Inspection on 11/05/06 for Begbrook House

This inspection was carried out on 11th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Begbrook House 18/05/07

Begbrook House 25/10/05

Begbrook House 11/05/05

Begbrook House 02/03/05

Begbrook House 10/09/04

Begbrook House 15/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Begbrook House Sterncourt Road Frenchay South Glos BS16 1LD Lead Inspector Melanie Edwards Key Unannounced Inspection 11th May 2006 09:30 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 Begbrook House DS0000020227.V294119.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. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Begbrook House Address Sterncourt Road Frenchay South Glos BS16 1LD 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) 0117 9568800 0117 9569900 Grandcross Limited(wholly owned subsidiary of Four Seasons Health Care Ltd) Mrs Erma Benedicto Fernandez Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate 32 Patients aged 50 years and over requiring nursing care Staffing Notice dated 3 December 2001 applies Manager must be a RN on parts 1 or 12 of the NMC register Date of last inspection 25th October 2005 Brief Description of the Service: Begbrook is a purpose built Home, operated by Grandcross Ltd, which is affiliated to Four Seasons Health Care. The Home is registered to provide nursing care for 32 people over the age of 50. It has ample car parking space at the rear and a small garden in front separating it from the main road. There is access to local shops, amenities and bus routes. Accommodation is provided on one floor. There is level access throughout the Home. Toilets and bathroom facilities are adequate for the number of service users and have adaptations to meet their assessed needs. All rooms are equipped with call alarm systems. Visitors may visit at any time. The fees charged for staying at the Home for nursing care are from £600 to £650 per week. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Eleven residents and a number of visitors were consulted to find out their views of the Home and the service provided. A number of care assistants, the deputy manager, and the cook were also consulted about their roles and responsibilities, their training needs, and how they assist and support residents. Staff were observed while they were helping residents with their needs. A selection of records that relate to the day-to-day running and management of the Home were inspected. A sample of resident’s care records were also looked at in detail. The majority of the environment was seen; and the only areas that were not viewed were a small number of resident’s bedrooms. The Commission sent a number of Comment/Feedback Cards for residents and relatives. Their views of the Home are also included in the report. The Home was operating within the required conditions of registration set down by the Commission for Social Care Inspection. The conditions of registration detail the type of care and the needs of residents as well as the numbers of residents who may stay at the Home. These judgments have been made using available evidence including a visit to the service. What the service does well: What has improved since the last inspection? Residents and their representatives are now better informed about the services provided at the Home. The service users guide now explains more clearly what daily life is like in the Home and has been updated to reflect changes in staff that have taken place. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 6 The mealtime experience and residents dignity, has been improved by the staff who assist residents with their meals sitting down rather than standing up while they do this. The resident identified at the last inspection now feels that they are being offered a diet that better reflects their specific cultural needs. The safety of residents is now being better protected as the following food safety practices are being carried out. Up to date checks of kitchen fridges and freezers are now being maintained, to ensure they are operating within food safety guidance levels. Secondly foods that food safety guidance advises are `high risk’ foods are being temperature probed before serving to ensure the food has reached above minimum required temperature. Thirdly uncooked eggs are being stored in the fridge, and food stored in the fridge is being covered and has the date it was placed in the fridge recorded. There is also now a duty record of the hours worked by all ancillary and catering staff. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6, Quality in this outcome area is adequate. Prospective residents are now informed about the Home and the services provided. However residents’ assessments of their needs are not being regularly reviewed and updated. Also one resident’s assessment record fails to reflect their range of needs. EVIDENCE: A copy of the service users’ guide about the Home was inspected to see what information is provided to prospective residents and their relatives. The document contained a range of helpful information about life in the Home, the staffing levels, and the service that is provided. The document has been updated since the last inspection and now reflects more clearly the services that are provided by the Home. A copy of the document is made available for residents and visitors in the entrance hall of the Home. A visitor came to the Home during the inspection for an unplanned look around to see if the Home may be suitable for their needs. The deputy manager was accommodating and helpful and showed the person around the Home. