Inspection on 11/01/07 for Beech Tree Hall

This inspection was carried out on 11th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beech Tree Hall 17/02/06

Beech Tree Hall 09/09/05

Beech Tree Hall 15/12/04

Beech Tree Hall 16/06/04

Beech Tree Hall 03/02/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Beech Tree Hall Marsh Lane Arksey Doncaster DN5 OSQ Lead Inspector Janet McBride Key Unannounced Inspection 11th January 2007 10:00 Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 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 Hall DS0000008012.V318427.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech Tree Hall Address Marsh Lane Arksey Doncaster DN5 OSQ 01302 875001 01302 822959 beechtreehall@btconnect.com 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) Mr Donald Smith Michael Robert Wilson Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The accommodation to include four separate units for four service users in each unit. Up to 8 beds can be used for young people aged 16 and 17 Date of last inspection 17th February 2006 Brief Description of the Service: Beech Tree Hall has been registered since it opened in May 2001;it is located in the village of Arksey on the outskirts of Doncaster. The home provides up to 16 places for young adults with Autistic Spectrum Disorders, and caters specifically for adults affected by Asperser’s Syndrome. One-to- one staffing is usually essential to allow each individual service users plan to be followed to the full. Accommodation is provided in one of four units, at the home, which are Oak House, Holly House, Birch House, and Elm House. The first three are located on the ground floor, each with its own front door and access to the gardens at the rear of the home. Elm House is located on the first floor. Fees range from £1248:97- £2070:57 as of November 2006. Additional charges are made for some toiletries, hairdressing, newspapers and magazines. Personal items and some activities. Information about the service is available to service users and their families via the home’s Statement of Purpose and the Service User Guide. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this Key Unannounced Inspection, which took place on the 11th January 2007 for 6: 45 hours. The home is registered for 16 beds; at the time of inspection 16 service users were residing in the home. Pre-inspection work was carried out for example, analysis of notifications, complaints and other relevant documentation. During the inspection documentation and records were examined for example, medication, complaints, accident records, staff rotas, staff training files and case tracking of two service users care plans, these were cross-referenced with other relevant documentation relating to those service users. Information was gathered from as many different individuals as possible, for example, discussion with two of the service users and individual interviews with members of staff, including the manager. Eight comment cards were sent out to residents prior the inspection, 5 were received back these were completed by the service users parents. Four comment cards were sent out to professionals who have contact with the home, only one was received back, all comments were very positive about the home and the staff and the care received by service users. A tour of the premises and direct observation of staff interaction with service users was carried out throughout the inspection. The inspector would like to thank all the staff and service users for their cooperation in the inspection process, and any issues or concerns that were raised were discussed with the manager at the end of the Inspection. What the service does well: The manager and his staff work hard to ensure that service users are provided with a fulfilling lifestyle at the home, they are provided with a range of social, educational and recreational opportunities in keeping with their ages. Links are maintained with family and friends with the support of staff, most service users had regular home visits; especially holiday times throughout the year. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2&4 Quality in this outcome area is Good. This judgement has been made using available evidence in records, interviewing staff on the day and a visit to this service. Prospective service users had sufficient information about the services; all were individually assessed prior to admission to the service, to ensure that their needs will be met. Potential service users are encouraged to visit the home prior to admission. EVIDENCE: Care plans showed that service users were assessed prior to admission; the homes manager and programme coordinator carried out a pre-placement visit to potential service users. A pre-placement visit involves direct observation of the potential service user, meetings with their current carers, educationalists and family as part of the assessment process. Evidence in care plans showed that the home ensured that any potential service users visit the home and spend time there, and encouraged their families to visit the home and ask questions. Care plans showed the history of the service user and assessments that had been completed by other professionals involved in their care. Detailed plan of care that reflected any specialist interventions; and risk assessments that had been completed. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is Good. This judgement has been made by a visit to the service, using the available evidence in records and talking to staff and service users. The home ensured that service users were assessed, assisted and supported to live an independent life as possible within the home, and make decisions about all their daily living needs. EVIDENCE: Two service users care plans were case tracked and discussed with the key workers. Records showed that service users care plans were devised from the pre assessment; and reflected the needs of care for health, personal and social support that they need for their daily life. All care plans addressed any impairments brought about by their autistic condition, e.g. the absence or impairment of social interaction, or impairment of communication, and provided strategies aimed at reducing them. Thereby enabling each service Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 10 user to have the opportunity to learn and use practical life skills and increase their confidence. Service users were supported in taking risks as part of their daily living to enable them to be as independent as possible. Limits were only imposed where risks were identified, e.g. having no awareness of the dangers that sharp objects bring, unawareness of hot and cold-water differences. Records showed that plans were in place to monitor behaviour when service users were aggressive and caused harm or self-harm, triggers and strategies were in place, these records showed they are monitored, reviewed and any changing needs re-assessed. Records of incidents showed that staff responded promptly to these, but not all records were as detailed as others. Staff must ensure that the Commission for Social Care Inspection is informed of these incidents. Each service user was assessed on their ability to make decisions about all their daily living needs. Were involved with their key worker and had plans in place to do daily tasks on what ever level they were able to participate in. Evidence was seen that the home uses appropriate formats to give information to the service users. Appropriate psychiatric input and continued support, was evident as the home had the services of a psychiatrist specialising in Autistic Spectrum Disorders. Therefore service users were reviewed on a regular basis; staff had support for to refer to when needed. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is Good. This judgement has been made using the available evidence, interviewing staff and service users, including observation on the day. Service users rights, privacy and dignity were respected; the home provided and promoted communal living and leisure activities for service users. Service users did spend time outside of the home giving them opportunities to mix with other people. Service users were offered a healthy diet weighed on a regular basis, and had access to a dietician when required. EVIDENCE: Records showed that service users had the opportunity to either maintain or develop practical life skills. All service users had access to a day centre owned and operated by the owner of the home, time spent there is based on the individual’s ability to participate and mix, for example records showed that Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 12 some activities are enjoyed as a group and other activities were carried out with each individual as part of their service user plan. Daily routines within the home were flexible and individual, for each service user. Staff were asked about daily routines within the home; from their responses it was evident that staff respect service users rights and trying to promote independence, choice and freedom whenever possible. Service user plans reflected the immediate work required but longer-term goals of employment/educational opportunities were not specified. Some service users had the opportunity to mix independently within the local community and attend college others did voluntary work. Records showed that as service users progress, reassessments had taken place to help the individual develop further. Service users nutritional needs were assessed, some service users had the input of a dietician and all were weighed on a weekly basis. Staff promoted a healthy and nutritious diet, menus seen showed that service users follow a healthy eating plan, service users did have take away meals and meals out at least once a week. Service users who were capable helped prepare food and make their own packed lunches. Staff support service users to maintained links with family and friends, for example staff stated they assist service users to keep in contact either by letter or by telephone. Most service users have regular home visits; especially holiday times. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is Good. This judgement has been made using the available evidence in various documents and records including a visit to the service. The promotion of personal and healthcare support to service users was good, medicines were managed and administered by the staff. Health care needs were met through appropriate access to health care, and specialist care services and personal support that meets individual service users needs. EVIDENCE: Personal support for service users was discussed with key workers and records checked during case tracking. Staff stated wherever possible they promote privacy and dignity along with independence when carrying out personal tasks, and ensure choice was given at all times. Where choice is ignored or rejected by the service user, staff had guidance in achieving the desired goal in a nonconfrontational manner that did not provoke anxiety for service users. Staff gave an example of a service user not wanting a bath, they would step back and try later or usedivert practice. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 14 Records showed that service users had appropriate access to health care services e.g., epilepsy services, dentist, chiropody and optical services. The home continues to have the input of a psychiatrist specialising in Autistic Spectrum Disorders, who visits the home, monitors medication and reviews mental health problems for all service users. There were policies and procedures in place for the safe handling of medication, records checked, were satisfactory. Care plans recorded what prescribed medication each service users took and its possible side effect. Details of what condition the medication treated was also recorded. Staff who administer medication had completed accredited medication training and were familiar with each individuals preferred way of taking medication, none of the service users administered their own medication . When service users go on home leave they take the original pack, and staff recorded what medication is taken home with them. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is Good. This judgement has been made using the available evidence in records, interviewing staff, service users and visitors on the day. Service users and relatives are provided with information to enable them to raise concerns or complaints about the home and their care; staff had knowledge and understanding of adult protection issues, which promoted protection of service users from abuse. EVIDENCE: The pre inspection questionnaire stated that the home had not received any complaints since the last inspection, records checked confirmed this. Staff stated that if service users or parents raised any minor issues or concerns these would be documented in service users files, and dealt with appropriately and immediately. All parents who completed a comment cards for this inspection were aware of the complaints procedure, and commented that they were aware who to speak to if not happy. They stated that staff were always available when they needed them to speak to. The home ensured that service users were safeguarded from any abuse, they had policies and procedures in place for staff to follow, training records showed that staff complete abuse training courses. Staff spoken to were found to have knowledge and understanding of Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 16 adult protections issues, and were aware of the whistle blowing policy, and who to refer this to. All staff had CRB and POVA checks completed. Records showed that any incidents or allegations are recorded, physical and verbal aggression by service users was dealt with appropriately with guidance in care plans. No adult protection issues had been raised since the last inspection. Policies and practices were in place to protect service users finances, all service users have personal accounts with records kept of any withdrawals, receipts and balance left. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 30 Quality in this outcome area is Adequate. This judgement has been made by a visit to the service and tour of the premises, and evidence in records. Service users live in a homely, comfortable and safe environment, but it would benefit from some general repairs, and redecorating. This would more homely for service users. A refurbishment plan for the home is not in place. EVIDENCE: A tour of the home found it to be a clean, tidy and a comfortable environment for service users. Each unit had a range of safe and accessible accommodation. Service users cannot wander freely from one unit to the other as this invades the space and privacy of others. Shared space includes outside areas, and service users had unrestricted access to this area. Because of the client group the furniture and fittings require ongoing refurbishment, but the home did not have a refurbishment plan. The maintenance man carries out general maintenance of the home, staff document in maintenance book any repairs, problems or concerns that are Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 18 raised. Evidence was seen that these repairs are not being completed on a regular basis. A number of issues were found during a tour of the environment, these had been reported, for example the lock on a kitchen cupboard door does not work and was reported as needing a new lock. A hand basin is cracked in one of the kitchens, carpet gripper is required in one of the corridors, a new lock is required on the kitchen door. All had been reported but none of these repairs had been completed. The kitchen on oak unit was identified as very worn and required refurbishing on the last inspection, this has only been made tidy, it still looks very worn. All service users within the home had single bedrooms; one bedroom was checked on each unit, those seen met the individual service users needs. Toilet and bathroom facilities within the home were satisfactory, staff said they were having a shower fitted in Elm unit as its been identified as more appropriate for the service users on that unit. Laundry facilities are on site in a central laundry and staff on each unit is responsible for service users laundry. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Quality in this outcome area is Good. This judgement has been made using the available evidence in records, interviewing staff and a visit to the service. Appropriate staffing and skill mix, to meet service users care needs was in place and on going development of staff to ensure they have the skills and knowledge to carry out their role. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 20 EVIDENCE: Staffing and management structure was discussed with the manager, who said that staff hours are determined according to the assessed needs of service user, e.g. 50 of service users require 1:1 staffing ratios, at times some service users require 2:1 staffing dependent on that individual. Evidence was seen that extra staff are used when needed, e.g. changes in service users care which requires more monitoring, or when certain activities are being organised. The home had a stable staff group, and comments from parents confirmed that the home had very little turn over in staff. Staff members who were interviewed were aware of their roles and responsibilities within the home; staff could give a clear account of the care given to service users. They worked positively with service users to improve their quality of life, and felt they worked effectively as a team within the home. Recruitment within the home was checked, three staff files were examined all the recruitment policy and procedures had been followed. Files contained proof of the person’s identity, including a recent photograph. Equal opportunities had been applied to the recruitment procedure. Staff training and development was evidenced by checking training records, which showed all staff, are either on a skills for care course or NVQ course. Nine staff had completed NVQ level 2 and six staff were in the process of completing this training, this will assist staff to care in a more professional manner. Staff interviewed on the day confirmed they are encouraged to develop their skills, said they received supervision on a regular basis, care issues, training and development are discussed within supervision sessions, also in team meetings which are held monthly with written minutes taken. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 & 42 Quality in this outcome area is Good. This judgement has been made using the available evidence in records, talking to staff and a visit to the service. Overall management of the home was good, service users lived in a home that was managed to ensure their health, safety and welfare were promoted and protected. Records required by regulation for their protection were maintained. Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager has the relevant experience to run the home; he has completed the Registered Managers Award. The manager said he encourages staff to put ideas forward and hopes he creates an open and transparent atmosphere within the home. Those staff spoken feel the manager is very supportive and encourages them to complete training for their development. The home did have some auditing systems in place, evidence available confirms the homes programme co-ordinator audits care plans and medication records. No evidence was available to show that the home seeks the views of family, friends and stakeholders in the community. The manager and staff said any issues or concerns are usually highlighted in reviews. Staff said they do speak to parents when they visit, comments from parents said that staff were always available to speak to when required. Health and safety arrangements were in place, the manager and staff, were aware of the policy and procedures within the home. They ensured that service users health, safety and welfare are protected, with records kept. The home employs the services of Lloyd’s employment Law and Health and Safety, who visit the home, carry out audits and make recommendations if required. Service users records included up to date risk assessments related to their personal health, safety and welfare these were secure in locked cabinets. The Commission receives Regulation 26 visits and Regulation 37 incident forms on a regular basis, but records showed that some incidents involving aggressive outbursts from service users had not completed as required by regulation 37. Beech Tree Hall DS0000008012.V318427.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 2 3 X Beech Tree Hall DS0000008012.V318427.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 YA24 Regulation 23(2)(b) Requirement Premises. 1) General maintenance of the home must be carried out on a regular basis to ensure that repairs that are reported are completed. 2) A refurbishment and renewal plan must be established for the home. The kitchen on Oak must be refurbished. (Timescale of 30/04/06 not met). Continue with on going NVQ training to ensure a minimum ratio of 50 of care staff are trained to NVQ Level 2 or equivalent must be achieved. Notification must be sent to the Commission without delay. Timescale for action 01/02/07 2 YA24 23(2)(c) 31/03/07 3 YA32 18 01/04/07 4 YA41 17(2) Schedule4 11/01/07 Beech Tree Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 25 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 Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Hall DS0000008012.V318427.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!