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Inspection on 30/06/05 for Bearwood House Residential Care Home

Also see our care home review for Bearwood House Residential Care Home for more information

This inspection was carried out on 30th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a good standard of residential care in a very homely atmosphere. Staff interaction with residents was very good and there was a high level of satisfaction from the residents. To support the above, very positive comments were made to the inspector by five residents and six visitors. The inspector observed the care being delivered and the good interaction between staff and residents. A discussion took place with all staff on duty, who gave a good account of how they were meeting the needs of the residents, and their documentation of care delivery was seen as comprehensive.

What has improved since the last inspection?

Since the last inspection, and also since the change of ownership ten months ago, there has been a marked improvement in the management and the delivery of care. There is now stability and a sense of belonging amongst the staff. The home is now full and is successfully running. Families are very much involved, with meetings and events now taking place. Talking at length with residents, the visiting relatives, staff and management evidenced the above. The documentation seen in the home also evidenced the above. It was very pleasing to note the vast improvement in this home during the past 10 months since the change of ownership, new care manager, and changes in both care and ancillary staff. All are to be commended, as this has not been an easy period for them.

What the care home could do better:

Long term the home is considering an extension, which would increase the number of single bedrooms and provide facilities such as; a hairdressing salon, a large assisted bathroom and a sluice room. Staff training, which is now being addressed, should continue to enable carers to achieve NVQ qualifications, and all to attend the statutory training, as agreed. The staff supervision, now in place, should be undertaken. The quality assurance system must be implemented. The log of weekly fire alarm tests and monthly emergency lighting tests must be kept up to date. The revision of the care plan documentation should be completed, as discussed and agreed.

