Care Home: Beechtree House

What the care home does well Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Residents who sent us completed surveys say they like living at the home. Their comments include: “I think they do alright”, “I’m quite happy here” and “I’m very happy being here”. There is an open, relaxed and friendly atmosphere with good interaction between residents and staff. The staff members spoken with are enthusiastic about providing good quality care. They are encouraged to undertake training and receive supervision. Residents enjoy the meals that are of good quality. Personal health care needs are well supported and residents’ individual preferences are catered for where practicable. The Manager is very good at keeping people informed of developments at the home. What has improved since the last inspection? The staff roster and deployment of staff have been amended to facilitate daily routines that better meet residents’ preferences as far as is practicable. There are improved arrangements for staff hand-over so that important information is exchanged between shifts. The menus and meal times have been adjusted to suit residents’ tastes. The atmosphere within the home is more calm and relaxed. The home has made arrangements so residents have easy access to their money at all times and thereby further promote independence. Staffing levels have been increased and more training is available to staff. The home is using a new design of contact sheet so daily records of care are clearer. Parts of the home have been redecorated. Free-standing support frames around toilets have been secured, making them safer for residents to use. What the care home could do better: Beechtree HouseDS0000050691.V377250.R01.S.doc Version 5.2 No Requirements are made as a result of this inspection. The Manager agreed to amend the pre admission assessment forms to include prompts to ensure all necessary information is obtained from health care professionals and to make it clearer that prospective residents are asked if they have specific needs in respect of spiritual beliefs, culture or sexuality. This will help the home accurately assess its suitability for people with more complex requirements if it is able to meet people’s needs in the way in which individuals prefer. It is recommended the Manager proceeds with her stated intention of further developing the care plans so they are less cumbersome and important information is more readily accessible to staff. The Manager undertook to ensure all hand written entries on the Medication Record Administration Record (MAR) sheets are double signed to help confirm accuracy. She also agreed to introduce a system that records the audits of the MAR sheets and shows that any gaps in the records are investigated. The Manager agreed to introduce a more robust and regular system of environmental checks. Key inspection report CARE HOMES FOR OLDER PEOPLE Beechtree House 62 Buckland Road Maidstone Kent ME16 0SH Lead Inspector Gary Bartlett Key Unannounced Inspection 1st September 2009 8:00 DS0000050691.V377250.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. Beechtree House DS0000050691.V377250.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 Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beechtree House Address 62 Buckland Road Maidstone Kent ME16 0SH 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) 01622 752047 01622 752047 kupendrarajah@btconnect.com Beechtree House Ltd Ms Demi Jean Seager Care Home 24 Category(ies) of Dementia (0) registration, with number of places Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Dementia (DE). The maximum number of service users to be accommodated is 24. Date of last inspection 19th November 2008 Brief Description of the Service: Beechtree House is a care home for 24 older people with dementia. It offers 24 hour care with waking staff on duty at night. It is a detached property that has been extended and adapted to become a residential home. The accommodation is arranged on three floors and is accessible by way of a passenger lift as well as by stairs. The majority of bedrooms are for single occupancy, there are two shared bedrooms and most rooms have en-suite facilities. There are three bathrooms with one having an assisted bath. There is also a wheel-in shower facility. The home has a small garden and limited parking facilities. Street parking is available but limited to two hours. The home is within walking distance of amenities such as a shopping centre, post office, railway and bus station and river walks. Fees for this service range between £338.56 (local authority rate) to £497 per week. Full details of the fees and any additional costs can be obtained from the Manager. Beechtree House DS0000050691.V377250.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. This key unannounced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in Beechtree House from 8.00 a.m. until 3.00 pm. Judgements about quality of life and choices were taken from direct observation and by discussion with the Manager, residents and staff. Some records and parts of the building and grounds were inspected. Reference was made to the results of recent quality surveys undertaken by the home. We received a number of completed surveys prior to our site visit. Six were from residents and 2 from staff. They indicate good standards of care and overall satisfaction with the service. The Care Homes Regulations 2001 and the National Minimum Standards for Care Homes for Older People refer to people who use the service as “service users”. People living at Beechtree House prefer to be referred to as “residents”. Accordingly this shall be done in the text of this report. The Inspector would like thank everyone for their contribution to the inspection. What the service does well: Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 6 Residents who sent us completed surveys say they like living at the home. Their comments include: “I think they do alright”, “I’m quite happy here” and “I’m very happy being here”. There is an open, relaxed and friendly atmosphere with good interaction between residents and staff. The staff