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 9 To find out how the Home assesses needs, three resident’s assessment records were reviewed. There was information included in the assessment records referring to the physical, communication, and mobility, needs of the person. There was also an assessment for each resident of their vulnerability to pressure sores, risk from falls, and their nutritional needs. The completion of these assessments helps demonstrate residents’ needs have been identified and addressed. However one resident identified at the inspection did not have an assessment of their complex mental health needs in place nor a care plan in place that reflected their complex mental health needs as well as physical needs. Also two of the three assessment records had not been reviewed and updated on a regular basis to demonstrate residents’ needs are monitored by the Home. There were no residents in the Home at the time of the inspection admitted solely for intermediate care. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Overall quality in this area is outcome area is adequate. Residents’ care plans show how physical needs are met, but residents’ plans fail to show how mental health needs are met. The practices for storage and administration of medication are safe. Also residents feel they are treated with respect and their privacy is maintained. EVIDENCE: A number of residents were consulted to find out how they are treated by staff. There were a number of comments of satisfaction expressed by residents as well as by resident’s visitors. Examples of comments made included, ‘it’s perfect here’, `the service is very good’, and ‘all the girls are excellent’. These comments demonstrated residents feel satisfied by the care they receive, as they were reflective of comments made by all the residents and visitors, who were consulted. Staff were observed helping residents with their needs, and speaking to them in a polite and respectful way. Staff were also observed knocking on bedroom doors before entering them. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 11 There was a medical health record maintained for each resident. This records when residents had seen the doctor, the optician the dentist and the chiropodist and the reason for the referral, and any outcomes, such as if treatment was required. There was evidence written in daily records that showed residents see the optician and the chiropodist on a regular basis. There was information in the daily records that staff were monitoring and observing the health of residents and call the doctor, if they were concerned about the resident. Three care plans were inspected to find out how residents are supported to meet their needs. The care plans seen were reasonably informative and detailed how to meet the health care needs of the residents. Care plans included guidance for staff to follow to support residents with physical, social and communication needs. However one resident did not have an assessment of their needs or a care plan in place that reflects their complex mental health needs as well as their physical health needs. Two of the three care plans that were inspected had not been reviewed and updated which is required to demonstrate residents’ health needs are monitored and reviewed. A sample of residents daily records were read to find out how the Home monitors residents day to day well being. The care records that were read contained a number of entries that were very subjective and judgmental in tone and had been written in a negative way. This must be addressed as writing about residents in this way can have a negative effect on the staffs’ perceptions of residents. The procedures for the administration, and storage of medication were checked to monitor if safe medication practices are being carried out. Medication supplies are stored in wall mounted secure cupboards in a larger walk in secure clinic. Three residents’ medication administration charts were reviewed. There was a photograph of each resident with his or her charts, which should ensure medication is administered correctly to the resident named on the chart. The administration charts were up to date. The registered nurses had signed for medication administered, or recorded the reasons for any omissions. Begbrook House DS0000020227.V294119.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): 12,13,15 Quality in this outcome area is adequate. Residents are provided with a healthy varied diet. Residents are also able to maintain contact with family and friends as they so wish. However the Home fails to provide residents with a varied programme of social and therapeutic activities that meets residents’ individual needs. EVIDENCE: An activity organiser is employed who works for half a day a fortnight with residents. However the organiser has had to cancel the time they spend in the Home recently. Residents all spoke positively about the activities that the organiser provides. However the amount of time allocated falls far below the required time needed for regular social and therapeutic activities for thirty-two residents. It is also a significant failing by the Home to meet residents’ range of social care needs. Comments made by residents on this matter included, `there is a lot of nice people who live here except they’re all bored’, `I’m lonely here I’ve got no one to talk too,’ `I would like to be able to play bingo’, `I wish we had the chance of more trips’ and `I would like to be able to sit in the garden more often’. Visitors spoke positively about the Home and how staff welcome them. Staff were