Inspection on 04/07/08 for The Reigate Beaumont

This inspection was carried out on 4th July 2008.

CSCI found this care home to be providing an Good 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

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Reigate Beaumont The Reigate Beaumont Colley Lane Reigate Surrey RH2 9JB Lead Inspector Marion Weller Key Unannounced Inspection 10:10 4th July 2008 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 Reigate Beaumont DS0000069297.V366755.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 Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Reigate Beaumont Address The Reigate Beaumont Colley Lane Reigate Surrey RH2 9JB 01737 225544 01737 242172 john.lavan@barchester.com www.barchester.com Barchester Healthcare Homes Ltd 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) Mr John Lavan Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (0) of places The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - (N) to service of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category - (OP) The maximum number of service users to be accommodated is 60. Date of last inspection 11/07/2006 Brief Description of the Service: The Reigate Beaumont is a residential care home providing accommodation and nursing care for up to 60 residents. The home is owned and operated by Barchester Healthcare Homes Ltd, a major provider of nursing and care homes throughout the UK. Residents bedroom accommodation is arranged over two floors in single rooms with en suite facilities. Some bedrooms are larger and could be arranged to accommodate people that wish to share. The home employs registered nurses and care staff working a roster, which provides 24-hour cover. Ancillary staff for administration, catering, maintenance and housekeeping duties are also employed. The home has a dedicated activities staff. A hairdresser and chiropodist visit the home on a regular basis. The service provides an elegant and very comfortable environment and there are extensive, well-maintained gardens and grounds. Car parking is available within the grounds for visitors. The fees at this service range from £850 to £1100.00 per week. Fees are based on individual assessed care needs and the room chosen. Residents pay separately for hairdressing, chiropody, opticians, personal toiletries and newspapers at cost. Please contact the home’s General Manager for more information. The Reigate Beaumont DS0000069297.V366755.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 2 star. This means the people who use this service experience good quality outcomes. This was a key unannounced inspection of The Reigate Beaumont. The site visit was conducted by Marion Weller, Regulation Inspector between 10:10 am and 4:30 pm. During that time the inspector spoke with several residents, the general manager, the clinical manager and other members of the staff team. Some judgements about the quality of life within the home were taken from observations and conversation. Some records and documents were looked at. The annual quality assurance assessment (AQAA) sent to us by the service before the site visit took place was also used to inform our judgements. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives some numerical information about the service. In addition, a tour of the building and some of the grounds was undertaken. As part of the inspection process, surveys were sent out before the visit to some people living at the home and other care professionals involved with the home. Responses indicated people were generally very satisfied with the standard of care the home provided. Statements made included: “I am very happy here and think the place is well run” “I am so appreciative of the staff” And “As far as I am aware residents are offered choices that enable them to live the life they choose” One survey respondent out of a total of nineteen returned a survey form that recorded, ‘food offered in the home could be improved upon’ and felt that the current standard was ‘very low’. Another recorded a concern that their call bell was not working at times and another felt that repairs to the home should be carried out in a more timely fashion. These issues, amongst others were discussed either with the general manager or the home’s clinical manager. This is the first inspection since the service was re registered from Westminster Healthcare to Barchester Healthcare in January 2007. This followed the restructuring of Barchester Healthcare and its wholly owned subsidiaries and The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 6 was as a result of a change in company number only. There were no structural management or service changes. The home has therefore retained its quality rating and inspection frequency. The home has seen the appointment of a new general manager since the last inspection. The new manager is responsible for the day-to-day operation of the home and leads a dedicated team of department heads. The general manager took up post in September 2006 and made application to be the registered manager of the Reigate Beaumont. He completed the fit person process and was assessed as fit to be registered by the CSCI in June 2007. John Lavan is an experienced manager but has no experience of working in the care sector and no care related qualifications, however a clinical lead has also been appointed at The Reigate Beaumont to undertake admission assessments, develop care and treatment plans and to carry out clinical supervision for the registered nurses. The home is in the process of consolidating changes and making future plans for further improvement. The manager and staff gave their full co-operation throughout the inspection. What the service does well: What has improved since the last inspection? The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 7 All the requirements from the previous inspection have been met. Improvements have been made to the way medication administration records (MAR) are being maintained. They now clearly record the reason for nonadministration of medicines on the back of the medicine administration chart. This ensures all the necessary information is available to inform a review of the persons care needs. The service now ensures that its own safeguarding adult’s procedures accurately reflect the Surrey Multi Agency procedures to better protect residents and ensure the service takes appropriate, timely action to safeguard people they accommodate and care for. The manager ensures that any gaps in the employment history of staff