Inspection on 24/04/08 for Beecholme House

This inspection was carried out on 24th April 2008.

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

Beecholme House 23/11/09

Beecholme House 09/09/09

Beecholme House 14/10/08

Beecholme House 31/10/07

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Beecholme House 2-4 Beecholme Avenue Mitcham Surrey CR4 2HT Lead Inspector Liz O`Reilly Key Unannounced Inspection 28th April 2008 10:45a 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 Beecholme House DS0000070341.V362148.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. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beecholme House Address 2-4 Beecholme Avenue Mitcham Surrey CR4 2HT 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 8648 6681 020 8288 9797 Sharon Egbo Lartey Joseph Benedict Awolowo Kpebi Care Home 15 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (12) of places Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service onlyCare home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP (maximum number of places:12) Dementia over 65 years of age - Code DE(E) (maximum number of places:3) The maximum number of service users who can be accommodated is: 15 31st October 2007 2. Date of last inspection Brief Description of the Service: Beecholme House is a registered care home for up to fifteen older people. The building is made up of two houses which have been joined together and extended. The home is situated in a residential area of Mitcham with a small number of shops within a short walking distance. Parking is to the front of the building. Public transport bus services are within a short distance of the home. Two double bedrooms and eleven single bedrooms are available. One bedroom has an en suite bathroom. Weekly fees for this service are £550 to £700 per week. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is zero stars. This means people who use this service experience poor quality outcomes. This unannounced inspection was carried out by two regulation inspectors over four and three quarter hours. At the time of this inspection eight people were using the service. We spoke to five people who use the service, four visitors, one member of the care staff team, the manager and the responsible individual. We looked at records and documents kept in the home including three care plans. We provided surveys for people who use the service, staff and relatives. No responses were returned to the inspectors. The home sent us an annual quality assurance assessment (AQAA). This is a self-assessment, completed by the manager, that gave us information on how well outcomes are being met for people using the service. We found information supplied in this document on how the service is operating was not accurate in a significant number of areas. The information provided was a statement of what the service intended to do rather than what is being put into practice. We found little progress had been made in meeting requirements made at the last inspection of the service. Of the fourteen requirements made in October 2007 ten had not been met. During the course of and as a result of this inspection the manager did take action to acquire the correct documentation for staff to ensure the safety of people who use the service. However it is of concern that these checks had not been carried out before this inspection. The service has failed to comply with previous requirements regarding care planning and risk assessments. The Commission is concerned that such non-compliance undermines the health and welfare of people who use the service and is therefore taking enforcement action to ensure compliance and secure the health and welfare of people who use the service. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There has been a lack of progress in meeting requirements made at the last inspection. Care planning and risk assessments need to be in place and kept up to date to make sure that the needs and wishes of people who use the service are known and can be met. The lack of good recording on the needs and wishes of individuals and guidance for staff on how to meet these puts people who use this service at risk. Staff are in need of clear guidance on supporting people in meaningful daily living activities and working with individuals who are living with dementia. To ensure that people who use the service are supported by an appropriately knowledgeable staff group, information on training carried out by staff needs to be in place along with the arrangement for training to be updated. Staff recruitment procedures need to be followed to ensure the safety of people who use the service. The manager must ensure that information provided to the Commission is up to date and accurate. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 7 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. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 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 Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People who use this service experience poor quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Pre admission assessments carried out by staff from the local authority are in place for the individuals who use the service. However the lack of information from any pre admission assessment by staff from the home and the lack of initial care plans means that people who use the service cannot be assured their needs will be known and met. This service does not provide intermediate care therefore Standard 6 does not apply. EVIDENCE: We looked at the records for three people using the service including one person who had recently moved into the home. Pre admission assessments were seen to be carried out by staff from the local authority. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 10 Information provided in the AQAA by the manager stated that ‘Before anyone moves into the home an assessment of their individual needs is carried out. Care plans will include a comprehensive risk assessment package and working guidelines for care staff’ The manager informed the inspectors that he had visited this person before they moved into the home and carried out his own assessment. However we could find no information from this assessment available to staff. No initial care plan had been set up to ensure that the needs of this individual were known along with information for staff on how to meet these needs. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 11 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 and 10 People who use this service experience poor quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The information that the home provided, stating that improvements had been made in care planning was not accurate. We found no improvements in this area. The lack of individual risk assessments particularly where assessments point out high risks is also of real concern. It is of concern that staff are not provided with up to date information on the individual needs and wishes of the people they are supporting. There is a significant risk, particularly where there is a high staff turnover, that the needs of individuals will not be met. Staff have maintained the improvements in managing medication which were seen at the last visit to the service. EVIDENCE: The service has failed to comply with previous requirements regarding care planning and risk assessments. The Commission is concerned Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 12 that such non-compliance undermines the health and welfare of people who use the service and is therefore taking enforcement action to ensure compliance and secure the health and welfare of people who use the service. Information provided by the manager in the AQAA included:- ‘ The care plan tailored to meet the needs of each resident will be drawn up in conjunction with the resident, the plan will be reviewed regularly with full involvement of all concerned’ Under the section