Inspection on 20/11/06 for Beech House (Binfield)

This inspection was carried out on 20th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 House (Binfield) 22/10/08

Beech House (Binfield) 31/10/07

Beech House (Binfield) 24/04/07

Beech House (Binfield) 02/05/06

Beech House (Binfield) 06/03/06

Beech House (Binfield) 27/09/05

Beech House (Binfield) 12/04/05

Beech House (Binfield) 05/10/04

Beech House (Binfield) 06/04/04

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

CARE HOMES FOR OLDER PEOPLE Beech House (Binfield) London Road Binfield Bracknell Berkshire RG42 4AB Lead Inspector Julie Willis Unannounced Inspection 19:45 20th, 21st & 23 November 2006 rd 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 DS0000011071.V314586.R01.S.doc Version 5.2 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. DS0000011071.V314586.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech House (Binfield) Address London Road Binfield Bracknell Berkshire RG42 4AB 01344 451949 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) Charnley Care Limited Mrs Gill Kirk Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places DS0000011071.V314586.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2006 Brief Description of the Service: Beech House offers accommodation and care to 28 older people. The home has 25 bedrooms 3 of which are double-bedded rooms. The home is located close to the town centre of Bracknell and within close proximity to rail, bus routes and the M4 motorway. The fees charged range from £390 and £480 per week Hairdressing, Chiropody, Papers are additional cost DS0000011071.V314586.R01.S.doc Version 5.2 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’. This inspection took place over 3 days. The first visit was at 7:45pm to 10:00pm on the 20th November and provided an opportunity for the inspector to observe the handover between night and day shifts and to observe care practice late evening. The following day 21st November two inspectors arrived at the home at 09:45 am and stayed until 2 pm. During the visit inspectors toured the building, checked records and talked to service users, staff and management. On the 3rd day 23rd November the inspector arrived at 10:00 am and left at 11.00 am after checking service user finances and talking to the Proprietor. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the service since the last inspection. The inspector looked at records and asked the views of the people who use the services and other people who responded to questionnaires that the Commission had sent out. The inspector had the opportunity to talk with 14 of the 28 users of the service individually or in small groups . The residents thoughts, opinions and comments are reflected throughout this report. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. There were 3 requirements made at the previous inspection, which remain outstanding, and 7 new requirements and 1 recommendation was made as a result of this inspection. The CSCI has received 1 complaint about the service since the last inspection, which took place on 23rd August 2006. The complaint was considered as part of this inspection but was not evidenced. The inspectors are concerned that the management of the service users and homes finances is compromising the good care being provided by dedicated staff. What the service does well: DS0000011071.V314586.R01.S.doc Version 5.2 Page 6 The service has improved its admission procedure since the last inspection. All new residents have been fully assessed by the home before admission to ensure the home will be able to meet their needs. The information gathered before admission is used to plan the resident’s care. The care plans were clearly written so that staff could provide the right type of care to each resident. The staff team are kind, caring and well trained. They know the needs of residents well and are quick to respond when needed. There is enough staff on duty at the home to meet the needs of residents effectively. What has improved since the last inspection? What they could do better: Residents should be provided with the opportunity to take part in a wider variety of activities as a number said that they were “bored” and felt there was not enough to do. The home should monitor levels of customer satisfaction more effectively as there was little opportunity for the users to have a say in the way the home is run as residents meetings were held infrequently. Food should be more varied and rely less on shop-produced products. Service users say that the quality of food provided has deteriorated lately and that the menu is repetitive. The home should be kept in better decorative order and the carpet on the second floor stairs and landing should be replaced. The dishwasher in the kitchen needs to be repaired or replaced because it is leaking. The lift should be kept in good working order so it doesn’t break down. The heating in the home should be sufficient to keep users warm. DS0000011071.V314586.R01.S.doc Version 5.2 Page 7 The monies belonging to residents should be kept at the home and be available to them spend as they wish. The temperature of hot water should be regulated so that residents can’t be scalded. Suitable weighing scales should be available to weigh residents and ensure that their health and nutrition are being maintained effectively. 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. DS0000011071.V314586.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000011071.V314586.