Inspection on 24/04/07 for The Berkshire Care Home

This inspection was carried out on 24th April 2007.

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

The inspector 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 Berkshire Care Home 21/04/08

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Berkshire Care Home 126 Barkham Rd Wokingham Berkshire RG41 2RP Lead Inspector Julie Willis Unannounced Inspection 24th April 2007 09:40 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 Berkshire Care Home DS0000068325.V333531.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 Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Berkshire Care Home Address 126 Barkham Rd Wokingham Berkshire RG41 2RP 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) 0118 977 0233 01189 787 157 the.berkshire@fshc.co.uk Four Seasons Rosedale Limited Mrs Pauline Elizabeth Byrne Care Home 58 Category(ies) of Old age, not falling within any other category registration, with number (58) of places The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Chronically disabled persons under the age of 60 years will not be received except for convalescent or respite care for periods not exceeding three weeks. Date of last inspection Brief Description of the Service: The Berkshire Nursing Home is owned by Four Seasons Rosedale Limited. The home is a large adapted house situated in pleasant grounds on the outskirts of Wokingham. Public transport, shops and other amenities are approximately half a mile away. The home has three lounges and a large airy conservatory, which leads to a patio area and garden that has level walkways for people to enjoy. The home provides nursing care for adults aged over 65 and is staffed by qualified nurses and care assistants. The fees for this home are £625 (contract beds) to £850 per week. Additional charges are levied for chiropody, hairdressing and newspapers. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspection took place on Tuesday 24th April, 2007 between 9.40am and 5.15pm and covered all the standards for older people. Prior to the visit a questionnaire was sent to the manager along with survey and comment cards for residents, relatives and visiting professionals such as doctors and nurses. Any replies were used to help form judgements about the service. Consideration has also been given to other information that has been provided to the Commission since the last inspection. The inspector toured the building, examined records and met most of the residents and five relatives who were visiting at the time of the inspection. The inspector also spent time talking to staff and observing how care was being delivered to the residents. The home’s approach to equality and diversity was considered throughout. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to meet the needs of individuals with various religious, racial or cultural backgrounds. The inspector gave feedback about her findings to the home’s manager and deputy at the end of inspection. There were no outstanding requirements from previous inspections and four new legal requirements were made as a result of this inspection The Commission has received no information regarding any complaints about this home since the last inspection. What the service does well: The home is comfortable, clean and attractively decorated and furnished throughout. Residents are encouraged to personalise their own rooms and these are decorated and furnished to a good standard. There are enough staff on duty at all times to meet the needs of residents effectively. Recruitment practices are well carried out and the staff files contain all information needed to ensure the safety of residents. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 6 The written care records are well kept and up-to-date and provide staff with the information they need to provide the right care. The home offers users a wide range of leisure activities including games, crafts and quizzes, as well as the opportunity to see outside entertainers and to join in parties and themed events. Food provided by the home offers users variety and choice and is well presented, in pleasant comfortable surroundings. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Berkshire Care Home DS0000068325.V333531.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 Berkshire Care Home DS0000068325.V333531.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): Standard 3 Quality in this outcome area is good. Service users are fully assessed prior to admission to ensure their needs can be effectively met by the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Admissions to the home only take place if the service is confident that staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. All prospective residents are fully assessed by the management of the home prior to admission. The documentation for four people who use the service was examined and residents were case-tracked from pre-admission to date. The records evidenced that all necessary information about the users’ health and personal care needs were sought prior to admission. The use of clinical tools to assess the users’ nutrition, communication, mobility, risk of falls, continence and mental state were well developed. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 9 The inspector had the opportunity to meet residents who were being case tracked. The residents confirmed that they had been visited by the home’s staff pre-admission and had been provided with sufficient information about the home to enable them to make an informed decision as to whether to live there or not. One of the residents said that they had been visited and assessed in hospital and commented that, “The manager appeared friendly and kind”, “The manager told me what to expect and I believe what she told me was a true picture of this home”, “ I like it here, I’ve made some friends and my room is lovely now that I have my own things around me”. Several of the residents said that they had been given the opportunity to visit the home informally prior to admission and this gave them the opportunity to meet staff, view the home and bedroom allocated and to meet with other residents. Two people said that their relatives had visited the home on their behalf but commented, “My son made a good choice, I’m happy here, although of course I would sooner have gone back home”, “The home is actually better than I expected”, “I have a nice room, I’ve got everything I need”. The Berkshire Care Home DS0000068325.V333531.