Inspection on 23/06/05 for Beechwood

This inspection was carried out on 23rd June 2005.

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 no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beechwood 25/06/07

Beechwood 27/04/06

Beechwood 31/10/05

Beechwood 10/05/05

Beechwood 29/11/04

Beechwood 08/09/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Beechwood The Lodge High Pitfold Hindhead Surrey GU26 6BN Lead Inspector Susan McBriarty Unannounced 23/06/05 10:00 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Beechwood Address The Lodge, High Pitfold, Hindhead, Surrey, GU26 6BN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01428 604278 Robinia Care Group Limited Donovan Bent (acting manager) CRH 6 Category(ies) of LD - Learning Disability registration, with number SI - Sensory Impairment of places Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The age/age range of the persons to be accommodated will be 18-50 YEARS To accommodate one person with a sensory impairment. Date of last inspection 10/05/05 Brief Description of the Service: Beechwood and The Lodge are both part of the Robinia Care Group. The Southern Region Organisation specialises in services for people with learning disabilities and challenging behaviours. The homes are located on the Robinia South Old Grove site, just off the A3 South of Hindhead and situated on a small complex of largely purpose built single storey buildings, one providing day care (The Grove) and the remainder are residential. Beechwood is a five-bedroom bungalow and The Lodge is a two-bedroomed bungalow with one service user, supported by two members of staff over a twenty-four hour period. The Lodge is registered for one service user only. Beechwood and The Lodge are staffed independantly of each other with the Registered Manager overseeing the two homes. Each of the homes has its own communal facilities and enclosed secluded gardens with adjacent parking. The service users all present with challenging behaviours. Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection with two inspectors checking in detail Standards 6,7,13, and 14 of The National Minimum Standards for Adults age 18-65 years. These standards focus on the social, leisure and financial needs of residents. The residents have complex needs including limited verbal skills and their views could only be sought through a great deal of planning and support. The CSCI instigated the service review as concerns had been expressed regarding the provision of care and support services and the management of the finances of residents. The inspection therefore focussed on those areas. A report will be provided under separate cover to address any concerns and or issues raised by the review. The inspection began at 10.00 and ended at 1pm and through the inspection process some issues were raised under other standards of The National Minimum Standards for Adults age 18-65 years. These have been noted within this report and requirements made from the findings of the inspectors. The previous inspection undertaken by The Commission for Social Care Inspection in May 2005 covered a number of Standards and the report is at present in draft format. A number of requirements were made and the home is in the process of considering the outcome of the inspection. The inspectors wish to thank the staff members of the home for their assistance during this inspection. What the service does well: What has improved since the last inspection? What they could do better: Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 6 A number of requirements have been made from this inspection. Staff explained that to take the residents out they had to access either a pool car, which given the challenging behaviour of some clients were unsuitable or transport from The Cedars, which was dependent on the resident at The Cedars not requiring it. This meant that trips had to be planned well in advance and limited flexibility. Resident’s activities were also limited by the cancellation of day services and corresponding need for residential staff to remain with them as this limited one to one support. The organisation is required to review the provision of transport to the home. A review of activities was required. Some of the information required to make a judgement about the full impact on residents can only be gained in discussion with the organisation. Staffing levels require review to ensure that the one to one provision can be provided on a regular basis and that those hours are recorded clearly for each of the specified residents. The home is required to ensure that staff members complete all documentation required and to ensure the information is correct and up to date. The staff members must follow the organisation’s policies and procedures with regard to the recording and use of all residents’ finances. The records were found to be incorrect and staff members were not following the organisation’s procedures. The particular information held by the manager in relation to a specified resident requires review. No records were available for inspection regarding the specified resident. The storing of the keys to the medication cupboard and resident’s cash requires consideration. They were kept in an accessible and unlocked space within the home. Enforcement action is being taken with regard to the provision of Criminal Record Bureau (CRB) checks as required. Some staff working at Beechwood did not have a CRB neither had application been made. The original documents are kept at head office and on the day of the inspection the Inspectors were unable to sample the evidence as the information held by Robinia Care’s head office was not adequate. 