Inspection on 20/05/05 for Beech Street Home

This inspection was carried out on 20th May 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Beech Street Home 01/08/07

Beech Street Home 21/06/06

Beech Street Home 27/09/05

Beech Street Home 14/09/04

Beech Street Home 20/04/04

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

CARE HOMES FOR OLDER PEOPLE Beech Street Home Jarrow Tyne & Wear NE32 5LD Lead Inspector Nic Shaw Unannounced 20 May 2005 10:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Beech Street Home Address Jarrow, Tyne & Wear NE32 5LD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 489 8549 0191 489 3007 South Tyneside MBC, Kelly House, Campbell Park Road, Hebburn Ms Maureen Aziz PC care home only 35 Category(ies) of 35 x OP registration, with number of places Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14 September 2004 Brief Description of the Service: Beech Street Elderly Persons home is a Local Authority purpose built home which is situated in Jarrow. The home is registered for up to 35 residents, some of whom have a dementia type illness. Nursing care is not provided but District Nursing services are accessed as required. Accommodation is over one floor, with level access throughout. Accomodation consists of a number of communal areas, including smoking and none smoking lounges, and a seperate dining area. Residents also have access to a well-equipped reminiscence room, separate hairdressing facility and spacious garden. There is an attractive entrance foyer to the home, which has been enhanced with a water feature, plants and ornaments. There is also a short break wing, which includes a lounge and sepeate dining area, which can offer a service for up to three people. The home is situated on Beech Street which is located close to the busy town centre of Jarrow where facilities such as shops, pubs, GP surgerys and places of worship can be easily accessed. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 7.5 hours in May 2005 and was a scheduled unannounced inspection. The inspection process involved spending time talking to a number of the people who live in the home as well as the manager, staff, and visitors, including a District Nurse. A sample of records were examined including care plans, rotas, accident book and fire log book. A tour of the building took place which included all communal areas and a sample of residents bedrooms. The lunchtime meal was also sampled and observations were made of the support the staff offered to residents throughout this process. The judgements made are based on the evidence available on the day of the inspection. The manager stated the people who live in the home prefer to be referred to as residents and this will be reflected throughout the report. What the service does well: The home is run by an experienced manager. Staff are well trained and staffing levels are good. Residents spoken to said that they were “content” and that “the staff look after you”. Other favourable comments received from visitors to the home included “I like it here”, “there’s a nice atmosphere”, and “there is no mucking about if a resident is ill”. The home is clean, warm and homely and one person said that it was always “immaculate”. Meals are nutritious and nicely presented. Residents are able to choose what they want from a menu and everyone spoken to said that the food was good. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: A number of the records need to be improved. This includes the Statement of Purpose so that prospective residents know that Beech Street is the right home for them. Care plans also need to be improved so that staff know what they should do to meet the residents needs. Systems must be put in place to ensure that those resident’s whose GP will not visit the home, receive medical attention when they need it. The manager needs to establish if some of the residents are not regularly taking their medication. The supervision of residents during mealtimes needs to be reviewed as currently those people who need support are not receiving this. The health and safety of residents could be improved by ensuring that staff receive regular fire drills and by putting systems in place to ensure that the home is free from hazards, such as equipment being stored in bathrooms, which could be a potential tripping hazard. An activities programme needs to be developed which reflects the needs of the people living in the home. The manager needs to obtain feedback on the service provided from the people who live in the home and their relatives. This information must be used to improve the services provided. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 7 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 Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 2 Full information is not available to prospect residents therefore they are not able to make an informed decision as to whether to move into the home. Residents have not been issued with a contract, therefore, their rights as residents are currently unprotected. EVIDENCE: There is a Statement of Purpose and a Service User Guide, which are combined as one document. Each resident has access to a copy of this document, which was found hanging on the back of their bedroom doors. However a visitor spoken to indicated that she had not been provided with a copy of this prior to her relative being admitted to the home. As such it would not have been possible for the family and resident to make an informed decision as to whether they wanted to live in this home. This was discussed with the manager who agreed that it was not normal practice to provide prospective residents with a copy of the Service User Guide, only to people once admitted to the home, an issue which she agreed to address. An examination of this document indicated that it needs to be developed further to inform prospective residents of room sizes, as some of these fall below the National Minimum Standards. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 10 Residents are not provided with a contract. A draft contract has been developed by the Local Authority and this was available for inspection. Once finalised a copy of this must be issued to all residents. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 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 standard(s) 7,8,9 &11 The health and personal care needs recorded in the care plans do not reflect the residents current level of need. Some of the medication administration procedures are unsafe. This means that the resident’s health and personal needs are not being adequately met and therefore their welfare is potentially at risk. At the time of their death residents physical and emotional needs are met by staff with sensitivity and care. EVIDENCE: Of the sample of resident’s case files examined these contain an assessment, referred to by the home as the “daily routines” document. This provides staff with basic information in relation to the resident’s care needs. Care plans developed from this information lacked detail and did not reflect the level of care some of the residents users currently need. There were no risk assessments or risk management strategies in place for those residents at risk of developing pressure sores, for those residents who have a dementia type illness or for whom a nutritional assessment identifies that this is an area of need. The manager agreed that this is an area for future development and in order to address this issue the Local Authority have developed a corporate care Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 12 plan document which is soon to be implemented with all Local Authority care homes. Discussion with the manager, staff, residents and a district nurse, who was visiting the home that day, confirmed that the resident’s health care needs are being adequately addressed by the home. A separate record of medical visits is maintained in the home in which details of dental, optical, GP and district nurse visits are documented. The manager stated that specialist professional input is always sought where this has been identified as a need and provided examples of where this has been necessary with the involvement of a physiotherapist and community psychiatric nurse. Discussion was held with one resident who had recently been admitted to the home who raised some concerns in relation to her health care needs. This was later discussed with the manager who indicated that as this resident, prior to admission to the home, did not live in Jarrow, her GP would not visit the home. Advice was given of the need to develop procedures to instruct staff of what action they should take should a resident require medical intervention from a GP who’s surgery is outside of the catchment area. Since the last inspection the manager confirmed that medication which has been “found”, “dropped” or “spat out” is no longer disposed of in the waste water system. A large number of tablets were stored in a container which were to be returned to the pharmacist. The manager said that this was a result of tablets being “found” by staff over the last two months. This was concerning as this means that some residents may not be regularly receiving their prescribed medication. Medication had also been signed for which had not actually been given as the medication had been discontinued. In another instance a resident’s medication was evident in her bedroom and had not been taken, yet signed for on the medication record by a member of staff as being administered. An audit of the controlled medication held in stock did not balance with the records maintained. Records examined confirmed that this was as a result of a recording error by staff. A record of the temperature of the fridge is not maintained and therefore it is not possible to ensure that medication is stored appropriately. Discussion was held with a visiting district nurse who said that the staff in the home addressed the needs of a resident who has recently died in the home sensitively and competently. It has been identified within the “personal development plan” of some of the staff that, in order to adequately address the needs of the residents and their family members in the area of dying and death, they would benefit from training in relation to bereavement counselling. The manager has raised this issue with the Local Authority training department for their attention. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 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 standard(s) 12&15 Residents are offered a varied menu with wholesome food, which promotes their health and well being. However, additional staff support is required at mealtimes, to ensure that residents can more easily consume their meals, and to help promote their general health and wellbeing. There are limited opportunities for social activities therefore there is little for the residents to do in the home. This restricts the resident’s ability to lead stimulating and fulfilling lifestyles. EVIDENCE: Observations made on the day of the inspection confirmed that the routines of daily living are flexible for the residents. For example: residents are able to have their meals in the privacy of their bedroom. However, there was little in the way of activities which meet the needs of the residents currently living in the home. Prior to lunch residents were found sitting in the lounges throughout the home with little in the way of stimulation other than the television or music. Resident’s spoken to also said that “there is little