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 Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 8 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 Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are assessed prior to their admission but processes should be improved to ensure that care needs and provision are fully understood by staff from the time that service users arrive. EVIDENCE: Service users were generally happy about their admission to the home although the two who shared their experiences with the inspector could not remember receiving any written information or brochure. They said that relatives had arranged everything for them and that they were happy with the outcome, and with the warm welcome that they had received. The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 10 Service users needs were assessed prior to admission, but not all the relevant information including areas of risk had been properly transferred to the initial care plan. For example a service user who was deemed to be at risk of falling (on the hospital discharge note) was recorded not to be at risk of falls on the homes risk assessment. This lack of full information to staff at the time of admission could leave service users at unnecessary risk. In one instance some aspects of the admission process were inadequately resolved by the time of a service users admission, resulting for example in the use of bedrails that had not be professionally assessed as suitable. The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 11 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. This judgement has been made using available evidence including a visit to this service. Overall personal and health care are adequate, but there are areas that need to be improved to ensure service users can be fully confident in the professionalism of the home. EVIDENCE: Generally physical healthcare is reasonable with a prompt response by staff to service users perceived needs. Healthcare professionals are generally promptly accessed as needed. Service users spoke of their general satisfaction with health and personal care and records generally reflect this. The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 12 Care plans do not always contain sufficient information for staff to be able to establish service users full needs and wishes. Medical information relating to the service users condition/s at the time of admission is often missing. Service users who were able to discuss their care with the inspector were not aware of their care plans or any review of their needs. Care plans were not signed or dated and there was no record on the care plan of how information had been established or whether service users themselves and/or relatives had been involved. Service users with specific mental health needs had insufficient information on their care plans to inform staff properly about potential behaviours, and how to deal with these consistently. There was a note on one file for example that a service user was diagnosed as suffering from a specific mental health issue, however staff have not been trained in this area and there was only generalized information on this condition. There were no detail as to how she may be effected or what symptoms staff should be aware of in relation to her personal history. Another service user was recorded as being occasionally aggressive. The care plan gave no further information as to how this aggression might present; whether staff had observed what might trigger her behaviour or how staff were to respond. This sort of detail is necessary to ensure best care practices and to avoid service users suffering unnecessary distress. A service user who had arrived at the home with bedrails that staff felt were unsuitable for the bed she was allocated, was given bedrails that the home had already got on site. There was no proper assessment by a District Nurse to ascertain whether these rails were suitable. There was evidence in records that this service user made attempts to get out of bed and thereby the correct assessment of the use of bedrails was critical to her Health and Safety. There was also a failure to have bedsides properly assessed by the District nurse at the inspection of May 2005. During the current inspection the Acting Manager was advised to telephone the District Nurse to ask her to visit to assess the situation, and did so. Medications are generally well managed although the home had not accessed the correct procedure for dealing with medications that service users have difficulty with. For example although staff had discussed a situation with the service users General Practitioner, they had failed to consult the pharmacist about a particular medication that was being crushed for administration to the service user. The instruction on the medication read “do not chew”, and it is doubtful therefore that crushing this medication was appropriate. There had been no multidisciplinary discussion or decision about the administration of medicines to the service user in this way. There was indication of plans to provide one essential medication in liquid for form this service user, but this intention had apparently been withdrawn by the surgery on grounds of cost. The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 13 Medications are not always properly labelled leaving staff unable to cross check the label against the Medication Administration Sheets. (see also under “Premises”, re Standard 10 Privacy and Dignity) The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 14 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 poor. Staff appear to lack sufficient understanding of the importance of appropriate activity and stimulation during the day time in relation to the