Care Home: Beech House, South Molton

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What the care home does well The home has a good admission process and gathers appropriate information about people planning to move to the home. People living at the home are cared for by staff who are knowledgeable and recognise their individual needs. The home works well with health care professionals and staff are observant and recognise people`s changing needs. Medication practice in the home is well managed. People have their respect and dignity maintained by appropriately trained staff. The home has shown a commitment to providing end of life care. People visiting the home are welcomed, and people living at the home are supported to make choices, and supported to maintain their independence. A range of good quality meals are provided. The home has an accessible complaints procedure, and staff are clear about their safeguarding duties. The home is well maintained, clean and fresh with a range of communal rooms for people to use.Beech House, South MoltonDS0000039190.V376734.R01.S.docVersion 5.2The home is well managed and people have opportunities to influence the service. Finances are also well managed, as are health and safety issues. What has improved since the last inspection? The home`s approach to recruitment has improved. More staff now have access to training to help them meet the needs of people with dementia. People now have double electrical sockets in their rooms. What the care home could do better: One requirement has been made as a result of this inspection, which is to improve the social opportunities for people living at the home in order to promote their sense of well-being. Two recommendations have been made to improve practice in the home. The garden should be made secure and safe to offer people more choice as to where they spend their time. Staffing levels should be kept under review to ensure that they can meet all the needs of people living at the home. This recommendation was also made on the previous inspection. Key inspection report CARE HOMES FOR OLDER PEOPLE Beech House, South Molton North Road South Molton Devon EX36 3AZ Lead Inspector Louise Delacroix Key Unannounced Inspection 8th May 2009 09:00 DS0000039190.V376734.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech House, South Molton Address North Road South Molton Devon EX36 3AZ 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) 01769 572124 01769 572996 stella.scoins@devon.gov.uk http/www.devon.gov.uk Devon County Council Mrs Stella Margaret Scoins Care Home 37 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (37) of places Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th May 2007 Brief Description of the Service: Beech House is a care home providing personal care and accommodation for up to 37 older people and have now also extended their categories of registration to include caring for those people with dementia. Most people live at the home on a long-term basis, but short stays are available. The home is owned by the Local Authority, Devon County Council and is centrally located in South Molton, North Devon. First opened in 1975 the home consist of a two-storey purpose built building which is close to shops and local amenities All service user accommodation is on the ground floor with private accommodation provided in single bedrooms. There are 3 lounges, 3 dining rooms, 2 conservatories and a quiet room for residents shared use. The home is divided into three wings, Verney, Loosemore and Carter. The home is surrounded by its own grounds, which are easily accessible. Beech House, South Molton DS0000039190.V376734.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 stars. This means the people who use this service experience good quality outcomes. The inspection was unannounced and took place over seven hours and twenty minutes. During this time we met with people living and working at the home, and spoke to visitors, and we have included their opinions on the service in our report. We have also included the results of surveys that we sent out before we visited Beech House. Twelve relatives and friends sent us surveys, plus six staff and five health and social care professionals. Sixteen people living at the home also responded to our surveys with five people filling the form in independently and twelve with help. Prior to the inspection, the home completed an Annual Quality Assurance Assessment (AQAA), which provides us with information about the service. During our inspection, we checked how this written information translated into practice and how people are cared for. We spent time in communal areas observing the skills of staff and how they cared for people. We also looked at the standard of written records in the home, such as medication records, plans of care and recruitment and training records for staff. What the service does well: The home has a good admission process and gathers appropriate information about people planning to move to the home. People living at the home are cared for by staff who are knowledgeable and recognise their individual needs. The home works well with health care professionals and staff are observant and recognise people’s changing needs. Medication practice in the home is well managed. People have their respect and dignity maintained by appropriately trained staff. The home has shown a commitment to providing end of life care. People visiting the home are welcomed, and people living at the home are supported to make choices, and supported to maintain their independence. A range of good quality meals are provided. The home has an accessible complaints procedure, and staff are clear about their safeguarding duties. The home is well maintained, clean and fresh with a range of communal rooms for people to use. Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 6 The home is well managed and people have opportunities to influence the service. Finances are also well managed, as are health and safety issues. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Beech House, South Molton DS0000039190.V376734.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 Beech House, South Molton DS0000039190.V376734.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 3,5 and 6. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally people can be confident that the home can meet their needs and they will have the information to help them make a decision about moving to the home. EVIDENCE: In the home’s AQAA, it states that the service ensures that people will only move to the home once the relevant paperwork has been received, and states that the manager has can refuse admissions unless all the information has been received. When we looked at the admission process for people who had moved to the home since the last inspection, we found as stated in the AQAA the relevant paperwork was in place. Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 9 Staff told us that generally the people who moved to the home had needs that they could meet, and that they were informed about people’s care needs. But several people expressed concern that this needed to be monitored because of an increasing number of people had high care needs. For example, some people needing two staff members to help with moving or needing care in bed. Some staff felt that this is putting increasing pressure on the current staffing levels. We saw this to be the case during our inspection. The AQAA records that people are encouraged to visit before moving in; this was confirmed by a person we met at the home. Another person we spoke told us they had been too ill to visit and had asked their family to visit on their behalf. In their surveys, seventeen people told us that they had received enough information to help them to decide that the home was the right place for them. The home does not provide intermediate care. Beech House, South Molton DS0000039190.V376734.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 7,8,9,10 and 11. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their physical and emotional needs met by a caring staff team who seek advice from health professionals and act upon their advice. EVIDENCE: We looked at a range of care plans for people with different care needs. We saw that they were up to date, reviewed and that people had been consulted about their preferences. And a relative told us that they had been consulted about the content of the care plan for their relative who has dementia. These plans provide guidance to staff and staff told us how the information from them are shared with them i.e. handovers, and we saw staff writing up care plans during their shift. Several people that we met who live at the home commented positively on the care that was provided, and this was confirmed by the majority of the Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 11 seventeen surveys that we received from people living at the home. This was also the case for relatives who responded to our survey and told us that the home always (nine people) or usually (two people) met the needs of their relative/friend. A relative told us that the care was ‘first class’ and another visitor praised ‘the care and attention’ given to their relative. As part of our inspection, we looked at how people’s mental and physical health needs are met by care staff. Our discussions with staff and our observations of their practice showed us that the majority of staff are skilled in providing support for people with mental health needs i.e. dementia and have an understanding of why people behave in particular ways. For example, when people became restless or anxious, we saw staff providing reassurance and taking time to try and resolve perceived problems. This good practice was confirmed in one of the care plans that we looked at for somebody whose moods were often fluctuating. However in the early evening, some staff struggled at times to respond in this person centred way when they were busy and a number of people’s moods were deteriorating or people were becoming tired and needing extra care. People living at the home told us in their surveys that the home made sure they received the medical care they needed, and this was confirmed by the responses from health and social care professionals. They told us that that people’s health care needs are usually properly monitored and reviewed, which we saw from records and daily notes. They also told us that that the service sought advice appropriately and acted upon it. One person said ‘Staff have always made me aware of patients’ foot problems…and have always listened to any advice I have been able to give…’ Staff told us that there was nobody with pressure sores but that a number of people were vulnerable to damage to their skin and we were told that specialist mattresses had been provided for them and when we checked we saw this to be the case for a person that we visited in their room. We also saw from records that regular checks were being carried out for people being permanently cared for in bed, which at the time of the inspection was the case for three people. A GP who we met during our visit told us that the service picked up on changes and that senior staff members are up to date with information about people’s medical needs. During our inspection, we saw that staff were observant and picked up on people’s changing health needs i.e. pain control. They were proactive in seeking medical help for people and providing reassurance i.e. requesting that a staff member sat with someone who was in pain and in bed. Medication practice is generally safe and well managed. We observed two medication rounds and saw that the lunchtime round was managed in a calm manner, with the staff member providing information and reassurance to people, while other staff met the care needs of the people living at the home. Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 12 However, in the evening the staff member administering medication was interrupted on several occasions by both staff and people living at the home, which has the potential to lead to mistakes. The general atmosphere was less calm. Medication records are well maintained and up to date but on several occasions there were handwritten amendments, which had not been double signed by two staff to check for errors. We saw that staff treated people in a way which respected their dignity and privacy, and listened to their requests. For example, we saw people being supported discretely with their continence needs. We also saw people being moved using equipment by staff who were courteous and took time to explain what they were doing so that the person was involved in their care. During the lunchtime meal, we saw staff sitting beside people to help them with their meals and ensuring that people’s dignity was respected by maintaining eye contact and helping them with their appearance after eating. The layout of the building also means that people can spend time with their visitors in both communal areas or in their own rooms, which offers people privacy. However, one family said they enjoyed the communal atmosphere of the home and seemed at ease spending time in one of the lounges. The manager told us about training that had been provided to staff in the area of end of life care. They recognise that some staff are inexperienced in this area of care and we were told how they were supported to increase their confidence and competence. A discussion with a staff member confirmed this approach and the use of mentors, and praised the flexible approach of the home’s cook, who will prepare individualised meals for people nearing the end of their life. A GP who we met during our inspection told us that the staff were ‘very caring’ and that the home was able to provide end of life care with the support of the local medical team. Records showed that staff provide regular observation for people at the end of their life, including their need for physical and emotional comfort, and their positioning in bed. Beech House, South Molton DS0000039190.V376734.