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Inspection on 09/05/06 for Beech Court Nursing Home

Also see our care home review for Beech Court Nursing Home for more information

This inspection was carried out on 9th May 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 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 home provides a homely and friendly environment for residents. There have been few changes in the staff team over several years, so that residents benefit from being cared for by friendly staff who know them, and their care needs, well. The manager and staff have a commitment to training and updating their knowledge.

What has improved since the last inspection?

Two residents rooms, toilets, a bathroom and corridors have been redecorated. New carpets have been laid in part of the ground floor corridor, the dining room and two bedrooms. A new washing machine, kitchen hot water boiler, bath and bath hoist also additional mobile hoists have been purchased, to improve the standard of the equipment for staff to use when caring for more dependant residents. Staffing levels have improved, with more attention given to having all staff start shifts at the same time where possible, to avoid having `dips` in the numbers of staff available to care for residents at the busiest times of the day.

What the care home could do better:

More attention should be given to making sure that any worn or damaged equipment and linen is promptly taken out of use and repaired or replaced. The standard of cleaning of equipment, such as commodes and shower chairs and shared-room curtain screens, should be improved to reduce the risk of cross-infection and odour. Nurses should check that any residents who are able and wish to manage their own medicines, have a secure place to store tablets and that the home assesses and records the resident`s ability to continue to take their own medication safely. The routine maintenance and checking of small items of clinical equipment and electrical appliances used in the home should be undertaken annually and a record kept, so that residents and staff are not potentially at risk when using plug-in electrical items. Improvements to the staff recruitment and interview records should be made so that the homes records show that the managers use a consistent and thorough process when checking and appointing new staff to work in the home.

