Inspection on 19/01/06 for Beech Court Care Centre

This inspection was carried out on 19th January 2006.

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.

Other inspections for this house

Beech Court Care Centre 02/08/07

Beech Court Care Centre 29/09/06

Beech Court Care Centre 20/06/05

Beech Court Care Centre 14/01/05

Beech Court Care Centre 09/07/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Beech Court Care Centre 298-304 South Street Romford Essex RM1 2AJ Lead Inspector Joanna Moore Unannounced Inspection 19th January 2006 09:30 X10029.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and Care Homes for Adults 18 – 65*. 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. Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beech Court Care Centre Address 298-304 South Street Romford Essex RM1 2AJ 01708 720 123 01708 720 220 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Life Style Care Plc Mary Zuwaradoka Care Home 50 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (18), of places Physical disability (12) Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2005 Brief Description of the Service: Beech Court Care Centre is a care home with nursing, providing 24 hour nursing care. The home is registered to care for three different service user groups. People who are over the age of 65 and physically frail or who have a diagnosis of dementia and people between 18 – 65 who have physical disabilities. The home is owned by Life Style Care PLC a company which operates similar homes in London and the Midlands. The home is situated just outside Romford and has good access to local facilities and transport links. The home was purpose built in 1999. It is a three storey building. The home consists of single bedrooms with en-suite facilities. A large passenger lift services all floors. There is a secure garden for service users with dementia. There were two vacancies at the time of the inspection. Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the annual inspection program. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that records in relation to nursing care carried out are appropriately completed and that nurses can evidnce the care given. The registered person is required to ensure that all staff are able to fluently understand and converse in English. Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 6 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. Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All key standards were covered and assessed as met in the previous inspection and were not assessed further during this visit. EVIDENCE: Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 7,8&9 Service users benefit from a wide range of professionals who guide and support the care offered by staff in the home. Service users benefit from a comprehensive care plan which examines all aspects of daily living, however these were not always fully completed and reviewed appropriately. Service users were protected by appropriate systems of storing dispensing and recording medication. EVIDENCE: Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 10 The medication of two service users were checked. Clear records of medication administered were held. The home was for most medicines using a monitored dosage system. The storage of medication was satisfactory. Where a service user was refusing to take their medication a referral to the Gp was made for advice. The care plans key information was recorded as updated monthly however this update did not always identify changes in care needs and approach for example on service users care plan and nutritional assessment recorded them as having no nutritional issues but the daily log contradicted this highlighting a significant reduction in appetite and the fact that “ensure” a nutritional supplement was being used to support their nutrional intake. The care plans must be reflect service users changing needs and care provided. One-service users care plan identified that their blood levels required twice weekly monitoring due to diabetes, the home was not able to evidence that this was done. The recording of blood tests indicated that blood tests were often left for 7 days and on one occasion had not been checked for 18 days. The acre plan had been reviewed but the reviewing nurse had not picked up this issue. The registered person is required to evidence that instructions issued by a medical practitioner are fully carried out. The manager audits care plans quarterly taking a small selection from each floor. The daily records evidenced that’s service user were supported by a variety of appropriate healthcare professionals such as Gp, dietician, dentist. Specific Manual handling and cot side use risk assessment were in place which supported general risk assessments these were reviewed six monthly. Where specific adaptations or equipment were used which could pose a risk or limit peoples freedom of movement, for example bed rails or wheelchair belt, these were recorded as discussed with the family and signed for. Formal reviews of care by the placing Authority had taken place annually. Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 Service users benefit from a variety of activities and events and are supported in maintaining active contact with their families. EVIDENCE: Two of the younger residents with physical disabilities attend a day centre resource 2/3 days per week. Two activities co-ordinators are employed between the hours of 10-5 Monday to Friday. One of the care files viewed evidenced a consideration to recording social activities that the service user had enjoyed. The activities this person Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 12 Was recorded as joining in included: trips to Southend, Tiptree and Romford shopping. In-house activities enjoyed included: A barbeque, bingo sessions, coffee and sherry mornings, skittles, music, sing-along, bowling, card games, arts and crafts sessions, quizzes, keep fit and reminiscing. The inspector spent some time with the two activities co-ordinators discussing how activities were organised and what had been provided over the last year. The home in addition to the above had organised two trips to see Cinderella at the Hornchurch theatre, nail painting and manicure sessions, film afternoons, had a summer fun day with an owl display, a Christmas party and other festivities. The home arranges small birthday parties for residents including a cake. A church service is held each Sunday at 4pm.There was a planned list of activities for the summer of 2006. An activities plan for the week is written on a notice board on each floor. On the day of inspection a popular entertainer was performing in the main lounge. The activity coordinators advised the inspector that they went in regularly to all bed bound residents to read them the newspaper, do manicures and hand massages. Relatives interviewed as part of the made the following comments: “My mum has been here 2-3 years and we have had no problems she settled in well. As soon as mum has had any problems the staff have been on the phone to me. Mums in the lounge now enjoying the entertainer there is quite a lot put on for them.” “My brother only moved in very recently so I haven’t had much chance to form an opinion but he seems fairly well cared for and okay.” “What can I say I am so grateful he is in such a good place. He is well looked after . Immaculate room. He is clean and well dressed. I can’t say enough about the lovely staff and manager, a couple of weeks ago he became unwell and they picked it up really quickly and got him into Oldchurch Hospital. We cannot praise the staff and the people enough for the way he is looked after. The food is lovely but he has really lost his appetite so they are giving him ensure (a liquid nutritional supplement). He has a glass of wine quite often. I ring up when I can’t get in to visit him and the staff keep me updated and informed. We know that he is well looked after.” “F is j’s keyworker but we have never met her. She takes J to the opticians etc but we don’t know her. J Has been her for 6 years and we are very happy with it. We visit regularly.” “ our sister has only been in her six weeks. We are very happy with the home we are always made welcome. They look after her well, she is well dressed and well fed and the staff are nice. It seems a really nice place. She came home to us on Christmas day and Boxing day but came back each night. (Two relatives visiting together) Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 13 “I visit at least once each week and I am always made welcome, all the staff are friendly and that includes the admin. They organise to have her hair done regularly and sort out chiropody and all healthcare, She is very well looked after, The food looks nice when I see it. The staff are marvellous, they joke with her and the staff seem to really enjoy their work. I feel she is safe her if she were worried I am sure she would tell me.” The care plans and daily records of three service users were viewed and the designated contactable relative of these was telephoned to understand their views on the care provided their comments are included above. Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 &18 Service users and their families benefit from clear systems in place to respond to complaints. Service users are safeguarded by robust systems to respond to any allegations of abuse. EVIDENCE: A relatives comment: “J has been here six years and we have been very happy with the home we visit regularly at least twice a week and I think if there were any problems we would find out. Any issues arising within the home are where appropriate referred to the Local Authority Adult Protection team to investigate. A designated senior manager within Lifestyle Care but external to the home investigates complaints. At the time of the inspection one such complaint was being investigated. A clear complaints procedure was in place, which was displayed in the central hallway. The complaints procedure included clearly the process for complaints and included the complainants right to contact the CSCI. Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26 Service users and their families benefit from a clean, safe, well maintained and conveniently situated home which meets their needs. EVIDENCE: The building was purpose built as a care home with nursing and meets all the items in the national minimum standards regarding single rooms and spatial requirements. All bedrooms are single ensuite rooms with lockable doors. The Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 16 home is located on the outskirts of central Romford and is easily accessible by all means of travel. The main shopping centre and community facilities are a short walk away. The building is well decorated and maintained and specialist equipment required by service users is provided. The home is equipped with grab rails in toilet areas and is fully wheelchair accessible. Call bells are provided throughout the building and one service user confirmed that these were responded to swiftly. The home is clean and hygienic and systems for monitoring infection control and health and safety are in place. The fire prevention and warning systems are regularly maintained and checked. The fan in the second floor assisted bathroom was broken, the regsitered person is required to repair this. Service users are able to bring into their rooms whatever personal possessions they wish within health and safety limits to help them feel at home. No issues of concern were noted and the home meets the national minimum standards. Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 all other key standards were assessed as met at the previous inspection The home provides sufficient staff to meet the needs of service users however there is a need to ensure that all staff are able to fluently understand and converse in English. Relatives comments about the caring nature of staff were positive. EVIDENCE: Relatives comments included: “Staff are friendly but we have trouble understanding a couple of them and they don’t always understand English very well for example I asked one to get j’s hearing aid and they went and got a glass of water.” “The staff change but they are kind and look after her well” “I can’t say enough about the lovely staff and manager.” Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 18 The registered person is required to ensure that all staff are able to fluently understand and converse in English. Staffing levels were maintained in line with those previously appropriate to the needs of the service users : 8am-2pm 2pm-8pm Ground floor 1 Qualified 1 Qualified 4 Care staff 3 Care staff First floor 1 Qualified 1 Qualified 4 Care staff 3 Care staff Second floor 1 Qualified 1 Qualified 2 Care staff Care staff agreed and were 8pm-8am Over the whole of the home 2 Qualified 4 Care staff Designated throughout the building Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 all other key standards were assessed as met at the last inspection. Service users are generally protected by clear recording and documenting of income and expenditure however one requirement has been made. EVIDENCE: Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 20 The home does not fully manage anyone’s finances but holds a petty cash amounts for most residents. Two service users finances were checked. Clear records were held of the transactions and receipts were in place to compare against the records. The cash held tallied with the recorded expenditure. When the money was used for activities such a visit to the panto no record of the cost is held by the home other than a staff signature for a set amount. The activity co-ordinators later in discussion with the inspector said they did have receipts for things like panto tickets but there was no clear set system for the recording of such expenditure. The inspector was told that any drinks and small expenses like an ice cream were often funded out of the staffs’ pocket as there was no agreed system for how to fund such expenditure. It is not appropriate for staff to have to bear the cost of such items. It is required that the home agree a clear system for calculating the full cost of activities, how they will be funded and systems of recording expenditure. The inspector was advised that service users finances held by the home are audited randomly every two years. Health and safety was not fully checked as the home was able to evidence on its last inspection that clear systems were in place for monitoring health and safety. There were however no issues of concern noted during the inspection. Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 3 X 4 X 5 X 6 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 X 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 3 20 3 21 3 22 3 23 3 24 3 25 3 26 3 STAFFING Standard No Score 27 2 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No Score 31 X 32 X 33 X 34 X 35 2 36 X 37 X 38 x Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 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` Standard OP7 Timescale for action 15 (2) (b) The care plan must be updated 01/03/06 to reflect and direct changing needs and methods of care. Repeated requirement previous date set 25.7.06 17(1)(a)Schd Records in relation to nursing 01/03/06 3,3(K) care carried out must be appropriately completed (blood sugar monitoring charts). Repeated requirement previous date set 25.7.06 17 The registered person is 01/03/06 required to evidence that instructions issued by a medical practitioner are fully carried out. 12(3) The registered person is 01/06/06 required to ensure that all staff are able to fluently understand and converse in English. 17 It is required that the home agree a clear system for calculating the full cost of activities, how they will be funded and systems of recording expenditure. 01/03/06 Regulation Requirement 2 OP7 3 OP7 4 27 5 OP35 Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 23 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 Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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. Extracts may not be used or reproduced without the express permission of CSCI. Beech Court Care Centre DS0000015585.V282413.R01.S.doc Version 5.1 Page 25 - 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. 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