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality outcomes in this area are good All service users are fully assessed prior to admission to ensure that the staff of the home will be able to meet their needs. This judgement has been made using available evidence including a visit to the service EVIDENCE: Examination of the records of the 3 most recently admitted residents evidenced that the Manager had carried out a full assessment of the users needs prior to admission. The newly developed assessment tool was holistic and comprehensive in detail and gathered sufficient information to ensure that the home would be able to effectively meet users need. Details of the users social and medical history, dietary needs, communication needs, mobility needs, history of falls, continence and mental state were included in the record. DS0000011071.V314586.R01.S.doc Version 5.2 Page 10 Information was gathered from a variety of sources, including the user, their family and other health and social care professionals. A copy of the Care Management assessment produced by the purchasing authority was also on file. The information gathered was used to produce an initial care plan and to ensure that any aids or equipment needed by the user were available on admission Service users confirmed that they had visited the home informally before their admission. This had provided an opportunity for users to ask questions about the home and to meet staff. One user said that they thought that the home was “nice and staff seemed friendly” and “people were kind”. DS0000011071.V314586.R01.S.doc Version 5.2 Page 11 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, 10 Quality outcomes in this area were good. Sufficient information is in place to enable staff to effectively meet the health & personal care needs of users effectively. Service users are encouraged to participate in the care planning and review process from the outset. Service users are provided with care in a manner, which maintains their right to dignity, privacy, independence and choice. The system for the administration of medication is good with clear and comprehensive arrangements in place to ensure the safety of users. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The files of four service users were examined in detail and case tracked from pre-admission assessment to date. The written records were user friendly and satisfactorily documented. Sufficient information was included in the plans to enable staff to offer the appropriate level of care. DS0000011071.V314586.R01.S.doc Version 5.2 Page 12 Service users confirmed that they see their GP when they need to and are referred to hospital when necessary. Routine screening and preventative treatments are provided to all residents. The majority of users have recently been given the ‘flu’ injection and this has been recorded in their care plan. Service users are encouraged to remain as independent as possible. The staff were observed to offer one user the opportunity to transfer from armchair to wheelchair with staff assistance, rather than using the hoist. This took patience, time and gentle persuasion. The user clearly responded well to the verbal prompts and was seen to carry out the transfer safely with the kindness, encouragement and the support of staff. There is a need to obtain a set of scales that can effectively weigh users on a regular basis. From examination of users care plans it is evident that several of the current users have difficulty maintaining a healthy weight and have a poor appetite. A dietician has recently seen one of the users. Weights should be routinely monitored and recorded. Observation of care practice concluded that users were provided with the appropriate levels of support to maintain their privacy, dignity and independence. Staff provided personal care in a discreet and sensitive manner and were polite and courteous to users at all times. The staff routinely knocked and waited until they were invited in, before entering users bedrooms. Service users confirmed that they could rise and retire at a time of their choosing. One user said that “he liked to wake at 5 am because he had woken early all his life”. Service users said that they were free to choose where they spent their time and were offered appropriate choices in relation to daily living. From examination of the medication administration system and discussion with senior staff it is clear that the home follows best practice guidance when administering drugs. A monitored dosage system is in operation at the home and medication is delivered to the home on a monthly basis. Storage systems are effective and disposal systems are safe. The inspectors spoke at length to 14 service users. All confirmed that they were happy with the quality of care provided and felt that the staff were “kind, helpful and considerate”. Users felt that staff would listen to what they had to say and would carry out personal care in the manner they preferred. DS0000011071.V314586.R01.S.doc Version 5.2 Page 13 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, 15 Quality outcomes in this area were adequate Service users are provided with the opportunity to participate in limited leisure activities and entertainments. Service users maintain contact with the local community, their friends and relatives. The meals in the home are satisfactory. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Although the staff at the home arrange Bingo sessions and quizzes each week two of the service users told the inspector that they sometimes feel “bored” and that “there isn’t enough to do”. The home has an outside entertainer visiting the home on a monthly basis and manicure sessions and keep fit are offered weekly. The televisions in the lounges have small screens that are difficult to see over a distance or if users have impaired vision. DS0000011071.V314586.R01.S.doc Version 5.2 Page 14 Visitors are made welcome at any time and are offered appropriate hospitality during their visits. Service users confirmed that they make appropriate choices about their everyday lives and can choose when to be in company or alone. Most visits take place in the communal lounge or in the users bedroom in privacy. Feedback from service users about the quality of the food provided was mainly positive however, several service users said that the “food is ok but isn’t as nice as it used to be”. One user told the inspector that there was “too much chicken on the menu” and that they would like to see other meats on offer more often. One user said that they felt that the “tea was too early at 5 pm” and would like it later. Another user said there was “too many mushy peas” and another said “the food was cold because it was served on a cold