CARE HOMES FOR OLDER PEOPLE Beech Court Nursing Home 37 Newland Street Eynsham Oxfordshire OX29 4LB Lead Inspector Delia Styles Unannounced Inspection 9th May 2006 10:00 X10015.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 Nursing Home DS0000027140.V293632.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. 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 Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beech Court Nursing Home Address 37 Newland Street Eynsham Oxfordshire OX29 4LB 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) 01865 883611 beechcourt@talk21.com Dr Brian Cheung Glynis Lynette Dunbar Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. On admission persons should be aged 60 years and over. Admission of two named residents under the age of 60. Date of last inspection 4th November 2005 Brief Description of the Service: Beech Court is a large listed building of architectural and historical note. It is situated in the village of Eynsham a village five miles west of Oxford, and is close to shops, Post Office and 3 Churches. Beech Court is home to 26 older people who are frail, and require nursing care 24 hours a day. The home offers convalescence, holiday breaks, long, and short stay care. The accommodation is provided in single and shared rooms on 2 floors, and there is a passenger lift to provide access to all areas. The communal rooms are spacious and large picture windows afford a good view of the delightful garden. There are spacious, well kept grounds on both sides of the house, which the service users have access to. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at Beech Court at 10 am and was in the home for 7 hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection. There were no comment cards (questionnaires) received in time to include in this report: CSCI provides comment cards for residents, relatives and care professionals who visit the home to complete if they wish to give their views about the home. Any comments received will be taken account of at the home’s next inspection. The inspector looked at how well Beech Court was meeting the standards set by the government and has in this report made judgements about the standard of the service. The inspector toured the building, spoke to 4 residents, four visitors, and care and ancillary staff during the day. The home owner, Dr Cheung, and the homes registered manager, Mrs Dunbar, were available throughout the day and discussed the inspector’s findings at the end of the inspection. A sample of staff recruitment and training records, residents’ care plans and medicine records, the menus, and the homes own quality assurance surveys were looked at during the inspection. What the service does well: The home provides a homely and friendly environment for residents. There have been few changes in the staff team over several years, so that residents benefit from being cared for by friendly staff who know them, and their care needs, well. The manager and staff have a commitment to training and updating their knowledge. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 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 the following standard(s): 3. Standard 6 is not applicable. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The homes assessment procedure could be improved with more detailed assessments being made for those residents admitted for short or ‘transitional’ stays EVIDENCE: The inspector looked at a sample of three assessments of residents that had been done before their admission to the home. The home manager or her deputy undertakes pre-admission assessments. The written assessments information was brief and focussed largely on people’s physical care needs. The inspector feels that there is reliance on the verbal exchange of information about prospective new residents’ care needs and that this may be insufficient for the home’s staff to be aware of all aspects of people’s care needs on admission to the home. It is recommended that a more detailed record of initial care needs assessment is made, so that prospective residents and their relatives can be confident that the home will meet their needs. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 9 Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Evidence shows residents’ health and personal care needs are being met. There is good communication between the home and other health and social care professionals. EVIDENCE: The inspector reviewed the care plans of three residents and discussed these with the manager. The written records were indexed and systematic. There is a variety of risk assessment methods in place – for example for looking at people’s risk of developing pressure-related skin damage (pressure sores/ulcers) and overall physical dependence. The nutritional assessment information recommended for use (the Malnutrition Universal Screening Tool – MUST) is available but not used consistently or effectively. Where residents are assessed as having a potential health care problem, the care plans should give detailed information for staff about the care needed to avoid that problem. Improvements should be made to the way in which staff record whether the care that is given is effective for the residents. There is little evidence that residents and their relatives are aware of their care plans or are consulted about their accuracy. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 11 Consideration should be given to periodically discussing residents’ satisfaction with their care with them (and their representatives, if appropriate) and noting this, and any suggested changes, in their care records. The home’s systems for the safe storage and disposal of medicines are satisfactory. The Medication Administration Records (MAR) were up to date and showed evidence of regular review by the doctor. A check was made of the records and running total of tablets stored in the controlled drug cupboard and these were found to be correct. The home uses a system of having a handwritten (by a nurse) list of the residents’ medications and administration instructions, countersigned by the prescribing doctor. Nurses then enter the relevant capital letter denoting the listed medication, on a record sheet after giving them to the resident. Some of the medication instructions for frequency and dosages included abbreviations. Where MAR records are not computer-generated by the supplying pharmacist, nurses should ensure that they follow the guidance set out in the Nursing and Midwifery Council (NMC) and British National Formulary (BNF), to minimise the risk of medication errors. Where residents self-administer medicines, records should be maintained to show that this is the case, and that arrangements are in place for the safe and secure storage of the specific resident’s medication to which only they (and nursing staff) have access. The home has purchased two hoists since the last inspection, to improve the availability of equipment when assisting residents. There is evidence that the home has sought specialist advice and arranged for additional disability aids for residents. The size and layout of some rooms (many have fitted wardrobe and vanity units) restricts the positioning of beds and accessibility for staff assisting residents in and out of their beds and rooms. The home has four electric adjustable beds and 3 hospital-style beds suitable for more dependent residents. A number of the protective fabric bed pads used for incontinence were seen to be very worn and are likely to be ineffective. The manager said that they have adequate new supplies and she would ensure that old and worn out items were discarded. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is evidence that the home has made progress in increasing the social and recreational opportunities for residents. EVIDENCE: Residents and a visitor spoken with said that they enjoyed the services and singing in the home organised by a local church. The home organises ‘Bingo’ twice weekly and a ‘seated exercise’ group fortnightly and there are regular visiting entertainments, such as music ‘sing-a-long’ events and a harpist. Individual resident’s social and recreational interests and needs were not included in the sample of care plans seen, so it is not clear to what extent the home matches their expectations or preferences about their daily life and hobbies. The communal lounge areas have radios and supplies of jigsaw puzzles and games, newspapers and magazines. The home owner, Dr Cheung, and registered manager said that they have increased the number of organised entertainments and social events for residents that wish to, to be involved in. Residents were appreciative of the food; one person said it was ‘very good’ and other that it was ‘usually good’. Residents said that they were able to tell the chef about what they liked or did not like on a daily basis. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 13 The menu for the lunchtime meal was written on a board in the lounge. The inspector noted that residents breakfast time is from 8 am to 10 am, lunch at 12 midday, and the last meal of the day, consisting of soup and sandwiches, is served at approximately 5 pm (residents who need helping with their food are served at 4.30 pm). The registered manager confirmed that there are snacks and drinks available for residents at any time if they request them. The ‘National Minimum Standards for Care Homes for Older People’ recommend that ‘the interval between a snack meal [offered in the evening] and breakfast the following morning should be no more than 12 hours’. For some residents, especially those unable to make their wishes known, the spacing of mealtimes and availability of snack foods, should be revised, to make sure that residents are actively offered additional evening drinks and snacks by staff. Also, for those residents who prefer a late breakfast, a later main meal service may be needed. The menus appeared varied and well balanced. They are discussed and agreed between the chef, proprietor and registered manager. There were several visitors to the home during the day. All were welcomed and at ease with the registered manager and staff. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The homes written procedures and staff training in relation to complaints and protection are adequate. EVIDENCE: The CSCI have received no complaints about the home. The home complaint record showed that one current concern raised by a resident’s family is being looked into by the manager within the timescales set out in the homes complaints procedure. There is evidence that staff have training about adult protection issues and have their own policy and procedures and the Oxfordshire Multi-disciplinary Adult Protection Codes of Practice documents available for staff to refer to. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 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 the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall, in the home environment there is evidence of improvement in the décor and furnishing. There is limited progress in addressing the attention to detail of day-to-day maintenance, cleanliness and tidiness of equipment since the last inspection. EVIDENCE: The inspector toured the home and found the general standard of cleanliness to be satisfactory. Several areas of the home’s décor and furnishing have been improved with the fitting of new carpets, re-decoration, and new chairs. However, the cleanliness, tidiness and repair of some equipment remain inadequate, as reported at the last inspection. For example, a hoist sling was worn and stained, with missing or protruding plastic inserts; several commode frames were chipped and flaking, and the seats and inserts were dirty; plastic curtain screens in shared rooms were very dusty. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 16 Used disposable razors, hairbrushes and toothbrushes were left in communal bathroom cupboards. Several items of furniture, towels and bed linen were worn and stained. The inspector recommends that the manager and key staff work together to undertake a daily visual check of all rooms and a regular detailed audit of equipment in use. Action to improve these standards is important as they increase the risk of cross infection and poor odour control and detract from an otherwise attractive and homely environment. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. These standards are met by the home, but improvements to the recruitment records and practices are indicated. EVIDENCE: The manager reported that since the last inspection staffing levels had improved and that as far as possible, staff started their shifts at the same time, or additional staff worked for a short ‘cover’ period until colleagues could arrive, to avoid ‘dips’ in staffing levels that had been identified previously. The home benefits from having had few changes in the staff team, who mostly live locally. This provides familiarity and continuity of care for the residents. It was evident from discussions with residents and observing the staff and residents’ interactions, that they have a good relationship. The home does not use agency staff and continues to advertise for new staff to increase the number of part-time or bank staff who can be called upon to cover for staff annual leave or sickness absence. A sample of staff recruitment and training records was looked at. The proprietor pointed out that they had not had any new employees recently and that some of their staff are employed by other registered care homes locally. Two staff had not had a Criminal Records Bureau (CRB) check undertaken Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 18 through Beech Court CRB ‘umbrella’ body, though they had had satisfactory CRB clearance from their other employer. Dr Cheung was informed that he must ensure that all staff he employs in the home have CRB checks through Beech Court umbrella body, as CRB checks are not ‘transferable’ between employers. Some staff did not have a recent photo on file (a requirement, as part of the information and documents that must be kept in respect of all people working at a care home). Dr Cheung said he was not aware of this and would address it; all the current staff have been employed in the home for some time and are known to him and the registered manager. The records of staff recruitment and interview are poorly organised and do not demonstrate that the home has a thorough and consistent procedure, although Dr Cheung described an adequate and effective screening system for prospective new employees in practice. Recommendations are made to improve the records of staff interviews outcomes and the recruitment process. The home has an established programme of staff training and development in place and currently has 3 care staff who are undertaking National Vocational Qualification (NVQ) level 2 in Care; 3 staff undertaking NVQ Level 3; and 1 at NVQ Level 4. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. These standards are met, with evidence of a well-established staff team and friendly, supportive relationship between staff and residents. The home has taken action to address health and safety matters identified by other regulatory authorities. EVIDENCE: Mrs Dunbar became the Matron in 1998, and the registered manager of Beech Court in 2002 and has considerable experience in care of older people. She is a Registered General Nurse and has the Registered Managers Award (NVQ 4). Though there are no formal residents meetings held in the home, residents and relatives say that they feel they can raise any concerns or suggestions Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 20 informally because the manager is available on a day to day basis, and this is a relatively small home. The inspector saw the results of the homes annual quality assurance questionnaires sent to residents and relatives for 2004 and 2005, with analysis of the results. The results of this year quality survey were not yet available. The inspector did not ascertain whether the results of the surveys are shared with residents and their representatives. The home keeps appropriate records of any expenditure made on behalf of residents, for example for hairdressing or chiropody. In most cases, relatives deal with the financial affairs for residents who are unable to do this themselves. There is evidence of regular staff training, for example First Aid; Moving and Handling; Food Hygiene; and Fire Safety. The inspector observed one instance of poor moving and handling technique by staff transferring a resident from an armchair to a wheelchair using an underarm lifting manoeuvre. All staff should always the recommended safe moving and handling procedures and aids to protect residents and themselves from injury The proprietor said that the fire safety officer had visited the home recently and that new fire evacuation procedures for staff, in line with the Fire Authority’s new guidance, would be produced. An inspector from the Water Board has also advised the home on additional updating and safeguards to reduce the risk of water contamination. Random checks of the hot water temperature were taken mid-morning by the inspector, in the laundry, ground floor bathroom and two ground floor rooms and this was found to be tepid at 35ºC. Weekly checks of the water temperature are recorded and the proprietor said that it was possible that there had been an adjustment made to lower the temperature; or that the hot water supply had not recovered from residents and laundry usage during the morning. Staff should report any excessive alterations in water temperature to the manager, who should ensure that there is sufficient hot water for residents to comfortably wash and bathe at any time of the day. Recommendations are made in relation to replacing or repairing some items of equipment in the kitchen, cleaning the hand washbasin and removing floorcleaning equipment from the kitchen. The home should ensure that a designated competent person regularly checks all portable electrical items used in the home – for example, bedside lamps, fans and extension sockets – to protect residents and staff from preventable hazards. Beech Court Nursing Home DS0000027140.V293632.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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 OP3 OP7 OP8 Good Practice Recommendations Improve the detail of information in pre-admission written assessments of prospective residents. Improve the detail in care plan instructions and evaluation of care given. * Use a consistent and validated system for assessing and monitoring all residents’ nutritional status and documenting the actions taken where residents are at risk. * Repair or replace worn or damaged equipment, such as hoist slings, fabric bed-protection sheets etc. * Nurses’ written transcribed medication instructions on the Medication Administration Record sheets should be made in accordance with current professional guidance documents. * There should be adequate records kept in relation to any residents who are self-medicating, including assessment of the storage, security and resident’s capability to hold and administer their own medicines. DS0000027140.V293632.R01.S.doc Version 5.1 Page 23 4. OP9 Beech Court Nursing Home 5. 6. OP12 OP15 7. 8. OP26 OP29 9. 10. OP33 OP38 Improve the assessment and recording of residents’ social and recreational care needs. Review the spacing of meal times for residents and adjust where necessary: ‘the interval between the last snack meal of the day and breakfast the following morning should be no more than 12 hours’. (NMS 15.3). Ensure that commodes, disability aids, room screens and residents’ personal toiletry equipment are kept clean, tidy and maintained in good repair. Improve the standard of recordkeeping in relation to the homes recruitment policy and practices. The home should hold a current photograph of all staff employed; there should be evidence of satisfactory Criminal Records Bureau (CRB) checks through the homes’ own umbrella organisation; and a record of any additional checks and the interview process and outcome. The results of the homes quality assurance surveys should be published and shared with current and prospective residents and representatives. * All staff should use the recommended safe moving and handling techniques to protect residents and themselves from injury, when assisting residents to mobilise. * The homes fire evacuation procedures should be revised and rewritten in line with the Fire Protection Officer’s advice; all staff should be trained and familiar with the updated procedures. * There should be a constant supply of hot water (at a temperature close to 43ºC) available in residents rooms, bath and shower facilities. * Worn or damaged work surfaces and equipment in the kitchen should be repaired or replaced as identified during the inspection. * All portable electrical appliances should be checked regularly to ensure they are safe for use. Beech Court Nursing Home DS0000027140.V293632.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Nursing Home DS0000027140.V293632.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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