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 12,13,14 and 15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from friendly and welcoming staff and good quality meals. However, further work is needed to ensure that everybody has access to activities that are meaningful to them and freedom to access the garden without relying on staff accompanying them. EVIDENCE: Three people who live at the home told us in their surveys that the home always arranged activities that they can take part in, and a further eight people said this was usually the case, while two people said this happened only ‘sometimes’. Some staff raised concerns in their surveys that there was limited time to provide activities. For example in the section regarding how the service could be improved they said, ‘provide more activities for the clients’ and ‘I feel the needs of the service users we care for are becoming more complex…has an impact on time to undertake other duties such as activities, trips out and one to one time’. A person living at the home also echoed this last concern when we spoke with them. Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 14 We saw from a notice board and records that some people living at the home have access to trips out in small groups. We looked at the records of someone who can be quite restless, which staff described, and we observed during our visit. We saw from their records that only five activities had been recorded in a five month period. This reflected a concern raised by a staff member who told us that the service needed to ‘provide activities appropriate for specific needs rather than just more able clients’. Visitors told us that the staff at Beech House were good at keeping them up to date with information about their friends and relatives living at the home. They told us that they felt welcomed and kept informed. We observed that on the day of the inspection, relatives looked relaxed with care staff, who were friendly and welcoming. One relative told us that staff who they had not met before were good at introducing themselves. The home has invested in a new telephone which is more accessible to people who have mobility difficulties. Families told us that their relatives are helped to keep in touch with them. During our inspection, we saw a number of examples of how staff support people to make choices regarding day to day decisions i.e. managing pain control. Care records also support a flexible approach to how people have their care provided, and staff gave us examples of their understanding of people’s individual needs and choices. We saw from the minutes of residents’ meetings that people are able to offer suggestions to influence the service, and staff could give us examples where these had been adopted i.e. choice of meals. However, people cannot have easy access to the grounds surrounding the home. The doors are alarmed and staff told us this was because the garden area is not secure and they are concerned about the safety of people with dementia who live at the home. Relatives also told us about the lack of safe garden space. As a result people are limited in their ability to exercise choice to access the garden as they are reliant on staff accompanying them. We spoke with staff who work in the home’s kitchen, they were passionate about providing an individualised service to people and promoting choice. They were knowledgeable about the different needs of people living at the home, and we saw examples of this when we watched people’s individual meals being served and from the notes in their care plans. The majority of the people who returned their surveys told us that they always or usually liked the meals at the home. We saw that people are provided with equipment to help them to eat their meals independently, such as plate guards and adapted cutlery. People were offered ‘seconds’, which was appreciated by a number of people, and staff showed knowledge of people’s likes and dislikes, which matched the information held in the home’s kitchen. The lunchtime meal was calm and Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 15 unrushed, and people were generally relaxed. One person told us how much they appreciated the way the table was set. However, at teatime the atmosphere was less calm, as staff were busy trying to meet the needs of a range of people. For example, people being cared for in bed, one person who was in pain because of a problem with their arm, a person recently discharged from hospital and a person who was very restless. As staff were busy elsewhere, several people sat at the dining rooms tables before the teatime meal was due and became anxious about the length of time it took for them to be served, which made some people quite tense and worried as nobody explained that they were early. Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 16 and 18. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from being cared for by a staff team who are confident about their role to respond to concerns and report safeguarding issues. EVIDENCE: The Commission has not received any complaints about the service since the last Annual Service Review. The home’s AQAA states that one complaint had been received by the home, which had been responded to within 28 days and had been upheld. People told us that they knew who to speak to if they were unhappy and the majority of people living at the home and their relatives told us they knew how to make a formal complaint. We also saw that information had been given to people during a residents’ meeting about how to make a complaint. Staff were confident they knew what to do in these circumstances, and health and social care professionals said in their surveys that the home always or usually responded appropriately if they had raised a concern. Staff working at the home receive training in safeguarding vulnerable adults; we saw this from staff training records and from our discussions with staff about their role and responsibilities. Beech House, South Molton DS0000039190.V376734.