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Inspection on 26/06/07 for Beechcroft Nursing & Residential Home

Also see our care home review for Beechcroft Nursing & Residential Home for more information

This inspection was carried out on 26th June 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 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.

What the care home does well

Residents are assessed prior to admission to ensure that the home will be able to meet their needs. Senior staff, in consultation with residents and their representatives, complete care plans to ensure that all staff have access to detailed instructions on how to meet those needs. Residents feel cared for by the staff. Comments included "the staff are lovely / very nice". They can exercise choice and control over their lives and retain links with family, friends and the local community. Sufficient resources are provided to allow time for resident activities and stimulation. Recruitment procedures, staff training and staff supervision ensure that residents are protected from harm. The home is clean and comfortable and residents are able to choose from a varied, nutritious menu. The management of the home is based on openness and respect for residents and their friends and family.

What has improved since the last inspection?

Medication administration records are now completed accurately to demonstrate that residents have had the medication prescribed by their doctor. Complaints and action taken are now recorded more accurately to ensure that residents` concerns are addressed effectively.

What the care home could do better:

The manager needs to ensure that all residents are given a copy of the service user guide so that they have easy access to all the information they need about the home. Medicines must be stored at a lower temperature to ensure they are still in good condition when administered to residents. Customer satisfaction questionnaires should be given to residents as well as relatives to enable residents themselves to give their views of the home.

