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Archived: Beechlands EMI Residential Care Home

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Inspection report

Date of Inspection: 30 July 2013
Date of Publication: 3 September 2013
Inspection Report published 03 September 2013 PDF | 76.3 KB

People's personal records, including medical records, should be accurate and kept safe and confidential (outcome 21)

Meeting this standard

We checked that people who use this service

  • Their personal records including medical records are accurate, fit for purpose, held securely and remain confidential.
  • Other records required to be kept to protect their safety and well being are maintained and held securely where required.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 30 July 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and reviewed information given to us by the provider.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Our judgement

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

Reasons for our judgement

Our inspection of May 15th 2013 found people who used the service may be at risk of receiving inappropriate care because care plans and risk assessments were not reviewed and updated consistently. The provider wrote to us and told us they would take the necessary action to address the concerns.

During this inspection we found that care records including care plans, risk assessments and daily records were stored securely, properly completed and readily available. We saw that each person had a care plan and records showing that they had been regularly reviewed. The plans provided details of the person’s needs, any risks identified and the care or support that they required. We found people’s personal records were up to date, accurate and well maintained.

During this visit we spoke with a visiting nurse who was carrying out reviews on people’s care plans and they told us that they had found people’s care records to be satisfactory. The nurse told us that during their visits to the home they had noted continuous improvements to people’s records and that the manager had always responded to any recommendations they made.