are thoroughly investigated and explanations recorded to evidence a robust recruitment policy, which is designed to protect residents from any potential for harm. The manager has developed a quality audit system, which takes into account the wishes of the residents and any other visitors to the home and has made the results available to all stakeholders in the service. Responses to recent quality assurance surveys were included in the home’s AQAA and illustrated areas that people would like improved, as well as those areas they were satisfied with. This ensures the home is being run in the best interest of the people living there. Parts of the home have been redecorated to ensure residents continue to be offered a safe and comfortable place to live. What they could do better: Residents are largely protected by the home’s policies and procedures regarding the handling of medication. The current minor shortfalls in procedure and resources need to be resolved in light of good practice advice to secure residents safety and protection. Improvements should be made to sluices to ensure suitable arrangements are in place to prevent infection, toxic conditions and the spread of infection at the home. Staff and residents would benefit from the provision of more general storage areas in the home to ensure that large items of equipment can be stored safely and do not impinge on communal space The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 8 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 Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 9 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 Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 10 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): 36 Service users experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their needs will be properly assessed prior to them making a firm decision to move in. They further benefit from being able to visit the home prior to admission and from the receipt of sufficient information about the home to make an informed choice. EVIDENCE: The clinical manager or a trained senior member of staff visits prospective residents prior to admission to make a decision as to whether the home can meet the person’s needs. Information is obtained from other parties, including relevant health care professionals to assist in assessments. Samples of pre admission assessments were inspected in resident’s files and were found to be detailed and comprehensive. The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 11 Prospective residents and their families are invited and encouraged to come to the home for a visit, have coffee or stay for lunch and inspect the service prior to making their final decision to move in. In December 2007 the home undertook a quality assurance exercise. Residents, relatives, visitors and visiting professionals were asked to complete a survey on a variety of issues in relation to the services offered at The Reigate Beaumont. 33 surveys were returned, results were collated and survey responses shared with all stakeholders. In relation to this outcome area, results reflected that people responded thus: • • 100 of respondents were satisfied with the information they received about the home and the welcome given to them by staff 90 would probably or definitely recommend the home to other people The home does not provide intermediate care. The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 12 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 Service users experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s health and social care needs are clearly set out in individual plan of care ensuring their needs will be met. They are largely protected by the home’s policies and procedures regarding medication administration. They can be confident that where minor shortfalls exist the home will review its arrangements and facilities to secure their safety and protection. EVIDENCE: Each resident has a plan of care based on the homes pre admission assessment. The home has adopted the Barchester Healthcare format. Contents of resident’s files were found to be comprehensive and detailed. Care plans had been developed with the resident or their representatives help and had been signed by them to evidence their involvement and agreement to the plan. Some care plans addressed people’s wishes during periods of serious illness or at the time of death. The clinical manager said that this information is sometimes difficult to capture initially, it is a sensitive area and must be The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 13 approached with a good understanding of the person. Hence, information gathering can sometimes be delayed until all parties are comfortable to discuss this openly and to have the home record their wishes. Residents’ daily monitoring records were being maintained. They clearly reflect that staff are following the demands of a resident’s plan of care and give sufficient detail on which to base the monthly review. Care plans were being regularly reviewed with changes recorded and actioned. Risk assessments were completed and covered, amongst other things, the prevention of falls, nutrition and maintenance of skin integrity. Some generic risk assessments were in place for those individuals who regularly access the garden and grounds unassisted by staff. Staff had a good understanding of residents needs. Records indicated the home had a good working relationship with specialist and local health care professionals, supporting residents in their health care needs. Specialist mattresses, cushions, hoists and other aids were seen in use and the clinical manager evidenced a sound knowledge of tissue viability care and followed treatment plans closely. Trained nursing staff administers medication in the home. An appropriate policy and written procedures are in place for the storage and administration of medication. Authorisation had been obtained from the GP in respect of the administration of homely remedy medications. Medication was obtained from a local pharmacy and dispensed in a monitored dosage system. The supplying pharmacy visits the home regularly to audit and give good practice advice. An up to date list was maintained of all nursing staff authorised to administer medication in the home, together with their specimen signatures. Medication records inspected were sound with no unexplained gaps and evidenced a photo of residents to aid identification. It was possible to evidence improvement in the way medication administration records (MAR) are now being maintained in line with a recommendation made at the last inspection. Staff are clearly recording the reason for non-administration of medicines on the back of the medicine administration chart. This ensures information is available to properly inform a review of the persons care needs. Residents, following assessment to establish capacity are able to self medicate. Oral and topical medicines were however observed to be left on view in a number of bedrooms and had not been locked away when not in use as good practice demands. Due to the vulnerability of some of the residents accommodated in the home, this needs to be addressed to ensure everyone’s safety and welfare. It was strongly recommended that the home revisit current self-medication assessments. Once capacity is re-established, individuals must also have clear access to a lockable facility for the correct storage of their medicines. The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 14 The fourth question on the home’s self medication risk assessment document asks if the person being assessed is aware of the need to store medicines in a locked draw. In this instance, the home failed to monitor the correct storage of medicines left with residents who were assessed by them to have the capacity to self medicate safely. One bedroom visited, where medication packets were seen on a tabletop, did not offer the facility of a locked space. Facilities are available for the proper storage and administration of controlled drugs. Drug balances and records were checked and found to be accurate. There are procedures in place for trained staff to hand over keys/ stock balances between shifts. Minor medication shortfalls detailed above were discussed with the manager and senior staff. The inspector is confident the home will quickly review its arrangements and facilities to secure residents safety and protection. Residents felt that staff were kind and considerate and treated them with courtesy and respect. The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 15 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 Service users experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have a relaxed, comfortable lifestyle with opportunities to occupy themselves with a range of interests. They are offered a nutritious, well balanced diet in pleasing surroundings. Their views are sought and taken into consideration in relation to menu planning and improving the dining experience. EVIDENCE: The home offers people elegant suroundings in which to live and sits in extensive grounds and woodland. The gardens and grounds receive regular praise and it was clear from residents comments that they are well used and very much appreciated by the people who live in the home. There are no set routines that you wouldn’t expect to see in any other busy, well run and managed home. Residents spoken with felt that the lifestyle in the home largely matched their expectations and preferences. The manager records in the home’s AQAA – “Our dining experience has improved with the launch of 5* dining in the main dining area creating more The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 16 choice and positive dining experiences. Dining staff meet regularly with the care team to further improve the nutritional quality of the meals for residents. Residents may also avail themselves of private dining areas if so desired. We use fresh produce at every available opportunity. We hold parties for residents and provide alcohol for those wishing to partake. Breakfast is provided daily to all rooms on trays commencing at 7am. Choice is paramount, especially with regard to the activities of daily life. We are flexible in our service and respect residents needs and desires”. One survey respondant recorded comments prior to the inspection that the standard of food in the home was, “Unfortunatly of a very low standard indeed” Food was therefore discused with the manager, who felt that more people liked the food offered than didn’t. He explained that in December 2007 the home undertook a quality assurance exercise. 33 surveys were returned, in relation to this specific subject, collated results reflected that people would like the home to do some things differently and one of these was to, ‘improve the appeal of dishes on offer– 67 of respondents were however satisfied with the food offered. The manager said he continues to improve this aspect of daily living and listens closely to people’s views. He will be encouraging catering staff to speak to residents at mealtimes for immediate feedback on the quality of the dining experience. Individual care plans record each residents social and leisure interests. Cultural and religious needs are also recorded. Residents are encouraged to discuss their beliefs and an individual plan is created to recognise and support their religious and spiritual diversity, where this is necessary. The home employs a full time activities coordinator. The manager is aware how important it is to offer meaningful and stimulating activities to residents. Residents spoken with said they are able to choose the activities they wish to take part in, or not for that matter. The home’s quality assurance survey records that people requested the number and range of activities outside the home to be increased, but 80 were satisfied. In direct response, the manager made a number of changes, including the recruitment of an additional driver for the home’s minibus to facilitate more external trips and outings. Residents are enabled to maintain links with their relatives and friends. This information is recorded in their care plans. All residents have a landline telephone in their bedrooms, which allows incoming calls to be received, and outgoing calls to be made directly without accessing a central exchange hub. During a tour of the home it was observed that residents could bring their own furniture and possessions into the home. Bedrooms seen clearly reflected the personality and interests of the occupants and were comfortable. The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 17 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 Service users experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that their concerns and complaints are taken seriously and acted upon. They are also systems and procedures in place to protect them from the risks of abuse. EVIDENCE: The home keeps a record of all complaints received by them. The home’s complaints register was inspected and it was clear that complaints and minor