plate”. Users confirmed that there was too much reliance on shop bought pies and cakes. Lunch on the day of inspection was half a Tesco individual chicken & ham pie served with mushy peas and chips. In the case of users with smaller appetites only quarter of a pie was provided. Dessert was shop bought ginger cake served with custard. The use of shop bought products has escalated due to the shortage of dry goods purchased by the home. The proprietor visits the supermarket 2 to 3 times a week to buy the food for the home. The inspectors were told that suppliers deliver very few items to the home as the home has delayed paying the bills. DS0000011071.V314586.R01.S.doc Version 5.2 Page 15 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, 18 Quality in this outcome area is good. The home has a satisfactory complaints system. Service users feel their views are listened to and acted upon. Service users are protected from abuse and exploitation by staff that can demonstrate knowledge of the homes abuse of vulnerable adults and whistleblowing policies. This judgement has been made using available evidence including a visit to the service EVIDENCE: The complaint policy in the home meets the requirement of Regulation and Standard. The details of the complaints were well documented and evidenced the outcomes provided to complainants. One complaint was reported to the CSCI about the home since the last inspection carried out in August 2006. This complaint was considered as part of this inspection. No evidence was found during the inspection to support the complaint. Service users confirmed that they felt that if they raised any issues management would deal these with swiftly and effectively. DS0000011071.V314586.R01.S.doc Version 5.2 Page 16 There was evidence in staff files that all staff receive training in the abuse of vulnerable adults as part of their formal induction and NVQ training in which it is a core module. Refresher training courses are also offered regularly to staff by the homes management team. Service users confirm that they feel safe at the home and are well cared for by the staff. DS0000011071.V314586.R01.S.doc Version 5.2 Page 17 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, 26 Quality outcomes in this area are poor. There are a number of shortfalls in the environment that require attention in order to provide users with a comfortable place to live. This judgement has been made using available evidence including a visit to the service EVIDENCE: The general appearance of the home is worn and shabby. There are areas that require redecoration. Bathrooms and toilets are in need of refurbishment as part of an on-going maintenance programme. There is a need to replace the 2nd floor landing and stair carpet due to excessive staining. The dishwasher in the kitchen requires repair or replacement because it leaks. At the time of inspection a rolled cloth was beneath the door to prevent water DS0000011071.V314586.R01.S.doc Version 5.2 Page 18 leakage onto the floor, which could pose a risk to the health & safety of staff working in the kitchen area. Several areas of the home appeared cold during the inspection, particularly a number of ground and first floor bedrooms. Two service users complained to the inspector that they were feeling cold during the evening inspection visit. Room 2 required supplementary heating and two users said their rooms were either “too hot or too cold”. Maintenance had been called in recently to attend this problem but it remained unresolved at the time of inspection. Inspectors were told that water temperatures were controlled at the boiler. This means that water is possibly circulating at an incorrect temperature which could pose a potential health risk to service users. Water should be stored and circulated through the home, at a high enough temperature to eliminate the risk of bacterial growth. The temperature of hot water at sinks, baths and showers accessible to service users should not exceed a safe temperature of 43°c and should be fitted with regularly serviced thermostatic mixer valves to maintain the water at a safe temperature. Records of recent hot water checks indicated that the temperature had repeatedly exceeded a safe one but records did not indicate any action taken to rectify the problem. The weekly hot water records were out of date and had not been completed since the 1st November 2006. The passenger lift has been recently repaired after a week out of action. Inspectors were told that the motor leaks oil continuously and staff have on occasion had to purchase oil from Halfords to maintain the lift in a serviceable condition. DS0000011071.V314586.R01.S.doc Version 5.2 Page 19 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, 30 Quality in this outcome area is good. Staff individually and collectively were able to demonstrate that they have the necessary skills and experience to effectively meet the needs of service users in their care. Staff recruitment procedures are robust and transparent and protect service users from harm. Staffing levels are sufficient to meet the needs of users of the service. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Since the last inspection the numbers of staff on duty in the daytime has been increased. This has led to an improvement in the quality of written records and the quality of care provided to users. There has been an increase in staffing to 5 carers on duty from 8 am – 1 pm and an increase in the afternoon and evening to 4 carers on duty from 1 pm – 6pm and 3 carers on duty from 6 pm to 8 pm. The manager has more time to carry out her management tasks and is in the main supernumerary. DS0000011071.V314586.R01.S.doc Version 5.2 Page 20 Examination of the recruitment files for 4 employees indicated that all necessary checks are undertaken on prospective staff to ensure the safety and protection of service users. Records were well kept and met the required standard. From discussion with staff it is clear that they have a good understanding of how their individual role benefits the work of the team and a thorough knowledge of the key values that underpin their work with service users. Staff are offered opportunities to gain qualifications to further enhance their knowledge and skills such as National Vocational Qualifications at level 2 & 3. 