Care Home: Beechlands

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What the care home does well Beechlands provides residents with a secure, clean, comfortably furnished and well maintained home. Good information on the home and local health services and facilities is provided in the foyer/ entrance of the home. Individual rooms are well personalised with residents` personal belongings and furniture. The home has four units each with its own dining room/lounge that provides a homely environment. People who express an interest in moving into the home have a full assessment prior to being admitted and are invited into the home to view the facilities before making a decision. Care planning is good and regularly reviewed and there is good monitoring and good access to healthcare services. Residents have an individual key worker who supports their personal and social needs. The home is well supported by two local GP practices and there is good liaison with district nurses and general practitioners. Residents are supported to maintain links with friends and relatives who are able to visit the home at any time. All food is cooked on site and residents have a varied and nutritious diet with specialist diets catered for. Staff work well as a team. Recruitment processes are robust with the required checks obtained prior to appointment provided. Communication is good with monitoring of care practices and regular staff supervision provided. Staff are supported to develop their skills through in-house, external and distance learning courses. Senior staff are supported to develop their skills through a development training programme. All staff are supported to obtain NVQ qualifications. The home is well managed and there are good health and safety systems in place that are generally well adhered to. What has improved since the last inspection? The service user guide has been developed to be more user friendly. The home has been redecorated and refurbished and new profiling beds and recliner chairs purchased. The hobbies room has been changed into a lounge area /social room where relatives can sit, eat and talk in private as well as a quiet area for residents to sit rather than the communal lounges. New social activities equipment has been purchased. Senior staff are supported to develop their skills through a development training programme.Staff supervision includes a question on equality to enable staff to speak up if they believe that the policy is not being adhered to. A more robust residents` finance procedure has been developed. What the care home could do better: Currently medicines are stored in several different areas of the home. Trolleys were not secured to the wall. There was no monitoring of room temperatures and the record of fridge temperatures could not be found. The Controlled Drugs Register did not detail the name and address on receipt and disposal of controlled drugs. There is no designated activities coordinator and the programme of social activities needs further development. The home had been redecorated and refurbished in part. However there were worncarpets in one unit of the home that needed to be replaced. A clinical waste bin was found unlocked. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beechlands 42 Alderton Hill Loughton Essex IG10 3JB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Diana Green     Date: 1 4 1 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2010) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Beechlands 42 Alderton Hill Loughton Essex IG10 3JB 02085085808 02085081484 beechlands@southendcare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southend Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 28 Number of places (if applicable): Under 65 Over 65 28 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is 28 The registered person may provide the following categories of service only: Care Home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Beechlands is registered to provide personal and residential care for 28 people over the age of 65 years. Beechlands is a detached property, located in a residential area a short distance from local shops and facilities. Accommodation is on two floors, accessed by a through floor passenger lift. The home is divided into four units, each with its own lounge/dining area and bathroom facilities, and each accommodating seven service users. The home has 24 single bedrooms and 2 double rooms, all with ensuite toilets. The home has Care Homes for Older People Page 4 of 30 Brief description of the care home appropriate aids and equipment (e.g. mobile hoist, assisted bathing facilities, hand rails, etc.) to assist residents with limited mobility. There is limited parking to the front of the property. The fees range from £463.63 to £550.00. Additional charges apply for hairdressing, chiropody, toiletries and newsapapers. This information was provided on 14/12/2009. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. This unannounced inspection took place on 14th December 2009. All of the Key National Minimum Standards (NMS) for Older People, and the intended outcomes, were assessed in relation to this service during the inspection. This report has been written using accumulated evidence gathered prior to and during the site visit, including the homes Annual Quality Assurance Assessment (AQAA). The Annual Quality Assurance Assessment (AQAA), which is required by law to be completed by the service, is a self assessment that focuses on how well outcomes are Care Homes for Older People Page 6 of 30 being met for people using the service. This was completed by the registered provider and returned to us prior to the visit to the home. Information received in the AQAA provided us with some detail to assist us in understanding how the registered persons understand the services strengths and weaknesses and how they will address them. The inspection process included reviewing documents required under the Care Home Regulations. A number of records were looked at in relation to residents, staff recruitment and training, staff rotas and policies and procedures. Time was spent talking to residents, staf, the manager and operational manager who attended for part of the inspection. Management and staff were welcoming and helpful throughout the inspection. What the care home does well: What has improved since the last inspection? What they could do better: Currently medicines are stored in several different areas of the home. Trolleys were not secured to the wall. There was no monitoring of room temperatures and the record of fridge temperatures could not be found. The Controlled Drugs Register did not detail the name and address on receipt and disposal of controlled drugs. There is no designated activities coordinator and the programme of social activities needs further development. The home had been redecorated and refurbished in part. However there were worn Care Homes for Older People Page 8 of 30 carpets in one unit of the home that needed to be replaced. A clinical waste bin was found unlocked. 