concerns are taken seriously, investigated fully and recommendations made as a result, implemented immediately. Residents said they felt confident that they would be listened to and any necessary action would be taken if they were concerned. The managers AQAA records the receipt of 18 complaints in the last year. The Commission has not received any complaints about the home in that time. There are procedures in place for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. The staff induction and NVQ training has elements of adult safeguarding training and there has been adult protection training for staff. All staff are aware of the whistle blowing policy. In relation to a requirement issued at the last inspection, the service now ensures that its own safeguarding adult’s procedures accurately reflect the Surrey Multi Agency procedures to better protect residents and The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 18 ensure the service takes appropriate, timely action to safeguard people they accommodate and care for. There has been one safeguarding alert and investigation made in relation to this home. This is now closed. The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 19 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 26 Service users experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The general environment is good providing people who live in the home with an attractive and comfortable place to live. Residents would benefit further from the service making better provision for the storage of large items of equipment, which do not encroach on communal facilities. Improvements to the finish in sluice areas would ensure infection control measures in the home are fully met and there is no potential to place residents at risk. EVIDENCE: The home has a generally well-maintained environment, which provides aids and equipment to meet the care needs of the people who live there. It is a very pleasant and attractive place to live and was found to be completely odour free. All bedrooms have ensuite WC facilities and wash hand basins. The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 20 Two residents bedrooms also offer baths. Residents spoken with were happy with their bedrooms. All bedrooms were comfortable and had been personalised by the occupants to reflect their individual taste and interests. Residents said the home was warm, well lit and there was always sufficient hot water available. Radiators in bedrooms were guarded to ensure safety. Shared areas of the home provided a choice of communal space with opportunities for residents to meet relatives and friends in some privacy or to take them to their own rooms. The home generally appeared badly off for storage areas. The sluices and the medication stores for instance were quite limited for space. Several large items of the home’s equipment were stored in all of the resident’s communal bathrooms inspected. The manager agreed that they are under pressure to find adequate storage for some large items. He said it would be bad practice to place them in corridors where they may cause a trip hazard and compromise emergency fire evacuation routes. It is difficult however to understand where they are placed when the bathrooms are actually in use when you consider the home’s storage space limitations. Equipment seen was of a very good standard and regularly serviced. The home had a good supply of transfer slings for hoists and moving and handling belts. These are maintained for individual residents and evidence the home’s general adherence to good infection control measures. The sluice rooms in the home are generally well organised but again space is very limited. They are also in need of refurbishment. Paint finishes are peeling making it difficult to keep the room clean to the required standard. Some sink seals were seen to be old and worn and also had the potential to compromise good infection control measures. The manager stated that he has plans to refurbish sluices. The home has a sufficient level of housekeeping staff and a good infection control policy. They encourage staff to work to the policy to reduce the risk of infection. The inspector is confident that the provider will recognise areas in need of improvement that have emerged from this site visit and will take advice to reduce any risk and seek to resolve them. The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 21 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 Service users experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from being cared for by a dedicated staff team who are well supported and supervised. The home continues to effectively train and develop its staff to their full potential to ensure residents’ needs are met at all times. Residents are protected from any potential abuse by the home’s robust recruitment procedures. EVIDENCE: The home was not fully occupied on the day of the site visit; discussions with the manager evidenced 10 empty beds. Adequate levels of staff were available to care for residents and staff were being appropriately supervised. Vacant duties on staffing rosters are covered with substantive staff taking on additional hours or by the use of the home’s bank staff. The home does not use agency staff, which allows for greater continuity of care for the resident group. Survey responses sent to the CSCI before the inspection raised issues of staffing pressures and lack of staffing when the home’s occupancy levels and dependency levels are high. The clinical manager stated that the home has the capacity to increase staff numbers if occupancy and dependency levels The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 22 increase and remains aware and watchful that it can be very busy for all staff when the home is full. Training takes a high priority in the home. Apart from qualified registered nurses, care staff are encouraged to attain National Vocational Qualifications (NVQ). The manager provided information that the home exceeds the standard of 50 of NVQ qualified care staff. All staff spoken with were enthusiastic in regard to developing their skills. The home also has 4 qualified NVQ assessors. The home has comprehensive and well-maintained training records. There is an electronic staff training matrix/ database, which provides a clear overview of staff, training completed, staff training planned and when training updates are due. The home has a comprehensive induction programme for new staff. All mandatory training for staff is up to date, including moving and handling. CRB & POVA checks for staff were clearly in evidence and the home follows a robust recruitment process designed to protect residents from any potential for harm. In line with a requirement issued at the last inspection, the manager ensures that any gaps in the employment history of staff are thoroughly investigated and explanations recorded to evidence a robust recruitment policy. Residents spoken with said they liked the staff and felt they did a good job. One survey respondent said, “ I am most appreciative of the staff” The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 23 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 Service users experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Management arrangements are meeting the needs of the service and residents benefit from living in a home that is run in their best interests. EVIDENCE: The general manager is responsible for the day-to-day operation of the home leading a dedicated team of dept heads. He was assessed as fit by the CSCI to be registered as manager of The Reigate Beaumont nursing home and attended for his fit person interview on 21st June 2007, during which he demonstrated a good understanding of the role and responsibility of a registered manager. He has a strong management background but has no experience of working in the care sector and no care related qualifications. A clinical manager is the lead person for all matters that relate to the nursing The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 24 and care needs of residents in the home. The clinical manager undertakes pre admission assessments and oversees the formulation of residents care plans. In addition, the clinical lead carries out clinical supervision for the registered nurses. The general manager has attended many short courses relating to the management of services and people and holds a BA qualification in Sports Studies. He does not however hold a recognised management qualification. He has registered to commence the Registered Managers Award (RMA) through Barchester’s training department. Evidence of his enrolment has been received by the CSCI. In discussion, he stated that he still has some work to do to complete the RMA qualification, but believes he will complete course work by the end of this year. In line with a requirement issued at the last inspection, the general manager has developed a quality audit system, which takes into account the wishes of the residents and any other visitors to the home and has made the results available to all stakeholders in the service. Responses to recent quality assurance surveys were included in the home’s AQAA and illustrated areas that people would like improved, as well as those areas they were satisfied with. This ensures the home is being run in the best interest of the people living there. Relatives are offered the opportunity to attend resident reviews where they can make comment about the service. The general manager is also intending to relaunch residents and relatives meetings, which have lapsed of late. The home’s AQAA records, ‘Relatives meetings are to be reaunched and will further improve the communication and open door policy of the home’ Barchester have a quality assurance policy and both provider representatives and the general manager conduct regular comprehensive audits of the service offered at The Reigate Beaumont. Visits to the home by a representative of the provider organisation under regulation 26 are carried out and recorded monthly. The home is fully committed to ensuring staff receive appropriate training and support for their role. Training records were sound and staff understood what is required of them. Ensuring staff are appropriately trained maximises safety to both residents and staff. All records seen are kept in a manner that preserve confidentiality. General record keeping is good and well ordered. The home initially pays for any expenditure incurred by residents and then invoices relatives or their representatives for the cost. The home does not assist with managing residents’ personal money and they do not hold any cash for people who live in the home. Resident’s relatives and representatives are encouraged to be fully involved and assist them with this aspect of their care. The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 25 An up to date insurance certificate and their registration certificate is prominently displayed in the home. There are records of fire systems checks and fire drills/training and staff spoken with have a sound understanding of emergency procedures. The manager said all records of maintenance and safety checks are up to date. These were not inspected on this occasion. Feedback at the end of the inspection raised some issues of health and safety with both the general manager and the clinical manger in relation to shortfalls in medication procedure and resources. Improvements that should be made to sluices to ensure suitable arrangements are in place to prevent infection, toxic conditions and the spread of infection at the home. It was also discussed that staff and residents would benefit from the provision of more suitable general storage areas in the home, large items of the home’s equipment should not be allowed to impinge on resident’s communal space. The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 26 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 2 10 3 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 2 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 3 X 3 X 3 X X 2 The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 27 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. Standard Regulation Requirement Timescale for action 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 OP9 OP38 Good Practice Recommendations It is strongly recommended that the registered person fulfil the stated intention of reviewing the medication administration practices and storage facilities in the home in line with good practice advice to secure residents safety and protection. Suitable storage facilities should be provided for items of the home’s equipment that does not encroach on residents’ communal space. Improvements should be made to sluices to ensure suitable arrangements are in place to prevent infection, toxic conditions and the spread of infection at the home. 2. OP22OP38 3. OP26 OP38 The Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Reigate Beaumont DS0000069297.V366755.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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