Care Home: The Beeches (Mansfield)

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What the care home does well Comments received from preople who live at the Beeches, and their relatives were all positive, and included: "My mother has been well looked after up to now." "The staff do act on what we say very well." "The staff are there whenever we need them." " There are good activities." "The food is very nice, and we always get a choice." "The food is great." The Beeches is a homely environment, and observations of the staff working with the people who live at the home, showed a caring and considerate attitude. What has improved since the last inspection? Following a visit and recommendation by the Environmental Health officer, a new cooker hood has been fitted in the kitchen. The home has a new washing machine tumble dryer and a new hoist for moving and handling people who live at the home. Five new hospital beds with cot sides have been acquired. There is a new microwave and three new tea urns, and the lounge has been redecorated. What the care home could do better: No statutory requirements have been made as a result of this key inspection visit. Nine good practice recommendations have been made, and these relate to: Dating the Statement of purpose and Service User Guide, so that it is possible to judge how up to date the information is. Handwritten medication records should be signed by two members of staff for safety and good practice. Every person living at the Beeches should have a care plan relating to their end of life. The notice on the front door about visitors after 6:00pm should be reworded. All members of staff should receive safeguarding adults training, and have an update at least once every two years. Staffing levels should be reviewed to ensure that they are appropriate to meet the needs of the people living at the home. Consideration should be given to ways in which the views of the people living at the home can be gathered if formal meetings are not being held. Every member of staff should receive a minimum of six formal supervision sessions per year. The recording system for staff supervision should be reviewed to ensure it captures the content of the sessions. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Beeches (Mansfield) 59 High Street Mansfield Woodhouse Mansfield Nottinghamshire NG19 8BB     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: Rob Cooper     Date: 0 9 0 1 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 27 Information about the care home Name of care home: Address: The Beeches (Mansfield) 59 High Street Mansfield Woodhouse Mansfield Nottinghamshire NG19 8BB 01623421032 01623421234 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Justcare Homes Ltd Name of registered manager (if applicable) Mrs Susan Ann Wagstaff Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Beeches is a care home providing personal care and accommodation for 26 older people, including up to 8 beds that can be used for people with dementia over the age of 55. The home provides short term, long term and respite care and can accommodate emergency admissions. The home is owned by Justcare Care Homes who purchased it in April 2006, and is run as a small business. The home is located in the centre of Mansfield Woodhouse close to shops, pubs, the post office and other amenities. The home was opened in 1989 and consists of a house with an extension all of which are listed. 24 of the homes bedrooms are single, and all of the bedrooms have en-suite facilities. Bedrooms are located on 2 floors and there is a passenger lift. The home has well appointed gardens that are well maintained and easily accessible. Care Homes for Older People Page 4 of 27 care home 26 Over 65 26 26 26 0 Brief description of the care home There is car parking available for 12 cars. The manager said the fees range up to £380 per week depending on dependency needs. There are additional charges for hairdressing and chiropody. The last inspection report is available in the reception area of the service. Care Homes for Older People Page 5 of 27 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 stars. This means the people who use this service experience good quality outcomes. This was an unannounced visit as part of the key inspection process so that no one at the Beeches knew that the inspection visit was going to take place. The visit took approximately five hours through the middle of the day, with one inspector present. In preparing for this inspection, the information that the Commission holds about this care home was reviewed, this included looking at the last inspection report, the inspection record, considering any complaints or concerns that have been made about the service, and reviewing any notifications made relating to incidents that affect the Care Homes for Older People Page 6 of 27 well being of people living at the Beeches. The methods used during this key inspection and visit were to visit the Beeches, where a method called case tracking was used; this involved identifying four people who live at the care home and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was followed by a partial tour of the Beeches, looking at the activities on offer, and talking to three residents, and five members of staff about the quality of the service, and their experiences of living and working at the Beeches. The Commission for Social care inspection sent the Beeches an Annual Quality Assurance Assessment (known as an AQAA) as part of the inspection methodology, this allows them to self assess their service. Information provided by the Beeches helped to form the judgements in this report. We also sent out ten surveys asking for views and information to people who live at the home, five to relatives and five to staff. Of these we received two surveys from people living at the home (which had been completed by relatives), no surveys from relatives and three from members of staff, which also helped with the judgements that we made. The registered manager Susan Wagstaff provided much of the information during this key inspection visit. On the day of this inspection there were twenty five people living at the Beeches. People who might want to live at the Beeches can obtain information about the home direct from them, and this would include seeing previous inspection reports prepared by the Commission for Social Care Inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 8 of 27 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 9 of 27 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, who live at The Beeches, and those who would want to, have access to detailed information about the services on