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 set out 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. Care Homes for Older People Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this 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 planning to live at Beechlands can be assured that they will received full information to enable them to make a decision and have an assessment prior to admission to ensure their needs can be met. Evidence: The home had a statement of purpose and service user guide that met regulatory requirements. The statement of purpose was seen on display in the entrance of the home together with various information on health and social care services for residents and their representatives information. Three people told us that they had received enough information to enable them to make a decision about moving into the home. The admission procedures were discussed with the manager of the home. Prospective residents and /or their relatives were encouraged to visit the home and view the Care Homes for Older People Page 11 of 30 Evidence: accommodation. We were informed that wherever possible assessments were undertaken either in the persons own home, care home or hospital. Referrals were accepted by telephone and information on care needs obtained including a copy of the community care assessment provided by the social worker. A pre-admission assessment was undertaken using a pre-assessment form as a prompt to discuss care needs. Information was used following admission to complete a full assessment and care plan. Three residents care plans were viewed during the visit to the home. All included a detailed pre-admission assessment form that provided key information on the residents care needs from which a care plan could be developed. Two health professionals who completed surveys told us that the care homes assessment arrangements always ensured that accurate information is gathered and that the right service is planned for people. The home does not provide intermediate care. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have their assessed personal and health care needs met but more robust storage and recording of administration of medicines is needed to ensure they are appropriately safeguarded. Evidence: Three residents care records were viewed during the site visit. All three contained a pre-admission assessment detailing the residents care needs that had been undertaken prior to admission. Care plans were seen for personal care, communication, manual handling /risk of falls, mobilising, eating and drinking/elimination, likes and preferences, social activities/hobbies, spiritual/cultural needs, welfare/finance. All three files viewed contained very detailed care plans that provided clear guidance to staff when providing care to meet individual residents needs and had been signed by the resident confirming their agreement to their care. Care plans detailed the residents profile and included information of their family history that enabled staff to gain an understanding of the residents personal life and interests and hobbies and supported them in providing care to meet their needs. Care Homes for Older People Page 13 of 30 Evidence: Nutritional risk assessments were undertaken on admission and reviewed with weight monitoring also undertaken monthly. Risk assessments were seen for risks associated with manual handling, risk of falls, continence, pressure sores, safeguarding adults risks and all had been regularly reviewed. Residents access to healthcare services was discussed with the manager and confirmed from the care records. Residents were registered with one of the two local GP practices who attended regularly on request. One residents care records viewed during the visit to the home confirmed they had received visits from their GP, chiropodist, district nurse, optician and community psychiatric nurse. A relative spoken with said that the key worker was very helpful and ensured their loved one received their personal care as they liked. Advice on local health services was also seen on display in the home for residents and relatives information. A resident who completed a survey told us they look after my well being. Surveys completed by a health care professional and a GP told us that peoples health and social care needs were always properly monitored, reviewed and met by the service. When asked Does the care service seek advice and act on it to meet peoples social and health care needs and improve their well-being? Two health care professionals stated always. When asked what does the service do well? a GP told us I am happy with all aspects of the care ...and...there are no shortcomings identified. The home had a medication policy and procedures for staff guidance. The medication systems were discussed with the manager. Medication was supplied from the local supplying pharmacy in monitored dosage systems and individual containers. There were appropriate procedures for the receipt and disposal of medication available and these were seen to be well adhered to. Medication was given by designated senior care staff employed at the home who had received medication training and confirmed from the records viewed. A list of staff signatures and initials was held to enable appropriate follow up in the event of an adverse incident. There was no clearly defined medication storage. Medication was stored in cupboard