CARE HOMES FOR OLDER PEOPLE Beechcroft Nursing & Residential Home Lapwing Grove Palacefields Runcorn Cheshire WA7 2TP Lead Inspector A Gillian Matthewson Unannounced Inspection 26th June 2007 10:00a 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 Nursing & Residential Home DS0000005171.V333281.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 Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beechcroft Nursing & Residential Home Address Lapwing Grove Palacefields Runcorn Cheshire WA7 2TP 01928 718141 01928 714573 beechcroft@highfield-care.com www.schealthcare.co.uk Southern Cross Care Homes No 3 Limited 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) Ruth Welsby Care Home 67 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (67), of places Physical disability (2) Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 67 service users to include:* Up to 67 service users in the category of OP (Old age, not falling within any other category) * Up to 2 named service users in the category DE(E) (Dementia over 65 years of age) in receipt of personal care only * Up to 2 service users in the category PD (Physical disability) * Up to 26 service users may be in receipt of nursing care 3rd October 2006 Date of last inspection Brief Description of the Service: Beechcroft is a care home providing both nursing and personal care for 67 older people. The home is located in the Palacefields area of Runcorn, in a quiet cul-de-sac, close to churches, a pub and local shops. The home was opened in 1989 and consists of two single storey purpose built units. Ash House has 26 beds allocated for nursing care and Oak House has 41 beds allocated for personal care. All bedrooms apart from one are single and six have en-suite facilities. The grounds are landscaped and well appointed, with good access for persons with a disability, both within and outside the building. Fees range from £326 to £600 per week, depending on the level of care required. There are additional charges for hairdressing, toiletries, newspapers and outside social activities, for example cost of transport and theatre tickets. Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place on 26th June 2007 and took eight hours. The visit was just one part of the inspection. The home was not informed of the date the visit was to take place, but a few weeks prior to the visit the manager was asked to complete a questionnaire to provide the inspector with some information about the service. The manager was also asked to distribute questionnaires to residents, relatives and health and social care professionals to help the inspector find out what they think of the home. Responses were received from two relatives and one health care professional. All were positive about the standard of care in the home. During the visit the inspector spoke with the manager, staff, residents and visitors. She toured the premises and looked at various records held by the home. Feedback was given to the registered manager at the end of the inspection. What the service does well: Residents are assessed prior to admission to ensure that the home will be able to meet their needs. Senior staff, in consultation with residents and their representatives, complete care plans to ensure that all staff have access to detailed instructions on how to meet those needs. Residents feel cared for by the staff. Comments included “the staff are lovely / very nice”. They can exercise choice and control over their lives and retain links with family, friends and the local community. Sufficient resources are provided to allow time for resident activities and stimulation. Recruitment procedures, staff training and staff supervision ensure that residents are protected from harm. The home is clean and comfortable and residents are able to choose from a varied, nutritious menu. The management of the home is based on openness and respect for residents and their friends and family. Beechcroft Nursing & Residential Home DS0000005171.V333281.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. Beechcroft Nursing & Residential Home DS0000005171.V333281.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 Nursing & Residential Home DS0000005171.V333281.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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents have a full assessment of need prior to admission to ensure that the home has the resources to meet their needs. EVIDENCE: The home had a statement of purpose and service user guide. These contained the information required and were available in the reception area. One resident spoken with had not received a copy of the service user guide. When asked, the administrator said they were provided on request. They must be provided to every resident. Prospective residents were assessed by the home’s manager or her deputy prior to admission. Residents’ files contained documentary evidence that such assessments fully met the criteria contained within this standard. The Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 9 assessment document, in conjunction with the social worker’s assessment, were used as a basis for formulating a plan of care. However, it was noted that some assessment documents had been completed in pencil and not dated or signed. This is not good practice and does not meet the Nursing and Midwifery Council guidelines for records and record keeping. Beechcroft Nursing & Residential Home DS0000005171.V333281.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 good. This judgement has been made using available evidence including a visit to this service. Residents receive health and personal care based on their individual needs. Residents’ privacy and dignity are maintained. EVIDENCE: Individual care plans were in operation for all residents. As part of the inspection process five residents’ files were reviewed. Assessments for falls, pressure areas, dependency, nutrition, continence and moving and handling had been carried out and were being reviewed on a regular basis. Where necessary, other risk assessments were also carried out, for example in regard to smoking. Care plans were found to be detailed and comprehensive, and there was evidence of on-going evaluation and monthly review by staff. Residents and/or their relatives were consulted regarding their care plans, and documentary evidence was available to confirm this fact. It was clear that staff provided individualised care to ensure that residents’ diverse needs were met. Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 11 Residents’ files contained evidence that their healthcare needs were being clearly identified as part of the assessment process. Separate records were maintained of visits by district nurses, general practitioners and other health care professionals and care planning documentation demonstrated that individual healthcare needs were being monitored. Residents were also supported by staff to access a full range of community healthcare services, such as optician, dentist, audiologist and chiropodist, where necessary. The arrangements for ordering and disposing of medication were satisfactory. The recording of medication was good apart from one discrepancy in the controlled drugs register on Oak House. The record stated that there were 29 Fentanyl patches in the controlled drugs cupboard, when in fact there were 39. Ten had been delivered and not entered into the register. The medicine storage arrangements were satisfactory apart from the temperature of the medicine store on Oak House. Medicines should be stored at a temperature below 25 degrees Celsius. The room temperature was recorded daily and was over 30 degrees most of the time. Residents felt that staff showed respect towards them and confirmed that staff members always knock on their bedroom doors and await permission before entering. Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The range of recreational activities provides stimulation and interest for people living in the home. Links with the community are good and support and enrich residents’ social opportunities. Residents are able to exercise choice and control over what they eat. EVIDENCE: The home employs an activities coordinator for 24 hours a week. A weekly activity programme was displayed on notice boards throughout the home. Activities included quizzes, beauty sessions, film shows, arts and crafts, games, sing a longs, bingo, reminiscence and gardening. Photographs were on display of residents participating in activities in the home and on trips out, such as recent ones to Llandudno and Southport. On the day of the inspection six residents went out to the Albert Dock in Liverpool for the day. The previous week some had been to the Blue Planet aquarium in Ellesmere Port. The home was having a barbeque and summer fair at the weekend and the activity coordinator was planning a boat trip and a men only pub lunch for the Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 13 following month. Residents are able to bring pets into the home provided they do not cause any risk to residents and staff, or additional work for staff. This could be negotiated on an individual basis. It was clear from the number of visitors seen in the home throughout the day that there were no restrictions imposed on visiting. The home had links with local schools and churches. Religious ministers visited regularly. Staff would take residents to church if they wished. The home also sponsored Windmill Hill school football team and the children sometimes visited the home. A hairdresser came to the home twice a week. Residents confirmed that they were able to exercise choice in aspects of daily living such as times of rising and retiring to bed, choosing what clothes they wear, how they spend their time, food menus (and where to eat), spending time in their own rooms, joining in activities etc. They were able to personalise their own rooms with small items of furniture brought from home, pictures, ornaments and other mementoes. The home had access to a service called Care Aware for any resident who required support from an independent advocate. Breakfast was served from 8am to 10.30am and residents could have a cooked breakfast if they wished. Lunch, the main meal of the day, was served from 12.30pm to 2pm. The evening meal was served from 5pm to 6pm and supper from 9pm to 10pm. Menus submitted indicated that there was a choice of a main course or a salad for lunch, followed by a sweet. In the evening there was soup, a hot choice or sandwiches and a sweet. Residents spoken with said the food was ‘good’. They said that there was plenty of choice and if they didn’t like what was on the menu the cook would make something else. Staff were seen providing assistance to people who could not fed themselves. This was done discreetly and sensitively. Mealtimes were flexible. One resident said he preferred his main meal in the evening and staff accommodated his request. Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a robust complaints procedure and are protected from abuse. EVIDENCE: The home had a satisfactory complaints procedure, which was displayed in reception and included in the service user guide. Residents said they would know who to complain to if they had any concerns. The complaints record contained details of five complaints that had been made since the last inspection in October 2006. Two were still under investigation and three had been resolved. There were no common themes. The home had a satisfactory policy in relation to adult protection. This included definitions of abuse, signs or indicators and reporting procedures. The protection of vulnerable adults was included in the induction training. The manager and one of the nurses had attended training run by the local authority to enable them to provide more in-depth training in adult protection for the home’s staff. This was provided to staff on an annual basis. All staff had to supply references and a Criminal Records Bureau disclosure prior to employment. Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 15 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): 19,21, 22 & 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 well-maintained, enabling residents to live in a safe and comfortable environment that encourages independence. EVIDENCE: The home provided a good standard of accommodation throughout. Many of the furnishings were new, and all were domestic in character and of good quality. Gardens were attractive and accessible to wheelchair users. Oak House has 3 bathrooms, one of which has a bath hoist and two shower rooms, both of which have wheel-in showers. Ash House has 2 bathrooms, both of which have bath hoists and a shower room with a wheel-in shower. Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 16 All accommodation for residents was on ground-floor level. Where necessary, adaptations had been made to meet the needs of residents who had a physical disability. These included grab rails along corridors and in bathrooms and toilets, raised toilet seats, assisted baths/showers, wheelchairs and hoists. Specialist pressure relieving mattresses and communication aids were made available when necessary. All areas were clean and free from any offensive odours. There were sufficient laundry and sluicing facilities. The hand wash basin in Oak House medicine store could not be used because it was leaking. The inspector was informed it had been like that for some time. Staff must have access to a hand washing facility before they handle medicines. There was a shortage of storage space on Ash House. Food supplements were stored in the corridor and the medicine store was very small. The inspector discussed options for providing a larger medicine store with the manager. Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 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. 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. Staff are trained and in sufficient numbers to meet the needs of the residents. EVIDENCE: At the time of the inspection there were 40 residents in Oak House and 24 in Ash House. Staff rotas demonstrated that staffing levels were sufficient to meet the needs of residents. Staff records showed that all staff undergo rigorous checks prior to employment to ensure they are suitable for the job. The home employs seven registered nurses and 36 care assistants. Eight of the care assistants have an NVQ Level 2 or above in Care. Four more are currently training for a Level 2 and five are awaiting a start date. This means that only 22 of the care assistants are currently trained to NVQ Level 2 and a further 25 are in the process. This does not meet the standard that 50 of care assistants should be trained to this level. The manager said that the previous training provider had stopped providing this training and the current training provider could not provide any more places on the training at present. Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 18 All new staff complete an induction programme that covers the skills for care induction standards. Staff had also had training in care planning and record keeping, medication management, foot care, pressure area care, nutrition and falls awareness. Dates had been set for training in catheter care. The residents were generally content and full of praise for the staff. Staff were observed attending to residents’ needs and appeared to do their best to make residents comfortable. One relative said they were “very impressed with how caring and thoughtful the staff are.” A resident said “They are marvellous, and couldn’t do any more for me if they tried.” Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provides clear leadership and communicates effectively with residents, relatives and staff. EVIDENCE: The registered manager qualified as a first level registered nurse in 1965. Since 1982 she has held various management positions in hospitals, care homes and for NHS Direct. She has additional nursing qualifications in Teaching and Assessing in Clinical Practice (ENB 998), Health Education, Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 20 Gerontology, Developing the Scope of Professional Practice (R20), Tissue Viability (N49) and Rehabilitative Care in Specialist Clinical Settings (R33). She has also completed the Leading an Empowered Organisation Programme at the University of Leeds School of Healthcare Studies. All residents and staff spoken with said that they saw the manager around the home several times a day and that she was very approachable. The manager carries out monthly audits of the home. Areas covered include facilities, kitchen, staff training and accidents. She also carries out regular checks on medication, care plans and residents’ weights. The manager has daily meetings with senior staff and also meetings with other staff and relatives. The manager also holds a weekly surgery for residents and relatives who wish to discuss any specific issues. Customer satisfaction surveys are sent out to 10 relatives every month, but none to residents. The home handles residents’ personal allowances only. These were not audited on this occasion, but on previous inspections the arrangements have always been satisfactory. The manager carries out staff appraisals on an annual basis and staff are supervised on a day to day basis. A system was in place for formal, documented supervision, and records confirmed that they participated in this regularly. Staff received training in safe working practices on induction and annual updates were provided. There was a computer programme in place to flag up when staff were due for an update. Pre-inspection information submitted to the Commission indicated that all equipment was serviced at the required intervals. The fire log book showed that fire systems were tested regularly and fire drills were held monthly, alternating between days and nights. No unsafe practices were observed on inspection. Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X X 3 X 3 Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 5(2) Requirement The registered person must supply all residents with a copy of the service user guide to ensure that they have all the information they need about the home. The registered person must ensure that all controlled drugs received into the home are recorded in the controlled drugs register to maintain a clear audit trail. The registered person must take steps to ensure that medicines are stored below 25 degrees Celsius to maintain their shelf life. This will ensure that they are in a good condition when administered to residents. Timescale for action 26/07/07 2 OP9 13(2) 26/07/07 3 OP9 13(2) 26/08/07 Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 23 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 Refer to Standard OP3 OP26 OP33 Good Practice Recommendations All assessment documents should be written in ink and signed and dated by the person completing them. The sink in Oak House medicine store should be repaired promptly to give staff easy access to hand washing facilities before they administer medicines to residents. Customer satisfaction surveys should be sent out to residents as well as relatives. Beechcroft Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Nursing & Residential Home DS0000005171.V333281.R01.S.doc Version 5.2 Page 25 - 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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