CARE HOMES FOR OLDER PEOPLE Bearwood House Residential Care Home 183 Bearwood Hill Road Winshill Burton on Trent Staffordshire DE15 0JS Lead Inspector David Cowser Unannounced 30 June 2005 @ 10.00hrs 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 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. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bearwood House Address 183 Bearwood Hill Road Winshill Burton on Trent Staffordshire DE15 0JS 01283 561141 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Judith Dena Griffin Mrs Wendy Hyde Care Home 21 Category(ies) of 21 OP registration, with number 1 DE(E) of places Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: That the Care Manager completes NVQ Level 4 qualifications during the coming 12 months as agreed Date of last inspection 23 November 2005 Brief Description of the Service: Bearwood House is a large Victorian detached house that has been extended to provide 21 beds. The home is registered for 21 older people, one of which may have dementia care needs. The home is located on the outskirts of Burton on Trent in a residential area. Public transport and all amenities are close at hand. Accommodation is provided on three floors accessible by staircase and a shaft lift. There are six double and nine single bedrooms, of which two doubles and one single are on the ground floor. Communal facilities consist of two lounges and a dining room. There are four bathrooms and an adequate numbers of WC’s situated throughout the home. There is no sluice facility or hairdressing facility in the home. Externally there are small gardens to the front, where access is by steps from the road. To the side and rear there are larger gardens all accessible to residents. Car parking is restricted with additional on street parking adjacent. The aims of the home are to provide 24-hour care for residents in a homely environment whilst enabling residents to maximise their independence. Care is provided by care assistants lead by a Care Manager. District nurses, community psychiatric nurses and other professionals are accessed by the home when required. A local GP surgery and pharmacist service the home. NHS facilities and health services are accessed, and assistance is provided for residents to attend, when required. Activities take place with family and relativesinvolvement. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced visit was made on the 30 April 2005 @ 10.00hrs. The inspection was undertaken using the National Minimum Standards for Older People as a reference. The total time spent for the inspection, including pre and fieldwork, amounted to 7hrs. The registered care manager was in charge of the home accompanied by two care assistants. The ancillary staff on duty included; cook, domestic, laundry person, and maintenance person. These staffing levels were adequate to meet the needs of current 21 residents in the home. The total of 21 elderly residents included; 1 with a dementia related condition, and 20 people receiving personal care for needs associate with old age. The inspection included the following elements; a tour of the building, observation and inspection of records relating to provision of care, discussions with six residents, discussions with all the staff members on duty, observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects such as staffing issues, quality assurance and health & safety. Since the last inspection on 23 November 2004; there had been no changes to the management of the home, no complaints had been received and no additional visits had been necessitated. It was evident that aspects of care had been addressed well, with residents able to choose the home following an assessment and invitation to visit the home. Service user plans had been completed, based on the community care plans written by social workers. Health, personal and social care needs had been met and documented. Privacy, dignity and choice aspects for residents were being upheld. No complaints, incidents or reports of abuse of any kind had been received since the last inspection, and policies and procedures seen covered these issues. Two residents had attended an A&E department, one of which had sustained a fracture, and no resident had a pressure area. There had been only one death since the last inspection. The home was fit for purpose and provided a safe environment for the residents and staff. A very homely atmosphere had been created, and the premised were clean, warm and tidy. Adequate areas for residents were provided including; communal space, dining/activity space, bathing/toilet facilities, and bedrooms. Services and facilities, including catering and laundry, were adequately provided. Health and safety aspects had been given a high priority and no shortfalls were noted. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 6 Staffing levels and skill mix had been adequate to meet the assessed needs of the existing residents. Recruitment and retention of staff aspects were much improved with little staff turnover. Staff training was now being given a high priority, with induction training being followed by NVQ training. Staff supervision was in the process of being introduced. The home appeared to be managed well by a qualified and competent care manager. General management aspects were good with quality assurance being introduced. Records had been correctly filed and stored. Assurances were given regarding the positive financial viability of the home, and that suitable accounting/business procedures are adopted. It was pleasing to note that previously reported requirements and recommendations had been completed. The outstanding items are listed below. What the service does well: What has improved since the last inspection? Since the last inspection, and also since the change of ownership ten months ago, there has been a marked improvement in the management and the delivery of care. There is now stability and a sense of belonging amongst the staff. The home is now full and is successfully running. Families are very much involved, with meetings and events now taking place. Talking at length with residents, the visiting relatives, staff and management evidenced the above. The documentation seen in the home also evidenced the above. It was very pleasing to note the vast improvement in this home during the past 10 months since the change of ownership, new care manager, and changes in both care and ancillary staff. All are to be commended, as this has not been an easy period for them. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 7 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. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Individual health, personal and social cares needs had been established and were being met by staff, which individually and collectively had the necessary skills and experience. Intermediate care is not undertaken in this home. EVIDENCE: The documentation seen, and a discussion with residents/representatives, evidenced that residents had been assessed prior to admission and they had been enabled to make a choice about the home. All involved had the opportunity to visit the home prior to choosing to stay. Two residents spoken to had visited the home, and had a meal prior to deciding to stay, and this was seen documented within the care plans. The community care plans provided by the social worker, as part of the individual needs assessment process, were seen within the service user plans. Residents asked confirmed that they had been fully involved and were in agreement with the assessments. The records seen and a discussion with the staff evidenced that care staff, individually and collectively, had the necessary experience and skills to meet the assessed needs of the current service users. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 The assessed health and personal care needs of residents had been documented and were being met, with good standards of care being delivered. There was a safe system for the receipt, storage, administration and disposal of medicines. Residents were treated with respect, privacy and dignity, during the caring process. The revision of the care plan documentation should be completed, as discussed and agreed. EVIDENCE: Five service users, and six relatives spoken to, all commented very positively about the care being provided. The service user plans and associated documentation was completed, and reflected the current condition of residents. However it was agreed that the revision of these plans and changes to the presentation would be completed. The documentation seen and a discussion with both residents and staff members evidenced that health and personal care needs were being well met. NHS facilities and professionals including community nurses, medical consultants and clinical nurse specialists had all been accessed when required, Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 11 and these events were seen recorded. A local GP practice and a local pharmacist service the home, and there is a good working relationship with them. Records of their visits and outcomes were seen documented. The medicines within the home, medication administration records, controlled drugs book and drugs returned book, were all checked and no errors were noted. It was observed that a safe system was in place, and that the comprehensive medicines policy documentation seen was being complied with. The documentation seen evidenced that only senior care staff administered medicines. Certificated training had been completed for the senior staff involved. No resident was ‘self medicating’, but locked facilities were available. During the inspection it was observed that privacy and dignity were being afforded to residents, and there was very good interaction with staff. Care staff were seen knocking on doors before entering. Four residents told the inspector that they were treated with respect, and that the staff were very good. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Residents were satisfied with their lifestyle in the home, and they had been able to exercise choice and influence decisions affecting them. Contact had been maintained with relatives and friends of residents. Opportunities to access the local community had been made available. Catering aspects were very good with balanced nutritious meals being served, along with resident consultation and choice. EVIDENCE: Several residents told the inspector that their views had been listened to, and that they had been able to influence some aspects of the running of the home e.g. mealtimes, menus. These comments had been documented along with the feed back from the resident/relatives questionnaires, and they had been acted upon. Contacts had been maintained, where possible, with relatives and friends and this was seen documented. Residents spoke of their visitors and their involvement with the home. Several visitors attended the home during this inspection, and all told the inspector of the good links and communication with them. Trips out to the community had been well organised and transport provided. Events were organised for the coming month, and the residents were looking forward to them. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 13 Several residents spoke of their satisfaction with the meals and choices offered. The menus and catering records were examined and evidenced that the dietary requirements of residents were met. The cook when asked said that fresh good quality food from local suppliers was delivered on a weekly basis, the records seen confirmed this. Fresh vegetables and fruit were also seen. The mid day meal seen was well presented and met all nutritional requirements. The inspector sat with the residents at lunchtime and also enjoyed the meal. The cook spoke to each resident on a daily basis to establish his or her choice of food for the day, and this was seen documented. Staff, who were knowledgeable of residents likes and dislikes, assisted where choices had to be made and residents were not fully able to make a decision. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Complaints or grumbles are listened to and resolved. The home policies, procedures and staff training, protected residents from aspects of abuse. EVIDENCE: An examination of the complaints book, the relevant policy and procedure documentation, and a discussion with staff and residents, evidenced that complaints and grumbles were listened to and dealt with in the correct manner. Since the last inspection no complaints had been recorded or brought to the attention of this commission. ‘Thank you’ and complimentary cards were seen from appreciative relatives. No incidents of neglect or abuse of any kind has been reported. The policy documentation seen, and a discussion with staff confirmed that residents are protected from all forms of abuse. Documentation seen evidenced that the above issues had been discussed at length during staff induction, training and the recently introduced supervision. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,26 The home provides a safe and adequately maintained environment for residents. The home was clean, warm and tidy, and had a very comfortable and homely atmosphere. Consideration should be given to the provision of the following facilities; a hairdressing salon, a larger assisted bathroom and a sluice room. EVIDENCE: A tour of the building, and a check on the maintenance documentation, verified that the premises were fit for purpose, clean warm and tidy. The duty rosters evidenced that adequate ancillary staff were employed. Staff when asked told the inspector of their knowledge on infection control, and showed him the relevant documentation. Adequate hand washing facilities were available throughout the home. The laundry facilities were seen to be fully compliant, and a sluice installation is planned. The records evidence that maintenance of the premises was now being given a high priority. On going painting and re-decorating was seen completed. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 16 There are no outstanding issues known from the Fire Prevention or Environmental health departments. It was pleasing to note that previously reported issues had all been completed since the last inspection. An extension of the home is being considered that will provide more single bedroom accommodation (currently 42 ), and additional facilities. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) ,28,29,30 The assessed needs of service users had been met by an adequate number of suitably trained staff. Recruitment procedures had been correctly addressed which had contributed to the protection of service users. Staff training was now being given a high priority. Staff training should continue to enable carers to achieve NVQ qualifications, and all to attend the statutory training, as agreed. EVIDENCE: The duty rosters seen, and a discussion with the care manager and the staff, evidenced that adequate numbers of staff had been on duty to meet the needs of the existing service users. Staffing rosters were checked and were in order. Including the manager there had been a minimum of three care staff on each morning shift, two care assistants on each evening shift, and two awake on each night shift. Adequate ancillary staff had been provided each week. Six residents asked stated that staff were available when they wanted them, and that the staff were capable. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 18 The records seen evidenced that in addition to the manager the home employed 12 care assistants, of which 3 (25 ) were trained to NVQ level 2 or above. Staff training should continue to enable carers to achieve NVQ qualifications, and all to attend the statutory training, as agreed. The homes recruitment policy, procedures and documentation were examined and recruitment issues had been handled correctly. Staff had been subject to POVA/CRB comprehensive checks, and these were seen recorded. Staff asked stated that they had job descriptions and contracts of employment. Training was now being given a high priority and the training records of individuals were seen. The records evidenced that care assistants had benefited from ‘in house’ and external training, which had covered the needs of the registered client group. Staff told the inspector that they had been afforded the time off and encouraged to study. Training had been provided for staff in the awareness and management of dementia related conditions, and staff outlined this to the inspector. Further training was arranged for the management of aggression, as previously requested. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35,38 The home appeared to be well managed. Financial aspects were correctly addressed and recorded with safeguards to residents. However the staff supervision (system now in place), must be undertaken and documented, as agreed. The quality assurance system must be implemented and documented, as discussed. Health and safety issues had been given a high priority and managed well, with the following exception; the recording of weekly fire alarm tests and monthly emergency lighting tests. EVIDENCE: From observations made, discussion with service users, and discussions with the manager and staff, it was evident that the home was being run in the interests of service users. Quality assurance, including feedback from residents and their representatives, was being undertaken but not adequately documented. Documentation seen evidenced that the views of visiting professionals had also been established, and included in the review process. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 20 A check on the records and a discussion with both residents and representatives evidenced that all service users had the opportunity to handle their own finances and all residents and families had chosen to do so. Day to day monies of residents were checked and money held reconciled with the ledger. Inventories of valuables and belongings brought into the home were seen recorded. The log of weekly fire alarm tests and monthly emergency lighting tests had not been kept up to date. The manager and staff spoken to confirmed that health and safety issues are given a high priority. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x 3 2 x 2 Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 22 yes Are there any outstanding requirements from the last inspection? 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. 2. 3. Standard OP36 OP33 OP38 Regulation 18(2) 24(1)(a)( b) 4(c )(v) Requirement Staff supervision (system now in place), must be undertaken and documented, as agreed. The quality assurance system must be implemented and documented, as discussed. The log of weekly fire alarm tests and monthly emergency lighting tests must be kept up to date. Timescale for action 30 August 05 30 September 05 30 July 05 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. 2. 3. Refer to Standard OP28 OP19 OP7 Good Practice Recommendations Staff training should continue to enable carers to achieve NVQ qualifications, and all to attend the statutory training, as agreed. Consideration should be given to the provision of the following facilities; a hairdressing salon, a larger assisted bathroom and a sluice room. The revision of the care plan documentation should be completed, as discussed and agreed. Bearwood House Residential Care Home E51-E09 S61581 Bearwood House V236091 300605 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 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. 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