on the ground floor, in a locked trolley that was not secured to the wall and also in a locked wall cupboard on the first floor with controlled drugs stored in a separate cupboard. Some room storage temperatures were recorded and monitored to ensure medicines were stored within safe recommended levels (maximum 25 degrees centigrade). However these were not consistent, for example there was no record from 19/10/09 for one storage area and there was no record of fridge temperature monitoring available. The medication storage and medicines administration records for three residents were examined. Records were generally well recorded and medication was available as prescribed. However there was one omission that had not been followed up and a change to one prescribed medication that stated changed by hospital but had no signature or date to confirm when and who had documented the change. The Controlled Drugs (CD) Care Homes for Older People Page 14 of 30 Evidence: storage met requirements and a CD register was in use. Records were completed accurately and confirmed by two staff signatures. However this did not include the name and address on receipt and disposal of CD drugs as is required. Staff were observed to be friendly and relaxed in their conversations with residents. A relative told us that staff are very kind. Residents personal care was observed to be provided in private. Rooms included personal items of furniture and lockable facilities for storage of valuable and medication in the event that a resident chose to self medicate. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have a varied and nourishing diet and are supported to maintain contact with their family and friends. Provision of an activities coordinator will promote the development of a more fulfilling social life for residents. Evidence: The homes social activities were discussed with the manager. There is no designated activities coordinator employed for the home but residents are supported by care staff with the various activities on offer. There was a good range of activities equipment stored at the home. There were no organised activities observed during the visit to the service. Several residents were seen watching television and talking to each other or spending time in their own rooms. One resident was noted to be speaking on the telephone and others were being visited by relatives. One residents care records showed that they had taken part in bingo, sing a long, arts and crafts, film shows, quizzes and reminiscence and had a hand massage and manicure. However a relative told us there were not enough activities. When asked does the home arrange activities that you can take part in if you want? two residents responded always and one said usually. However three staff who completed surveys when asked what could the home do better? stated activities. Care Homes for Older People Page 16 of 30 Evidence: The homes visiting policy was included in the statement of purpose. A visitors book was seen and confirmed that visitors came into the home at various times during the day, evening and weekends. Several visitors were observed visiting the home. A relative told us they could visit at anytime, could see their loved one in private and always felt welcome. A relative who completed a survey also told us when we come to visit they always greet us and make us feel very welcome. During the visit to the home residents were observed to be encouraged to eat in the dining rooms of the home. Residents were observed to be enabled choices in how residents spent their day, whether they took part in activities or chose to have a rest in their rooms following lunch. Several residents rooms were seen with their agreement and were personalised with their own belongings (photos, pictures,ornaments etc.). Information on advocacy services was seen on display in the home. Residents were observed enjoying the lunchtime meal which comprised a choice of beef stew and dumplings or ham salad followed by bread and butter pudding or fresh fruit. Drinks were served with the meal and were noted to be provided during the day. Several residents spoken with said they found the meal enjoyable. The menu of the day was seen on display for residents information and the supper choice was quiche or spaghetti on toast with a desert of mousse or jelly and ice cream. Residents records viewed confirmed that a nutritional risk assessment was undertaken on admission to the home and weights monitored with nutritional supplements provided as needed ensuring that residents did not lose weight unduly. The care records confirmed that specialist diets were catered for and advice obtained from a dietitian where needed. When asked Do you like the meals at the home? two residents who completed surveys told us always and one said usually. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are assured their complaints will be listened to and acted upon and they will be safeguarded by the homes policies, procedures and practices. Evidence: The home had a complaints procedure that was included in the statement of purpose and service user guide and was seen on display in the home. The record of complaints was viewed and confirmed that complaints were fully investigated in line with the homes procedures. A compliments file was also seen with comments from three relatives who had written to say they had enjoyed the Halloween party that had been held at the home. The AQAA informed us that all residents are made aware of how to make a complaint through the statement of purpose and service users guide. All residents and their relatives who completed surveys confirmed they were aware of the complaints procedure and who to speak to if they had a concern. One relative told us Beechlands is a very well run home and another said my x is very well cared for and is happy at Beechlands and we havent any complaints. The AQAA informed us that all staff receive training in Safeguarding Vulnerable Adults (SOVA) , Deprivation of Liberty and the Mental Capacity Act (MCA) and a copy of the whistle blowing policy is given to each staff member. Staff are also provided with both the Essex SOVA procedures and the General Social Care Council Code of Practice. This ensures that staff are aware of the standards expected of them and know how to Care Homes for Older People Page 18 of 30 Evidence: recognise abuse and how to refer an allegation. This was also confirmed from policies and procedures seen. An inspection of staff records confirmed that staff receive training in safeguarding adults on appointment and annually. There had been one allegation made since the previous inspection that was appropriately investigated. The homes recruitment procedures were inspected and were confirmed to protect residents by ensuring all relevant checks were undertaken prior to appointment. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured the home is safe, clean, secure, well decorated and generally well maintained. Evidence: A tour of the premises was made during the visit to the home. The entrance to the home was secure with a door entry system in place. The foyer/entrance of the home was welcoming with various items of information on display. The home comprised four units, two on the ground floor and two on the first floor of the home, each with seven beds. Several residents rooms, communal rooms, bathrooms, toilets, a shower room, sluice room, laundry and training room were viewed. The premises were clean and pleasantly decorated. There was a programme of maintenance and repair in place, however carpeting in Woodlands unit corridors was worn and needed replacement. The home had a large garden to the rear that was laid mainly to lawn with shrubs. Seating and a gazebo were provided for residents use as weather permitted. Records viewed during the visit to the home confirmed that systems were in place to ensure the building complied with the requirements of the local fire and environmental health department. The home had stairs and a passenger lift to enable access to the first and second floors of the premises. There were grab rails throughout corridors with aids in Care Homes for Older People Page 20 of 30 Evidence: bathrooms and toilets to meet the mobility needs of residents. Call systems were provided throughout communal and individual rooms to enable residents and staff to call for assistance and records confirmed these were well maintained. A range of specialist pressure relief equipment was available to meet the needs of individual residents. The home was clean with no malodorous smells evident. Systems were in place to ensure staff had personal protective clothing for use when providing personal care. Hand washing facilities (liquid soap and paper towels) were provided throughout to ensure care staff had appropriate equipment to safely provide personal care. However one shower room had no hand wash basin to enable staff to wash their hands and the manager was advised to ensure that antibacterial hand gel was made available for staff to minimise the risk of infection. The laundry room was viewed and was clean and well organised with shelving, individual boxes and hanging rails to enable staff to organise the sorting and return of residents laundry to the rightful owner. There were two washing machines fitted and a drier all in working order. Both washing machines had sluice facilities (able to wash at 65 degrees centigrade for a minimum of 10 minutes) to minimise the risk of infection. Residents spoken with during the visit to the home confirmed they were satisfied with the standard of laundry. However one person did inform us that some items of clothing had not been returned to them. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 Beechlands are cared for by skilled staff who know them and who are employed in sufficient numbers to ensure their needs can be met. Evidence: There were twenty-five residents at the home. We were informed that in addition to the manager there was one senior care assistant and five care assistants (including one trainee) on duty. Two domestic staff, a laundry assistant and a cook were also on duty. The duty rota was seen and confirmed the staffing levels were as discussed. During the visit to the home, residents were observed to be well supervised and well cared for indicating that staffing levels were appropriate for their needs. A relative spoken with told us that staff were very kind but they had been short staffed at times. Three people living at the home who completed surveys told us that staff were always available and they always received the care and support they needed and one person told us they usually were available and they usually received the care and support they needed. The AQAA informed us that no agency staff were employed meaning that residents were cared for by people who knew them and who were aware of their care needs. We were informed that the home employed a total of twenty-five care staff of which seven had an NVQ level 2 qualification and five had an NVQ level 3 qualification. This Care Homes for Older People Page 22 of 30 Evidence: is marginally less than the 50 needed to meet the recommended standard. However in addition, all other care staff were undertaking NVQ level 2. This shows that the organisation promotes staff development and ensures that residents are cared for by skilled staff who understand their needs. The AQAA informed us that Beechlands is an equal opportunities employer and has a recruitment process that is robust with all the necessary checks completed before the applicant starts work. During the visit to the home the recruitment files for three recently employed staff were viewed. All files included evidence that the relevant checks (CRB, two satisfactory references, identification etc.) were undertaken prior to appointment. We were informed that a copy of the General Social Care Council (GSCC) Code of Practice was given to all new staff on appointment to ensure they were aware of their responsibilities as a care worker and this was also confirmed from the files viewed. The AQAA informed us that all staff complete a full induction based on Skills for Care induction, there is a trainee senior carer programme and personal development is encouraged through in-house, external and distance learning programmes. It was good to hear that some staff were supported to attend numeracy and literacy programmes. A copy of the training matrix was provided. This comprised a rolling programme of mandatory training (health and safety, manual handling, fire safety, food hygiene, first aid and infection control). The training records for the same three staff were viewed and confirmed that since appointment they had received training in manual handling, safeguarding adults, food hygiene, fire safety, stroke awareness and had completed the common induction standards. We were informed that new staff were provided with a welcome pack that included guidance on communication, daily shifts and duties, key worker role, safeguarding adults guidance, philosophy of care, pressure sore prevention and personal care guidance. This demonstrated that staff were provided with information to ensure they were clear of the standards expected of them. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are assured they live in a safe and well managed home that is run in their best interests. Evidence: Discussions were held with the manager for the home who had recently been appointed. She informed us that she had qualified as a nurse in the Philippines, held an NVQ level 3 qualification and planned to undertake NVQ level 4 training/Registered Managers award. The AQAA informed us that support was given from the operations manager and senior managers from other homes within the organisation. This was also confirmed in discussion with the manager. During the visit to the home it was clear that the manager was well known to all the residents. Staff who completed surveys told us the manager is very helpful and listens to any needs we have and another told us I have worked at Beechlands for eight years and have always been able to speak to the manager who is supportive. From observation and an inspection of records, the home appeared to be well managed. Care Homes for Older People Page 24 of 30 Evidence: The homes quality assurance policy and procedures were discussed with the manager. We were informed that monthly listening forms were distributed to residents with basic questions about life at the home and there were plans to develop this further. Internal audits were undertaken by the manager to check that procedures were being followed appropriately and evidence of a medication audit was seen during the visit to the home. Random audits were also undertaken, for example for incidents of falls. Information obtained was used to address any issues raised and a copy of the Quality audit report for 2008 was seen confirming the process. We were informed that regulation 26 reports were completed from visits by senior managers and copies of these were also seen. The home had a comprehensive range of policies and procedures in place for staff guidance that had been regularly reviewed ensuring they met with up to date legislation and best practice guidance. The arrangements for handling residents monies were discussed with the manager. Neither the manager nor representative were appointee for any resident. One resident managed their own financial affairs. All others had a relative or representative to manage their finances on their behalf. Personal allowances were held in secure facilities on their behalf. The personal allowances and records were inspected for three residents. The amounts of money were present and correct for all three residents with records of transactions made and receipts held as evidence. From discussion with the manager it was evident that any allegations of financial abuse would be appropriately referred and investigated in line with local safeguarding procedures. The AQAA informed us that all staff receive regular supervision including direct observation of practice. Handover was observed to be provided between shifts to ensure staff were aware of residents changing needs and this was noted during the visit to the home. Three members of staff who completed surveys said they felt supported by the manager and senior staff. The records for three staff members were viewed and confirmed they had received weekly supervision as part of their induction. The home had a health and safety policy and procedures in place for staff guidance that had recently been reviewed. The records confirmed that staff had attended health and safety training following appointment. Evidence of a sample of records viewed showed that there were systems in place to ensure the servicing of equipment (hoists, slings etc.) and utilities and there was evidence of appropriate weekly and monthly internal checks being carried out (e.g.checks on fire equipment, fire alarms and emergency lighting etc.). However one clinical waste bin was observed to be unlocked during the visit to the home posing a potential risk to service users and the public. Care Homes for Older People Page 25 of 30 Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The Controlled drugs register must include the name and address on receipt and disposal. This will safeguard residents. 28/02/2010 2 9 13 Omissions must be monitored and the reason recorded. This will ensure residents received their medication as prescribed. 28/02/2010 3 9 13 All changes in prescribed medication must be confirmed by date and the signature of the person making the change. This will safeguard residents. 28/02/2010 4 38 13 Clinical waste bins must be locked at all times. This will safeguard residents and the public. 05/03/2010 Care Homes for Older People Page 28 of 30 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 9 12 The storage of medication should be reviewed to minimize the risk of error of administration. The programme of social activities should be reviewed and provision of a designated activities coordinator considered. This will ensure dedicated time for activities that is not compromised by care staff having to undertake other tasks. Worn carpets should be replaced. This will enhance the appearance of the home and comfort for residents. Hand gel should be provided for care staff to minimise the risk of infection. This refers to the shower room with no hand wash basin. 3 4 19 26 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or 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 © (2010) Commission for Social Care Inspection (CSCI). 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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