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): Standards 7, 8, 9, 10 Quality in this outcome area is adequate. Clear information is in place to enable staff to meet the health and personal care needs of residents. People are encouraged to participate in the care planning and review process from the outset. However, residents’ dignity is not always maintained whilst staff carry out personal care. The systems for the administration of medication are good with clear and comprehensive arrangements in place to ensure the safety of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a strong belief that residents should be fully involved in planning their care. Examination of the care plans for four people living in the home evidenced that each resident has a plan that has been agreed with them. The plan considers all aspects of a person’s lifestyle including their personal, health and social care needs. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 11 Care plans are regularly reviewed and updated and any changes to the plan are discussed and agreed with the resident and their family. Residents have individual care plans that give an overview of the resident’s general health and which act as an indicator for changing health needs. Residents are offered a shower or bath on a regular basis and are supported to remain as independent in their personal hygiene as possible. Residents confirm that they are provided with access to health and social care professionals for advice and support as necessary. They regularly see the GP who visits twice weekly and are referred to hospital when necessary for further advice, support and treatment. Routine screening and preventative treatments are provided to all residents of the home. Specialist nurses visit those people with dementia, diabetes and hypertension and McMillan nurses provide specialist support to residents requiring regular pain relief. A number of residents have private physiotherapy to aid their mobility and have been provided with walking aids, wheelchairs and other equipment. There is a need for staff to ensure that equipment, including wheelchairs, is always kept clean and hygienic as one relative and two residents said that their wheelchairs were often left in a dirty condition. The use of clinical tools to identify risks to residents in relation to tissue viability, nutrition, dependency rating, environmental risks, bathing and falls were fully developed. Care plans, treatment plans and appropriate equipment were in place to reduce the risks identified. There was evidence in the files that body maps, measurements and photographs are used when necessary to evidence resolution of wounds. The home refers residents with wounds to the tissue viability nurse at Wokingham Hospital when necessary for further specialist advice and support. Examination of the daily records clearly evidenced that care was being delivered in accordance with the individual’s care plan and that residents are involved in ongoing review. There is a need to pay more attention to the privacy and dignity of residents when delivering personal care. Staff make every effort to enable residents to choose who delivers their care and respect their preferences, but several residents said that staff spoke across them in a foreign language rather than talking to them in English. They said that staff spent a lot of time talking together rather than conversing with the residents whilst washing or bathing them. Recruitment of staff takes into consideration the need to employ a varied, balanced and skilled staff group. Staff were observed throughout the course of inspection to provide personal care in a discreet and sensitive manner. Residents were addressed courteously and staff knocked on service users’ bedroom doors and waited to be invited in before entering. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 12 During the inspection the call bells were often going unanswered for long periods. One call bell was ringing for 14 minutes before staff attended. Several residents commented that they are made to wait for attention at times. One resident said, “Staff come in, tell me to wait and then don’t come back”, and “The call bells never get answered”. The inspector spoke at length to 13 residents and to others in small groups in various parts of the home. The inspector also had discussions with five relatives who were visiting at the time of inspection. The residents and relatives were generally complimentary about the qualities and caring attitudes of the staff. They said, “Staff know when I’m not feeling well, they ask if I want to stay in my room”, “I can’t fault the carers, they’re kind and helpful and come to see me when I’m a bit off colour”. A relative said, “I know Dad is safe here, I can go home and don’t have to worry whether he is getting the care he needs”. From examination of the medication administration system and discussion with senior nurses it is clear that the home follows best practice guidance in relation to medication needs. The storage systems for medication are effective and disposal systems are safe. The ‘Doom Box’ system has been adopted by the home for the disposal of waste medication and the home has an appropriate contract with a registered disposal company. The Berkshire Care Home DS0000068325.V333531.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): Standard 12, 13, 14, 15 Quality in this outcome area is good. A range of activities is offered that provide opportunity for mental and physical stimulation. Residents are encouraged to maintain contact with their family and friends and are able to have visitors at any time. The home provides a varied and nutritious menu designed to meet the needs of its residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From discussion with the management, staff and residents it was clear that service users are offered the opportunity to participate in a range of activities suited to their needs. The activity co-ordinator is responsible, in liaison with the manager, for purchasing new activities equipment and for arranging festivities and celebrations. The home celebrated St George’s Day on the 23rd April and had a party where typically ‘English Fayre’ was provided. The activity organiser has involved residents in craft activities and has provided statues and ornaments for the garden. The activity organiser also involves residents in drawing and painting classes, gardening and ‘Boccia’ games. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 14 The garden is very attractive and is laid to flower beds and lawns which are easily accessible to residents. Some of the bedrooms have French doors that open onto the garden. These rooms are particularly favoured by the residents. There is a large patio outside the conservatory with comfortable seating and sun umbrellas which was being well used and enjoyed by a large number of residents at the time of inspection. One resident told the inspector that they felt that, “There is enough to do in the home, but not all residents want to join in”. The resident went on to say that they had tried to encourage residents to participate in Bingo but no one had turned up. Service users confirm that their visitors are made most welcome at any time and are offered appropriate hospitality during their visits. A number of social events are held throughout the year which promote community involvement and which provide residents’ families with the opportunity to engage with the staff and residents on an informal and regular basis. The menu provided is varied and nutritious. Service users are encouraged to take meals in the dining rooms to aid socialisation. The users were eating lunch of homemade tomato soup followed by chicken casserole or chicken Kiev with sweet corn, carrots and potatoes. There are many alternatives to the main course each day and these on the day of inspection were salad, omelette or baked potatoes with mixed fillings. Pudding was rhubarb and custard or ice cream. Special diets can be catered for including soft diets, diabetic and vegetarian meals. Tea was soup, ravioli, sandwiches, salad or cheese on toast followed by homemade chocolate sponge. The residents confirmed that the food was very well cooked and tasty. Residents commented, “No one can complain about the food here, there is plenty of choice”, “Good food and plenty of it”. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 15 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): Standards 16 & 18 Quality in this outcome area is good. The home has a satisfactory complaints system. Residents feel their views are listened to and acted upon. Residents are protected from abuse and exploitation by staff who can demonstrate knowledge of the home’s abuse of vulnerable adults and whistle-blowing policies. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaint policy in the home meets the requirement of Regulation and Standard. Service users are provided with information on how to make a complaint and the stages and timescales for action. The complaints procedure is written in plain English and is easy to understand. Examination of the complaint records indicated that there have been no serious complaints made to the home since 6th September 2006. The details of previous complaints were well documented and evidenced the outcome to complainants. The home has recently introduced a concern and comment book for residents and relatives to write their comments in. The introduction of this book has been well received by residents who use it to express minor comments about services. The manager said that she looks at the book daily and takes The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 16 appropriate action to remedy any comments or issues of concern in a timely fashion and before the issues that are raised become formal complaints. Residents said that that they felt confident that any concerns or complaints would be taken seriously by the home and efforts would be made to remedy any problems in a timely fashion. There was evidence in staff files and from discussion with staff that they receive training in the protection of vulnerable adults as part of their formal induction to the home. Their learning is later consolidated when undertaking NVQ training in which it forms a core module. Staff interviewed understood the importance of protecting users from abuse and exploitation at all times and were conversant with the home’s whistle-blowing policy. Residents and others associated with the home stated they felt satisfied with the service, and “felt safe” and well supported by the organisation that has their protection and safety as a priority. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 26 Quality in this outcome area is good. The standards of décor and furnishings in this home offer residents a comfortable and homely place to live. Standards of hygiene are good throughout. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well maintained throughout. It provides a pleasant safe place to live with the majority of rooms being highly personalised to reflect the preferences of residents. The management and staff encourage residents to see the home as their own and encourage residents to bring in small items of furniture, pictures and ornaments to make their bedrooms more homely. The home has a good range of general aids such as hoists and variable height beds for the use of residents but is also careful to assess residents for their need to have individualised equipment before they move into the home. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 18 There were a number of wedged doors at the time of inspection that could have posed a risk to residents in the event of fire. There is a need to fit ‘hold-open’ devices to a number of doors that will close automatically in the event of fire. These should be fitted where necessary (and as identified on the day of inspection) in consultation with the fire service. Service users were complimentary about the quality of décor and furnishings in the home. They said that the home was always clean, comfortable and hygienic. They said that the domestic staff always kept the toilets and bathrooms clean and fresh and vacuumed and dusted their rooms regularly. Communal areas were spacious, bright and airy and comfortably furnished. Service users spend much of their time in one of the ground floor lounges or the conservatory, which is currently the focus of the home’s activities. Residents made comments about the home such as, “Lovely home”, “Glad I chose this home, it always smells so clean”, “The gardens are so well kept, it’s obvious the gardeners work hard”. One resident said that they were unhappy about the size of their bedroom. This was later addressed with management who undertook to offer the resident an alternative larger room that day. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29, 30 Quality in this outcome area is good. Staff recruitment procedures are satisfactory and protect residents from harm. Staffing levels are sufficient to meet the needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examination of the staff rosters evidenced that there were sufficient numbers of staff on duty at all times, with particular attention given to busy times of the day. Examination of eight staff files evidenced that the selection and recruitment procedures at this home are robust. All necessary checks are carried out on staff to ensure that they possess the necessary attributes to care effectively for users. Records were well kept and met the required standard. The qualifications of nurses have been checked effectively to ensure that they are fit to practice. The nurses’ pin numbers and statement of entry on the register were well recorded and up-to-date. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 20 The home has a comprehensive training matrix, which provides the manager with details of the whole staff team’s need for training. There was evidence that care staff have been properly inducted to Skills for Care Standard and have received training in core skills such as fire safety, first aid, medication, communication, nutrition, manual handling, food hygiene, health & safety, COSHH and infection control. All staff have received training in adult protection as part of their induction and as a core module in NVQ training. All staff at the home are well motivated and have either achieved or are working towards a National Vocational Qualification at Level 2 or 3. There were sufficient staff on duty at the time of inspection to effectively meet the needs of users. There were six nurses and six carers on duty in the morning and three nurses and four carers on duty in the afternoon. At night there are two nurses and four carers on duty. Staff confirmed that they only have limited opportunities to express their views because no team meetings have been held at the home since 23rd October 2006. There is a need to reinstate these meetings as soon as possible to ensure that staff feel valued and appreciated and have the opportunity to express their views, concerns and suggestions. Residents and their relatives were generally complimentary about the qualities of the staff. However, several residents said, “Staff speak over me”, “I feel uncomfortable when staff speak in their native language“, and, “I think staff should spend more time talking to me rather than one another”. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 31, 33, 35, 36, 38 Quality in this outcome area is adequate. Residents benefit from living in a satisfactorily managed home, where there is evidence that their health, welfare and safety is of primary importance. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a newly appointed manager in post at the home who is not yet registered with the CSCI. The Manager is a well-qualified registered nurse with an NVQ 4 and the Registered Manager’s Award to further enhance her knowledge and skills. The manager, Jane Simpson, has suitable previous experience of being a registered manager in another care home in the area. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 22 There was evidence that the home regularly monitors its own performance against quality standards using the team audit process. This requires all heads of department to carry out regular audits of their service area and to make reports that are forwarded to head office. During the audit process the home seeks the views of residents, relatives and staff. The results of the team audits and outcome of proprietor’s (Regulation 26) visits are used to measure the home’s success in meeting its published aims and objectives. From discussion with a number of residents on the residents’ committee it was evident that they are regularly consulted on issues that affect them, and feel that their views are taken into account. All residents do not share this view as a number of those residents spoken with appeared to lack knowledge of the meetings or, indeed, that they actually had a committee to represent them. From examination of the minutes of residents’ meetings in September and October 2006 there was evidence that when requests are made or concerns expressed in the meetings, the issues raised are followed up by management. There is a need, however, for meetings to increase in frequency to keep residents up-to-date with what is happening in the home. The inspector was informed that the home does not administer residents’ monies or accept valuables for safekeeping. All residents are required to have a family member or advocate who deals with their financial affairs if they are unable to manage their monies themselves. The inspector examined a number of supervision records. The records for staff evidenced that the nurses were being effectively supervised and supported on a one-to-one basis, but carers were not being provided with the same level of support. There is a need to ensure that all care staff receive formal supervision at least six times a year which covers all aspects of practice, the ethos of the home and developmental training needs. Examination of health and safety records indicated that they were up to date and in good order. Routine servicing and maintenance of equipment is undertaken at appropriate intervals to maintain the home as a safe and risk free environment for users. The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 2 x 3 The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 24 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 OP10 Regulation 12 Requirement There is a need to ensure that residents’ rights to dignity and privacy are respected and maintained at all times: • Call bells should be answered promptly • The staff should converse in English whilst providing care to residents All equipment used by residents should be kept clean and hygienic at all times to prevent cross infection. This should include residents’ own wheelchairs. To protect the health & safety of residents, fire doors in the home must not be wedged open. Advice on this should be sought from the fire service. All staff should be provided with the support and supervision they need to care effectively for residents. All staff should receive formal one-to-one supervision at least six times a year. Timescale for action 25/04/07 2 OP26 13 (3) 25/04/07 3 OP38 23 (4) 24/07/07 4 OP36 18 (2) 24/04/08 The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Berkshire Care Home DS0000068325.V333531.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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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