Inspection on 09/05/06 for Beechcroft House

This inspection was carried out on 9th May 2006.

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

Beechcroft House 02/09/09

Beechcroft House 19/02/09

Beechcroft House 28/08/07

Beechcroft House 22/08/07

Beechcroft House 26/03/07

Beechcroft House 14/11/05

Beechcroft House 23/05/05

Beechcroft House 15/03/05

Beechcroft House 14/12/04

Beechcroft House 21/01/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Beechcroft House St Johns Road Rowley Park Stafford Staffordshire ST17 9BA Lead Inspector Sue Jordan Key Unannounced Inspection 9 May 2006 09:40 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.V291975.R01.S.doc Version 5.1 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.V291975.R01.S.doc Version 5.1 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) Beachcroft Homes Limited Mrs Rita Elaine Sandra Middleton 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.V291975.R01.S.doc Version 5.1 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 14th November 2005 Brief Description of the Service: Beechcroft House is an extended Victorian town house close to local services and shops with the railway station being one mile away, close to the town centre. Beechcroft offers 24-hour residential care, for up to 25 adults. All places are available to persons falling within the category of Old Age [OP], and six places are available for persons over 65 with physical disabilities [PD(E)]. The Home is well maintained and there is a continuous programme of redecoration. Information regarding the fees charged was requested in the pre-inspection questionnaire but not supplied. The Home is managed by Mrs Rita Middleton. On the day of the inspection there were 20 people resident in the Home. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over six hours. This was a ‘key inspection’. Most of the core standards were assessed, however the absence of the manager and proprietor meant that some information was unavailable. The methodologies used were scrutiny of the pre-inspection questionnaire completed by the manager, discussions were held with a number of the residents, a visiting relative, a chiropodist, a district nurse and some staff. Case tracking of three residents was undertaken, which included discussions and the checking of their records. Observations were made of staff and service user interaction and non-personal care tasks. The medication systems were examined and a tour of the environment undertaken. Since the last inspection on 14/11/2005, the Commission for Social Care Inspection undertook an Additional Visit on 09/03/06. What the service does well: The management and staff make the residents’ relatives welcome and there are frequent visitors to the Home. Discussions with the residents indicated that they enjoy flexible routines and are able to go to bed and rise when they choose. Health needs are well monitored and a district nurse reported that the management and staff communicate well and follow any medical subsequent guidance. The environment is well maintained and kept clean and hygienic. There is ample communal space, which allows the residents to choose in which area they spend their time. There have been no complaints made either to the home or the Commission for Social Care Inspection in the last twelve months. There is a fairly consistent staff team and adequate numbers of staff provided. Most residents spoke highly of the staff team saying that the care workers are very good and kind. One visiting relative said, “they’re a nice set of girls” and a district nurse said that the staff are very helpful. Generally observations of care and attitude towards the residents were positive. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 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. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 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.V291975.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6 Quality in this outcome area is “poor”. This judgement has been made using available evidence, including a visit to this service. Assessments of specific needs and risks must be undertaken and the information available to staff, in order that the service users are not left vulnerable. EVIDENCE: The Statement of Purpose and Service Users’ Guide are available in the lobby. However there is no evidence that they have been reviewed. The care records of the last three people admitted to the Home were checked. Of the three, only two contained assessments from the Local Authority. The management team had completed ‘in-house’ assessments for two of the service users, however a care plan was developed for only one. There is no current information for a service user receiving respite care. The only record available is an out of date local authority care plan, completed in January 2006. The manager is aware of the need to obtain an assessment for Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 9 every prospective service user and previous improvements had been made. It is disappointing that these improvements have not been sustained. Although the management team assessed the needs of one of the residents prior to admission, a subsequent care plan has not been developed and there is no mobility assessment. This particular resident has mobility problems and specific needs, which have not been assessed leaving the service user vulnerable. The staff do not have the information required to provide safe care. The manager must also ensure that they are registered with the Commission for Social Care Inspection to care for the specific needs of the residents admitted. For example, if the diagnosis states that the person has dementia. A letter has been sent to the proprietor requesting assurances that people are being admitted within the Home’s registration categories. Assessment information that is available is complicated and repetitive and does not actually contain clear, concise guidance for staff as to how they are to deliver care safely. For example, mobility assessments do not clearly explain how staff are to assist the residents and with what equipment. It is recommended that the management team review the assessment methodology used. Beechcroft does not provide intermediate care. