Care Home: Bentley Care Home

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What the care home does well The Bentley Care Home has enthusiastic management and staff teams and provides care for residents with a wide range of needs, some of them extremely complex. The home has a number of Chinese residents and provides some Chinese meals and Chinese TV channels to help meet their needs. Those residents who are able to go out of the home independently are encouraged and supported to do so. A range of activities is provided for residents, especially the younger ones in the `Bentley Unit`. The people who live at the Bentley play a full part in the life of home to the best of their ability and residents attend staff interviews. What has improved since the last inspection? More than half of the care staff now have NVQ qualifications. A staff supervision programme has been out in place, with senior staff supervising other staff. The medication system has been improved, with the manager regularly auditing the system. Detailed advice on any medication to be given `as required` is in place. `Freeview` TV boxes have been bought for residents to help improve reception and choice. CARE HOMES FOR OLDER PEOPLE Bentley Care Home 2 Bentley Road Liverpool Merseyside L8 3SE Lead Inspector Peter Cresswell Key Unannounced Inspection 09:15 19th May 2008 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bentley Care Home Address 2 Bentley Road Liverpool Merseyside L8 3SE 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) 0151 727 3003 No email Argyle Care Group Limited Mrs Bernadette Roberts Care Home 58 Category(ies) of Dementia (36), Mental disorder, excluding registration, with number learning disability or dementia (22) of places Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To accommodate one named person over the age of 65 with past or present dependence on alcohol (A/E) in the ‘Bentley House’ wing. To accommodate one named person under the age of 65 with past or present dependence on alcohol (A) in the ‘Bentley House’ wing. The registered person may provide the following categories of service only. Care home with Nursing - code N, to people of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE) (maximum number of places: 36) Mental disorder, excluding learning disability or dementia - Code MD (maximum number of places: 22) The maximum number of people who can be accommodated is: 58 Date of last inspection 9th July 2007 Brief Description of the Service: The Bentley Care Home (generally known as ‘The Bentley’) was converted from three large houses and provides accommodation on three floors for up to 58 people. It has been a care home since the 1980’s but has been extended in that time. Residents with dementia (usually older people) tend to be located in the main building (‘Bentley House’), and younger people with mental disorder are in the building that faces on to Greenheys Road (the ‘Bentley Unit’ or annexe). Both units share the kitchen and the main entrance. A number of Chinese residents live at the Bentley and the home provides Chinese television channels and Chinese meals for them. The home is opposite Princes Park in the Liverpool 8 area and is convenient for Princes Park Health Centre, local amenities on Lodge Lane and bus routes to Liverpool city centre. The home has a well-maintained walled garden and off-road car parking. The Bentley’s present owners, Argyle Care Group, own a number of other care homes. The manager of the Bentley Care Home is qualified and experienced. The standard fee is £498 a month. Bentley Care Home DS0000056187.V362197.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 inspection included an unannounced site visit. We spoke to the Registered Manager, one of the owners and a number of staff as well as several residents. We toured the home, visiting all of the shared areas, the kitchen and several of the bedrooms. We examined care plans, medication, fire safety records, financial records, recruitment files and the menu. Some survey forms were distributed to relatives but none had been returned by the time we wrote this report. The manager had completed a CSCI Annual Quality Assurance Assessment (AQAA) some weeks before the site visit. What the service does well: What has improved since the last inspection? More than half of the care staff now have NVQ qualifications. A staff supervision programme has been out in place, with senior staff supervising other staff. The medication system has been improved, with the manager regularly auditing the system. Detailed advice on any medication to be given ‘as required’ is in place. ‘Freeview’ TV boxes have been bought for residents to help improve reception and choice. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Bentley Care Home DS0000056187.V362197.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 Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Quality in this outcome area is good. Residents are assessed before moving into the Bentley and are encouraged to visit the home before making a final decision, helping them to decide if the home is right for them. The home’s service user guide and Statement of Purpose are regularly reviewed, so prospective residents have an up to date guide to the facilities offered, though there are still some minor inaccuracies in the service user guide. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user guide and the Statement of Purpose are kept under review. However, whilst the service user guide is readable ,well presented, and contains much useful information for residents, it still does not include all of the information required by Regulation 5. People are assessed by the manager before they are admitted to the home and copies of the assessments are kept on file. We looked at the assessments made for the four most recently admitted residents. The pre admission assessment includes information about behaviour, risks, mood, elimination, sleep and mobility. The assessments form the basis of detailed care plans. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 9 The assessments should be signed and dated. The files we looked at also included assessments from the referring authority, such as Merseycare NHS Trust or social services. Contracts are usually signed a month after admission once the person has decided to stay at the Bentley. There are now a number of people aged under 65 with dementia in the ‘Bentley House’ wing. The Bentley has developed the reputation of successfully taking people who have needs that have not been readily met in other facilities. The standard fee for the Bentley Care Home is £498 a month. The home does not provide intermediate care, so standard 6 does not apply. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11. Quality in this outcome area is good. Care planning is good and helps staff to focus on the needs of service users. Medication is well organised but to ensure residents’ safety, special care needs to be taken when new or temporary staff administer medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at the care plans for six people who live in the home. Each had a detailed care plan with separate sections on mood, behaviour, communication, dressing, socialising, nutrition, skin care and physical well being. The home uses Waterlow scoring to assess the risk of pressure sores and carries out appropriate risk assessments. No residents had pressure sores at the time of our visit. Those people who are at high risk of developing pressure sores are clearly identified on a wall chart in the manager’s office. Risk assessments are also completed to assess the risk of falls. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 11 There is a single page summary of the care plan and staff complete daily reports which address key elements of the care plan. The plans are evaluated every month by the manager or her deputy, and changed if necessary. The plans are written on a computer and can therefore be readily changed if necessary following a review, though some changes had been made by hand. Where this happens they should be entered on the computer quickly so that there is no danger of two different plans existing. The home liaises with medical and mental health professionals and details are recorded on the case files. A CSCI pharmacist inspector inspected the home in October 2007 and we followed up the requirements and recommendations from that visit. Medication was checked by ‘case tracking’ a number of residents in each wing of the home. ‘Bentley House’ has its own spacious, secure medication room; in the ‘Unit’ medication is securely stored in an office. For most people the home uses a monitored dosage system, with medication provided by the pharmacist in monthly blister packs. The system was at the start of the month for this visit but there was an error where an agency nurse had failed to complete the Medication Administration Record (MAR) sheet for at least one resident that morning. It was this nurse’s first shift at the Bentley and although this should be within the capability of any qualified member of staff, new staff should be shown the home’s systems before they actually do a medication round. The manager said that this is in fact the normal system. The agency nurse was not allowed to complete his shift. Where any medication is to be taken on a PRN basis (‘as required’) there is individual information available for each person setting out the circumstances in which the medication should be administered. As suggested by the CSCI pharmacist the manager has introduced a policy for the use of homely (everyday, nonprescribed) drugs. The policy only covers the use of Paracetamol and there is written guidance from each resident’s GP to indicate if this medicine is suitable for their patient. The home did not have any controlled drugs, but has suitable storage for them should any be prescribed. Only one person (in the ‘Unit’) administers their own medication, and they have secure storage for it. The manager now carries out regular, recorded audits of the medication system. All residents have single rooms (though people can share if they choose) so personal care can be given in the privacy of their own room. Care plans include a section to record residents’ wishes when they die. Most of those examined on this occasion stated either that the person had refused to discuss the issue or that arrangements were to be left to a nominated close relative. The manager has researched the necessary information for the home to be able to deal appropriately with the death and funerals of the people of different religions and cultures who live in the Bentley. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. The home arranges a range of activities that enhance its residents’ quality of life. There is a choice of meals to meet the dietary and cultural needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are two part time activities organisers at the Bentley, one for each wing; we were not able to speak to them on this visit as they were out with residents. They have the use of an activities room and, once a week, a minibus belonging to the owners that is also used by other homes. Recent activities include pub lunches, gardening, walks, arts and crafts, quizzes, bingo, cookery, line dancing and shopping. Recent trips out included Chester Zoo, New Brighton and Knowsley Safari Park. One resident in the ‘Unit’ said that there should be more activities and that staff were very busy, but had no particular ideas in mind and was involved in planting flowers in the garden. There were orientation boards in the corridors of both wings and they were up to date. Benji the dog lives at the home, and one resident in the Unit takes particular responsibility for his care. Most of the Unit residents who spoke to us said they were very fond of him. Chinese TV channels are available for the home’s Chinese residents. The home holds a popular summer fair every year. Several residents went out whilst we were at the home and those needing support were helped by members of staff. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 13 Family and friends are encouraged to visit the home at any reasonable time and some also attend meetings at the home. The inspector spoke to one relative at the home who was happy with the care given to her husband. Meals for all residents are prepared by the chef in the main kitchen in Bentley House and served in separate dining rooms in each unit or in people’s own rooms if they wish. There is a small ‘rehab’ kitchen in the Unit where some cold snacks and drinks can be prepared and stored. Several residents made tea and coffee for themselves (and staff) during our visit. Residents who spoke to us said that they enjoyed the meals at the Bentley. A full cooked breakfast is available every day for those residents who want it. The main meal is served in the evening but there are cooked options available for each meal. There are choices available at all meals. The main courses are usually traditional British dishes (bacon ribs or pie and mash, for instance), but the chef prepares Chinese dishes for the home’s Chinese residents (and some others who like Chinese food). He has made every effort to familiarise himself with Chinese cuisine and there is usually one such option every day, normally at the evening meal. The Chinese dishes include, for example, steamed minced pork, ‘Chinese fish’ and chicken with ginger. The chef also prepares dishes such as home made pizzas for some of the younger residents who prefer that. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. Procedures for complaints and adult abuse allegations are in place and provide protection for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Bentley has an appropriate complaints procedure which is prominently displayed and records any complaints. Staff are trained in the protection of vulnerable adults. Staff we spoke to were aware of the need to report suspected abuse and how to do so. There had been one safeguarding referral since the last inspection (concerning an incident outside of the home) and it had been correctly dealt with by the manager and her staff. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is adequate. The Bentley provides a comfortable environment for its residents and further plans for improvement are in hand, though progress now seems to have slowed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was clean and free of offensive odours apart from in one small area where the manager and staff are taking action to resolve a longstanding problem. In ‘Bentley House’ the two lounges were clean and well decorated. The main dining room was being cleaned but the smaller dining room was attractively laid out for lunch with clean tablecloths and flowers on all the tables. It needs redecoration as does the corridor to the dining room, which now looks very scruffy. The dining rooms provide a spacious, light environment for the residents. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 16 The former dining room has been carpeted and is now used as a lounge. The smoking room in ‘Bentley House’ is unattractive, though it does have a good view over the gardens. The carpet is badly burnt by cigarette stubs and the manager said that this happens quickly to any surface they provide. Additional ashtrays and bins might help. Some of the furniture in the common areas looks rather worn. Television reception remains rather poor on most televisions in the home. Contractors and suppliers have been contacted to try to improve TV picture quality but as yet nobody has been able to solve the problem. Freeview boxes are now being purchased for everyone as these give improved reception as well as a wider choice of channels. The smoking room and dining room in the ‘Unit’ were clean and well decorated. As noted at the last, “random” inspection (i.e. not a full, or ‘key’, inspection) the old medi bath has been disposed of and replaced with a normal bath as part of a reshaping of the toilet and bathroom facilities in the home aimed at creating wheelchair accessible toilets on all floors. This work has not yet been completed and progress now seems to be rather slow. The ground floor shower – which leaks and looks grubby - is being replaced with a new shower unit which has been bought but has still not been fitted. The refurbishment of the bathroom facilities is now dragging on and should be prioritised by the owners in order to provide a pleasant environment for bathing. Many of the bathrooms need either modernising or at least basic redecoration such as regrouting, resealing and floor repairs. The “residents’ kitchen” in the Bentley Unit has been greatly expanded and was being put to good use by some of the residents who were making hot drinks for themselves (and staff!). One of the residents who had previous experience as a decorator has done some of the work on the kitchen. The attractive walled garden is mainly used by residents from the Unit and the proposed possible extension would make it more accessible to the older residents in the ‘House’. The garden is well used, especially in pleasant weather, and has two large gazebos, complete with chairs and tables. The plans to extend the walled garden to allow better use by the residents with dementia have not yet progressed. All of the residents have single rooms though they can choose to share with someone else (e.g. partners) if they so wish. We looked at a number of the rooms and they showed evidence of being personalised to reflect the interests and personality of the resident. The rooms vary in size; some of them are very spacious indeed, others are more basic, though all meet the National Minimum Standards. There is a programme for certain bedrooms to be redecorated and one was being re-papered when we visited. Bedrooms have locks but one person in the ‘Unit’ said that he needed a lock that he could use more easily and the manager said that this would be sorted out for him. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 17 Amongst the other areas that need redecoration or repair were: the corridor near the dining room in the ‘House’ needed redecorating; small dining room needed some redecoration; hole in ceiling of room 24; redecoration of lounge in ‘Unit’ needs to be completed; wall in upstairs corridor needs repair and redecoration; stained ceiling in room 26. This is not an exhaustive list. Lack of attention to detail in the physical environment detracts from the excellent work that has been done by the manager and her staff to improve the Bentley over the last two years. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. The home has sufficient staff to meet the needs of its residents. It has a training programme to ensure that staff are sufficiently well trained to provide the appropriate care, and sufficient care staff with NVQ2 to ensure that residents are cared for by suitably qualified (non nursing) staff in addition to the nurses. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing is calculated using the Residential Forum model. The Bentley employs six registered nurses, including the manager and her deputy, and the rota indicated that staffing in both wings of the house was adequate. There is always a nurse in charge of each unit in addition to the registered manager. Five domestic staff are on duty most days, plus two kitchen staff, including the chef. The clerical/administrative worker has still not been replaced, though some administrative duties are carried out by staff at other sites. As mentioned in previous reports, the National Minimum Standards and Care Homes Regulations do not specify a need for dedicated administrative staff. However, running a home of the size and complexity of the Bentley involves a lot of administration and routine clerical work. If this is done by professional staff, that time cannot be spent on caring duties. It is unusual for a home of this size to have no on-site administrative staff at all and the owner should review the situation. Some agency staff are used and it is important that they are familiar with those aspects of the home’s systems they are dealing with before they start work. The significance of this was seen in the problem over the medication system set out in an earlier section of this report. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 19 In the past the Bentley has had a number of Chinese speaking staff who were able to ensure there was proper communication with Chinese speaking residents. Most of these were students and have left. The manager has attempted to recruit further Chinese speaking staff via the Pagoda Chinese community centre in central Liverpool and adverts in the main Chinese supermarkets. However, this has not been successful and the manager feels that there are now fewer Chinese students looking for work. In the meantime the home uses the services of relatives, interpreters and a community-based Chinese charity to help communication. The manager said that she was continuing to seek to recruit Chinese speaking staff. We examined recruitment files for staff employed since the last inspection and they showed that the necessary checks had been carried out before they started work. Some residents attend staff recruitment interviews, complete appraisal forms and play a full part in the discussions about whether or not to employ the candidate. This is excellent practice. There is a full programme of NVQ training, organised by the owner’s group training officer, who is based at the Bentley. Over half of the care staff now have NVQ2 or better so the home exceeds the National Minimum Standard of 50 of care staff with NVQ2. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37, 38. Quality in this outcome area is good. The Registered Manager provides positive leadership and operates some quality assurance procedures to ensure that the home is run in the best interest of the residents. Staff are appropriately supervised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager is an experienced nurse and manager who continues to provide positive and enthusiastic leadership for the staff team. The home uses a range of quality assurance measures including questionnaires to residents and relatives. The manager actively pursues issues raised in the survey forms and they provide useful feedback to help improve the quality of care. Fire safety records were up to date except that the weekly tests had not been recorded for the last two weeks. Notices were in place reminding staff and residents of the need to keep fire doors closed unless they are held open by an approved device. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 21 Accidents are recorded in an Accident Book and the individual records are kept on the individual’s file. One accident which had resulted in a broken arm had not been notified to the Commission as required by the Care Homes Regulations 2001. Events such as this must be notified to the CSCI and we gave the manager a copy of the appropriate advice and a form which can be used. The manager administers the personal allowances for six residents. In most cases they are given to the residents once a week but in some cases they are paid out as requested. A record is kept and receipts obtained. It is important that the records are kept accurately. There was a minor error in one of the cases (there was more money retained than indicated by the account) but the manager said that if the small amount of cash kept for a resident did not tally with the record then the record would be honoured. The staff supervision programme has been reinstated with staff receiving one to one supervision six times a year. Senior staff have received training in supervision techniques and carry out the bulk of supervision sessions. The kitchen was clean and well organised. The chef uses the Food Standards Agency pack ‘Better Business, Safer Food’ as the basis of checking and maintaining safety standards for food. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 23(2) Timescale for action The registered person must keep 01/11/08 all parts of the home reasonably decorated and must therefore arrange for: * all of the bathrooms and toilets to be renovated and refurbished where necessary; * all parts of the home to be regularly redecorated as necessary. The registered person must 01/06/08 notify the Commission without delay of the occurrence of those incidents set out in the Care Homes Regulations 2001. Requirement 2. OP37 37 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP4 Good Practice Recommendations The service user guide should be reviewed and all pre admission assessments should be signed and dated. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 24 2. 3. OP9 OP27 Agency staff should be thoroughly familiarised with the home’s medication systems before they are allowed to carry out a medication round. The Registered Person should keep the situation regarding administrative work in the home under review so that professional and care staff are not unduly burdened by administrative and clerical tasks. Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bentley Care Home DS0000056187.V362197.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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