Inspection on 21/09/07 for Belle House

This inspection was carried out on 21st September 2007.

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

Belle House 19/08/08

Belle House 19/05/06

Belle House 18/10/05

Belle House 17/05/05

Belle House 25/10/04

Belle House 22/06/04

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

CARE HOMES FOR OLDER PEOPLE Belle House Belle Hill Old Town Bexhill-on-sea East Sussex TN40 2AP Lead Inspector Caroline Johnson Key Unannounced Inspection 21st September 2007 10:00 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 Belle House DS0000021048.V338504.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. Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belle House Address Belle Hill Old Town Bexhill-on-sea East Sussex TN40 2AP 01424 221624 01424 732704 britheadoffice@hotmail.co.uk 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) Britannia Care Homes Limited Mrs Gillian Parsons Care Home 16 Category(ies) of Dementia (16) registration, with number of places Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of residents to be accommodated is sixteen The people accommodated will be aged sixty five years or over on admission The people accommodated will have senile dementia type illness Date of last inspection 19th December 2006 Brief Description of the Service: Belle House is registered to accommodate up to sixteen older people with a dementia type illness. The building is an old converted property situated in the old town area of Bexhill on Sea, close to local amenities. The main town centre with its access to bus and rail routes is approximately half a mile away. Accommodation is provided on two floors and a stair lift is fitted to assist access to first floor accommodation. The registered providers are Britannia Care Homes Ltd who also own another three homes in the area. The home makes CSCI reports available to prospective residents and/or their relatives/representatives upon request. The fee charged as of April 2006 is £345 to £400 per week. Additional charges are made for chiropody and hairdressing. Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of the inspection process an unannounced site visit was carried out on 21 September 2007. The inspection lasted from 10.00am until 5.00pm. During the visit there were opportunities to meet with the deputy manager and with two other staff members in private. Time was spent speaking with residents in the lounge area and observing lunch and part of an activity in the afternoon. A full tour of the building was carried out. A wide range of documentation was examined including the pre-admission documentation held in relation to one resident and three care plans. In addition records held in relation to staff rotas, menus, complaints, quality assurance and health and safety were examined. At the time of inspection the manager was on leave. The deputy manager facilitated the inspection and another staff member from another home within the company came to free up the deputy manager. Prior to the site visit survey forms were sent to the home to distribute to visiting professionals and to the relatives of the residents. Three professionals and five relatives responded. Comments from professionals included ‘Friendly attentive staff, caring, no concerns re care provided. ‘Good care of their residents and good communication with doctors and nurses at the surgeries’. ‘Care appropriately for a difficult clientele’. Comments from relatives included ‘many improvements have been made in recent months at BH to both the interior and exterior of the property. Perhaps at times more staff are required to be on duty’. ‘I understand that Belle House has recently taken on additional staff which they anticipate will help to keep track of clothes etc that go missing (this will be good), amongst other things reducing pressure on staff enabling them to provide more attentive care generally’. ‘Seems to be that care workers do all the cooking – I feel this is a job that should be done by someone else as all the residents need a lot of attention. Staff are always very busy keeping up with their needs’. ‘They understand the needs of people with dementia and are helpful with relatives’. In relation to a question about how the home could improve, the response from one relative was, ‘possibly with extra staff’. Following the inspection the manager contacted the Commission to advise that the problem identified whereby one resident was trying to climb over the stairgate is not longer a problem. The requirement made to carry out a risk assessment is therefore no longer necessary. The manager also confirmed that the bathroom on the first floor is now in use by residents so the home now has an adequate number of bath facilities. A fax was also received confirming that there are now three care staff on duty at all times throughout the day and that the manager’s hours are in excess of this. Belle House DS0000021048.V338504.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: 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. Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that prospective residents are given information and an opportunity to visit the home prior to making a decision about accommodation. EVIDENCE: Pre admission documentation was seen in relation to one resident who was recently admitted. Social Services provided a detailed care plan and in addition the home carried out their own assessment of needs. Records also showed that the resident visited the home twice, prior to making a decision to move in. The resident advised that he is settling in well, he likes the food and likes his room. It was noted that one of the needs stated in his care plan was as yet unmet. It stated that the resident ‘needs to be able to access smoking facilities Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 9 that provide a dry warm environment to be able to smoke’. The day of inspection was dry and warm and the resident was able to use the garden to smoke but there is no covered smoking area. It was noted in the daily records that a new risk had been highlighted, as this resident had on a couple of occasions climbed over the stair gates. The deputy manager advised that she would draw up a risk assessment as a matter of urgency. Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A large number of the residents have quite complex and changing needs so increased emphasis needs to be placed on ensuring that care plan meetings are held regularly to ensure that the information available remains relevant. Facilities for weighing all residents need to be available and residents should be able to make and receive telephone calls in private. EVIDENCE: Four care plans were seen on this occasion. Generally the care plans had been reviewed and updated at regular intervals. Details of appointments such as chiropody, district nurse and doctors visits are recorded. Care plan meetings are held regularly. This involves carrying out a review of the care plan and inviting the resident and their relative if appropriate to comment on the outcome. Minutes of the care plan meetings seen provided minimal Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 11 information and relatives are not currently signing to indicate that they have been involved in the process. One resident who has very complex needs had not had a care plan meeting for some time. As this residents needs have changed significantly in recent times it would be useful to have a review to up date the care plan and take out information that is no longer applicable. Of the four care plans seen two of the residents’ weights had been recorded on a monthly basis. Records in the other two care plans stated ‘unable to weigh’. Staff advised that they only have a ‘stand on’ weighing scales. Advice in one care plan is that staff should use a hoist to transfer the resident. However it also states that if the resident becomes distressed then ‘two or three carers should assist at all times and use the lifting belt’. Staff advised that they have not experienced any problems lately in transferring, but that depending on staff levels this could potentially present a problem. One resident is in bed most of the day and when this is the case they are turned every two hours. The care plan refers to the period of time at night when there is only one carer and advised that the resident should have pressure points relieved. The district nurse advised that this resident should be moved at least three hourly through the night and that it would take two care staff to carry out this task. The district nurse spoken with confirmed that staff are very helpful and they work hard. They felt that staff levels are low and at times have led to a fall in standards in relation to personal care. However, the home always responds positively to concerns raised. At the time of inspection the pay phone was located in one of the dining rooms. Staff advised that the phone is normally in the kitchen but they were waiting on an engineer to carry out repairs. The location of the phone in the kitchen means that residents are unable to have privacy to receive telephone calls, as they could not be left on their own in the kitchen area. Staff who also need to make a call connected with work also need to use the pay phone when the office upstairs is closed. As recommended at the last inspection, the deputy manager advised that staff are careful to check that residents’ shoes are fitting correctly prior to transferring residents so as to minimise accidents occurring. In addition they have spoken to relatives to ensure that there is a range of clothing available for each resident that is appropriate to the season. Records seen showed that not all staff are up to date on medication training. The records seen in respect of medication administered to residents were generally in order. Storage and record keeping in respect of controlled drugs was in order. Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is continually trying to increase the range of activities available to residents. More planning in advance of activities would assist staff to think about what they are hoping to achieve from the activity and with each individual resident. EVIDENCE: Shortly after arriving for the inspection a local Vicar arrived to provide a service for the residents. The staff member introduced the Vicar to the residents and explained the reason for his visit. Staff advised that residents always enjoy the service. A non-denominational service is provided each week from two of the local churches. Staff advised that musical entertainment is provided on a regular basis. This includes the ‘Land Army Girls’, music and motivation and two other singers one Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 13 who plays the piano and violin and another who plays the guitar. A hairdresser comes to the home every Thursday. The recently introduced book club is also going well. Staff stated that on Sundays they tend to have games and quizzes in the lounge followed by a casual tea. A staff member also stated that recently they have had cake-making sessions with a few of the residents and this has worked very well. On the afternoon of the inspection the resident activity involved looking at pictures of famous people and seeing if the residents could identify them. It was noted that during the activity a film was also being played so this was a missed opportunity to encourage a conversation about the individuals and what they did and to try to start a group conversation. Staff advised that sometimes they take a few residents into the dining room for group activities. The home has recently changed the way they are recording information about the residents’ activities. Emphasis is being placed on recording the activity but more emphasis could be placed on recording each resident’s level of participation. One staff