offer. People have contracts or a service agreement and they receive a comprehensive assessment of their needs, which allows the people to make an informed decision about whether the home can meet their needs. Evidence: Both the statement of purpose and service user guide for the Beeches were seen during the inspection visit. These documents contained a great deal of useful information about the care home, and discussions with three people who live at the home showed that they had been given copies of the service user guide. Copies were seen in peoples bedrooms. The foyer of the home also has copies of the last inspection report on display. Neither the statement of purpose or the service user guide were dated, which means it is not possible to tell when the information was last Care Homes for Older People Page 10 of 27 Evidence: reviewed, or if the information is current. As part of the case tracking process four people who live at the care home were identified, and their care files were seen, each one contained either an agreement from Social Services to fund their placement, together with a copy of the terms and conditions of residence, or a private contract, for those individuals whos placements are not supported by Social Services. the terms and conditions also form part of the service user guide. Each of the four files that were seen contained a formal assessment of need. The assessments had either been completed in-house, for private individuals, or contained Shared Nottinghamshire Assessment Process (SNAP Assessments) which are Nottinghamshires multi-agency assessment tool for older people. The evidence showed that the information provided by these assessments had been used to draw up the care plans, with the assessments having been carried out before people moved into the care home. In their AQAA the Beeches said: We assess residents needs prior to their admission and ensure that they have sufficient information to enable them to make an informed choice. The Beeches does not offer intermediate care, and therefore this National Minimum Standard was not assessed. Care Homes for Older People Page 11 of 27 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. People have their personal care given in a professional and caring manner by the staff, which means that individuals are having their health and personal care needs met at the Beeches. Evidence: Each of the files that were seen as part of the case tracking process contained a plan of care, which identified personal goals and identified peoples needs and how to meet them. Evidence was seen that care plans were being reviewed on a monthly basis, and there were daily entries by care staff in the daily log and communication sheets, to record progress and any issues relating to individuals care. All of the files contained health care plans. The plans included information relating to health care professionals such as visits to the doctor, or by the nurse, and any hospital visits. A mobile optician provides a service to people living at the home, and three people were asked about seeing the doctor, and they all said that the staff would get them a doctor if they were unwell, and if they needed one, usually at the home, but Care Homes for Older People Page 12 of 27 Evidence: sometimes at the surgery. The care plands all had a range of health related information recorded such as weight charts, and pressure area assessment charts (Waterlow assessments.) A local chemist provides the Beeches with their medication. An inspection of the homes medication systems showed that medication is handled safely. Administration records were seen and found to be complete. No one living at the Beeches currently self-medicates. All aspects of the medication procedures that were seen showed a clear audit trail for medication, and indicated that people living at the care home were safe. Staff training records showed that staff had received appropriate training in medication administration procedures. Statutory requirements relating to medication made at the last key inspection have now been met. Some of the administraion record sheets (MARs) were hand written, and these only had one staff signature, rather than the two that good practice requires. Discussions with three people who live at the Beeches, and observation of the staff working with people generally showed that the staff treated people with respect and dignity. This included observing staff knocking on doors before entering, and speaking in a respectful manner. Two surveys were returned, which had been completed by relatives, and contained the following comments: My mother has been well looked after up to now. The staff do act on what we say very well. The staff are there whenever we need them. In their AQAA the Beeches said: We endeavour to respect service users privacy and dignity at all times. Each persons file that was seen had space to record their wishes at the time of their death. In two examples this was blank, and in a third it said that the family would sort out. The fourth example gave good details of the funeral plan. This was discussed at some length with the manager, particularly with a view to taking a positive stance over recording relevant information. The manager said that people and their families were often reluctant to discuss this, which should then be reflected in the documentation. Care Homes for Older People Page 13 of 27 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. People have a lifestyle that reflects their cultural, social and religious interests, and needs, and there is clear evidence that their social care needs are being met at the Beeches. Evidence: Discussions with three people who live at the home identified that there were plenty of activities arranged, although on the day of this inspection visit none were seen actually taking place, as the activity co-ordinator was on a day off, and staff were busy carrying out their care duties. discussions with members of staff and people living at the Beeches identified that there were trips out, with a trip to the cinema organised on some Thursdays. In house activities include a pianist who comes in to play, ladies from a local Chapel who come in and sing, as well as table top activities, quizzes and memory games. Comments received through the questionnaires included: There are good activities. While in their AQAA they said: We now provide activities five mornings a week, together with cinema visits and additional monthly activities. There is a choice of videos and DVDs for residents preferring not to join with other activities. No visitors were seen during the inspection visit, although comments received in two Care Homes for