maintenance of quality of life, and healthy sleeping patterns for service users with Dementia EVIDENCE: Service users who were not suffering from Dementia were fairly satisfied with their lifestyles. One service user commented that she had lacked activity at first but was being supported by a visiting relative in her interests now. These service users were often able to occupy themselves through reading, watching television or through conversation with each other. Service users with Dementia were less well occupied. On the inspectors arrival at the home many were already up, and most dozed on and off through the morning in their chairs. Night staff confirmed that service users had been assisted to dress as they had been active through the night and had woken early. The lounge area where they were placed, was not supervised by staff for considerable lengths of time. The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 15 The inspector observed that there was very little activity or stimulation offered during the morning, and this lack of activity during the daytime is likely to contribute toward sleep pattern disturbances. Staff failed to promote service users choice and control in respect of their activities. Generally feedback on comment cards was positive about the home. But several relatives expressed an “unsure ness” about their knowledge and expectations for care for their relatives with dementia. Whilst thinking the home was very good, opinions were expressed that service users with dementia may not be able to make choices, and questions were raised about the lack of, or “erratic” activities in the home. One visitor felt that staff had made efforts to interest her relative. There was no evidence of the provision of regular daily activities for individual service users in their records. Notices around the home gave notice of some planned social events inviting friends and family and when asked about the use of the garden, staff mentioned these occasions. On the key inspection report last year the inspector advised of the fact that some service users spoke of their yearning to go outside. The home has pleasant accessible gardens, and the current inspection was undertaken on a fine day. However it was not until the inspector commented that this option for service users was still not being offered that staff enabled service users access to the garden. There were positive comments about the catering at the home. Service Users felt that the food was appetizing and nutritious. The cook explained how she ensured service users were enabled to have choices and how she encouraged service users with poor appetites. The Beeches Residential Care Home DS0000066337.V341085.R02.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 poor. This judgement has been made using available evidence including a visit to this service. The failure by staff to respond in a professional manner to issues arising leaves service users at risk. EVIDENCE: The Inspector found evidence that a service user had recently reported an incident between two service users to staff. This was noted in the handover book by a senior staff member but had not been properly reported to the acting manager, and had therefore not been properly investigated. By the time of the inspection there was evidence that this was an ongoing issue. Service users are not always being properly supervised and thereby protected from abuse. Three complaints have been investigated by the home since the last inspection and these investigations appear to have been undertaken within the timescales. One complaint referred to the behaviours of a service user. The inspector advised of the need to review whether the lack of supervision of service users with Dementia was a contributory cause to the problem, especially as staff had not apparently been aware of the situation. A service The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 17 user had taken photographs of other service users in support of his complaint. Although these photographs do not demonstrate any abuse it is regrettable that service users privacy was invaded in this fashion without their permission, and that service users were clearly not being fully supervised and thereby protected at that time. Two complaints were made to the Commission for Social Care Inspection, one of which was properly investigated by the home. The other relating to premises issues was reviewed through the inspection process and comments are included in the premises section of this report. Whilst staff have received training in safeguarding adults, insufficient response to situations arising are indicative of a need for further knowledge and understanding in this area. The Beeches Residential Care Home DS0000066337.V341085.R02.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): 19,21,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally, maintenance and decoration are properly addressed and the home was seen to be clean and tidy. The facilities available to service users have been temporarily reduced without notification to the Commission for Social Care Inspection resulting in privacy and dignity issues for service users. EVIDENCE: Service Users expressed satisfaction with their rooms and the general areas of the home. The level of cleanliness and hygiene were good. The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 19 One registered room, currently vacant, was very limited in its use and the arrangement of furniture was not conducive to good care. For example the bedside light was behind the bed due to space restrictions and was not available for its designed use. The Registered Owner should give proper consideration to the future use of this room, which would be unsuitable for many elderly people. The