to do”. Later discussion with the manager confirmed that activities had taken place that morning in the “games room” which consisted of a game of dominoes. However, the manager said that residents are only able to go out on social Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 14 outings if the Local Authority provides transport, which is not a regular occurrence. The manager also said that there is an activities programme, however, this was not displayed in the home and not accessible to the residents and as such of little value. The lunchtime meal was nicely presented with choices being offered to the residents by the staff. Residents spoken to said that the food is nice. However, during the mealtime it was evident that those residents who needed assistance were not being adequately supported by staff. For example: the three staff available spent the majority of the time serving the meal with little time available to sit with residents. As a result of this one resident, who was not being supervised, poured a large quantity of salt on one part of her plate and later dropped some food into the milk jug. One resident kept getting up from her table and wandering. Another resident was given fish and chips. Her facial expression indicated that she did not want this meal, however, staff in passing verbally prompted her to eat this, then later stood and physically tried to encourage her to eat. Eventually an alternative sandwich was provided which the resident ate. If a member of staff had been available to sit with the residents this would have been observed and acted upon much sooner. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 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 standard(s) 16&18 The home has a satisfactory complaints system. Complaints are handled appropriately and the outcomes used to improve the service. However, in order to ensure that all residents know how to make a complaint this needs to be made available in different formats. Appropriate systems are in place to protect residents from abuse and potential harm, however, staff are not informed through the home’s policies that they must report bad practise. This could mean that bad practise is not always reported, which potentially compromises the safety of residents. EVIDENCE: The complaints procedure was on display in some of the lounges throughout the home. Residents and relatives spoken to said that they had no complaints but would feel able to raise any concerns they have with the staff. This was evident from the complaints record where four complaints had been documented and addressed by the manager. The complaints procedure is not in large print nor is it available in audio format and therefore not accessible to those residents who have a visual disability. The Local Authority’s Adult Protection Procedure is available within the home, to guide staff on what to do if they have concerns in this area. All of the staff have had training in relation to this. Residents spoken to said that they felt safe living in the home. However, in order to further advise staff that it is their duty of care to report bad practise the whistle blowing policy should be Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 16 reviewed and amended to reflect this in line with the General Social Care Council code of practise. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 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 standard(s) 19 The home is clean, warm and well maintained offering residents a homely environment in which to live. EVIDENCE: Since the last inspection two corridors have been decorated as well as a number of residents bedrooms. In order to improve accessibility for the residents door guards have been fitted to all bedroom doors as well as communal areas. The manager stated that any maintenance issues identified are immediately reported to the maintenance section within the Local Authority for their attention, and confirmation of this is documented. Future plans to improve the environment include the fitting of a new door with a key pad system to keep residents safe and the possibility of developing the garden area in order to make this accessible to those residents who have mobility needs. All bedrooms are single occupancy. There are no en-suite facilities, however, communal toilets are located near to bedrooms and lounges. Some of the residents took pride in showing me their rooms and how they have personalised them to suit their preferences and likes. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 18 A particular pleasant feature of the home is the reminiscence room which is well equipped with memorabilia from the past. A number of residents had chosen to spend time in this room on the day of the inspection. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28&29 The residents are in safe hands with their personal care needs being met by a staff team who are sufficient in numbers. EVIDENCE: Records examined confirmed that the minimum staffing level has been exceeded with an additional member of care staff being provided during the waking day. Eleven of the twelve care staff have achieved the NVQ level 2 qualification in care and one member of staff has the NVQ level 3 qualification. Discussion with the manager confirmed that 2 further staff have requested, within their personal development plan, to undertake the NVQ level 3 qualification. The majority of staff have not received in-depth training in relation to the needs of people with dementia. The manager has recognised this as a need and in order to equip the staff with the skills and knowledge to understand the complex needs of people with this illness she is in the process of arranging for 10 of the staff to complete an NVQ level 2 qualification in the care of people with dementia. Only some of the staff records are held in the home, other records, such as the job application form are available for inspection within the council offices. As such it was not possible to fully assess the staff recruitment procedures in order to ensure that they are robust and as such protect the residents. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,36&38 Residents health and safety is generally well promoted by an experienced manager and closely supervised staff team. However, some practices need to improve in this area. Formal systems need to be put in place in order to ensure that residents views are sought and used to influence the development of the service. EVIDENCE: The manager has managed Beech Street care home for a number of years and is currently completing the Registered Manager’s Award. She has also recently attended a seminar on the needs of people with dementia in order to up-date her knowledge and skills in this area. Residents and visitors to the home all said that they were happy with the service provided and there are comments cards available at the entrance of the home which can be completed anonymously. However, there is no formal Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 21 quality assurance system to obtain the views of residents, relatives and visiting professionals and this is an area which is currently being developed by the Local Authority with the employment of a quality assurance officer. There is a planner on the office wall which is a management tool which has been introduced since the last inspection to ensure that all staff receive a formal supervision every eight weeks. On the day of the inspection there were two potential hazards to the health and safety of the residents. An oxygen cylinder was not being held in a stand and therefore not secure, and a wheelchair, with items of clothing stored on the top, was being stored in a bathroom, a potential tripping hazard. These issues were discussed with the manager who took action to address them at the time of the inspection. Appropriate records are held in relation to accidents. Systems are also in place to monitor falls in order that preventative strategies can be implemented. The fire log book examined confirmed that fire alarms are tested regularly and fire equipment and emergency lighting checks are carried out as recommended by the fire authority. All staff have recently received fire instruction, 14th April 2005, however, records indicated that this had not been provided six monthly as required. A record of the checks being carried out on the recently installed doorguards must also be maintained. A particular positive feature is the provision of a pen picture of those people staying in the home for a short break service which advises nightstaff if they have mobility needs, should there be a fire during the night. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 x x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 3 x 2 x x 3 x 2 Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 23 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 1 Regulation 4 Requirement The Statement of Purpose must be developed to meet the requirements of regulation 4, schedule 1 of the Care Homes Regulations 2001. (Timescale not met 10th December 2004). A copy of the contract, once finalised, must be issued to all current and future residents. The Service User Guide must contain a copy of the contract. (timescale not met 10th February 2005). Residents care plans must be in sufficient detail to provide clear guidance for staff on the action they must take to meet their health and welfare needs. Procedures must be developed to ensure that those residents, whose GP will not vist the home, recieve medical intervention should they require this during their stay. Systems must be put in place to ensure that all residents are recieving their prescribed medication. A programme of activities must be arranged which meets the needs of the residents. Timescale for action 30th June 2005. 2. 2 5 30th August 2005. 3. 7 15 30th September 2005. 30th June 2005. 4. 8 13(1)(b) 5. 9 13(2) 30th June 2005. 30th September 2005. Page 24 6. 12 16(2)(n) Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 7. 15 18(1)(a) 8. 16 22(6) 9. 29 19(b) 10. 11. 33 38 24 12(1)(a) 12. 38 23( e ) A review of the deployment of staff during mealtimes must be carried out in order to ensure those residents who require support are provided with this. The Complaints procedure must be made available in a suitable format for those residents who have a visual impairment. ( Previous timescale not met 10th February 2005). The records required in relation to the recruitment process required under the Care Homes Regulations 2001 must be kept in the care home and available for inspection. Systems must be put in place to obtain the views of residents and their relatives. Systems must be put in place to ensure that the environment is kept free from hazards to residents and staff. All staff must be given a fire instruction every six months. A record must be mainatined on the checks carried out on the doorguards. 31st July 2005. 31st July 2005. 31st July 2005. 30th September 2005. 30th June 2005. 30th June 2005. 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 18 Good Practice Recommendations The homes whistle blowing policy should be amended to inform staff that they must expose bad practise. Beech Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Baltic House Port of Tyne South Shields NE34 9PT 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 Street Home B52-B02 S37970 Beech Street V219751 250405 Stage 4.doc Version 1.30 Page 26 - 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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