Older People Page 14 of 27 Evidence: questionnaires were very positive. discussions with three people who live at the home, showed that visitors were made very welcome by the staff. A notice on the front door asking people not to visit after 6:00pm needs to be reworded, as it gives the impression that people living at the home may not receive visitors when they might wish to, which would be an unacceptable restriction. Staff were observed to see how well they interacted with the people who live at the Beeches, and whether choices were being offered. This was seen to be a positive situation with choice offered particularly around drinks and activities. Staff demonstrated how choices were offered and recorded at meal times. Many of the people living at the Beeches have some degree memory loss, which meant that discussions were quite difficult, as people found it difficult to focus on specifics, or give examples, however generally people seemed quite happy, and while the manager said that meetings for the people living at the home had stopped due to their limited ability to participate in the meetings, she also said that there was a great deal of one to one work, where peoples views and general satisfaction were heard and assessed. On the day of this inspection visit there was a good choice of meal on offer including a vegetarian option if required. Information related to peoples likes and dislikes was also seen in the kitchen. All of the people spoken with said good things about the food with comments such as: The food is very nice, and we always get a choice. comments received from a relative in a questionnaire were: The food is great. A recent visit by the Environmental Health Officer (the report of which was seen) recommended a new cooker hood be fitted, which has been done. Care Homes for Older People Page 15 of 27 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. People are safe, as a result of the policies, procedures and systems that are in place at The Beeches, and the people living at the care home and their relatives are confident that their complaints will be taken seriously and dealt with. Evidence: The Beeches has received two complaints since the last key inspection in December 2007. A review of the complaints showed that they had been dealt with in line with the homes complaints procedure, which is on display in the foyer, and also forms part of the service user guide. Discussions with three people who live at the home showed that they knew who to complain to, with one saying: Id speak to Sue, the manager. In their AQAA they said: We have up to date policies and procedures. Staff are aware of issues surrounding complaints and procedures. A review of the staff training records in relation to safeguarding adults, showed that there were some gaps among the twenty four care staff in relation to undertaking this training. The training is aimed at raising staff awareness of abuse, and issues around abuse and through raising those issues, offering people greater protection against abusive practice, while also making sure that the staff understand the correct policy and procedure to follow if abusive practice is found. All members of staff who come into contact with people living at the home should undertake this training. Five members of staff were asked about safeguarding adults training and two said they had Care Homes for Older People Page 16 of 27 Evidence: not received any training since coming into post. The records did show that Portland Training College had undertaken this training for the Beeches, although some staff members appeared to have missed out. The Beeches have not had made any safeguarding adults referrals since the last key inspection. Care Homes for Older People Page 17 of 27 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. People live in a safe, clean, well maintained and comfortable home, with their personal possessions around them, this means that people are living in homely surroundings that meet their needs. Evidence: A partial tour of the Beeches showed that it was comfortable and well maintained, with good quality fixtures and fittings. Discussions with three people who live at the care home showed that they thought the home was comfortable and meets their needs. Several bedrooms were seen, and these were well personalised, and homely, and all had en suite facilities. All of the people who were spoken with said they felt they had everything they needed, and that they thought their bedrooms were comfortable and the home was well equipped. In their AQAA they said: We have an on going rolling maintenance programme which is regularly updated. All resident bedrooms are of a good size and all rooms have en suite WC facilities. All rooms are decorated to a good standard and, as indicated, other areas used by residents continue to be upgraded on an on going basis. The home is well located close to shops, a public house, and public transport. Domestic staff were seen cleaning in different parts of the Beeches during this inspection visit, and discussions with staff showed that there were systems in place for Care Homes for Older People Page 18 of 27 Evidence: cleaning, and that the home had a good supply of cleaning materials. The building was found to be clean, and smelt fresh. In a questionnaire comleted by a relative we received the following comment: The home always smells fresh and is clean to a very high standard. Care Homes for Older People Page 19 of 27 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. Staff have been recruited professionally, and are competent and trained to do their jobs, which means that the people who live at the care home are safe, and have staff who are able to meet their needs. Evidence: The staffing rota was reviewed and this showed that there were enough staff currently employed to meet peoples needs. However discussions with several members of staff showed that they thought the increasing dependancy levels of the people living at the Beeches was making it harder to meet peoples needs effectively. Three staff questionnaires were returned to the Commission, and two contained comments relating to staffing levels: Need more staff when we are full and We feel that depending on the service users needs (example) if the person is unwell that sometimes there are not enough staff at this time. In their AQAA they said: What we do well: We still have a good skill mix, with care, domestic and catering staff in addition to an activities co-ordinator and a maintenance person. We employ a minimum of three care staff during the day and two at night, with extra staff to be introduced at peak times. The care industry considers National Vocational