requesting information on how the service has improved in the last twelve months the manager has stated:- ‘The review of the care planning system has been updated. Clear information on how the needs of individuals will be met with timescales for any goals set has been put in place’. We found there had been no progress made in updating individual care plans. The care plans in use were those provided by the previous manager. In one instance the care plan was dated 2005 and another was dated 2006. Care plans were not being reviewed on a monthly basis. We are aware that an assessment of all of the people using the service had been carried out by the local authority in October 2007 but there was no evidence that information from these reviews had been used to update care plans in the home. We looked at the documentation for one person who had recently moved into the home. The manager had provided no information to staff on the individual needs of this person or how they were to be met. We also looked at the documentation for one person who had over the last few months had significant medical problems. The care plan for this person had not been altered to take this into consideration. We found no evidence of consultation with people who use the service or their relatives on individual care planning. We are aware that the manager is investigating other types of care planning but this must not stop the development of the care plans already in use. The manager stated in the AQAA:- ‘Comprehensive risk assessments for individuals are now in place’. One person who had recently moved into the home was assessed as at high risk of falls by the local authority care manager. However no individual risk assessments had been produced within the service to provide staff with information on reducing any risks. This is of concern. We found no individual risk assessments in place in any of the files we looked at. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 13 Although access to health care has improved since the last inspection the lack of individual risk assessments and up to date care planning places the health of people who use the service at risk. We found medication continues to be well managed. Records were up to date, complete and accurate. All staff who administer medication were provided with accredited training on the management of medication last year. The manager reported that the problems which were being experienced in obtaining GP services have now been resolved. Records showed that health care professionals were visiting the service. We observed staff supporting people in a caring manner. However the requirement that staff be provided with written guidance on treating the people who use the service with respect had not been done. We also observed that some staff needed further guidance and or training on supporting people with dementia. On a number of occasions staff were preventing or trying to prevent one person from walking around the home by very frequently telling this person to “sit down” with little or no other more positive communication with this person. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 14 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 People who use this service experience poor quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The lack of progress being made in reviewing the social, cultural and recreational interest, needs and wishes of people who use the service and the lack of staff input is of concern. Mealtimes have not improved. EVIDENCE: Following the last inspection of the service the manager was required to carry out a review of the activities on offer, consult with individuals on social, cultural and religious needs and wishes and include social activities in the care plan. This has not been done. A review of mealtimes was also required. This has not been carried out. We found no changes had been made to the menu, how choices are offered, or in providing opportunities for people to maintain their independence at mealtimes. Although information provided from the service stated that mealtimes were now viewed as a social event this statement did not match our observations. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 15 We found little conversation at the mealtime, staff did not sit with people who use the service or join in the meal. People who use the service did not know what they would be eating. There was no information in the dining room on the menu for the day. The menu was changed as the cook was not available for work. When one person told staff they could not eat meatballs they were not offered any alternative but told by staff to “try and eat them”. This person was seen not to eat the meatballs but again was not offered an alternative. Although there were only eight people living at the service with two care staff, the manager and the owner on duty we observed no activities instigated by the care staff or manager. We discussed the provision of a more stimulating environment for people who use the service with the manager and owner at the end of this visit. A visit was made from a church group who provided a short service and communion for those people who wished to take part. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 16 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 People who use this service experience poor outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Information on the complaints procedure is available in the home and the management were seen to have responded in writing to three letters of complaint. However more work needs to be done to ensure that people who use the service and or their representatives feel confident that they will be listened to. The lack of information on staff training in safeguarding adults and the lack of appropriate checks carried out on new staff is of concern. EVIDENCE: Information on the complaints procedure is on display at the home. An easy read information sheet is available in the dining room. Three written complaints were seen to have been received and the manager has responded to these in writing. We received comments from the representatives of people who use the service which indicated that they did not have confidence in the management to respond to requests or concerns raised. No evidence was available on staff files to show that all staff had been provided with training on safeguarding adults. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 17 In one instance a member of staff has been employed without two written references and without appropriate checks being carried out. This places the safety of people who use the service at risk. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The home owners continue to make progress in improving the environment for people who use this service. Rooms are generally clean and tidy. In order to ensure that the needs of individuals are met a review of the moving and handling equipment available needs to be carried out. EVIDENCE: We found improvements continue to be made in the environment. Paper towels and liquid soap have been provided around the home and in all toilets which will assist in reducing the risk of cross infection. All rooms now have appropriate bedding and curtains. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 19 We found all toilets to be in good working order. Although the cistern cover for one toilet on the ground floor was cracked. An assessment of the moving and handling equipment has not as yet been carried out. Most areas were found to be clean and fresh. Three bedrooms were found to have a stale odour. However we noted that the home owner alerted the cleaning staff to this before we commented. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 20 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 People who use this service experience poor qualtiy outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The lack of evidence in relation to pre employment checks is of serious concern as this may place people who use the service at risk. Staff may have received the appropriate training to meet the needs of the people who use the service but information on gaps in training or knowledge for individuals was not available. EVIDENCE: The owner and manager informed us that they have been experiencing difficulty in recruiting and retaining staff. Following the last inspection we required an audit of the individual training needs of all staff to be carried out. This has not been done. We also required all staff to be provided with training on moving and handling and dementia care. Although the manager informed us that he thought all staff had received moving and handling training before they were employed there is no overall training needs assessment which will inform him of who has completed training and when up dates need to be done. All staff who administer medication have been provided with accredited training. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 21 We looked at a sample of staff files. One person did not have two written references. Evidence of a Criminal Records Bureau (CRB) check or a check of the Protection of Vulnerable Adults list (POVA) was not available for this person at the time of this inspection. The service had continued to accept checks made of List 99 which is a list of people found to be unsuitable to work with children. This issue was raised at the time of the last inspection. The information provided by staff on their previous employment was not complete. There were significant gaps in the employment record. In order to assist in ensuring the safety of people who use the service the manager must ensure that any gaps in employment records are explained and recorded on file. References and evidence of POVA or CRB checks were sought by the manager during the course of this inspection. It is of concern that these were not already available before the member of staff commenced work. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience poor quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Despite there being only eight people living in the home little progress has been made in meeting requirements. The lack of understanding of the importance of providing staff with accurate and up to date information on the needs of the people using the service and how these should be met is of concern. The lack of understanding of the appropriate checks to be carried out on staff before they start work is also of concern. The financial interests of people who use the service are safeguarded and some progress has been made to ensure the health and safety of people who use the service. However one requirement in relation to health and safety remains outstanding. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 23 EVIDENCE: At the time of the last inspection we recommended that the manager take part in further training on supporting older people particularly those living with dementia. This would enable the manager to provide guidance for staff on good practice. We were provided with no evidence that this had been carried out. The lack of accurate information on the way the service is operating provided by the manager in the AQAA supplied to the commission is of concern. At the time of the last inspection, to assist in ensuring the health and safety of people who use the service, we required that a record of hot water temperatures be taken and recorded before staff assist anyone into a bath or shower. This has not been done. A record of weekly checks on the fire alarm system is now in place. We examined as sample of the records of money held on behalf of people who use the service. These were well maintained, up to date and accurate. We saw a record of meetings with people who use the service. The record for the first meeting included good details. However the record for the last two meetings was very brief and included no information on the agenda or actions taken. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 24 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 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 1 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X X 2 Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 25 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 OP10 Regulation 12(4)(a) Requirement All staff must be provided with clear written guidance and training on treating people who use the service with respect. Timescale for action 22/07/08 2. OP12 16(2)(m) (n) Timescale of 15/01/08 not met To ensure the needs and wishes 22/07/08 of people who use the service are met a review of the activities on offer must be carried out. This review must include :Individual consultation on social, cultural and religious needs and wishes. Inclusion of social activities and how these will be met in care plans. Up to date information on activities being made available to people who use the service. Timescale of 15/01/08 not met To ensure that people who use 22/07/08 the service are provided with food which meets their needs and preferences a review of meal times must be carried out. This review must include:DS0000070341.V362148.R01.S.doc Version 5.2 Page 26 3. OP15 16(2)(i) Beecholme House How people are offered choices at mealtimes. Inclusion on the menu the alternatives at each meal time. Ensuring that sufficient staff are available to support people at meal times. Providing opportunities for people to maintain their independence at meal times. Timescale of 15/01/08 not met To ensure that people who use 22/07/08 the service are provided with appropriate aids an assessment of the moving and handling equipment in the home must be carried out by a suitably qualified person. Timescale of 01/02/08 not met. To ensure the safety of people 20/06/08 who use the service the manager must ensure that POVA First checks are carried out for any staff for whom a full and satisfactory Criminal Records Bureau check has not been received. Staff who are working with a POVA First check only must not work with people who use the service unsupervised. 20/06/08 To ensure the safety of people who use the service the manager must ensure:• Two satisfactory written references are received for each member of staff before they commence work in the home. • Information is sought from their previous employer, if this work involved working with vulnerable adults or DS0000070341.V362148.R01.S.doc Version 5.2 Page 27 4. OP22 13(5) 5. OP29 19 Schedule 2 6. OP29 19 Beecholme House 7. OP30 18(1)(c ) children, as to why the member of staff left. • An explanation is sought and recorded for any gaps in individual employment records. To ensure that people who use the service are supported by well trained staff the manager must carry out an audit of the individual training needs of all staff. Arrangements must be made for staff to receive the training they need. All staff must be provided with training on moving and handling and dementia care. Timescale of 15/01/08 not met To ensure the health and safety of people who use the service staff must check the temperature of any bath or shower before they help anyone into a bath or shower. A record of these temperatures must be kept. Timescale of 15/12/08 not met 22/07/08 8. OP38 13(4) 20/06/08 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 OP30 OP31 Good Practice Recommendations It is recommended that at least one member of staff is provided with training on organising activities. It is recommended that the manager takes part in further DS0000070341.V362148.R01.S.doc Version 5.2 Page 28 Beecholme House training on meeting the needs of older people living with dementia. 3. OP31 The manager should make sure that action is taken without delay should the service be unable to meet the needs of any individual. Beecholme House DS0000070341.V362148.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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. 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