members spoken with are enthusiastic about providing good quality care. They are encouraged to undertake training and receive supervision. Residents enjoy the meals that are of good quality. Personal health care needs are well supported and residents’ individual preferences are catered for where practicable. The Manager is very good at keeping people informed of developments at the home. What has improved since the last inspection? What they could do better: Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 7 No Requirements are made as a result of this inspection. The Manager agreed to amend the pre admission assessment forms to include prompts to ensure all necessary information is obtained from health care professionals and to make it clearer that prospective residents are asked if they have specific needs in respect of spiritual beliefs, culture or sexuality. This will help the home accurately assess its suitability for people with more complex requirements if it is able to meet people’s needs in the way in which individuals prefer. It is recommended the Manager proceeds with her stated intention of further developing the care plans so they are less cumbersome and important information is more readily accessible to staff. The Manager undertook to ensure all hand written entries on the Medication Record Administration Record (MAR) sheets are double signed to help confirm accuracy. She also agreed to introduce a system that records the audits of the MAR sheets and shows that any gaps in the records are investigated. The Manager agreed to introduce a more robust and regular system of environmental checks. 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. Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4, 5 and 6 An assessment of people’s health and personal care needs is made before they move into Beechtree House. EVIDENCE: If practical, the Manager visits the prospective resident in their home or hospital to help ensure the necessary information is obtained and that it is up to date and accurate. A pro forma is used to record this information which is used as a basis for the care plan. Whilst the forms seen include facilities for the assessments of personal support, health care needs and social interests, it is not evident that prospective residents are asked if they have specific needs in respect of spiritual beliefs, culture or sexuality. The Manager agreed to make it clearer that this is being done as this information can be very Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 10 important in getting a complete understanding of prospective residents needs and assessing if the home is able to meet them in the way in which individuals prefer. The Manager also undertook to amend the documentation to include prompts to ensure all necessary information is obtained from health care professionals such as Care Managers and hospital staff. This will help the home accurately assess its suitability for people with more complex needs. Residents said they or their families had been able to visit the home before moving in and said staff members are very helpful in assisting new residents to settle in. Intermediate care is not offered at Beechtree House. Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 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. Residents’ health and welfare are promoted through their individual care plans and with good liaison with relevant health care professionals. Residents are protected by staff adhering to good practice guidelines in the storage of medicines. EVIDENCE: Each resident has a care plan. Four were inspected in detail. It is evident the care plans are updated when there are changes in residents’ health and welfare and are regularly reviewed. They show residents have ready access to Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 12 health care professionals such as GPs, dentists, chiropodists etc. The Manager is intending to further develop the plans so they are less cumbersome and important information is more readily accessible to staff. Since the last inspection, the care plans have been augmented with a new design of contact sheet so daily records of care are clearer. The standard of daily records is generally good. The Manager is encouraging the staff to report on individuals’ moods and apparent mental states, thereby giving a fuller picture of the person’s welfare. This will help when it comes to reviewing the care plans. The home has a good working relationship with the specialist and local health care professionals. This assists in supporting residents in their health care needs. The Manager has a good understanding of getting a balance between perceived risks and promoting independence. There have been improvements to the risk assessments and they are being written or reviewed in response to accidents and incidents. The Manager said she is intending to introduce a new system that is more specific in detail and easier to cross reference to the care plans. The Manager and senior staff are responsible for medication and have undertaken medication training. The home uses a monitored dosage system and arrangements for the storing and administration of medicines are satisfactory. There are not any controlled drugs at the home. Where a resident self medicates, it is risk assessed to help safeguard people. The Medication Record Administration Record (MAR) sheets inspected have been generally completed appropriately. The Manager undertook to ensure all hand written entries on the Medication Record Administration Record (MAR) sheets are double signed to help confirm accuracy. She also agreed to introduce a system that records the audits of the MAR sheets and shows that any gaps in the records are investigated. The administration of medicines was not observed on this occasion. Residents say they like the staff and they are caring and considerate. This was confirmed by observation. Beechtree House DS0000050691.V377250.