member advised that they have recently been able to take residents out for a walk and those taken had really enjoyed this activity. Individual records are also being kept for the two residents that spend most of their time in their rooms. If an entertainer is in the home they are asked to visit the residents in their room and it was also noted that the Vicar spends time with both also. Client forum meetings are held regularly and this is an opportunity to check with residents that they are happy with the care they receive, happy about the food provided, the activities and the routines of the home. A record is kept of the findings. Lunchtime is busy as there are two dining rooms and three residents that need assistance with feeding. Two of the three residents are fed in their individual bedrooms. On the day of inspection, one resident was repeatedly seeking reassurance throughout the meal. It was also noted that whilst feeding a resident a staff member, although talking to other residents and providing reassurance to another resident, did not speak to the person they were feeding. One resident who choose not to eat her main meal was given a sandwich as an alternative. Menus seen were varied and well balanced. Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are clear procedures in place enabling anyone wishing to make a complaint to do so. More detailed record keeping could be maintained of the outcome of any complaint made. EVIDENCE: Complaint records were seen and showed that one complaint had been received in 2007. The complaint was in writing from a relative about missing items of clothing. Records showed that a phone call had been made to the complainant stating that some of the clothes had been found and stating that they would continue to look for the missing items and put in place a system for lost clothing. However, there was no written response to the complainant on file and no indication that any further items had been found. The restraint policy has been updated since the last inspection. The staff training matrix showed that four staff received training on adult protection and prevention of abuse in June 2007. The rest of the staff team received training either in 2005 or 2006. Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and decorated to a good standard. Action must be taken to ensure that there are sufficient numbers of bath/shower facilities in the home available for residents. EVIDENCE: A full tour of the building was carried out. It was noted that a number of areas have been repainted and a new carpet has been fitted in the lounge. The deputy manager advised that they would be getting new bedspreads for the beds. Overall bedrooms were well decorated and had been personalised by the relatives of the residents. It was noted that there were instructions for Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 16 staff about resident’s personal care needs posted on the outside of some of the ensuite doors. Whilst it is essential that care staff receive this information it should perhaps be in a more discreet location to preserve the dignity of the residents. In one room the wardrobe door was broken but the deputy manager advised that this had been picked up in the recent audit of the building. Information provided in advance of the inspection by the owner showed that there are plans to change the downstairs bathroom into a shower room. It was noted that the bathroom on the first floor is now for staff or visitor use only. At least half of the current residents are unable to use the current bath as firstly it is not possible to get a hoist into the bathroom and secondly the bath chair does not have a swivel mechanism so it would involve a lot of manual handling to get the residents into the bath. With the bathroom on the first floor no longer in use this means that the home does not meet the ratio of one bath/shower-room to eight residents. A maintenance programme has been drawn up highlighting all areas where work is required. There are plans to repair sections of the roof, and improve access to the garden. In addition the home intends to replace the dining room chairs. There were some timescales stated for some of the work identified in the maintenance plan. A fire risk assessment was carried out in February 2007. Action carried out in response to the recommendations was recorded in pencil on the assessment. Self-closing devices have been fitted to all communal areas and to one bedroom door. In the laundry area there is one washing machine and two tumble driers. It was reported that the home to is get another washing machine. All areas of the home seen were clean. The cleaner advised that she has set tasks each day, which ensures that all areas are cleaned on a regular basis. Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing arrangements are not appropriate for the needs of the residents accommodated. EVIDENCE: The staff rota showed that in addition to the manager there are two care staff on duty from 8am until 7pm. In addition a third carer works from 9am until 12.30pm and there is a cook and a cleaner employed in the mornings. At 12.30pm the staff ratio then reduces to two care staff. A tea girl works three to four evenings a week from 3-6pm but as they are 16 years old they are unable to assist with personal care tasks. From 7pm there are two night staff one waking and one sleep in. Six of the residents require the assistance of two carers for mobility. In addition two residents require support of two staff for transferring. Care staff carry out all for laundry duties. A district nurse visits every morning to provide support for two residents and another visits twice a week to provide support to another resident. It was reported that the majority of the residents are up in the mornings before the day staff arrive on duty. Three residents require support with feeding. Two of these feeds are carried out in individual Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 18 residents’ bedrooms and the third in the dining room. As the third member of staff is off duty at 12.30am this can place pressure on staff to complete tasks. Information provided in advance of the inspection confirmed that five staff are working towards NVQ (National Vocational Qualification) training to level two or above. The staff training matrix was not discussed in detail but it was noted that courses are regularly provided and that recent training included courses on food hygiene and the Mental Capacity Act and the owner had also run a dementia awareness workshop. Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good measures in place to ensure the health, safety and welfare of the staff and residents. EVIDENCE: The registered manager has a wealth of experience in working with people with a dementia type illness. She is currently studying for the Registered Manager’s Award. Staff spoken with described her as ‘very supportive’. Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 20 One member of staff stated that they had only had one formal supervision session in the past seven months. Another stated that they had received a formal supervision session two months ago. All care staff spoken with felt that they could approach the manager at any time if they had a problem. In relation to quality assurance it was noted that audits are carried out in relation to care plans, staff personnel files, activities, risk assessments, medication and food and fluids. The last audit for the areas listed was carried out in August 2007. Where there were shortfalls noted there was information about what was missing. There is an annual development plan in place, which highlights the homes plans to build upon and improve the quality of the home and care provided. Satisfaction questionnaires were sent to the relatives of the residents in April 2007. Records showed that ten responses were received. Overall the responses were positive. A response was sent to the relatives detailing action that would be taken as a result. This included appointing an extra member of staff at peak times to assist with client care and laundry and advising that the walk in shower would be installed in the next few months. Prior to the site visit survey forms were sent to visiting professionals and to relatives to seek their views on the quality of the care provided. Three professionals and five relatives responded. Comments from professionals included ‘Friendly attentive staff, caring, no concerns re care provided. ‘Good care of their residents and good communication with doctors and nurses at the surgeries’. ‘Care appropriately for a difficult clientele’. Comments from relatives included ‘many improvements have been made in recent months at BH to both the interior and exterior of the property. Perhaps at times more staff are required to be on duty’. ‘I understand that Belle House has recently taken on additional staff which they anticipate will help to keep track of clothes etc that go missing (this will be good), amongst other things reducing pressure on staff enabling them to provide more attentive care generally’. ‘Seems to be that care workers do all the cooking – I feel this is a job that should be done by someone else as all the residents need a lot of attention. Staff are always very busy keeping up with their needs’. ‘They understand the needs of people with dementia and are helpful with relatives’. In relation to a question about how the home could improve the response was ‘possibly with extra staff’. Records of accidents were examined. There were 30 records present. A brief examination of the records revealed that approximately seventeen of the accidents had occurred at night and only three occurred in the mornings. In relation to health and safety there were records in place to show that water temperatures are tested on a monthly basis. Certificates were in place showing that portable appliance testing, gas, fire equipment, stair lift and tests Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 21 for legionella had all been carried out within the last year. A health and safety checklist is carried out on a monthly basis. The last checklist was carried out on 4/9/07. The owner or a representative on her behalf visits the home on a monthly basis to monitor the running of the home. A report is written of the findings. Belle House DS0000021048.V338504.R01.S.doc Version 5.2 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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 2 X 3 3 3 3 STAFFING Standard No Score 27 1 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 2 X 3 Belle House DS0000021048.V338504.R01.S.doc Version 5.2 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. Standard OP7 Regulation 13(4a,c) Requirement A risk assessment must be carried out to determine any safety implications in relation to one resident who climbs over the stair gates. It must be possible to see from records information about each resident gain or loss of weight. Residents must have access to a telephone that they can use in private. A ratio of one bath or shower to eight residents must be maintained. There must be at least three care staff on duty throughout the day. [This was a requirement of the previous inspection – timescale 31/1/07]. It is now essential that a full review be carried out of staff levels and routines. The outcome of the review must be forwarded to the Commission. All staff must receive regular supervision. Timescale for action 31/10/07 2. 3. 4. 5. OP8 OP10 OP21 OP27 17 (1a) Sch 3, 3(m) 16 (2a)(i)(b) 23(2j) 18(1a) 30/11/07 30/11/07 31/12/07 15/11/07 6. OP36 18(2) 30/11/07 Belle House DS0000021048.V338504.R01.S.doc Version 5.2 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 Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Belle House DS0000021048.V338504.R01.S.doc Version 5.2 Page 26 - 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!