Inspection on 10/01/06 for Beeches House

This inspection was carried out on 10th January 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

Beeches House 16/02/07

Beeches House 29/09/05

Beeches House 14/03/05

Beeches House 21/10/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOMES FOR OLDER PEOPLE Beeches House 53 Park Hill Carshalton Surrey SM5 3SE Lead Inspector David Pennells Unannounced Inspection 10th January 2006 14:20 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 Beeches House DS0000007171.V270837.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. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beeches House Address 53 Park Hill Carshalton Surrey SM5 3SE 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) 020 8401 0071 020 8395 5668 brookcarehomes@blueyonder.co.uk Brook Care Homes Mrs Bridget Teresa Brook Care Home 13 Category(ies) of Learning disability over 65 years of age (13) registration, with number of places Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 5 service users under the age of 65. Date of last inspection 29th September 2005 Brief Description of the Service: Beeches House is a large family-style house set on a busy road centrally located to the community of Carshalton Beeches - thus being close to bus and train connections and local amenities such as newsagents, shops and restaurants, etc. This service has been provided here at Beeches House - for the current user group - since the end of July 2004 - when almost the whole community moved en masse to this new location from another residence, Woodcote House (located at the bottom of Sandy Lane South). The locational ‘swap’ (some service users from Beeches have now moved to Woodcote House) was arranged to enable this present client group to benefit from the better facilities close by, and the more central location of the house. Certainly service users indicate they are very happy with both the location of the house, and the facilities they now enjoy. The house provides services predominantly for older service users, the majority having learning difficulties - though five of the current service user group are under the 65 threshold. The house has five single bedrooms and four double-occupancy rooms. The house has a large lounge and dining room, and the garden area at the side is much enjoyed. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived on this unannounced visit in the early afternoon when only a few service users were present at the home - the majority, with staff member support, being out at local day care activities. Some service users were having their hair set by an outside practitioner - this cheering them up, on a drab winter’s afternoon. The inspector was able to talk to this small group of service users - and also to the staff members on duty - prior to the return of most of the remaining service users, who then settled down for supper and a warm and cosy ‘evening in’. During the visit the inspector was able to assess progress, where applicable, of the home in meeting the requirements and recommendations set at the last inspection visit. Documentation was examined and discussions with staff enabled the inspector to comprehend the current situation regarding care plans and other issues that were raised through this auditing process. The inspector is grateful to staff and service users for their cooperation, welcome and for the hospitality shown during his visit. The inspector left the home at suppertime, the service users all having had the chance to speak to the inspector and impress him with their statements of contentment with the service provided and their lifestyles at the home. What the service does well: What has improved since the last inspection? Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 6 In the three months since the last inspection visit, not a lot has been noted to change; service users continue to enjoy their active outward focused lifestyles and those who are older and more inward-focused also appeared content and satisfied with their lot. A club in Wallington - relatively new to the house’s population - was clearly being enjoyed and it was gratifying to see the home finding new opportunities for service users. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 8 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 Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 9 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): 3. Prospective service users can be confident that the information that is necessary for making an informed choice as to whether Beeches House could meet their needs will be provided with full detail included. Service users at the home will be clear about terms and conditions set by the home through the provision of a written document served on each individual. Service users can be assured that their needs and aspirations will be fully assessed and recorded both prior to a placement and on an ongoing basis once they are resident at the home. EVIDENCE: Standards 1, 2, 3 & 6 were assessed at the last inspection visit and none except the requirement against standard 3 (which remains outstanding) - were further pursued at this inspection. The above judgement statements cover / restate the findings of the last inspection visit. Beeches House DS0000007171.V270837.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): 9 & 10. Service users can expect that their care will be arranged through care planning and the regular monitoring of goals and achievements. Service users can be assured that their health care, in all dimensions, will be attended to - through appropriate contact with health care professionals as appropriate. Service users can be assured that the management of medication in regard to their individual needs will be managed and administered within a clear policy and procedure framework, though lines of responsibility could be blurred and service users placed at risk if the home takes decisions that are beyond their powers. Service users confirmed through their experience that they are treated with respect and their right to privacy is upheld - resulting in a culture of mutual respect, positive self-esteem and tolerance. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 11 EVIDENCE: Two standards were inspected at this visit - the first - medication procedures, as a matter of course, were examined - and a concern was raised regarding records of a service user not receiving a prescribed increased dose of medication on, apparently, the proprietor’s instructions. Although the (unofficially) revised lower medication dose was ‘regularised’ by telephone call twelve days later, the home must be cautioned against making unilateral decisions around medication rather than seeking and obtaining clear authorisation at the outset of a prescription. This particular service user described above was prescribed a changed medication dose due to concerns regarding behaviour problems that affected both themselves and the remaining service users (some have been recently physically assaulted) - and the home, sadly, continues to experience these issues. Service users expressed sympathy - but also clearly some anxiety around this continuing sporadic problem arising, and a few stated they felt some action should be taken to more properly address the issue. The recommendation that, wherever possible, medication stocks be obtained in a sealed 28-day ‘blister packs’ style of dispensing format - rather than the less secure Venalink system in place - has not been heeded and this, for best practice reasons - and in the staff members’ best interests - is reiterated. Standard 10 concerning privacy and a service users’ right to respect was explored with both service users and staff and the standard was found ‘met’. Service users all have their own clothes and their own personalities are certainly expressed through this aspect - and through their own personalities shining through. Beeches House accommodates twelve very different people! Privacy is promoted through seven service users having their own single rooms, and one service user now singly occupies a double-occupancy space. Screening is provided for those four who continue to share rooms; sadly there is no visitor’s room as such - the proprietors hope in the future to add on a conservatory area where such privacy could be afforded. Personal care and any medical examinations are carried out in the privacy of their bedrooms and private space is respected. The public telephone at present is only operational in the back corridor of the home (near the kitchen and toilet areas), and it is recommended that the hallway extension be reinstated - though this does also have a drawback, in that it is located in the only designated smoking areas of the house. There would at least be an alternative location to take calls if this was revived. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 15. Service users can expect to lead a fulfilling life based on individual assessment and the service user’s expressed preferences and dislikes. Contact with families and friends and the local community is positively encouraged, and service users can be assured that such links will be upheld through the home’s practices, support and encouragement. Service users are encouraged to sustain their own interests and preferences, through being enabled (with an advocate’s help) to make decisions as much as possible for themselves. Service users are provided with a pleasant & nutritious diet, with the emphasis on personal preferences - and mealtimes being a pleasurable experience. EVIDENCE: Standard 14 was examined, as it was not covered in the last report. The inspector found that all service users - within the context of their individual situations - exercise choice and autonomy: through deciding what activities to take part in - both inside and away from the home; by choosing their preferred food; by managing their monies as well as they are able; and by impressing their own personalities on the home; and through having and keeping their own possessions, and/or having relatives / advocates / friends visit them. The outstanding requirement from standard 15 in the last report - concerning storage boxes in the kitchen - was examined and this time found ‘met’. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 13 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): None inspected on this occasion. Service users and their advocates can be assured that complaints will be processed and dealt with swiftly and effectively; though it is clear that publicity about the procedure should be made more clearly to advocates outside the home. Service users can be assured that they will be protected from abuse of any kind through the policies, procedures and practices of the home. EVIDENCE: Both key standards were reviewed at the last inspection visit and found ‘met’. There was nothing noted on this occasion to suggest that the situation had changed and therefore the above judgements statements - from the last report - are reiterated for the reader’s information. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 14 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): 22 & 26. Service users can be assured that they will live in a well-maintained and safe environment, which is clean and hygienic and odour-free. Service users can have access to a variety of well-furnished comfortable facilities in the house suited to their assessed needs. The house has adequate toilet and bathroom facilities to ensure ease of use; the house is suitably assessed with regard to specialist service needs, in line with current professional advice, with action taken in response to its recommendations. Service users may be assured that their privacy and dignity will be maintained to a high level, within the parameters of the home’s actual ability to do so. The existence of shared rooms and lack of a visitor’s room / area to an extent compromises the capacity of the home to provide privacy to all service users. