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Inspection on 14/10/05 for Beaufort Hall Nursing Home

Also see our care home review for Beaufort Hall Nursing Home for more information

This inspection was carried out on 14th October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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 staff work well as a team and ensure the well-being and comfort of the residents` and treat them with great respect and kindness. For example ten residents spoken with said, "the home is lovely, the staff are kind and caring, and the food is good." During the inspection a good rapport was seen between staff, residents and their relatives. A number of residents are very frail. Their personal and health care needs are well met, by the staff team. Residents spoke of the "lively atmosphere" and "happy home" The home have good links with the local GP, district nurses and nurse specialists in the hospital whom they involve appropriately to ensure all care needs are well met. One resident said "I couldn`t think of a better place to live except my own home".

What has improved since the last inspection?

Thermostatic valves have been installed to all hot water outlets. Recruitment practices are now robust and ensure that checks required are completed prior to employment of staff to protect residents from potential harm. Many areas of the home have been redecorated with new furnishings and carpeting to the lounge areas, hall stairs and landings and redecoration of 4 bedrooms. Thermostatic valves have been installed to all hot water outlets for the protection of residents, also a new fire alarm system. The management of the home has improved over the last year under the new manager, with clear leadership and direction now being given to the staff team. The home is providing a good service and moving towards providing an excellent environment and care service.

What the care home could do better:

Excess medication and creams that are unopened should be returned to the pharmacy and not used for other patients. Provide fuller and more confidential records when accidents occur. Ensure that all fire prevention equipment is functioning properly and ready for use to safeguard residents from potential risk. Record resident wishes regarding their death and provide clear guidance for staff to follow to residents` choice and dignity are respected. The inclusion of timescales in the complaints policy for benefit of complainants.