inspector was concerned to note that the upstairs bathroom had been taken out of use at least a fortnight prior to the inspection and fittings had been stripped leaving a hazardous area with holes in the floor that was not properly secured against service users wandering in and injuring themselves. Some service users thereby had inadequate access to bathing facilities. In order to access a bath, service users have to go downstairs in their dressing gowns and walk the full length of the ground floor, through public areas. This is not in the interests of their privacy and dignity. The inspector had not been notified of this restriction of the available registered facilities of the home. The temperature in the conservatory and the direct sunlight on service users was observed to cause discomfort to a service user. Staff assisted her to move and provided soft drinks but there needs to be proper consideration as to how the temperatures in the area can be kept to an acceptable level through shading and/ or an air conditioner. Excessive heat presents serious risk to elderly people who may not have adequate internal heat control, and the need to resolve this is fairly urgent in view of impending summer weather. The Beeches Residential Care Home DS0000066337.V341085.R02.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 This judgement has been made using available evidence including a visit to this service. Staffing has improved since the last inspection and service users feel more confident in staff. Service users are still not all receiving the quality of care expected, and there are risk factors that have not been fully addressed. EVIDENCE: At the time of the inspection there were four care staff on duty, assisted by ancillary staff. This is an increase in the level of staffing since the last inspection. However given the layout of the home and the needs of service users this may still not be enough to meet the individual needs of service users with dementia, where care and supervision shortfalls have been identified. There are currently two staff on at night although approximately 6 service users need two carers together to attend to their night-time/movement and handling needs. This leaves other service users including those with Dementia, vulnerable to long waits when they use the call system for assistance at night, This could put service users at risk. The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 21 The inspector advised again on the need for a full review of staffing against the current needs of the service users. There may be issues relating to the supervision or deployment of staff or the leadership on shift. Concerns about staffing levels and deployment of staff were identified in the report of the inspection carried out in May 2006. A random inspection in July 2006 identified that a written commitment by the Registered Owner to improve staffing levels was not at that time being properly fulfilled. Given that this inspection has highlighted ongoing shortfalls in the level of care received by residents the process for determining staffing levels clearly needs to be reviewed. There was evidence that the training of staff is now being properly addressed, and that staff are receiving a far greater input of training. A number of staff have now completed their National Vocational Qualification 2. However despite the evident improvement, this is an area that still needs further input. For example there are issues relating to moving and handling assessments as discussed with the acting manager, and staff need a fuller understanding of mental health needs and protection, even if some of this training is delivered in house, by experienced personnel. Following the inspection the Registered Owner has talked with the inspector about the staffing improvements that have been made since the last inspection and explained she is confident that there is now a cohesive staff group who have undertaken a good deal of training. This was reflected in the general atmosphere of the home and the positive feedback about the kindness of staff from service users. Recruitment processes were reviewed through discussion with the acting manager and records. Staff records were well organized and all the necessary information was readily available demonstrating an appropriate recruitment process. The Beeches Residential Care Home DS0000066337.V341085.R02.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): 33,35,38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Although there are improvements in some of the management systems, overall management arrangements are not protecting the health, safety and welfare of residents. EVIDENCE: Standard 31 has not been assessed as such as this relates specifically to a registered manager and there is no registered manager in post. However The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 23 management arrangements have been considered and are reported on as they have a direct effect on standards of care provided to residents. Given the action plans previously submitted by the Registered Owner, which indicated a commitment to identifying and addressing shortfalls it is disappointing and of concern that this does not seem to have resulted in lasting improvements in standards of care. Health and Safety issues generally, are not being addressed with sufficient priority or commitment, as detailed also in other parts of this report (Health and Personal Care, Complaints and Protection, and Environment) and the failure to do this is leaving service users at risk. The home has a registration for service users with Dementia and it is of particular importance that risk factors are properly recognized and managed. The Inspector is concerned that the overall management of the