Inspection on 26/09/07 for Beech Tree Care Home

This inspection was carried out on 26th September 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Beech Tree Care Home 10/08/09

Beech Tree Care Home 26/09/08

Beech Tree Care Home 26/03/08

Beech Tree Care Home 02/05/06

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

CARE HOMES FOR OLDER PEOPLE Beech Tree Care Home Sprents Lane Overton Hampshire RG25 3HX Lead Inspector Liz Palmer Unannounced Inspection 26th September 2007 10:30 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 Tree Care Home DS0000066182.V344303.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. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech Tree Care Home Address Sprents Lane Overton Hampshire RG25 3HX 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) 01256 771353 Southern Cross Operations Limited POST VACANT Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (61), Physical disability (12) of places Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th December 2006 Brief Description of the Service: Beech Tree is a care home providing personal and nursing care for up to 61 service users in the older persons category. The home is situated near to Basingstoke in the village of Overton. The home consists of a three storey building which was purpose built. There are forty-seven single rooms and seven shared rooms most of the single rooms have en-suite facilities. There is a passenger lift and a small-enclosed garden with easy access for wheelchair users. The range of fees for the home is £335.00 to £650.00 per week. There are no additional charges. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection and was unannounced. The key standards were assessed by sampling records and talking to six service users, five members of staff and one relative. Time was also spent observing staff practice and talking to the acting manager. A member of staff showed the inspector around the building. All three floors were looked at and some communal areas including two lounges, the dining room and two bathrooms were seen. Two service users were seen in their bedrooms and others were spoken to in the dining room. Prior to the visit a review of the home’s recent history was undertaken, including the previous inspection reports. Information was also gathered from the Annual Quality Assurance Assessment (AQAA), which was completed by the home and sent to the commission when we asked for it. A selection of surveys were also requested, those returned included, one from a service user, two from staff, one from a relative and one from a health professional. What the service does well: What has improved since the last inspection? What they could do better: Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 6 Several areas have been highlighted for improvement as a result of this inspection. The home must appoint a permanent manager who is suitable to apply for registration with the commission. The issue of odours related to incontinence must be addressed. Staffing levels must reflect the needs of the people living in the home and must be maintained at a safe level at all times. Staff need to have a full and comprehensive induction programme and receive regular supervision to ensure they are competent to meet the needs of people living in the home at all times. 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. The summary of this inspection report can be made available in other formats on request. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 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 Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3, standard 6 does not apply. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed prior to admission so that the individual and the home can be sure that the home is right for them and will meet their needs. EVIDENCE: The home has a Statement of Purpose and Service User Guide, which are provided to prospective service users and their families to give them information about what is provided in the home. It was noted that the fees charged for the home are not included in the service user guide and a requirement has been made for this information to be added. Preadmission assessments were looked at for three new service users. Information recorded included details of physical care needs, emotional needs, weight, skin integrity, their needs and likes and dislikes regarding food. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 9 Hobbies and interests were also noted. Care manager’s assessments were included and hospital discharge notes where appropriate. The home’s AQAA states that prospective service users and their families are invited to spend a day at the home and visit for lunch or other meals. A trial period is usually offered to anyone wishing to move onto the home. According to the AQAA most enquiries convert to admissions. The survey returned by one of the people living in the home said they had enough information about the home to help them decide. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 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. 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. Peoples’ care needs are generally met. Low staffing levels and the use of agency staff at times mean that people’s needs are overlooked. EVIDENCE: Three care plans were looked at. These were drawn up from the initial assessments also seen by the inspector. Care plans are drawn up with the involvement of service users, families and relevant professionals. They are detailed and reviewed monthly. All medical, psychological and emotional needs are recorded. Any visits by General Practitioners (GPs) are recorded along with the outcome and any changes to the care needed. Risk assessments are in place detailing strategies for dealing with any high risks. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 11 One service user spoken to said she felt well cared for, that staff were polite, patient and treated her with respect. She said she once had to wait when she asked for personal care and found this distressing but it has not happened since she talked to staff about it. It was noted that this person had been given a cup of tea that she could not reach and it had gone cold. When asked she said that staff sometimes come back and help her to drink her tea, on this occasion they had not. This was discussed with the acting manager who agreed that a more suitable table for the service user would enable her to reach her own drinks. Another service user, when asked about the care in the home said it was ‘so so’. When asked about staff she said ‘some are nice and some get fed up’. The staff spoken to knew services users well and were able to describe the care required by individuals. Three of the four staff spoken to said they felt at times they were not able to meet people’s needs to the standard they should because they were short staffed. A relative said she was concerned her mother’s needs were not being met in the home and was planning to move her to another home. She said the staffing levels were often low and standards were not satisfactory. On one occasion recently, she said, service users did not come out of their rooms all weekend because there were not enough staff on duty. The professional survey returned to the commission stated that individual’s care needs are ‘usually’ met and that staff ‘usually’ respect people’s privacy and dignity and that the service ‘usually’ responds appropriately if concerns are raised about a person’s care. Only qualified nurses are permitted to administer medication. The administering of medication was observed during lunchtime. No concerns were noted. One member of staff assisted the inspector in sampling the storage and recording of medication. This staff member was competent and confident. The medication cupboard was seen to be suitably secure, clean and organised. A separate safe for storing ‘controlled drugs’ (CD) has seen to be secure and suitable. A CD register is in use and was seen to meet the required standard. Records for recording were sampled, no errors or omissions were seen on the records. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for activities and visitors are in place. Improvements to the lunchtime arrangements mean people are receiving suitable support and receiving a healthy, balanced diet. EVIDENCE: People who live in the home said there are activities for them to join in if they want to. One service user said she did not enjoy joining in the activities and that staff respect her wish to stay in her room. There are no restrictions on visitors and people said they could have visitors whenever they like. The home says that visitors are invited for meals and to join in on special occasions. The AQAA states that daily activities are provided and a notice board in the home showed that activities are planned twice a day, except at weekends. On the day of inspection, skittles was being played in the morning and another activity took place in the afternoon. A survey returned to the commission from a service user said there are ‘always’ activities that they can Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 13 join in. Evidence was seen to show that people are supported to practise their religions. The home’s AQAA states that they intend to improve the daily life and social activities for people by completing a life history/social profile for each service user. They also say they plan to increase the carer support and introduce ‘yesterday, today and tomorrow’ training for their staff. Everyone is encouraged to eat their lunch in the dining room, however the home states that people can chose to eat in their room if they wish to. During lunchtime people who needed support were observed being helped by staff in a calm and relaxed manner. Others were seen to be relaxed, chatting to each other and interacting in a friendly manner with staff. Due to the large number of people in the dining room some were seated and waiting for ten minutes. A requirement was made at the last inspection for menus to reflect the meals provided on the day so as not to confuse people. The menus were seen to be accurate. The menu shows three course meals are offered and states that snacks are available on request. Cooked breakfasts are ‘always available’ and fresh fruit, vegetables and salads are offered. People were observed being offered a choice of the two main courses on offer that day. One person was observed not being able to cut her food nor recognise what it was. The inspector called over a member of staff who offered sandwiches instead. Everyone else on the table also requested sandwiches. When asked they all said that they could always choose an alternative but usually the food was better. Results of a ‘satisfaction survey’ carried out by the home show that people are generally happy with the food provided in the home. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 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. 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 home has a complaints procedure, which is provided to all service users. However, the home needs to ensure that people feel confident about how to complain and have their concerns and complaints listened to and acted on. Policies and procedures are in place to protect people from abuse. EVIDENCE: The home’s AQAA states that complaints are dealt with quickly and investigated thoroughly according to company policy. It says the complaints procedure is available in the service user guide and all service users have a copy in their rooms. It also says that service users and their families’ feel listened to and taken seriously. The evidence gathered from talking to people and surveys completed shows a mixed reaction to how the home deals with complaints. One relative states in their survey that they don’t know how to make a complaint. This relative also said in their survey that a concern raised at a review meeting had not been addressed. A relative spoken to said they had written a letter of complaint about the staffing levels and standards of hygiene in the home, including unpleasant odours. They felt that although there was an initial improvement, things soon slipped again. They said they did not have confidence in the management to deal with their complaints properly. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 15 The log of complaints to the home was seen, this included letters in response to complainants. A service user survey says staff listen to and act on what they say, they know who to talk to when unhappy and know how to make a complaint. A service user spoken to on the day said she would probably tell her daughter if she had any complaints. Staff spoken to said they receive training in Adult Protection and were aware of their responsibilities. Records confirmed that training had been undertaken. The home has an Adult Protection policy and there is evidence to show that this is followed and the appropriate people are informed when necessary. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 16 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. 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. The home is clean and reasonably maintained, however, improvements need to be made to reduce the odours in the home. EVIDENCE: Decoration was in a variable condition, with one floor having recently been refurbished. Some communal areas and bedrooms were seen and were suitably furnished although one lounge was still being used as a storage area. A member of staff said that service users did not use this lounge. Another large lounge is provided on the ground floor, which was seen to be used by service users for activities during the day. Service users who were met in their rooms where seen to have personal belongings and said they were comfortable and mostly had what they needed. One person said she missed the table she Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 17 had over her bed in hospital. This was discussed with the acting manager who said a suitable table could be arranged. The home has a separate laundry containing washers and driers. Staff are employed to man the laundry which looked clean and well organised on the day. There is an infection control policy in the home and staff were observed wearing gloves and aprons throughout the inspection. Odours caused by incontinence were evident in hallways and in some bedrooms. Two relatives also commented on this and this has been raised at previous inspections. Continence care is incorporated into individual care plans. The acting manger said that the incontinence nurse was involved and they were continuously trying to address the problem of odours, for example, by regular washing of carpets Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 18 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. 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. Staff are trained and skilled, however moral is low and there are not always enough staff to meet the needs of people and ensure their safety. EVIDENCE: The home provides regular training in all mandatory courses such as Fire Safety, Manual Handling and Food Hygiene. There are always qualified nurses on duty. Currently just under 50 of care staff have reached National Vocational Qualification (NVQ) level 2. The home also employs chefs, laundry and domestic staff and a maintenance person. The availability of training and induction records has been raised at previous inspections. During this inspection training records were available, however, one new member of staff said she had had a one-week induction, the record of which was not available. A survey returned by a member of staff said they had a three-day induction and felt this wasn’t enough, as they had no previous care experience. Another staff survey said they had received a one-week induction but new staff now only received two days before they are counted as a staff member on the floor. They also said that the home loses a lot of staff because of this and the responsibility on them. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 19 At the last two inspections it was required that all staff are competent and skilled to meet the needs of service users, and that this includes their command of the English language. At the last inspection the manager explained that English lessons had been arranged for those staff whose English needed to improve but no staff had turned up. During this inspection the acting manager stated that the recruitment of staff was done by head office and managers of homes were not consulted on who worked there. She also said that due to difficulties in recruiting locally the company now usually recruits from overseas. During this inspection two service users were asked about communicating with staff and whether they all spoke good English, one said ‘no, some don’t but I can mostly understand them’ another said they had no problems communicating. One staff member said there were still communication problems, however none were observed on the day. The acting manager acknowledged that this is an area still in need of improvement, therefore the requirement has been repeated. Of the four staff spoken to three expressed concerns about the low staffing levels at times and felt they had been put in positions where they had put themselves and service users at risk due to this. For example, they all said they had hoisted alone, in spite of being aware this was against what was written in care plans and policies. They said the management were aware of this. When asked about this the acting manager said she was not aware that this practise was going on. The two staff surveys also expressed concerns about staffing levels saying that there are enough staff to meet individual needs ‘sometimes’. The service user survey stated that they ‘usually’ receive the care they need and staff are ‘usually’ available when you need them. One of the service users spoken to on the day said she needed two carers to support her and there are always enough and ‘they do their best’. A relative spoken to said that there are often not enough staff to meet the needs of her mother although the staff themselves are ‘good and caring’. Rotas for day shifts were sampled and showed a minimum of seven staff on duty in the morning. Staff said there are occasions when two agency staff are on the rota but only one ever turns up. Staff also said there are occasions when two staff are expected to provide care for thirty service users, some of whom need two people to assist them. They said that there is a high sickness rate amongst staff and this puts a strain on those left working. The recruitment records of two new staff were looked at. These were seen to contain all the relevant documents, including an application form, two references, a criminal record check and proof of identity. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Weaknesses in the management of the home does not ensure that it is run in the best interests of people who live there so that their health, safety and welfare is maintained at all times. EVIDENCE: An acting manager was in post on the day of the inspector’s visit to the home. Her temporary contract was expiring the following day and the current deputy was planning to be acting up into the post for one month. The managers post has been advertised and interviews planned for the following week. There has not been a registered manager in post since early 2006 and the Commission Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 21 has not been kept fully informed of the management arrangements during this period. The lack of a permanent and registered manager has impacted on the running of the home, staff moral and standard of care to service users. Staff say they are regularly short staffed and feel under pressure to rush the care they provide. They say they have been hoisting alone in spite of the training and policies provided which tell them two people are required to do this. This puts themselves and the service users at risk. The acting manager said she was not aware and made an undertaking to deal with this so that the practice did not continue. Staff say they are trying to do their best for people but it is not always possible and they do not feel supported. One staff survey said they had only had three days induction and having had no care experience they felt this was not enough. They felt that care needs are ‘sometimes’ met and commented that ‘although residents still get the care needed there is little time to stop and chat’. They also said that there were not enough staff at the moment and it can be ‘a bit of a struggle’, and ‘like a production line’. The supervision of staff has been sporadic and inconsistent at times. Records showed gaps where no supervision took place for months at a time. One staff member said they had received supervision four times in nine years, another said they had regular supervision. Another said it was ‘hit and miss’ and ‘not particularly useful’. One of the staff surveys returned said they ‘never’ meet with their manager for support and to discuss how they are working. The other staff survey said they ‘regularly’ meet and commented ‘we meet, I have lots of NVQs but can’t use a lot of it’. A requirement was made at the last inspection regarding the storing of service users’ records. This related to staff records and care plans not being stored securely and confidentially when not in use. During this inspection it was noted that care plans are now stored in the treatment room which is locked when not in use. The office is also locked when not in use therefore securing the staff records. The home carries out a satisfaction survey twice a year and consults with service users and their relatives. The results are published and changes are made in the home as a result of comments made. The home has a new computerised system for recording the finances of service users. This was briefly explained to the inspector and looked to be in order. Staff are trained in all aspects of health and safety, for example, moving and handling, infection control and first aid. However, there is evidence that it is not always followed. For example, with regard to hoisting. Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 2 X 3 1 X 2 Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 5 Requirement The service user guide must be up to date and include the fees charged. Complaints must be responded to and agreed actions carried out, according to the home’s complaints procedure. All areas of the home must be kept clean and hygienic this includes eliminating offensive odours. This is a repeated requirement from the inspection on 14/07/07 All staff must be competent and skilled to meet the needs of service users this includes their command of the English language. This is a repeated requirement from inspections on 14/07/06 and 28/12/06 Staff must be deployed in such numbers that meet the needs of service users at all times. DS0000066182.V344303.R01.S.doc Timescale for action 30/10/07 2. OP16 22 30/10/07 3. OP26 23 30/10/07 4. OP27 18 30/12/07 5. OP27 18 30/10/07 Beech Tree Care Home Version 5.2 Page 24 6. OP30 18 7. OP31 39 8. 9. OP31 OP36 8 18 Staff must receive a suitable induction programme and evidence of this must be available for inspection. Notice must be given in writing to the commission if there are any changes to the management arrangements of the home A manager must be appointed to manage the home. All staff must receive effective and regular supervision. This is an amended requirement from previous inspections on 02/05/06 and 14/07/07 The health safety and welfare of service users must be maintained at all times. This includes ensuring staff follow procedures for hoisting service users. 30/10/07 30/10/07 30/11/07 30/12/07 10. OP38 12 30/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Beech Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Tree Care Home DS0000066182.V344303.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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