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is “poor”. This judgement has been made using available evidence, including a visit to this service. Concerns were raised during this visit regarding the attitude of some staff and their lack of understanding of residents with more complex needs and the care records do not provide them with the necessary information. Staff administering medication must have the appropriate knowledge and competence to ensure that the Home’s procedures are safely followed. EVIDENCE: Care plans have not been developed for two recent admissions. The care plan formats used are complicated and difficult to complete and understand. Discussions with staff confirmed that they found it hard to access pertinent information in the event of an emergency. Care plan information must be further developed to ensure that staff know how to meet changing needs and address identified risks, which also includes emotional needs. Although some staff were able to verbalise their Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 11 understanding of an individual resident’s emotional needs, others were not as patient and care plan information should include clear guidance. The current care plan formats are not completed correctly. The section entitled, ‘service to be provided’ should include the care actually required to meet an individual’s needs. For example, what personal care support is actually required and how should it be delivered. The care plans are not being reviewed on a monthly basis. Discussions with staff suggested that the complicated formats do not motivate or assist them to do so. There does not appear to be specific responsibility for this and it is therefore recommended that a ‘key worker type’ system be introduced and that staff be trained as to how to complete and review care plans. Discussions with some of the residents, a district nurse and a chiropodist indicated that the staff closely monitor health needs and access medical intervention promptly and appropriately. It was noticed that footplates are not being used on any of the wheelchairs. This must be addressed and they must be used at all times, unless directed by a relevant medical professional, for example an occupational therapist. The chiropodist also mentioned this as a concern. Regular weight monitoring is being undertaken for all of the residents. The Home does not have ‘sit-on’ weighing scales and it was ascertained that less than 50 of the current residents are able to use the present ‘stand on’ scales, however those residents are taken to the general practitioner’s surgery or clinic to be weighed. Medication administration was observed. This was not carried out in a hygienic manner. Medication pots must not be placed into uniform pockets and tablets must not be handled. The senior care worker said that she was trained in a previous employment and that the manager of Beechcroft had observed her practice before allowing her to administer medication. She was not sure whether the manager had ‘signed her off’ as competent. The manager must ensure that all staff administering medication do so appropriately. It is recommended that staff’s medication competency be assessed at regular intervals and records kept. Most residents spoke highly of the staff team saying that the care workers are very good and kind. One visiting relative said, “they’re a nice set of girls” and a district nurse said that the staff are very helpful. Generally observations of care and attitude towards the residents were positive. However, some staff appear to find it more difficult to understand more complex needs. A number of staff reported that in the main, people now accessing residential care have more complex difficulties, including dementia care needs. The management Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 12 must equip its staff with the guidance required, including training and more detailed care records. One of the residents said that the staff treated them like a child and that they, “took the mickey”. When one of the staff was questioned, a feasible and sensible explanation was given, however comments later overheard from two of the staff did indicate an unsympathetic attitude to this person’s emotional state and distress. This was reported during the feedback to the senior on duty. The manager must ensure that all staff treat the residents with dignity and respect. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is “adequate”. This judgement has been made using available evidence, including a visit to this service. Visitors are made welcome and daily routines are flexible, however the Home needs to evidence that stimulus and choice is provided for the residents. EVIDENCE: The home previously employed a member of staff specifically to organise activities. Unfortunately this person has recently left and there is little evidence of stimulation for the residents. One of the staff did try to encourage the residents to do some exercises in the afternoon and the senior care worker said that it is very difficult to motivate the service users. Another staff member confirmed the lack of stimulation but said that the residents seemed to really enjoy the entertainment brought into the Home. There are three televisions, one in each lounge and one in the conservatory. These were on all day, even though some residents did not appear to be interested in the programmes. The senior reported that a priest comes to visit two of the residents, but that no other clergy attend the Home. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 14 One resident listens to ‘story tapes’ and two spoke of their love of reading. The manager was recommended to record activities offered and participated in. Visitors were seen coming and going and one relative spoke positively about the Home and the care for his Mum. Discussions with some of the residents indicated that they are free to go to bed and get up when they choose. Alternatives to the menu were seen to be available at lunchtime. One resident refused lunch and staff reported that he never ate it. When questioned by the inspector the resident said that it was because he did not want what was on offer. A sandwich was then organised by the inspector, which he said was “just right”. The senior care worker in the afternoon explained the techniques she used to encourage him to eat and she seemed shocked that other staff said that he never ate lunch. These are the very details, which should be included in the care plan so that all staff know and understand how to manage these situations. The manager must ensure that appropriate choices are offered to all residents. There are people living in the Home, with dementia care needs. However there is no evidence that staff have received training in this area. Residents were seen being offered or assisted to have regular drinks. The meals are prepared and cooked by one of the senior care workers, the manager or the proprietor. This role is specifically designated on the rota. The manager and proprietor are recommended to access the ‘In Focus’ magazine, “Highlight of the day-Improving meals for older people in care homes”, which is situated on the Commission for Social Care Inspection website. This will assist them in their menu planning. Three of the staff sat together with some of the residents to eat lunch, creating a homely atmosphere. It was noticed however that one of the staff had to go over to assist more dependent residents, meaning that she had to stand and lean over their shoulders. It is recommended that the a member of staff sit with the residents requiring assistance, ensuring that this is undertaken in a sensitive and discreet manner. The member of staff cooking the lunch was reminded that food placed into the fridge and/or on opening must be dated. A visit took place by the Environmental Health Department on 09/03/06. It was reported that all of the requirements have been addressed. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. There have been no complaints made to the Home or the Commission for Social Care Inspection regarding the service provided at the Home and staff have now undertaken Protection of Vulnerable Adults training. Protection for service users will be greater enhanced by comprehensive individual care planning and assessment. EVIDENCE: The manager reported in the Commission for Social Care Inspection questionnaire received prior to the visit, that there had been no complaints in the last 12 months. The Home has received numerous cards of thanks and praise from the families of residents previously cared for in Beechcroft. There have been no complaints made to the Commission for Social Care Inspection in the last twelve months. The staff have now completed Protection of Vulnerable Adults training, as previously required. It is recommended that the manager access training from the Adult Protection manager, Social Services, which will provide guidance as to the correct local procedures to follow. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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. Beechcroft Residential Care Home provides a homely, comfortable and clean environment for its residents. EVIDENCE: A tour of the environment was undertaken. The Home is well maintained and decorated to a high standard. There is a continuous programme of redecoration and refurbishment. A water feature has been added to the garden area. The residents tend to favour the downstairs bathroom and as a result it is showing signs of wear and tear. It is recommended that this room be given priority in the maintenance programme. The home was clean and hygienic on the day of this visit and appropriate infection control procedures are in place. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is “adequate”. This judgement has been made using available evidence, including a visit to this service. The Home has a fairly consistent staff team and low staff turnover. However the manager must ensure that all staff are trained to care for the needs of the residents with more complex needs and possess the necessary attitude. This will ensure that all of the residents are properly and safely supported. EVIDENCE: Staffing levels are appropriate and well maintained. Four care staff, one domestic and a staff member cooking work in the mornings and three care workers work the afternoon shift. The manager must ensure that the rota is maintained as a legal record. It should contain staff surnames; their designation and tippex must not be used. The Commission for Social Care Inspection questionnaire completed by the manager reported that 12 of the 19 care staff have NVQ 2 or above, which is 63 . This was not verified during this inspection and two of the senior care staff spoken to did not have an NVQ qualification. It was not possible to see the staff recruitment or training records. A requirement had previously been made that these records be kept in the Home, in order that the manager can monitor training needs. Since the Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 18 inspection the Commission for Social Care Inspection has been assured that these records are now kept in the Home, although locked away for confidentiality and security reasons. They will be checked at the next inspection. Discussions with staff did not provide evidence that the staff have received mandatory training at the required frequencies and observations of some staff indicated a need for training in dementia care needs and how to value and respect service users with more complex requirements. Some further training needs have been identified throughout this report. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36, 38 Quality in this outcome area is “poor”. This judgement has been made using available evidence, including a visit to this service. To ensure that residents’ views are pivotal to the care provided and staff have the support required to provide that care, management systems must be improved to include robust Quality Assurance and adequate staff supervision. EVIDENCE: The manager was not present during this visit as she was on holiday. Since the last inspection, she has obtained the NVQ 4 and Registered Managers Award. A previous requirement was made that the results of quality assurance questionnaires must be included in The Service Users’ Guide. The Quality Assurance folder was checked and the last collation of views was in 2004. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 20 It was not possible to see the residents’ financial records. However information is available that families support the residents with their finances and that the manager does not act as an appointee. Discussions with staff indicated that they do not have formal supervision and that there has not been a team meeting for some time. One member of staff did stress that she could approach the manager with concerns at any time. However, some of the concerns raised as a result of this visit point towards a need for more formal supervision and some of the senior staff should be taught the importance of being a professional role model. It was not possible to see the Health and Safety records, however the Commission for Social Care Inspection questionnaire completed by the manager prior to the visit indicated that maintenance and associated records are well maintained. A tour of the environment endorsed this and staff confirmed that regular fire equipment testing takes place. It is vital that this is supported by adequate mandatory training and thorough assessment of risk for individual residents. Requirements have been made under alternative National Minimum Standards. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 21 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 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 22 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 (1a) Requirement Individual assessments must be completed for all new service users, including mobility assessments and any other identified areas of risk. Care Management assessments must be obtained prior to admission. The individual assessments must be expanded to include mobility assessments for all residents and more information added to the identified areas of risk. Care planning information must be accurate and cover all the assessed needs. Care plans must be kept under review. Footplates must be used on wheelchairs at all times, unless directed by a relevant medical professional, for example an occupational therapist. The manager must ensure that the medication procedures are followed correctly. The manager must ensure that all staff treat the residents with dignity and respect. DS0000004916.V291975.R01.S.doc Timescale for action 01/06/06 2 3 OP3 OP3 14 (1a) 14 (1a) 10/05/06 01/07/06 4 5 6 OP7 OP7 OP8 15 15 (2b) 13 (5), 12(1) 01/07/06 01/06/06 10/05/06 7 8 OP9 OP10 13 (2) 12 (4a) 10/05/06 10/05/06 Beechcroft House Version 5.1 Page 23 9 10 OP14 OP30 12 (2, 3, 4a), 16 (2i) 18 11 OP33 24 (2) 12 OP36 18 (2) The manager must ensure that appropriate choices are offered to all residents. Mandatory training must be delivered to all staff at the appropriate frequencies. Previous Requirement 01/01/06 The results of quality assurance questionnaires must be included in The Service Users’ Guide. Previous Requirement 01/01/06 The manager must implement an effective staff supervision system. 10/05/06 01/06/06 01/06/06 01/06/06 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 2 3 4 5 6 7 Refer to Standard OP1 OP3 OP7 OP7 OP12 OP15 OP15 Good Practice Recommendations It is recommended that the Statement of Purpose and Service Users’ Guide be dated at the point of review. The manager is recommended to streamline assessment information, to avoid confusion and repetition. It is recommended that the management team review the care plan and assessment methodology used. It is recommended that a ‘key worker type’ system be introduced and that staff be trained as to how to complete and review care plans. The registered person, should examine further ways of evidencing that the Home provides recreation, fitness and training, which meet their diverse needs. It is recommended that the a member of staff sit with the residents requiring assistance to eat, ensuring that this is undertaken in a sensitive and discreet manner. The manager and proprietor are recommended to access the ‘In Focus’ magazine, “Highlight of the day-Improving meals for older people in care homes”, which is situated on the Commission for Social Care Inspection website. This will assist them in their menu planning. DS0000004916.V291975.R01.S.doc Version 5.1 Page 24 Beechcroft House 8 OP18 9 10 OP19 OP27 The manager is recommended to contact the Local Authority Adult Protection department and request training and guidance as to how to correctly follow the local procedures. It is recommended that the downstairs bathroom be given priority in the maintenance programme. The manager must ensure that the rota is maintained as a legal record. It should contain staff surnames; their designation and “Tippex” must not be used. Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Beechcroft House DS0000004916.V291975.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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