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 15 EVIDENCE: The house is a large, comfortable, family home, ideally situated for contact with the local community shops and transport links. There is a pleasant dining room, a lounge and a hallway. The main lounge has parquet (polished wood) flooring - which is now very ‘modern’ and attractive (and presumably easy to clean) - but the inspector continues to suggest that carpeting would be cosier / warmer, and provide a ‘safer landing’ if a service user were possibly to fall. Lighting and furnishings at the home are distinctly domestic and comfortable. An occupational therapy assessment of the home has revealed some recommendations, which - it is understood - have now been implemented. Standard 22 was re-examined to review the requirement concerning work to divide the call bell indicators for two different bedrooms on the first floor; this issue remains outstanding. There is, unfortunately, no room which can be dedicated to service users who smoke at the home - they smoke out in the garden in pleasant weather - and in the evenings and on inclement days they smoke in the hallway / stairwell. Once again, it is strongly recommended that this issue be addressed by the provision, perhaps, of a conservatory or other room being added to the ground floor communal space - which could then ‘double up’ as a visitors’ area. The prevalence of double-occupancy rooms is not ideal - especially as the standard expectation of, and for, learning disabled people nowadays is set much higher. The home should put in place a written strategy concerning the future of the double rooms - so that both present and new service users can be appraised / reassured of the situation. As ever, the home was noted to be generally clean and odour-free at the time of this unannounced visit. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 16 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 & 29. Service users can expect that their needs will be met by suitably qualified and competent care staff, though the numbers of staff provided should be reviewed to ensure they adequately to provide for their assessed needs. The recruitment policies and procedures at the home are designed both to protect (through checks and interviews), and to provide adequate and focused / appropriate care input to, the service users at the home. Staff members employed at the home are encouraged to undertake training, and the home strives to ensure that relevant training and supervision is provided to ensure that the home meets its statutory obligations. EVIDENCE: Staffing levels at the home have been provided at a minimum level of four staff in the morning, three staff on duty in the afternoon - and reducing to two into the evening, until two night staff, both awake throughout the night, arrive on duty. At this inspection visit, the rota indicated the presence of either two or three staff appeared to be common - indicating a possible reduction in the overall staffing input to the home. Care staff members are expected to clean the home during the week; a cleaner appears on the rotas in the morning at weekends - but there are only two care staff indicated on duty on a Saturday and three on a Sunday. On 12.01.06 (a Thursday), the rota also indicated only two care staff available in the morning and two in the afternoon - with a cleaner (unusually) on duty in the morning. The proprietor / manager is available at the house generally only on a Monday / Wednesday / Friday. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 17 A cook undertakes catering tasks on a few mornings per week when there are sufficient service users ‘on site’ to justify this input. At the time of the inspection she was described as ‘on a month’s holiday’. The proprietor is required to undertake a review of staffing in general at the home in the light of previous agreements / standards and the specific and individual needs of the service users. No new staff had been recruited more recently to the home - staff informed the inspector - this is due to the proprietors being able to call on a ‘bank’ of staff members who were previously recruited and employed at their nursing home, which closed a year and a half ago. With regard to standard 29 (not covered at the previous inspection) the general manager of the owning organisation, Jerry Brook, manages recruitment procedures and processes - and at previous inspections all aspects of these were clearly well implemented. In previous conversations with the general manager, the inspector was clear that Mr Brook is conversant with the correct processes of recruitment and selection - and is very clear as to the home’s statutory obligations with regard to recording and employment processes. Staff records have, in the past year, been brought in line with those required by statute; any new recruitment to the home must clearly evidence full compliance with the schedules and regulations as recently amended. ‘Local’ induction processes have been implemented, followed-on by the TOPSS-based Induction in Care, and a subsequent Foundation module. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 18 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 & 38. Service users can expect the home to be generally well run, under the guiding eyes of the proprietors. The proprietors must, however, seek to ensure that the manager is qualified in management skills to fully benefit the home. The service would also benefit from having management input spread over the majority of the days of the week. Service users can be confident in the knowledge that their finances held in safekeeping are properly managed, and that rigorous accounting ensures that any such transactions are clearly recorded and accounted for. Service users and their representatives can be confident that the home is kept in a safe and well-maintained way, thus ensuring the health and safety of all who engage with the home. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 19 EVIDENCE: Mrs Brook, co-proprietor and named registered manager, is generally present in the home on three days each week - usually on Mondays, Wednesdays and Fridays. She has an SEN/RMN qualification gained in long-term hospital settings and mental health units prior to starting Brook Care Homes in 1984. Mrs Brook does not have, and is not currently undertaking, a management qualification it is now required by the national minimum standards that a manager gains a qualification in managing care services at NVQ level 4 or 5 or a management qualification recognised by the Commission. The proprietor’s son, Jerry Brook - the ‘general manager’ (overseeing both the homes in their ownership), has his office ‘on site’ upstairs at the home; he is currently undertaking the Registered Manager’s Award at NVQ Level 4. The Commission does not currently consider the proprietor/manager’s qualifications to be adequate, nor is her presence in the home on three days out of seven deemed to be sufficient, and would wish to see this input increased - or as previously intimated by the proprietors, the alternative is to consider the recruitment of a full-time, fully qualified manager for the home. The proprietor reports that they have been interviewing candidates to take on this role, but to date have not found a suitable candidate. Unless the current manager commits immediately to management training at the appropriate level, this recruitment process must continue. The inspector expressed concerns to the senior on duty concerning the absence of reporting to the Commission of a number of incidents in the home that clearly should have been reported. Incidents such as a service user hitting two other service users - and ‘pacing up and down all night with the radio on loud’ and ‘not cooperating’ - are clearly events of significance affecting the home that should have been notified. Such incidents that “adversely affect the well-being or safety of any service user” must be reported to the Commission in writing - under the requirements of Regulation 37. Service user and relative surveys have been undertaken by the proprietors in the past - the requirement to survey other ‘professional stakeholders’ was yet, it was understood, to be undertaken, and remains a requirement. The Commission is to be sent outcomes of all such surveys - this is required under Care Homes Regulation 24. Ongoing maintenance and servicing of equipment and the premises in general were evidenced through documentation available in the home – indicating that the safety of service users were protected through the proprietors ensuring these maintenance and servicing elements were carried out. Records of fire drills and of fire alarm tests were consistent and up-to-date; accident records were also clear and well maintained. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 20 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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X 2 X X X 3 STAFFING Standard No Score 27 2 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X X X 2 3 Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 21 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(1) Requirement The long-term suitability of service users placed at the home must be formally confirmed with individual placing officers, and those outside the ‘learning disability’ category or requiring a special needs service must be considered, where felt appropriate, for a Variation. Timescales of 30/01 & 01/07 & 01/12/05 not met. All prescribed medication must be given strictly under the GP’s or Psychiatrist’s instructions without variation - unless the sanction of the prescribing physician is directly obtained. Rationalisation of the call points on the first floor must be effected to ensure that cancellation points apply to each room - and are not shared. Timescales of 30/01 & 01/07 & 01/12/05 not met. The proprietors are required to undertake a review of staffing in DS0000007171.V270837.R01.S.doc Timescale for action 31/03/06 2. OP9 13(2) 10/01/06 3. OP22 23(2)(n) 31/03/06 4. OP27 18(1) 15/03/06 Beeches House Version 5.1 Page 22 general at the home, in the light of previous agreements / standards - and to ensure the specific and individual needs of the service users are met. Details of this review must be sent to the Commission. 5. OP31 9 & 10 The manager must gain a qualification in managing care services at NVQ level 4 or 5 or a management qualification recognised by the Commission. If the registered manager continues to fail to meet requirement 5 above, the home must employ a long-term, category-specific trained and competent manager (to NVQ Level 4 or 5 in management & care) to manage the home, who is present at the home for the majority of days of each week. Timescales of 30/01 & 01/07 & 01/12/05 not met. Independent quality assurance / satisfaction surveys must be undertaken with service users’ representatives / stakeholders & survey outcomes communicated to the Commission. Timescales of 30/01 & 01/07 and 01/12/05 not met. 31/03/06 6. OP31 8(1) (2) 31/03/06 7. OP33 24(1)-(3) 31/03/06 8. OP37 37(1) (2) Notification must be made to the 15/02/06 Commission of any incidents that are deemed reportable under Regulation 37. Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 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. Refer to Standard OP9 OP10 Good Practice Recommendations That, wherever possible, medication stocks be obtained in a sealed ‘blisterpack’ style of dispensing format. That the public telephone facility be restored in the front hallway - to provide an alternative location from taking calls in the kitchen / toilets corridor. That service user’s bedrooms be provided with net curtains where there is a possibility of being overlooked by neighbours - or in respect of ground floor rooms - where visitors / ‘strangers’ can see into the room as they walk by the house. That additional space (perhaps a conservatory / garden room) should be created at the home for those who wish to smoke - so that the ‘passive’ experience is not passed on to those who do not smoke. That the situation concerning the future of double rooms and their occupancy at the home should be clearly stated in writing for the information of both current and possible new service users. 3. OP19 4. OP20 5. OP23 Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Beeches House DS0000007171.V270837.R01.S.doc Version 5.1 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. 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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