Qualifications (NVQ) to level II in care to be the basic qualification for staff working in residential care. A review of the staff Care Homes for Older People Page 20 of 27 Evidence: training records showed that currently there are twenty-four care staff at the Beeches, of whom there are fourteen staff with NVQ level II, or above. Certificates for those fourteen staff were seen in staff files. The files of three members of staff were seen, to check that they contained all of the information that would show that staff at the Beeches had been recruited in a safe manner, namely that applicants had filled out an application form, provided two written references and had had a Criminal Records Bureau check. The documentation showed that the homes recruitment policy and procedure had worked to protect the people living there. Discussions with five members of staff about their recruitment showed that they had gone through all of the pre employment checks, and had not started working until those checks had been completed. The staff training records showed that the Beeches does have a training plan for its staff. The training records showed that staff were receiving the training to help them to do their jobs. Discussions with five staff members provided evidence of the training courses staff had attended, including training in the mandatory areas of fire safety, moving and handling and food hygiene as well as dementia and health & safety etc. In their AQAA they said: Formal training sessions undertaken so far this year: moving & handling, first aid, infection control, medication training, food nutrition and health, dementia training, managing challenging behaviour, mental capacity act training, adult protection, and fire training (latter due in two weeks). Care Homes for Older People Page 21 of 27 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. The Beeches is a safe, well managed care home with good systems for ensuring its quality in place, which means that people living at the home are safe and have their needs met. Evidence: Susan Wagstaff is the Registered Manager. She is suitably qualified and experienced, and she has been judged by the Commission for Social Care Inspection to be a fit person to run a care home. Susan has managed the Beeches for fifteen years. The Beechs quality assurance system relies on questionnaires being filled in by service users, relatives and visitors on a six monthly basis. Copies of these questionnaires were seen together with evaluation of the results. The results of these surveys are discussed at staff meetings as part of the Beeches improvement strategy. The Beeches do not currently hold meetings for the people who live there, due to levels of dementia and memory loss, which make the meetings difficult. Regulation 26 visits Care Homes for Older People Page 22 of 27 Evidence: (these are monthly audits by a representative of the owners management team) are taking place, with copies of reports seen; these are part of the homes quality assurance system. In their AQAA they said: We have a quality assurance questionnaire that we circulate and monitor on a six monthly basis. The last survey was circulated on the 11 June 2008 with nine responses from 21 residents. The Beeches has a system for peoples small cash needs. This is operated on behalf of some people by the staff (dependent on individual choice and their ability to manage the money, or relatives involvement). Four peoples finances were checked at random. All of the cash tallied with the records, and receipts were seen, which enabled a clear audit trail of the individuals financial expenditure to be followed. The Beeches has a formal staff supervision system in place, in which staff receive supervision, either with the manager or with one of the other senior members of staff. This is usually in a one to one meeting. Formal supervision offers staff support and guidance in carrying out their work, and is seen as an essential management tool in residential care. Five members of staff were asked about formal supervision, and they all said they felt well supported, however it was clear that they were not all receiving regular supervision sessions. the National Minimum Standards recommend six times a year, but this was not being achieved by all staff members. In addition the recording systems for supervision were superficial, and did not fully capture the content of the meetings. A range of different health & safety records were seen, including the fire safety records, water temperature checks and the Control of Substances Hazardous to Health (COSHH) records, all were found to be correct and up to date, which shows that people are living and working in a safe environment. Care Homes for Older People Page 23 of 27 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 24 of 27 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 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 1 The service user guide and the statement of purpose should be dated, so that it is possible to see how up-todate the information within the documents is. If a MAR sheet (Medication Administration Record) is handwritten it should have two staff signatures to ensure that it has been properly checked for accuracy. Each person living at the Beeches should have a specific care plan relating to the time of their death, which details the familys involvement, and if the individual has any specific wishes. The wording of the notice on the front door about visiting times needs to be changed, as it gives the impression that people living at the home can not receive visitors after 6:00pm at night. Every member of staff should undergo training in safeguarding adults procedures, and have an update a minimum of once every two years. In the light of the increasing dependancy of the people living at the Beeches, a review of the needs and dependancy levels of the people living at the home, and the staffing levels to meet those needs, should be undertaken. Page 25 of 27 2 9 3 11 4 13 5 18 6 27 Care Homes for Older People 7 33 Consideration should be given to ways in which people living at the home can formally expreess their views, if they are unable to do that through a regular meeting. The recording systems used for staff supervision should be reviewed to ensure that there is more detail of content of the session captured. All members of staff should receive a minimum of six formal supervision sessions per year. 8 36 9 36 Care Homes for Older People Page 26 of 27 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 © (2009) 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. Care Homes for Older People Page 27 of 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!