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 19 and 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a clean and well maintained environment, which helps maintain their well-being and dignity. EVIDENCE: People living at and visiting Beech House told us that the home was always clean and fresh, which we found to be the case on the day of our inspection. We checked bathrooms and toilets and saw that they were clean and well equipped i.e. liquid soap and paper towels. We visited people’s individual rooms and saw that people had brought in their own possessions to make them more homely. One relative commented in their survey that the décor could be improved in the home; the home’s AQAA states that there is an on-going maintenance Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 18 programme in the home, including new carpets in three bedrooms. The home looked well maintained during our visit. We saw that staff have the equipment they need to maintain good infection control procedures, and we saw that the majority of staff have had training in the control of infection. We also saw from the minutes of staff meetings that staff have been reminded about good practice in this area of care. We also saw that staff promoted good infection control procedures for any staff entering the kitchen. Beech House, South Molton DS0000039190.V376734.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 27,28,29 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from a caring staff team, who have access to training and are generally recruited in a robust manner. However, staffing levels sometimes impact on the amount of time that staff have to spend with people on a one to one basis. EVIDENCE: People living at Beech House told us that generally staff are available when they need them and that they receive the care and support they need. People told us that the staff were ‘marvellous’ and ‘caring’. Currently the home is using two agencies to supplement the staff team and staff described how this was managed to ensure continuity and promote the well-being of people living at the home. When we completed an Annual Service Review last year, some relatives had raised concerns about the amount of agency staff used by the home but this was not raised as a problem during this inspection or in any of the surveys that we received. Staff raised concerns during the inspection and in their surveys raised concern that the level of people’s needs was increasing and that at certain times of the day this meant that staff were under increased pressure when they were trying to meet a wide range of need. For example, they told us that there were an Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 20 increasing number of people who needed two staff members to move them and that this impacted on staffing levels, which we noticed in the early evening when staff were very busy. One person living at the home told us that staff rarely had time to sit and talk with them, and that this had recently become noticeable. (See other areas of the report for further examples regarding staffing levels). According to the home’s AQAA, over fifty percent of the home’s permanent staff are qualified to an NVQ 2 level in care, and we saw certificates for people working at the home. We looked at the recruitment records for three newly recruited staff members and saw that the appropriate level of documentation was in place and that it was in place before they started working at the home i.e. job references, CRBs (police checks) and ID. We also looked at some recruitment files, which were work in progress for recently interviewed staff, and we gave guidance to ensure that the recruitment procedure was robust i.e. gaining references from the last care position. The manager told us that staff would receive further support in this area to ensure that people felt confident about the information they were requesting. Visitors told us that staff always or usually had the right level of skills and experience to look after people properly. On the day of the inspection, we saw staff with a range of skills, including people who provided positive role models for good dementia practice. We looked at the training records for six staff members and saw that staff had received mandatory training such as first aid and food hygiene, as well as dementia awareness. We spoke to staff who confirmed the training that they had access to, which now includes distance learning concerning the needs of people with dementia, which staff told us provided more in depth information, which they felt was beneficial . Beech House, South Molton DS0000039190.V376734.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 31, 33, 35 and 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run to promote the well-being of the people living there. EVIDENCE: The home is well managed with the manager supported by duty managers, who were generally up to date with the changing needs of people living at the home, and have good links with a senior carer who helps promote continuity of information. However, two health professionals felt that communication could still be improved between duty managers but one of them said that seniors on the floor held up to date information. Staff told us that the manager had an Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 22 open door policy, and that they were well supported by the deputy managers and a senior, who had a ‘hands on’ approach. We saw examples of how the home gains people’s views on how the service could be improved i.e. residents’ meetings and saw how people’s views were gathered and acted upon. We saw from records and talking with staff that people’s personal allowances are well managed and that there is a clear audit trail. During our inspection, we saw through staff practice and discussion with staff that they were aware of infection control procedures, and had received training in this area. The sluice is kept locked, which is good practice, chemicals are locked away and staff are provided with equipment to help prevent cross infection. The home is clean and we were told that carpets are replaced with suitable flooring where appropriate to help prevent odour. Throughout the inspection, we checked the communal toilets and saw that they were kept clean. We saw that equipment is well maintained and stored appropriately, and the AQAA confirmed that this. Beech House, South Molton DS0000039190.V376734.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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 3 Beech House, South Molton DS0000039190.V376734.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 OP12 Regulation 16 (2) (n) Requirement All people living at the home should have access to a range of activities/gentle exercise/meaningful occupation to suit the individual needs of people and promote their wellbeing. Timescale for action 30/09/09 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. Refer to Standard OP12 OP27 Good Practice Recommendations The garden should be made safe and secure so that people can access the garden without relying on staff accompanying them. The home should keep the care staff levels under review to ensure they can meet all the needs of people living at the home. Beech House, South Molton DS0000039190.V376734.R01.S.doc Version 5.2 Page 25 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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