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Inspection on 19/02/09 for Beechcroft House

Also see our care home review for Beechcroft House for more information

This inspection was carried out on 19th February 2009.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

CARE HOMES FOR OLDER PEOPLE Beechcroft House St Johns Road Rowley Park Stafford Staffordshire ST17 9BA Lead Inspector Mandy Beck Key Unannounced Inspection 09:30 19th February 2009 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 Beechcroft House DS0000004916.V374056.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. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beechcroft House Address St Johns Road Rowley Park Stafford Staffordshire ST17 9BA 01785 251973 01785 212652 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) Beechcroft Homes Limited Manager post vacant Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability over 65 years of age (6) of places Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. PD(E) - REGISTERED FOR 6, 2 OF WHOM MAY BE 50 ON ADMISSION Date of last inspection 28th August 2007 Brief Description of the Service: Beechcroft House is an extended Victorian town house close to local services and shops. It has a railway station one mile away and is close to the town centre. Beechcroft offers 24-hour personal care, for up to 25 adults. All places are available to older people, and six places are available for persons with physical disabilities. There are communal lounges and a conservatory area for people to make use of. The home has very nice gardens and there is a patio area for people to enjoy. The Home is well maintained and there is a continuous programme of redecoration. The fees the home charges people to live here are published in their service user guide. Readers of this report are asked to contact the home directly for this information. The most recent inspection report is available in the reception area. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that people who use this service experience adequate quality outcomes. We looked at all the information that we have received, or asked for, since the last key inspection. This included: • The annual quality assurance assessment (AQAA) that was sent to us by the home. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the home. • Information we have about how the home has managed any complaints. • What the home has told us about things that have happened in the home, these are called “notification” and are a legal requirement. • The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. • Relevant information from other organisations • We also spent time talking to the people who use the service and to the staff who support them. • We looked at the care of three people who use this service in depth. This is part of our case tracking process and helps us make judgements about the home’s abilities to meet people’s needs. What the service does well: What has improved since the last inspection? People told us the activity provision in the home has improved. They said “we are encouraged to take part but only if you want to”. Staff said “we are trying to do more things and make it more interesting for people”. There have been changes to the menu and there are more choices on offer for people to try, particularly at lunch time. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 6 The recruitment of staff has improved; we were able to see the home has taken steps to make sure all staff have the required security checks before they begin employment in the home. 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. Beechcroft House DS0000004916.V374056.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 Beechcroft House DS0000004916.V374056.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): 1,3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using this service have access to the information they need. Some improvement is needed to ensure that people can feel totally confident that their needs will be fully assessed and will be met once they move into the home. EVIDENCE: Since our last inspection in July 2008 the home has updated and improved their service user guide. The current range of fees people are expected to pay have now been included. The service user guide is available upon request from the home and is also available in the reception area for people to read. We looked at the care of three people as part of our case tracking process. This enables us to make decisions about the quality of care people are receiving in the home. We saw in two cases the home had obtained a needs assessment as is expected. The home also completes its own assessment of Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 9 people’s needs. We found shortfalls in this area. For example, one person’s needs assessment from the placing authority had identified a risk of falls and poor mobility. The assessment completed by the home failed to identify this despite the risk of falls being the primary need for admission at the time. The home must make sure that it documents each person’s needs in full so that potential risks in providing their care are recorded and understood by staff. The home does not provide intermediate care facilities. Beechcroft House DS0000004916.V374056.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): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home do have most of their healthcare needs met but improvements are needed to record keeping so that each person’s needs are individually recorded. EVIDENCE: Most of the people living at the home for long term care had their own individual care plan. But this was not the case for two people who had been admitted for short term care. We looked at the care records for three people, two of whom had been admitted for a short stay. We could not find any care plans for them. We asked the manager to find them for us; she said, “It doesn’t look like they have been done”. We were worried about this because we had seen in one person’s assessment they were at risk of falling and had had three recorded slips from bed since their admission. The home does have a bed rail risk assessment in place but the manager told us it is not used because the home does not have a policy for using bed rails. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 11 We told the manager that were we worried about this and about the safety for this person, the manager made arrangements to have their needs reassessed. Another person was assessed as being partially sighted but there was no care plan in place to guide staff about meeting this person’s needs. Other omissions in care plans included failing to record people’s dietary needs, moving and handling needs and weights of people on admission. If care plans are incomplete and do not hold information on people’s wishes staff are going to find it difficult to provide person centred care. We did note there has been some attempt to make some of the care plans person centred in their approach. We saw the home had taken time to sit with one person and record their preferences for getting up and going to bed, when they wanted to have a bath and how many sugars they would like in their tea. The home had also made sure the person had signed their care plans once they had been written. This can be viewed as a sign of the person’s agreement with the care planned for them. We also spoke to staff, we asked them how they knew what care to give the people they look after, they said “we ask them and they tell us”, “we get very good handovers now and we are told what people want and need”. We asked them about the care of the three people we case tracked and despite the lack of written information available to them they were all able to give a clear explanation of each person’s needs. There was evidence to show us that other healthcare professionals such as their own doctor, community nurses, and dieticians see people as needed. People also benefit from the services of the dentist, chiropody and optician. Medication systems are generally good. There are good storage facilities for people’s medication. The home has satisfactory systems in place for the ordering, administration and returning of medication. Records seen show us the home is recording the fridge temperature on a daily basis. We have recommended the home begin to record the actual temperature of the fridge as well as the range of temperatures. This will ensure that all medication requiring cold storage is kept as per manufacturer’s guidance. We have also recommended that two staff sign handwritten entries on the Medication Administration Records (MAR), this will reduce the risk of errors in transcribing occurring. The home is still not assessing staff competency in administration of medication. This is a requirement that has not been met during the last two inspections. The manager has told us that she plans to begin doing competency assessments as part of staff supervision in the near future. We observed throughout the inspection that people were spoken to politely and staff took time to knock people’s doors before entering. People living at the home said that they felt they were treated with respect and dignity at all Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 12 times. We did note that some people were given drinks out of plastic cups and beakers. We have recommended the home reviews this and offers people drinks in cups, glasses or mugs unless they choose otherwise. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers an activity programme for people to take part in. Meals are provided on a regular basis and people are generally happy with them. EVIDENCE: People do have the opportunity to take part in activities. The weekly activities offered are displayed on the notice board in the entrance hall. There are visiting entertainers and staff are trying hard to do more activity during the week. The manager told us “we have moved some people’s bath time so that it gives us more time in the week to get activities done”. People said, “They try hard and if we don’t want to join in we don’t have to”. One member of staff in particular is responsible for organising and recording activity provision. They have recently completed their National Vocational Qualification (NVQ) in activity provision. This has made planning activity easier although there is times because of staffing levels activities do not take place. The home has an open visiting policy and people are encouraged to visit their friends and relatives when they want to. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 14 People continue to be encouraged to make the home their own. They are supported by the home to bring in items of furniture and personal possessions that make the home feel more homely to them. We recommended during the last inspection the staff have some training around the Mental Capacity Act 2005. This will give staff an understanding of their role and responsibility in supporting people who may not be able to make decisions about their lives because of a lack of mental capacity. This training has not been done but the manager told us the owners are planning it. Meals have improved since our last inspection. There is a better choice at lunchtime with people now being offered two choices. On the day of this inspection the choices available to people were chilli Mexican beef or casserole. There is also more choice at tea time with a variety of sandwiches, soup and snacks available. People said, “The food is ok nothing to complain about there”. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 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 satisfactory complaints policy in place to help them deal with any complaints raised by people. People are protected from abuse and harm but staff knowledge is inconsistent in this important area. EVIDENCE: The home has not received any complaints since the last inspection. We have not been notified of any concerns about the home since the our inspection. The complaints procedure is on display in the entrance hall for people to read. There are also a lot of thank you cards and compliment letters from people pinned to the board where people have extended their thanks to the home for looking after their relatives during their time with them. We spoke to staff about their knowledge of safeguarding vulnerable adults. The answers were more positive than the previous inspection. Despite the fact staff told us they had not had any training in this area, they were able to demonstrate an understanding of abuse and whom they would report to if an allegation were made to them. They were however, unsure of what happened to their concerns once they had reported them to the manager. This was discussed with the manager and she will address this with the staff. We have seen the home has taken steps to protect one person living in the home by working with the safeguarding team to keep them safe from harm. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 16 There are currently no forms of restraint in use in the home. The home must however be responsive to people’s needs. If people’s needs are such that they require the use of bed rails, the home must speak with the district nursing service and complete their own risk assessment before they use them. The home has satisfactory recruitment processes in place and does make sure that it makes the required checks on people before they begin working in the home. This includes a check against the Protection of Vulnerable Adults list (PoVA) and a Criminal Record Bureau (CRB) disclosure. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and has a welcoming atmosphere. It is generally well maintained for people’s comfort. EVIDENCE: The home was seen in full during the July 2008 inspection. There have been little changes to the home since that time. It continues to be a homely and welcoming place for people to live. People living here said, “it is a lovely place, the views are very nice too”. People are encouraged to bring in with them items of furniture and other personal possessions to make their rooms feel like home to them. The home is generally well maintained. The home was updating their fire safety systems during the last inspection. Staff have received fire training and knew what to do in the event of a fire. The home still needs to complete their Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 18 individual fire evacuation plans for each person. The owner told us during this inspection that the home does not keep records of hot water temperatures because each of the taps has been fitted with a thermostatic regulator valve that controls the temperature. The temperature has been set at 43oC to reduce the risk of scalding to people. We have recommended that the home keep a record of the hot water temperatures on a monthly basis; this will help the home monitor safe water temperatures and the efficacy of the thermostatic regulator valves. There should also be maintenance records for the thermostatic regulator valves in the home. Infection control procedures have been updated throughout the home. There are paper towels and liquid soap available for staff use in all bathrooms and toilets. This will help reduce the risk of cross infection to people. The laundry is equipped to deal with people’s washing. The manager told us that recent problems with the washing machine have now been addressed and the laundry is running smoothly once again. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are staff available to meet people’s needs. Staff are recruited and trained to a satisfactory level. EVIDENCE: The staffing levels are such that people’s needs are being met. We have recommended in past inspections that staffing levels be reviewed so that people could benefit from activities. Whilst staffing levels have remained unchanged the staff have rearranged the way they work to allow them more time to provide activities for people. Staff appeared to be more settled during this inspection and said they felt supported by the manager. Staff continue to be encouraged to undertake their NVQ training and at present the home has 71 of care staff qualified to NVQ level 2 standard. The manager also told us she has recently completed her NVQ level 3 in health and social care. We looked at the recruitment practices for the home. We did this to make sure unsuitable people are prevented from working with vulnerable adults. The staff files we looked at contained all of the required information such as two written references, Protection of Vulnerable Adult ( PoVA) first checks and CRB’s. We have recommended that those staff that are allowed to work in the Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 20 home with only a PoVA first check in place have a written risk assessment completed by the home. The home should also identify one senior person on the staff rota to support and supervise the new worker. This will show how the home intends to protect the people living there until the return of a satisfactory CRB disclosure. There continues to be good systems in place to support people through the induction process. Records were seen and staff confirmed the service had supported them when they started employment. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not have a registered manager. Management of the home continues to be disjointed. There are systems in place to protect the health and safety of people living in the home. EVIDENCE: The home still does not have a registered manager. The home has been asked to address this situation on each of the last two inspections. When we visited the home on this day we found that there is still no registered manager. This is an outstanding requirement that must be met. Both the manager and the owners of the home are in breach of the Care Standards Act 2000, we will be taking further enforcement action with the home to bring about improvements. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 22 The current manager does not have the qualifications needed to be registered with us. The home must address this if the service is to go forward. We have seen throughout this inspection that some improvements have been made in activities, meals and the environment but there are still areas that need attention. There are requirements that have not been met and we will be considering further enforcement action with the home to bring about improvements. There are still improvements needed with care planning, assessment of people’s needs and promotion of their health and safety. The quality assurance systems in place remain unchanged since our last visit. The manager told us that new satisfaction surveys are due to be sent out to people in the coming weeks. The annual quality assurance assessment (AQAA) gives us little information about the home and the service it provides. Following our last inspection the home has provided us with an improvement plan. The plan has given us some information about how the service will move forward but does not cover all of the improvements we needed. We will be asking the home for an updated improvement plan after this inspection. There has been no change in the systems for safe storage of people’s money. As in previous inspections there are not many people who manage their own money most prefer the home to look after their “pocket money” for them. We looked at records for people’s money and found that the home does have good records for all transactions and monies did balance. The home does make attempts to promote the health and safety of the people living there. Staff receive training on an annual basis. The manager told us that training has recently taken place but there were no certificates of attendance held in the home. We asked that the home forward a copy of the training schedule to us following this inspection. This was done and we were able to see that training is planned for all staff in relation to health and safety. Staff do have training in fire safety but they were not sure when their last fire drill was. The manager told us that a weekly fire drill is conducted. There have been no fire drills for night staff. This should be done so that the home can be sure all staff are sure about actions to take in the event of fire breaking out. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 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 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 2 X X 2 Beechcroft House DS0000004916.V374056.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 OP3 Regulation 14 Requirement The home must make sure that the assessments they complete contain all the information about people’s needs. This will help the home plan effective care for people. People must have care plans in place at the point of admission to the home. This must also include those people who are admitted for short stay respite periods. (Previous timescale of 30/10/08 not met) People’s care plan must include clear guidelines for staff so that people’s needs are known, understood and carried out by staff. People’s plans must be kept under regular review. (Previous timescale of 30/10/08 not met) People’s weight must be kept under regular review with clear records kept. Care plans should clearly indicate the frequency with which this should happen. For example; monthly or weekly (Previous timescale of DS0000004916.V374056.R01.S.doc Timescale for action 02/04/09 2 OP7 15 02/04/09 3 OP7 15 02/04/09 4. OP8 15 02/04/09 Beechcroft House Version 5.2 Page 25 5 OP31 9 CareStand ardsAct (CSA) 2000 11(1). 30/10/08 not met) The registered person must submit an application to register the acting manager to the Commission for Social Care Inspection. (Previous timescale of 01/10/07 and 17/07/08 not met) 30/04/09 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 OP7 Good Practice Recommendations The home needs to develop a person centred approach to care planning so that people’s individual needs and wishes a recorded in relation to their care. Two staff should sign all handwritten entries on to the MAR sheet. This should reduce the risk of errors being made. The home should make sure that people who administer medication are competent to do so and keep records of this. The home needs to consider how it is going to offer more activity to people living in the home. This should also include trips outside of the home. The home should consider training for staff that underlines the principles of the Mental Capacity Act 2005. This should give staff guidance on their role and responsibility in supporting people who may not be able to make choices about their care because of a lack of mental capacity. All staff should have training in Safeguarding Vulnerable Adults. This is so that they will be aware of the signs of abuse and who to report to if an allegation is made to them. The home should record the hot water temperatures on a monthly basis to make sure the thermostatic regulator valves are in working order. There should also be DS0000004916.V374056.R01.S.doc Version 5.2 Page 26 2 3 4 OP9 OP9 OP12 5 OP14 6 OP18 7 OP25 Beechcroft House 8 OP33 9 10 OP35 OP38 maintenance records of this. The management team need to continue to develop the quality assurance systems. The analysis of the completed residents surveys should be completed and made available for people to read. The home should consider ways in which to support people to manage their own money. The home should make sure that all staff (inclusive of night staff) attends fire drills. This will ensure they know what to do in the event of fire breaking out. Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Beechcroft House DS0000004916.V374056.R01.S.doc Version 5.2 Page 28 - 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. 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