72 of the staff have a professional qualification in care. In the last year staff have been provided with refresher training in a number of core skills such as fire safety awareness, health & safety, first aid, manual handling, food hygiene, infection control and adult protection to ensure service user safety. However, the certificates for these training sessions were not always on file. Staff and management said that this was because the trainers hadn’t received their fees so would not supply the certificates until their bill was paid. There was evidence that new staff are provided with induction and foundation training to Sector Skills Council standard. Staff confirmed that they receive ongoing support on a daily basis but records of formal supervision had significant gaps. Service users were complimentary about the qualities of the staff that they said were “friendly”, “attentive and caring” DS0000011071.V314586.R01.S.doc Version 5.2 Page 21 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, 38 Quality in this outcome area is poor. Although the Registered Manager is supportive to the staff team it is not clear how empowered she is to affect necessary change particularly where expenditure is involved. There is a no formal system of monitoring in place to gauge service user satisfaction. The current finance systems put users at risk. Deficits in health & safety and the environment put service users at risk. This judgement has been made using available evidence including a visit to the service. DS0000011071.V314586.R01.S.doc Version 5.2 Page 22 EVIDENCE: The staff team say that they feel well supported by the Manager who is experienced and caring. Recent increases in staffing levels during the day has allowed the Manager more time to concentrate on her management duties ensuring that the written records are up-to-date and accurately reflect the needs of users. There is a need for the records of formal supervision to be up-to-date as records evidenced long periods of time between sessions. In a number of cases records indicated gaps of over a year. Supervision should be provided to each member of care staff at least 6 times a year. There is a need to monitor levels of customer satisfaction on an on-going basis. The Manager has carried out quality assurance surveys in the past year, but it is not clear how the results are being used to improve and develop services. The inspectors are very concerned about how the residents and the homes finances are managed and how this compromises the service being provided by dedicated, loyal staff. The Manager has nothing to do with the finance records and has no access to petty cash. This does not appear to be an affective way of managing the day-to-day finances of the home as it has resulted in staff paying for sundry items needed at the home, out of their own pockets and waiting to be reimbursed. The inspectors heard that suppliers and training organisations were refusing to supply services to the home because their bills had not been paid. Staff spoke to inspectors about difficulties they were experiencing with the payment of their wages. There were no service users monies on the premises on 1st & 2nd day of inspection despite this being subject to previous requirement. The inspector had to make arrangements with the Proprietor to visit the home a 3rd time to check that the cash accounts were accurate and funds balanced. During this 3rd announced visit the monies were in the home and were correct. It is essential that all monies belonging to users should be available to them at all times. The health & safety records were sampled and were in the main accurately maintained however, the water temperatures had not been checked since 1st November. Temperatures recorded at sink outlets exceeded a safe temperature of 43°c and there was no evidence that steps had been taken to rectify the problem. DS0000011071.V314586.R01.S.doc Version 5.2 Page 23 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 1 x x x x x x 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 1 x x 2 DS0000011071.V314586.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 OP12 Regulation 16 (2) m Requirement To review day care activities available in the home. This requirement should have been met by 24/08/06 2 OP33 24 To ensure there is a method of reviewing the quality of care in the home. This requirement should have been met by 24/08/06 3 OP15 16 (2) i Provide in adequate quantities, suitable wholesome and nutritious food which is varied and properly prepared and available at such time as may reasonably be required by service users Repair or replace the leaking dishwasher in the kitchen Ensure that a comfortable temperature suited to the needs of users is maintained in each room of the home 24/11/06 23/02/07 Timescale for action 23/02/07 4 5 OP38 OP25 23 (2) c 23 (2) p 23/12/06 24/11/06 DS0000011071.V314586.R01.S.doc Version 5.2 Page 25 6 OP35 17 (2) Schedule 4 13 (4) a Ensure that service users cash 24/11/06 accounts are kept secure and are available for inspection Ensure that the temperature of hot water accessible to users is maintained at a safe temperature to eliminate the risk of scalding The Proprietor must update the Commission on the financial viability of Beech House The Proprietor must send to the Commission a detailed action plan (with dates) that addresses the refurbishment, maintenance and supply of goods and services to the home. This action plan must include, bathrooms, carpets, kitchen, lifts etc. 24/11/06 7 OP38 8 OP34 25 14/12/06 9 OP19 23 31/01/07 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 Refer to Standard OP8 Good Practice Recommendations A set of weighing scales should be purchased that can be used to monitor the weights of all users. DS0000011071.V314586.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate 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. 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