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. Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 5 There was little evidence of clear contracting arrangements with the purchasers of services. The provision of a clear contract would assist the home and residents in planning each day to ensure that the needs of the residents can be met. A requirement has been made to ensure that this matter is clarified. EVIDENCE: As stated this inspection focussed on particular areas of The National Minimum Standards, Adults age 18-65 years as The Commission for Social Care Inspection had recently inspected the home. Each of the residents have care plans where their needs have been detailed in separate sections. For example socialization. On inspecting the area of socialization in detail for a number of residents it was found that there were problems with the provision of day care. The care plans indicated the number of days some of the residents should be attending the organisation’s (Robinia South) day centre (The Grove). This was not happening. For a number of residents the purchasers of the service had agreed residents additional one to one staffing. In order to gain clear information on the level of one to one funding available contact had to made with head office. Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 9 Beechwood does not have a vehicle available for the use of residents; they are reliant on borrowing the vehicle from another home.. It is a requirement that the home provide clear statements of terms and conditions setting out the needs of the residents and how they will be met. The details are set out in Standard 5 from 5.1 to 5.5 of The National Minimum Standards, Adults 18-65 years 2003.This would ensure that the residents, their families and advocates (if any) are clear about the services and facilities they must receive from the home. Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 The home provides detailed care plans for each resident. However, further work is required to ensure that if day services are not available for any reason the residents know what will be provided instead. EVIDENCE: The residents at Beechwood have complex needs and limited verbal skills. They would therefore be reliant, on most occasions, on others making good decisions on their behalf. At least one of the records sampled showed that staff had not kept the records up to date. The provision of personal physical care had not been recorded in full, in one instance since the end of May 2005. In other instances records had been kept up to mid June 2005. Of more concern this record showed that the medication sheet had not been completed since 6th May 2005. Please see Standard 20 in this report. The lack of transport for this home reduces the flexibility that might be available. The home has additional one to one hours provided for specified residents, however the care plans do not indicate the level of hours available. Some Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 11 evidence was available in the daily notes that one to one support was being provided. Resident’s finances were checked during this inspection and were found to be incorrect. The records showed that one resident had lent another money; this is not the policy of the organisation. The staff member spoken to had not been at the home long and had not been informed that this was not acceptable practice by the manager. The cash records and available cash were also checked, none of the records sampled were correct. The manager, who was on leave at the time of this inspection, held particular details which enabled access to the specified person’s bank account. The manager had inadvertently taken this on leave with him and was in the process of returning the documents by recorded delivery. The inspector could not check one resident’s accounts as no records were held. Transport can on occasion be booked if it is not needed by the specified person. The home had previously been provided with a vehicle and staff members were unclear as to why this was no longer the case. A requirement has been made to ensure that the needs of the residents are met when they do not attend the day centre, why they have not attended the day centre and what activities may be undertaken instead. A requirement has been made regarding the need for a statement of terms and conditions to indicate the level of one to one that is to be provided to each resident. (see Standard 5). A requirement was made that resident financial accounts records are maintained, are up to date, correct and open to inspection. A requirement has been made to ensure that the activities plan held for each service user is kept up to date and accurate. Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14, The lack of transport, unidentified one to one support hours and regular cancellation of day care services limits the opportunities for residents. Requirements have been made to assist the home to rectify these matters. This to ensure that the residents are provided with clear plans setting out what services and facilities are available for them to use or access and what will happen if for any reason those services are not available. EVIDENCE: As stated earlier the home provides detailed care plans for each resident, the care plans set out what services each resident should have every day. A number of those resident files sampled noted the level of day care to be provided at The Grove. Please note, The Grove is within walking distance of the home. In one instance the care plan held on a specified resident’s file held different information to that on the social services review information. The staff stated that The Grove is not open all year and is open during what might be called ‘college times’. At the time of this inspection the dates of Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 13 opening were not clear. Staff also stated that there are a lot of cancellations of sessions that may also evidence why so many days were not attended. The records made showed that other activities within the home took place and occasionally when transport was available outside of the home. The care plans detail the residents needs regarding day care. In many instances they note the need for routine in order to endure that the resident is clear about what is happening each day. However, the staff stated that there were times that these routines were changed in line with the residents needs at the time. The inspectors were unable to locate evidence that supported the statement made by staff. There were no clear plans as to what needs to happen on those days when the resident is unable to or does not wish to attend the day centre. Staff members at the home also support the residents at the day centre. The care plans did not identify clearly the level of one to one support available to some of the residents. The inspectors saw the staffing rota for June and this did not identify which member of staff would be providing one to one or when. As stated earlier staff had to contact Robinia’s head office to clarify the level of one to one available during each week. For example one of the care plans noted a very high level of one to one being provided, however on further discussion with the staff and through the head office it was found that this was incorrect and the information had been put together to request additional funding from the purchaser. It was found that this person is provided with one to one support on a regular basis although no funding is provided for this additional service. A vehicle is available for a specified person at another home, this may be needed at short notice and therefore no plan can be made to access that transport. Those at Beechwood have used the vehicle on occasion. The lack of transport, identified one to one hours and identified staff to provide the one to one support reduced the flexibility of the service. The number of sessions said by staff to be cancelled by The Grove Day Centre further reduced opportunities for one to one support as unplanned returns or stays in the home would have an impact on staff hours available. In addition care plans identified the need for routine to reduce any challenges to the service by residents. These issues together would not enable the home to meet the needs of the service users in the way that has been assessed as required. A requirement has been made for the home to urgently review its staffing levels taking into account the level of one to one funded. In addition the level of one to one must be identified clearly in the residents care plans. A further Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 14 requirement has been made for the service to review the provision of transport. Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 These standards were not fully assessed during this inspection, although some evidence in relation to NMS 20 was identified as requiring action by the home. EVIDENCE: Although this standard was not assessed during this inspection it was noted within one of the resident files sampled that up to date accurate records of support provided had not been kept. The home was unable to evidence that the required personal physical care had been provided on a regular basis. One of the records noted as inaccurate was the recording of medication. Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during the inspection. EVIDENCE: Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during this inspection. EVIDENCE: Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 A requirement has been made for the home to review current staffing levels. Additional one to one hours have been purchased for specified residents and the current rota did not identify this need. The assessed support required for those specified service users may be affected by this lack of clarity. EVIDENCE: The home has three (3) staff members on duty from 9am to 5pm, two (2) from 5pm through to 9am the following day. These times are split into three (3) shifts. Staff members generally work a forty (40) hour week. The information given by staff via the organisations head office show the provision of sixty seven (67) hours per week one to one support. It is required that the home urgently review the staffing levels available. Criminal Record Bureau (CRB) checks were not available at the home during the inspection. The area manager contacted Robinia Care Limited head office and requested that the documents be delivered to the home in order that the Inspectors could evidence that CRB checks were in place. It was not possible to sample the evidence provided as only a list of names was provided to the Inspectors. No record had been made of the date of issue or disclosure number of the CRB checks. It is Robinia Care Limited policy that no overseas staff Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 19 members are CRB checked until such times as they have a national Insurance number. Requirements have been made to ensure that staff have received satisfactory CRB checks and or are supervised until such times as a satisfactory CRB check is received. Enforcement action is being taken to ensure that Robinia Care Limited meet the requirements of The Care Homes Regulations (as amended) 2001. Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 40, 41, 42 Whilst these standards were not fully assessed during the inspection issues of concern were raised and are noted here. Requirements have been made in respect of the concerns. The details of the issues raised are noted in detail under Standards 5, 6, 7, 13, 14, 20 and 33. EVIDENCE: The staff team were found not to be following the organisation’s policies and procedures in respect of dealing with resident’s finances. The records of at least one resident file sampled showed that staff members had not maintained an up to date and accurate record of the support provided to the resident. The resident files sampled showed that residents day care needs were not being met and that the issues raised from the cancellation of day services and the need for replacement activities had not been recorded. Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 21 The inspectors noted the whereabouts of the keys for the medication cupboard and residents cash. This was of concern as the keys were accessible and were not kept locked away as required. One member of staff needing reminding not to leave the cash box unlocked with the inspectors whilst no staff members were present. Where additional funds had been made available for additional one to one time there is no up to date record in the home of the hours to be provided or to whom. The staff rota does not reflect the additional; staffing needing to provide the funded one to one time. In discussion with the staff and through contact with the organisation’s head office it was found that sixty seven (67) hours per week are available to specified residents for one to one support. Further investigation is required to check the information regarding the charge for and provision of transport for the resident’s use. Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x 1 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x 2 2 x x x Standard No 31 32 33 34 35 36 Score x x 1 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beechwood Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 2 2 x 2 2 2 x H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 23 N/A Are there any outstanding requirements from the last inspection? 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 YA5 Regulation 5(1)(b)(c) Requirement The registered person must ensure that each service user is provided with a statement of terms and conditions or contract, including the level of one to one support purchased, as detailed in Regulation 5(1)(b)(c) of The Care Homes Regulations (as amended) 2001 The registered person must ensure that staff are trained and supervised adequately in completing the documents required by the home. In this instance the recording of personal care and attendance at day centre activities.The documents to be up to date and open for inspection. The registered person must ensure that staff are trained and supervised adequately in completing the documents required by the home. In this instance the recording on medication sheets.The documents to be up to date and open for inspection. The registered person must ensure that care plans are updated to show clearly the Timescale for action 31st August 2005 2. YA6 15(1)(2)( a)(b)(c) (d), 17 (1)(a)(b) 31st August 2005 3. YA7 15(1)(2)( a)(b)(c) (d), 17 (1)(a)(b) 31st August 2005 4. YA7 15(1)(2)( a)(b)(c) (d), 17 31st August 2005 Page 24 Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 (1)(a)(b) 5. YA7 17(1)(a) (b)(2), 20(1)(a) (b) 13(6) 6. YA7 7. YA7 15(1)(2)( a)(b)(c) (d), 17 (1)(a)(b) 8. YA33 12(1)(a) (b), 18(1)(a) 9. YA33 18 (1)(a)(2)( a)(b)(i)(ii) (iii). 10. YA34 19(1)(a)( b)(c), 17(2)(3) (a)(b)(4) Schedule 4 correct information regarding service users needs including the provision of one to one support.The documents to be up to date and open for inspection. The registered person must ensure that all service users financial transactions are recorded, up to date, accurate and open to inspection. The registered person must ensure that no member of staff is solely responsible for the finances of a service user. The registered person must ensure that staff are trained and supervised appropriately in the homes policies and procedures and in completing the documents required by the home. In this instance the recording of service users financial income and expenditure.The documents to be up to date and open for inspection. The registered person must urgently review the staffing levels within the home to take into account the level of one to one additional funding being provided. The registered person must ensure that all members of staff are appropriately supervised within the home until such times as a satisfactory CRB check is received. This is already subject to a statutory enforcement notice. The registered person must ensure that all staff receive a satisfactory CRB check and that the original document is held at the home and is open to inspection by the CSCI. This is already subject to a statutory enforcement notice. 31st July 2005 31st July 2005 31st July 2005 31st July 2005 Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Beechwood H58-H09 s13702 Beechwood v241673 230605 stage 4.doc Version 1.40 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!