home has failed to sufficiently address this area. For example; • Doors, which were marked to be kept locked shut for Health and Safety reasons, including a cupboard with the main controls for the central heating and hot water were actually unlocked and accessible to Service Users. This matter was also brought to the attention of the Registered Owner in the report of July 2006, and has not been resolved. • There was no evidence of sufficient servicing of a hoist, the loose bolt of which had caused an accident. • The fire door from the laundry area, fitted with a door guard automatic closure device, was propped open, thereby presenting a fire risk. Some of the systems and practices observed indicate a need to consider training and practice for staff in relation to their particular roles. For example Steradent tablets were noted to be left in a bedroom occupied by a service user with diagnosed dementia and there was no evidence of a risk assessment for this or for similar products. Such products pose a particular risk to residents’ with dementia who may eat the tablets, with serious consequences. Issues leading to the staffing problems (see under Staffing) need to be identified by Management and resolved. Staff supervision has slipped. There was evidence of the performance of a staff member, not having been properly monitored or supported through regular supervision. Service users monies are kept safe by the manager and her deputy and records show receipted transactions undertaken on behalf of service users. The Beeches Residential Care Home DS0000066337.V341085.R02.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 x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 1 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 1 2 x 1 x x x x 3 STAFFING Standard No Score 27 1 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 1 x 3 x x 1 The Beeches Residential Care Home DS0000066337.V341085.R02.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 OP3 Regulation 14 Requirement Timescale for action 30/06/07 2 OP7 12,15 3 OP8 OP12 12 4 OP8 13 The care and equipment needs of prospective service users, which have been established during the initial assessment, must be known and accessible to care staff to ensure care given is sufficient and safe for the service user from the time of their admission. Care plans must be reflective of 31/07/07 service users current needs in order to ensure their needs are met. They must be sufficiently detailed to guide staff in providing consistent care. All aspects of service users 31/07/07 mental health and/or Dementia care needs must be properly recognized by staff and effectively responded to in order that service users may maintain their potential and lead as full and satisfying lives as they are able. A risk assessment must be 30/06/07 carried out, prior to the use of bed rails to reduce the risk of injury. A suitably qualified and trained person must do this. DS0000066337.V341085.R02.S.doc Version 5.2 The Beeches Residential Care Home Page 26 5 OP9 13 6 OP9 13 7 OP12 OP27 OP14 12,13,18 8 OP18 13 9 OP21 39,23 Proper procedures must be implemented in relation to the administration of crushed tablets to service users to ensure that this is safe practice. Medicines should always be properly labelled.” As directed” should be qualified in terms of the reasons for administration, the amount to be given, the minimum times between dosages and the maximum dose in 24 hours to protect service users from administration errors in relation to medication. There must be sufficient staff available to meet service users needs and ensure adequate supervision of their Health and Safety at all times. It is important that service users are enabled to keep adequately active and interested in their surroundings and can exercise choice in their daily routines. In order to ensure that service users are properly protected, all allegations and incidents of abuse must be reported and followed up promptly and action taken should be recorded Notification must be made to the Commission for Social Care Inspection where there is a significant change to the premises (upstairs bathroom), so that the management of this, and the impact on service users can be overviewed. Information must now be forwarded on the expected timescales for the renovation of this bathroom. Arrangements must be in place to ensure that service users are not put at unnecessary risk to their health and safety, as DS0000066337.V341085.R02.S.doc 30/06/07 30/06/07 30/06/07 30/06/07 30/06/07 10 OP33 OP38 13 30/06/07 The Beeches Residential Care Home Version 5.2 Page 27 detailed on this report. This requirement relates to protection from hazardous situations, and substances; fire protection; proper checking and maintenance of equipment; proper supervision of service users by staff and protection of service users from abuse. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. 3. 4. 5. Refer to Standard OP36 OP18 OP28 OP30 OP38 Good Practice Recommendations Staff supervision should be fully implemented in accordance with the Standards. Senior staff should receive further training in relation to the Protection of Vulnerable Adults All staff should be properly motivated to fully understand and meet the needs of Service Users with Dementia. The progress in staff training should be maintained. All staff should be alert at all times to Health and Safety issues and proper procedures should be implemented to ensure a prompt response to issues identified The control of heat in the conservatory area should be addressed (as above requirement re risk) as soon as possible. 6 OP38 The Beeches Residential Care Home DS0000066337.V341085.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. 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