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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents say they like the activities currently available and are able to maintain contact with families and friends. Residents enjoy the meals which are of good quality. EVIDENCE: Discussion with residents and staff show that the routines of the home are planned around the residents’ individual needs and wishes as far as is practicable. The Manager encourages residents to take control of their life and be as actively involved in the running of the home as they wish. The atmosphere is comfortable and relaxed. Residents say they have the confidence to discuss and comment where improvements can be made. They say that the Manager is always available to talk with. The Manager said she Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 14 takes residents feedback seriously and makes changes where possible, which enables them to enjoy a better quality of life. There is an activities programme for each afternoon of the week. Motivation & Co. provide an hour with residents to do exercises and have music and stimulation each fortnight. The Manager is hoping to increase these to weekly visits. Pet Therapy visit the home once a week and there are individual trips out for residents. The home has recently joined Kent County Council library and are looking forward to a regular supply of books, some in large print and some recorded. Residents can choose to bring personal effects with them on admission to the home and are encouraged to keep personal items that are important to them in their own room. A monthly newsletter about developments at the home is produced and distributed to residents’ families. The visitor’s book records regular visits by families, friends and others. During the inspection, several visitors were seen in the home. They say they are always made to feel welcome and can visit the home at any reasonable time. Although there is not a designated visitor’s room, the design of the home provides seating areas within the communal areas of the home where residents can entertain their visitors, in addition to the privacy of their own room. The home holds small amounts of cash for some residents who have easy access to their money at all times so as to promote their independence and autonomy of choice. Resident’s surveys returned to use included the comments “The food is excellent” and “I really like the food”. The Manager and cook had a meeting with residents to discuss the meals recently. As a result of this, the menus and arrangements for meals have been adjusted accordingly. Meal times are set for practical reasons and residents are complementary of the food served. Mealtimes are relaxed; staff members are patient and helpful and allow residents the time they need to finish their meal comfortably. Hot and cold drinks are served through out the day, as well as snacks. Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives know their complaints are listened to and acted on. There are systems to protect residents from abuse. EVIDENCE: People living at the home say they feel safe and are confident that they are listened to. The complaints procedure is readily available to people who use the service. The Manager described how she is intending to update the system of recording the complaints received by them, the result of the investigation and how the complaint has been resolved. Records show the home has received one complaint in the last twelve months. This has also been made known to the Commission and is still to be resolved. The Manager understands the homes responsibility to enable residents to exercise their legal rights and ensures they are able to vote in elections should Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 16 they so wish. She is aware of the assessments that need to be done in respect of Deprivation of Liberty Safeguards and the Mental Capacity Act. There are procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. Records show there is safeguard training and the staff members spoken with have a sound understanding of safeguarding vulnerable adults procedures and of the need to be mindful of individual’s needs. There have been three safeguarding alerts in the last twelve months, one of which remains open. It is evident the home reviews its practices as a result of these and makes any necessary amendments. Beechtree House DS0000050691.V377250.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): 19, 21, 22 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a generally comfortable and clean environment. EVIDENCE: Beechtree House is built on three levels with two shaft lifts that enable people with mobility difficulties access to all floors. It is a detached property that has been extended and adapted to become a residential home. The majority of bedrooms are single occupancy, there are two shared bedrooms and most rooms have en-suite facilities. Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 18 Beechtree House is not purpose built for caring for people with dementia and has many dead-end corridors that are not conducive for wandering. There is, however, good signage around the home to help orientate residents. A chair-lift and the provision of handrails help residents with mobility difficulties have access to the small rear garden. There are plans to landscape the garden specifically for people with dementia. This is to include raised flower beds that residents will be able to work, should they choose to do so. It is also planned to resurface the driveway which is currently uneven and to provide an entrance gate. It is recommended these works be done as soon as possible so as to provide residents with additional wandering space and stimulation. Since the last inspection the lounge and some bedrooms have been redecorated. Staff say that bathing and toileting facilities are adequate. Free-standing support frames around toilets have been secured, making them safer for residents to use. The Manager undertook to arrange for a rusted frame to be replaced. It was seen that some beds had been made with stained linen. The Manager agreed to take immediate action in regard to these issues. Accordingly, we did not issue an Immediate Requirement Notice. The Manager also undertook to introduce a more robust and regular system of environmental checks. A solid door from the small bathroom area opens into the dining room which is often used by residents throughout the day. It is recommended a clear vision panel be fitted to the door to help prevent accidents. Those parts of the home seen were clean and free from unpleasant odours. To help maintain this, the Manager has obtained a macerator, making the disposal of sanitary items more effective. As residents’ frailties have increased, the home has had to use more aids and equipment. As a consequence, storage space is now problematic. Although the home is being as diligent as possible, equipment still causes partial obstruction in some areas, as observed by the lift on the bottom floor. It is recommended the home reviews it arrangements for the storage of equipment so as better promote the safety and convenience of people there. Beechtree House DS0000050691.V377250.