observed talking in a warm and welcoming way to visitors. Residents also Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 13 said they can have visitors at any time they so wish this helps residents to maintain close contact with family and friends. A number of residents were asked their views of the quality and variety of meals provided at the Home and many residents said they thought the food was good and tasty, although one person said that the food was, `not terribly inspiring’. The menu was also reviewed to find out if residents are being offered a varied and well balanced diet. The Home operates a four-week flexible menu. The menu was looked at in detail, and there was a range of varied and traditional meals available. One resident had raised concerns at the last inspection that their specific cultural dietary needs were not being met. On this inspection they reported more positively and said there had been some improvement in this area. The resident was observed giving the cook some fresh herbs and leaves that they wished to be added to their meal. This is good practice and demonstrates the Home is working at meeting individual dietary needs. The lunchtime meal was observed being served. Staff were observed assisting residents in a sensitive way, and sat down next to residents when they were assisting people who needed extra help. The meal choices consisted of either savoury mince in gravy, or sausages and mash, and two cooked vegetables. There was also a choice of freshly made rhubarb crumble and custard or ice cream for desert. The inspector sampled the meal and thought it was satisfactorily cooked. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. Residents’ complaints are listened to and acted upon as required. There are also procedures and systems in place to help protect residents from abuse. EVIDENCE: A copy of the complaints procedure is on display in the reception area, which included the name of the Commission for Social Care Inspection. This will help anyone who wishes to contact the Commission for Social Care Inspection and make a complaint. The record of complaints received was also looked at to see how the Home responds when a complaint is made. There had been one written complaint received since the last inspection. There was a record of information to show what actions had been taken to address the complaints. Many residents said when asked, that they felt very able to speak to the manager if they had any concerns. A number of care staff were asked about the topic of `protection of vulnerable adults from abuse’. The staff demonstrated that they had an understanding of their responsibilities to protect vulnerable residents in their care. Staff have been on a training course on the topic of `protection of vulnerable adults from abuse’, to help them better understand issues around the protection of vulnerable adults. The Home has a `protection of vulnerable adults’ procedure and a range of guidance information including a copy of the ‘No secrets’ Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 15 government issued document for the protection of vulnerable adults from abuse, which should help protect vulnerable people who live at the Home. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is adequate. Residents live in a Home that is safe and looks satisfactorily maintained. However some rooms were not satisfactorily clean. EVIDENCE: Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 17 The Home is located close to private houses, a junior school, and a short distance from local shops and nearby bus stops, making the Home part of the local community. The building is wheelchair accessible. The Home is a purpose built care home. There are adaptations in place throughout the Home to assist residents as well as visitors who are disabled. The majority of the building was viewed both inside and out. The only areas that were not seen were a small number of bedrooms. The Home is set in woodland gardens, with squirrels and badgers roaming the grounds. This makes the gardens a popular area for residents and visitors in warmer weather. Several residents were spending time in the grounds during the inspection. Many of the residents said how much they enjoy the view of the garden from their rooms. The building was well ventilated and warm with plenty of natural light. Radiators were fitted with guards to help maintain residents safety by minimizing risk from radiator burns. The Home was clean in communal areas, however there were a significant number of rooms that require further cleaning as there were dusty surfaces, and a number of rooms that required vacuuming, as there was debris on the carpets. Soap and paper hand towels were available in the toilets and bathrooms and alcohol rub was in place for visitors use in the reception area to assist in minimizing cross infection in the Home. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. Residents are protected by the Home’s recruitment procedures. Residents are cared for by competent staff who are provided with some training to fulfil their roles and responsibilities. However there is a lack of staff time for social and therapeutic activities. EVIDENCE: To review how many staff are on duty for each shift, the duty record for the previous four-weeks was reviewed, for nursing and care staff. There is one registered nurse on duty at all times and five care assistants in the morning with four care assistants and one registered nurse in the afternoon. The registered manager works some shifts and some supernumerary management hours each week. They were on annual leave at the time of the inspection. There is also now a duty record of the hours worked by all ancillary and catering staff. The housekeeper was on duty on the day of the inspection, however there had been some recent domestic assistant staff sickness, which may have had an impact on the overall cleanliness of the Home (see environment standards of the report). Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 19 There was a small amount of short sickness recorded for the period of time reviewed. Residents spoke positively about the staff and how they are helped with their needs. Residents and staff were observed talking to each other in a warm friendly way, and staff clearly work hard to meet residents’ personal care needs. However the lack of sufficient regular structured social and therapeutic activities that has been written about already in the report is also applicable to the number of staff on duty. The number of staff on duty meets residents care needs. However based on observations, from reading care records and talking to staff and residents, the current numbers of staff are not sufficient to also be able to provide a varied and individual daily programme of therapeutic activities for residents. The recruitment records of three staff were inspected to find out if required ‘safety checks’ are being carried out when employees are recruited. The required Criminal Records Bureau offences checks and accompanying `protection of vulnerable adults from abuse first checks are being carried out for all new staff. These checks help ensure that staff are suitable and fit to work with vulnerable people, and helps protect vulnerable residents from potential risk of harm. There are also two professional references obtained for all newly recruited staff. This helps demonstrate the suitability of all new employees to work in the Home. Staff spoke positively about the improvement there has been in the range of training and development opportunities that they can attend. There was also evidence seen in the three staff files that demonstrated staff had attended some recent training and updating on subjects that are relevant to residents needs. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 20 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): 35,38 Quality in this outcome area is adequate. Resident’s health and safety is being protected. Also while staff are aware and have a good understanding of their roles and responsibilities they are not being provided with an appropriate level of supervision of their work. EVIDENCE: Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 21 Staff are clearly hard working and committed to meeting residents needs. Staff also demonstrated that they have an understanding of what their responsibilities are and how they support residents. However while there was written records to demonstrate the manager had carried out recent staff appraisals with two registered nurses. There continues to be a lack of evidence to demonstrate staff are supported by regular supervision sessions to review how they work and their practice. Staff who were asked by the inspector, said that there are no regular supervision opportunities provided for them to assist them in their work and personal development. This is needed as residents benefit residents from staff who feel well supported in their day-to-day work. The environment looked satisfactorily maintained throughout. The kitchen was tidy and organised when viewed and the cook demonstrated an understanding of safe food handling practices. Up to date checks of kitchen fridges and freezers are now being maintained, to ensure they are operating within food safety guidance levels. Foods that food safety guidance advises are `high risk’ foods are being temperature probed before serving to ensure the food has reached above minimum required temperature. Also uncooked eggs are being stored in the fridge, and food stored in the fridge is being covered and has the date it was placed in the fridge recorded. There are health and safety policies and procedures in place for staff to follow to ensure the safety of them and residents’ is maintained. The fire logbook was checked and showed weekly tests of fire alarms being carried out; helping to demonstrate the safety of people who are in the building is maintained. There was a record that showed staff had attended fire safety update training in the last twelve months, to ensure they were aware of fire safety procedures in the Home. Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 1 X 3 Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 23 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. 2. Standard OP7 OP12 Regulation 14.2,15(2 ), (b) 16(2), (m), (n) 14.2(a) 14 Requirement All residents’ care plans and assessments must be regularly reviewed and updated. There must be a programme of regular, varied, social and therapeutic activities provided for residents. Residents care records must be accurate objective and non judgmental in tone. The identified resident must have an assessment of their needs and a care plan that reflects their complex mental health needs. The environment must be satisfactorily clean in areas. There must be evidence to demonstrate staff are being provided with regular supervision of their work and practice. Timescale for action 11/06/06 11/05/06 3. 4. OP7 OP3 12/05/06 11/06/06 5. 6. OP26 OP36 23.2(d) 18. (2) 13/05/06 11/05/06 Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Begbrook House DS0000020227.V294119.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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