CARE HOMES FOR OLDER PEOPLE Beaufort Hall Nursing Home 28 & 30 Birnbeck Road Madeira Cove, Weston-Super-Mare North Somerset BS23 2BT Lead Inspector Patricia Hellier Announced 14 October 2005 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. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Beaufort Hall Nursing Home Address 28 & 30 Birnbeck Road Madeira Cove Weston-Super-Mare North Somerset BS23 2BT 01934 620857 01934 414426 jboyack@medical-recruit.com Boyack Enterprises Ltd 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 Jacqueline Margaret Bowen Care Home with Nursing 33 Category(ies) of PD (E) Physical Disabilies - over 65 years (6) registration, with number OP Old Age (3) of places Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 6 persons aged 65 years and over with physical disabilities. 2. May accommodate up to 33 persons aged 65 years and over requiring nursing care. Date of last inspection 5 May 2005 Brief Description of the Service: Beaufort Hall Nursing Home is registered for 33 elderly people aged 50 years or over. The home is on Weston-Super-Mare seafront and occupies a prominent position overlooking Marine Lake. The approach to the main entrance of the home is up a steep slope. Wheelchair access is available at the other end of the building. The home has 25 rooms used as single occupancy and four double rooms. All rooms have en suite toilets. Beaufort Hall is a four-storey building and has a six-person passenger lift accessing all floors. The home has been suitably adapted for the current resident group with handrails in corridors and grab rails in toilet facilities. There is a large dining room on the ground floor and two spacious lounges on the first floor, each of which has a small dining area. The home has a nurse call bell system throughout. There is a Registered Nurse on duty at all times. The home is well maintained, comfortably furnished and has a homely atmosphere. It is close to local amenities and the town centre. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over seven hours with two inspectors. Part of the focus of this inspection was to follow up on the serious concerns regarding recruitment practice that had been highlighted following the investigation of a complaint in August 2005. Before the inspection the requirements from the complaints investigation were reviewed and information about the home was received from the pre inspection questionnaire and comment cards from relatives and residents. All 4 of the residents who returned cards were happy with the home and care provided stating that they ”felt safe” and “liked the food”. Of the 7 relatives cards returned all felt welcomed in the home and that there relatives were receiving very good care. 15 residents, 4 relatives and 11 staff were consulted on the on the conduct and provision of the care. All residents and staff spoken with told the inspectors that the home was very good and the staff kind. Comments received were “it is very homely and comfortable”; “my relatives care needs are well met”. The inspectors toured the premises; spoke to 6 members of staff, 16 residents 4 relatives and inspected a number of records. What the service does well: What has improved since the last inspection? Thermostatic valves have been installed to all hot water outlets. Recruitment practices are now robust and ensure that checks required are completed prior to employment of staff to protect residents from potential harm. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 6 Many areas of the home have been redecorated with new furnishings and carpeting to the lounge areas, hall stairs and landings and redecoration of 4 bedrooms. Thermostatic valves have been installed to all hot water outlets for the protection of residents, also a new fire alarm system. The management of the home has improved over the last year under the new manager, with clear leadership and direction now being given to the staff team. The home is providing a good service and moving towards providing an excellent environment and care service. 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. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4 The Statement of Purpose and Residents’ guide is comprehensive and provides prospective residents with information to make an informed choice. The home’s assessment process is thorough and ensures that it is able to meet residents’ needs. Prospective residents and relatives are encouraged to visit the home to assess suitability. EVIDENCE: Residents are provided with a comprehensive Residents’ booklet containing the Statement of Purpose and all the information required to ensure they or their relatives have access to the relevant information at all times. Care needs are well met through a full assessment process and the completion of a care plan from this information. The assessment includes all the elements listed in the standard. Social services care plans had been obtained where relevant. Care practices observed showed that staff were fully aware of the residents needs as stated in assessments A comprehensive assessment was seen for a recently admitted resident. The resident when spoken to said ‘I am well looked after they know what I need’. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 9 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) 7,8,9,10,11 Residents benefit from care plans that are well formulated and give clear information to enable staff to meet residents’ health and social care needs. Personal and environmental risks are well managed. The systems in place for the management of medicines are on the whole well managed. Respect and dignity are well maintained by kind and caring staff. Residents’ wishes at death are not recorded and no policy guidance is given to ensure that residents’ wishes are upheld. EVIDENCE: Six care plans inspected showed clear and detailed information in relation to resident’s health emotional and social care needs. Resident and relative involvement in care planning was not seen. All care plans contained wellformulated risk assessments for Manual Handling and falls. Consent for use of bed rails and recliner chairs had not been obtained from residents or their relatives. This should be sought to protect residents from abuse and to demonstrate choice. Other personal and environmental risk assessments were present to ensure the safety of the resident while promoting independence as able. Daily records were up to date and written in a respectful manner. The medication policy is clear but needs updating to reflect the Nursing and Midwifery Council (NMC) guidance. Stock levels are well managed in the main. Stocks of creams supplied on prescription should only be used for the person Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 10 stated. A review of these stocks, and the use of unopened pots of creams, with the local pharmacy is recommended. Creams and eye drops should have the date of opening recorded on them to safeguard residents form use of out of date medications. Hand transcribed prescriptions were seen on the Medication Administration Records and these had not been signed by two members of staff when written thus not providing the recommended safeguard for residents. When hand writing prescriptions the amount of the does should be recorded and not just the number of tablets to ensure correct administration of medicines. All residents spoken with felt that kind and caring staff respected their dignity and privacy. Excellent care practices were observed and confirmed in conversations with relatives. No evidence was seen of residents’ wishes for end of life care and arrangements in death. The home does not have any policy guidance relating to care of residents at the end the end of life. It is recommend that a policy is developed to ensure a quality of life with sensitivity is provided up to and including death. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 11 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) 12,13,15 Social activities are limited however local links are maintained through visits from organisations within the town and personal visitors. Meals are well managed and the food varied and nutritious. Relatives and visitors are always welcomed by friendly staff. EVIDENCE: Most activities are organised by members of the staff team on a needs basis. Once a week a lady comes into the home to lead a reminiscence session that is greatly appreciated. There is no programme of activities to assist residents to maintain a social life. The development of this is recommended. Several visitors were seen coming and going during the inspection. Relatives spoken with said they could come any time and felt that their relatives were well looked after by friendly staff. A number of people living in the home were spoken to and everyone who commented on the food said how good it is and that they welcomed the daily choices offered. Menus and mealtime arrangements are flexible enough to accommodate individual preferences and needs. Good practice was observed in staff assisting residents with their food. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 12 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 Residents are confident that they are listened to and their requests acted upon. Residents are protected from abuse by knowledgeable and competent staff. EVIDENCE: The home has a detailed complaints procedure that is well displayed and all residents have a copy of. However it does not include timescales for response to a complaint. This should be included for the benefit of complainants. Residents stated that if they were not happy about anything they would speak to the manager. Staff and residents spoken to, say the manager is very approachable and understanding. One service user said ‘I’ve nothing to complain about, it’s the best place to live other that my own home’. A well developed policy and procedure for responding to allegations of abuse is available, however it does not refer to the possibility of including, or referring to the police or other outside agencies. This should be included to comply with the local Adult Protection policy, “No Secrets” policy and for the protection of residents. The home also has a Whislteblowing policy and staff said they would report any concerns to the manager. Staff said they had never seen any signs of abuse in the home and demonstrated understanding of what abuse is. All three staff interviewed stated they had not received formal Adult Protection training. Training is therefore required. Consent for use of bed rails and recliner chairs had not been obtained from residents or their relatives. This should be sought to protect residents from abuse and to demonstrate choice. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 13 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) 19,22,26 Residents are provided with safe, homely and comfortable surroundings. The home has suitable equipment to maximise resident independence. Robust Infection control practices are followed. EVIDENCE: The property is well decorated in most areas, with homely and comfortable communal spaces. Ongoing maintenance is evident however there remain areas of the home that require some attention. Residents’ rooms are personalised and comfortable. Redecoration and refurbishment to a number of the rooms and communal areas has been completed and further works are in progress. A maintenance plan is recommended to evidence the ongoing routine maintenance and renewal of the fabric for the benefit of residents. The home has grab rails situated at relevant points, also a shaft lift that is easily used to assist resident mobility and aid independence within the home. Equipment for pressure relief and the prevention of sores is available and appropriately used. All resident rooms are provided with locks that are accessible to staff in an emergency. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 14 The home was clean and free from offensive odours throughout. The laundry facilities were well organised with impermeable and washable flooring and walls to maintain cleanliness and prevent the spread of infection. However the flooring around the washing machines is split and needs attention to prevent spread of infection. Staff interviewed and observed demonstrated good understanding of Infection control procedures and practices and maintained a clean and hygienic environment. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 15 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) 27,29,30 The numbers and skill mix of competent staff are sufficient to meet residents’ needs. The procedures for the recruitment of staff are inconsistent and do not always provide the safeguards for the protection of people living in the home. Training is provided to ensure staff competence. EVIDENCE: Residents spoken to said that the staff were kind and caring and always there to help. During the visit staff were observed spending time with residents and call bells were answered quickly. There is now a stable staff team and recruitment practices are greatly improved. Four staff files inspected had all pre employment checks completed thus safeguarding residents. Pre employment checks are now completed prior to commencement of staff employment to safeguard residents from potential harm or abuse. Vigilance is recommended when receiving verbal and unsigned written references. All staff have received fire safety training recently. Staff spoken to said that there was lots of training and records seen showed attendance at a variety of relevant training sessions. Staff spoke of regular supervision and assistance in gaining NVQ qualifications. Staff attending training are not required to sign in. This is a recommended good practice Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 16 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) 31,32,33,35,38 The manager provides clear leadership and guidance to staff to ensure residents receive consistent care in a safe environment. Residents’ views are sought and acted on, but a formalised system is not in place. Resident’s monies are well managed and clear records are maintained for audit purposes. Health and safety issues have not all been addressed and thus provide potential risks for residents. EVIDENCE: The manager has a number of years experience of caring for the elderly and has recently obtained her NVQ 4 / Registered Managers Award. She gives clear leadership, guidance and direction to staff. Residents feel the manager is approachable, available and seeks to ensure all their needs are met. Staff interviewed stated that they felt well supported by an approachable manager. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 17 A formal quality assurance tool was not available however residents and relatives told the inspectors that their views were sought and acted upon. Records confirmed this. A formalised quality assurance process is recommended. Resident’s monies are well managed and the new system of invoicing residents provides clearer records and allows for a full audit trail. Residents monies held were inspected and tallied with records. Records inspected indicated regular safety and fire checks are carried out. However fire doors are wedged open and a number of fire doors are not closing properly thus putting residents at potential risk. Environmental risk assessments for wedged open fire doors had not been completed and this also potentially puts residents at risk. The fire exit appeared in need of attention and all fires safety checks need review. Staff spoken to confirmed that regular fire instruction and drills had taken place. Three members of staff have received First Aid training. A record of accidents is kept however the format does not comply with Data Protection to maintain staff and resident confidentiality. The home should obtain the appropriate HSE forms and start using them immediately. Accident records seen did not record full details or action and outcomes following the accident. This is required to ensure safe practice for residents. The top step from the first floor poses a fall hazard, as it is difficult to differentiate the edge. Ill-fitting bed rails pose a hazard and should be matched to the bed and be regularly checked and maintained. They pose a risk to residents. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 18 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 3 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 1 3 3 2 x 3 x x 1 Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 19 NO 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. Standard 9 Regulation 13.2 Requirement Medications and unopened creams prescribed for one resident should not be used for other residents The Abuse policy must contain references and contact details for other agencies as stated in the No Secretsdocument The registered person shall after consultation with the Fire Authority (c) make adequate arrangements(i) for decting, containing and extinguishing fires.This relates to the fires doors that do not close flush to the frames. The rear fire exit needs to be made safe for use The registered person to obtain and use the HSE Accident book to maintain confidentiality Timescale for action 31/12/05 2. 18 13.6 31/12/05 3. 38 23.4 31/12/05 4. 5. 38 38 23.4 17.4 31/12/05 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 20 Beaufort Hall Nursing Home 1. 7 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 9 11 12 16 18 26 26 29 30 33 38 Resident care plans must be reviewed and revised regularly in consultation with the resident or their relatives. Residents wishes regarding death to be obtained and recorded. Staff must sign and date hand written entries on the medicine administration records That the home develops and end of life care policy to protect residents wishes while maintaining professional duties. The development of an activities programme and recordof activites offered. The inclusion of timescales in the Complaint policy. It is recommeded that consent for the use of bed rails is obtained from all residents or their relatives. The provision of liquid soap in all areas for staff handwashing The laundry flooring to be repaired where cracked to prevent the spread of infection. Vigilance when receiving verbal and unsgned written references. Staff to sign to show attendance at training. A formalised system of Quality Assurance that analyses the results of a resident survey, produces an action plan and feedback to residents and staff, should be developed It is recommended that the manager arrange for a hazard warning notice to be placed by the top step of the flight of stairs from the first floor. A bright coloured hazard strip at may alert people to this hazard. Beaufort Hall Nursing Home D53-D02 S50501 Beaufort Hall V248442 141005 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Riverside Chambers Castle Street Taunton TA1 4AL 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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