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): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment processes are robust and offer protection to people living at the home. Training is available to the staff so they have the skills to meet the needs of the residents. EVIDENCE: A resident’s survey returned to use included the comment “Cheerful, caring”. Residents speak highly of the staff, saying they are friendly and helpful. Some very good interaction between staff and residents was observed. Residents said the number of staff on duty is enough to meet their needs. The staff roster and deployment of staff have been amended to facilitate daily routines that better meet residents’ preferences as far as is practicable. The staff rosters seen indicate staffing levels are geared to peak times of activity. Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 20 A laundry assistant has been employed which frees up a considerable time for carers to concentrate on providing direct support to residents. People applying to work at the home have to complete an application form, and provide satisfactory POVA and Criminal Records Bureau (CRB) checks as well as two references. The files of the most recently recruited staff show that appropriate checks are made prior to them commencing duties. The Manager was advised to obtain guidance about storing CRB checks from the CRB website. All new staff members are required to complete the Skills for Care induction programme. NVQ training in care is being encouraged and staff spoke of the support they are given in this. The Manager spoke of ongoing training for staff and a training matrix is used to monitor individual training needs. This indicates there is regular mandatory training and also training in residents’ more specialist needs such as dementia. Beechtree House DS0000050691.V377250.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): 31, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of residents. There is an open and friendly atmosphere. EVIDENCE: Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 22 Demi Seager, was registered as Manager of Beechtree House in October 2008. She has extensive experience in residential care and was previously the registered Manager of another care home. The Manager has acquired the Registered Managers Award and NVQ level 4 in Care. Staff members speak very highly of the Manager and of the improvements she has introduced. They say she is very approachable and supportive. A staff survey returned to use included the comment “Beechtree is a good place to work”. A lot of progress has been made during the last year and staff members say they feel better equipped to do their work through training and supervision. However, the Manager is aware that this still needs to be consistently translated into good daily practice by all staff. In the June/July newsletter, the Manager writes that she will be spending more time in the mornings on the floor ensuring that things are running smoothly and that there will be regular spot checks to ensure night staff are complying with procedures. An example of poor COSHH practice was noted when we saw that a cupboard containing toiletries in a communal bathroom had been left open and no staff members were in the vicinity. This was very shortly after we had arrived at the home. Staff locked it a short time after, indicating they knew what they should have done sooner. This meant we did not have to issue an Immediate Requirement Notice but we did notify the Manager of this. She undertook to remind staff of their responsibilities in maintaining the health and safety of residents at all times. People who use the service and other stakeholders are invited to comment on the quality of the provision made for them using questionnaires. The results of these are published in the new monthly newsletters. There is a suggestions book in the reception area. There is a sound system of holding and recording residents’ cash on their behalf. The records seen are kept in a manner that promotes confidentiality. The standard of cleanliness in the kitchen and surrounding area is satisfactory. There are records of fire systems checks and fire drills and training and staff spoken with have a sound understanding of emergency procedures. The Manager stated all records of maintenance and safety checks are up to date and that the home regularly reviews policies and procedures to ensure they comply with current legislation and good practice advice. These were not inspected on this occasion. Beechtree House DS0000050691.V377250.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 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 N/A 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 3 18 3 2 X 3 2 X X X 2 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 3 3 X 3 3 3 2 Beechtree House DS0000050691.V377250.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. 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. Refer to Standard Good Practice Recommendations Beechtree House DS0000050691.V377250.R01.S.doc Version 5.2 Page 25 Care Quality Commission South East Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.southeast@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. 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