Inspection on 10/05/07 for Bellevue Residential Care Home

This inspection was carried out on 10th May 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

Bellevue Residential Care Home 17/08/06

Bellevue Residential Care Home 25/11/05

Bellevue Residential Care Home 14/04/05

Bellevue Residential Care Home 04/11/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOMES FOR OLDER PEOPLE Bellevue Residential Care Home 51 Church Road Clacton on Sea Essex CO15 6BQ Lead Inspector Ray Burwood Key Unannounced Inspection 10th May 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 Bellevue Residential Care Home DS0000059848.V340124.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. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bellevue Residential Care Home Address 51 Church Road Clacton on Sea Essex CO15 6BQ 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) 01255 473976 sandy@sahadew.fsnet.co.uk Anglia Care Homes Ltd Mrs Sandhya Sahadew Care Home 10 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number disorder, excluding learning disability or of places dementia (2), Mental Disorder, excluding learning disability or dementia - over 65 years of age (10) Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 10 persons) Persons of either sex, aged 65 years and over, who require care by reason of mental disorder (not to exceed 10 persons) Two named persons under the age of 65, who require care by reason of a mental disorder, whose names were made known to the Commission in August 2006 The total number of service users accommodated in the home must not exceed ten persons 13th March 2007 Date of last inspection Brief Description of the Service: Bellevue is a detached house situated in a quiet residential area within walking distance of the seafront and local facilities. Accommodation is on two floors; a passenger lift provides access to facilities on the first floor. The home provides a garden area to the back of the premises. Parking is available to the front of the premises. Bellevue provides a long-term residential service for 10 older people with either dementia or mental disorder. The home charges fees between £378 and £450 per week. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Key Inspection was carried out on the 10th May 2007. The purpose of the visit, in addition to assessing whether or not the home met Key National Minimum Standards, was to look at how much progress had been made by the home to meet the shortfalls identified at the last inspection. A statutory enforcement notice was served on the home as a result of those shortfalls. The inspection was carried out with the assistance of the Proprietor/Registered Manager, people living at Bellevue and staff, my thanks to them all. The inspection of the home was conducted between the hours of 10:30am and 3.00pm. The inspection involved a tour of the premises, looking at records, documents, talking to some of the people who live at the home and staff working at the home. Comments received from people living at the home were positive about the care and support provided by the staff. Comments were also received from staff regarding the amount of positive changes that had been made at the home. A total of 23 standards were inspected, eighteen standards were met and five standards were partially met, three of which are repeated requirements. At the end of the inspection visit, the findings were discussed with the registered manager and staff. What the service does well: The home provides a comfortable environment that is well furnished and maintained internally. The registered provider had given staff clear and detailed procedures for the safe and appropriate handling of medication. People who live at the home are supported by staff who are experienced and qualified to meet their needs. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 6 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. Bellevue Residential Care Home DS0000059848.V340124.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 Bellevue Residential Care Home DS0000059848.V340124.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): 1,3 and 6. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Documentation about the home is good and provides prospective new residents with the information they require before making a decision about living at the home. The home’s pre-assessment arrangements are well managed and ensure that a place is not offered until a full needs assessment has been undertaken and the home can meet the needs of the person applying to live there. EVIDENCE: The home’s Statement of Purpose has been updated to include the facilities and services provided. Previously, this document did not provide the evidence to support the fact that people living at the home were consulted about new admissions to the home. Information relating to residents involvement and consultation about new admissions to the home is now included in the Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 9 document. The registered manager said that residents meetings would in future have new admissions on the agenda for discussion. Information previously contained in the same document about staff contracts and procedures to be followed when requesting annual leave and issues about sickness/absence from work have been deleted. There had been no changes to the home’s pre-assessment process since the last site visit other than the inclusion of additional documentation. The process remains appropriate and comprehensive in assessing the needs of prospective residents. The home does not offer intermediate care or facilities. Bellevue Residential Care Home DS0000059848.V340124.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): 7,8,9,and 10. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The health and personal care needs of residents are well met with a clear consistent care planning system being in place to ensure their wellbeing Appropriate medication arrangements are generally good, however, areas relating to the storage and disposal of medicines should be further improved to ensure that residents are kept safe. EVIDENCE: The files of three residents were sampled and inspected during this site visit, new care-planning documentation had been introduced in order that more comprehensive care plan could be generated. Areas covered all aspects of care including the mental health needs of individual residents. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 11 Sufficient information was made available to staff to ensure that the assessed needs of residents were carried out and met. Care plans seen were specific to the aims, plans, reviews and all eventualities in terms of risk to people living at the home. Staff spoken with demonstrated a good knowledge of the people living at the home and their individual and diverse needs. During the site visit staff were observed to treat people living at the home with respect and supported their privacy and independence. Issues relating to one of the residents’ care plan inspected, formed part of a Statutory Requirement Notice being issued following the home’s last site visit. The registered manager had addressed the issues highlighted and records were in place relating to Healthcare Professionals visits to this person and other residents living at the home. These included visits by the District Nurse; Psychiatric Team and General Practitioners. Medication storage facilities, medication records and relevant care records were examined along with written policies and procedures for the safe use of medicines. The registered manager had given staff clear and detailed procedures for the safe and appropriate handling of medication. The procedures for ordering prescriptions and medicines means that the home staff do not have sight of the original signed prescription from a doctor and so it is not always possible to check the instructions for medicines, particularly when they have been changed. The majority of medicines are stored securely for the safety of residents but when medication is needed to be stored in a fridge, it is not in a lockable container and so there is a risk they may be accessible to unauthorised people. The temperature of the office where medication is stored was 23 C at the time of the inspection and there is no regular monitoring or recording of the temperature. This is close to the recommended maximum of 25 C so it is important that the temperature is monitored and recorded to make sure that medicines retain their quality and don’t put residents at risk of receiving substandard medication. Records of the receipt, administration and disposal of medicines were of a good standard and means there is a good audit trail and medicines can be accounted for. When medication is given in a variable dose e.g. one or two tablets, the administration record does not indicate the actual dose given. This is necessary to prevent residents receiving too much medication that could cause serious harm. There had been some changes to medication made by the resident’s doctor and these were noted on the medication charts but no details were recorded in the resident’s care notes to validate this change. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 12 Where residents are prescribed medicines on a “when required” basis to control behaviour there was often no detailed guidance for staff to follow on how to manage the resident before resorting to giving medication. This is important to make sure that staff are consistent in their approach to the use of such medication, and to prevent inappropriate use of such medicines to control the behaviour of residents. Residents had their medication given to them by designated trained care staff. Staff only administer medicines following a training program but there is no documented assessment that they are competent to put this training into practice and to be able to safely give medicines to residents. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People who use the service experience adequate qualities outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Residents experience a varied life at the home with visitors encouraged and informal activities and good meals made available. EVIDENCE: People living at Bellevue were observed during the site visit and found to have different daily living and social needs. Care files inspected contained information relating to residents social and recreational preferences, however, from discussions with residents and staff it was clear that not all of the residents could expect the time and personalised support in their choices and expectations due to insufficient staff being on duty. Staff at times, provide some activities within the home and gardens. A fortnightly visit from an activities person, who is not employed directly by the home on a permanent contract, provides musical sing-a-long and fitness exercises. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 14 People living at the home are taken out by family members for meals, walks, and pub visits. One resident attends a Day Centre one-day a week, another residents’ spouse visits the home regularly and supports their hobbies and provides books and videos. Telephone contact with relatives is maintained by some residents, the home provides a mobile phone facility for private conversations. A hairdresser visits fortnightly and a chiropodist six weekly or sooner if required. People living at the home were observed during the luncheon period and found to be supported by staff when required. One member of staff was observed to assist a resident with their feeding in a respectful and caring way throughout. Residents spoken with during the luncheon period said the food was good and choices were available. Staff spoken with explained that they enjoyed cooking but were aware of the problems that this could create. This was discussed with the registered manager who said she was aware of the problems that could arise and would be looking at employing a cook. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home’s complaints policies and procedures help ensure that residents and their families feel confident in raising concerns or complaints, know they will be listened to, and action taken to resolve them. Adult Protection policies and procedures, together with appropriate staff training help ensure that residents are protected from abuse. EVIDENCE: The home has a detailed complaints policy and procedure that is made available to individuals wishing to register a complaint. Information for residents is contained in the Service Users Guide, with the addresses and telephone numbers of other agencies, including the Commission for Social Care Inspection (CSCI), that they and others may wish to contact. The Commission or the home has not received any complaints since the home’s last inspection. During the site visit the registered manager provided a letter received from a relative of someone living at the home saying how happy they were with the care and support offered by the home. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 16 Policies and procedures relating to Adult Protection and Whistle Blowing were in place together with local policies and guidelines provided by the Essex Vulnerable Adult Protection Committee. Staff spoken with had a good understanding of how to protect and prevent abuse situations and confirmed that they had undertaken Adult Protection training courses. The Registered Manager provided the evidence of further training courses that were made available for new staff and refresher training for established staff. There are no current adult protection alerts relating to this home. The financial affairs of someone living at the home are further discussed in the Management Standards at the end of this report (Standards 31-38). Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home provides an good internal environment that is appropriate to the specific needs of the people who live there, however the exterior of the premises is not well maintained. EVIDENCE: The physical environment of the home was appropriate for the needs and requirements of the people living there and was homely, clean, safe and comfortable. A carpet was to be replaced in one residents bedroom with a laminate covering due to an incontinence problem currently being experienced by the occupant. Bathrooms and toilets contained the appropriate adaptations required by the residents to promote their safety and independence. These included hoists, covered radiators and hot water outlets being regulated by independent valves. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 18 Window frames on the outside of the premises are in need of painting or replacement. The registered manager said that an application for an extension to the side of the property was being considered and would involve the replacement of the windows at the same time. Laundry facilities are appropriately sited with hand washing facilities provided where soiled articles are being handled. Records relating to clinical waste collections were in place and collections made on a monthly basis. A well-maintained rear garden provided residents with an easily accessed and pleasant area to relax in. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People living at the home can expect to be supported by a staff team that have received the appropriate training and have the knowledge to care for them, however, the deployment and number of staff available at key times of the day is not always sufficient to meet their needs. The procedures for the recruitment of new staff are robust and provide the safeguards and protection to people living at the home. EVIDENCE: The staffing levels observed on the day of the site visit continue to be of some concern. Two members of staff were observed to be responsible for providing additional duties such as cleaning, bed making/changing, food preparation and cooking meals. Arrangements at lunchtime were found to be adequate and people living at the home were supported in eating their lunch, however, if there had been a crisis, residents would not have been supported at a time when they needed it. The registered manager explained that they were available Monday to Friday during the day and would assist if required. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 20 The latest information provided by the home omitted to provide an analysis of staffing levels using a recognised tool. The registered manager agreed that staff should be supported in carrying out their care duties without having to be involved in additional duties that restricted their care of people living at the home. Discussions relating to the employment of kitchen staff took place and the registered manager said they were looking at employing a cook. People living at the home who were able to talk to the inspector said they were happy living at the home and felt the staff supported their needs and always appeared to be busy. Sometimes they had to wait a short time when requiring attention. Records relating to the home’s recruitment process were examined and found to include the relevant paperwork and checks required before employment was offered. The registered manager was in the process of replacing existing training documentation with new ones in line with “Skills for Care”. New members of staff will undertake an induction period following the guidelines and standards of “Skills for Care” and not the existing induction programme used by the home. Staff spoken with confirmed that they had completed training in respect of moving and handling, food hygiene, Adult Protection, first aid and health and safety. Staff induction and foundation training records were seen during the site visit. More than 50 of the staff had completed their National Vocational Qualification (NVQ) training at level 2 and 3. All staff had completed dementia training over an eight- week period of two hours per week. The registered manager confirmed that some members of staff who had completed their medication training were due for their refresher training. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The management of the home has improved ensuring that the health and safety of residents and others is promoted, however, fire risk assessments are not in place to further protect people in the home. The home does not review aspects of its performance through a programme of self-review and consultations, which includes the views of residents, relatives and staff. This process should be further developed. The home’s policies and procedures regarding residents’ finances ensure that they are involved and that their financial interests are safeguarded. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 22 EVIDENCE: The registered manager of the home is qualified and skilled in running a care home and has the experience of caring for older people with mental health disorders and dementia. The registered manager demonstrated that they had undertaken periodic training to update their skills and competences to enable them to transfer the knowledge to staff working in the home. Staff spoken with said the manager supported them and training had been completed in most cases. Requirements issued following the home’s last site visit have been dealt with effectively, with few requirements outstanding following this visit. The home’s quality assurance and monitoring systems remain at an early stage of development with little progress in place since the home’s previous inspections. The registered manager explained that they were seeking the advice of professionals from the Alzheimer’s Society about the best way forward in designing questionnaires and surveys for people with a mental disorder or dementia. Resident’s financial records were inspected and found to be correct with expenditures and receipts in place. The registered manager who is the appointee for one resident had since the last site visit, opened a bank account for this person and provided the inspector with bank statements related to this persons account. Also, the resident concerned has been issued with a debit card and is provided with support when wishing to withdraw money from the account. Staff files inspected contained up to date supervision sessions with action notes and recommendations in place. However, the registered manager pointed out that annual appraisals are still outstanding for all staff employed at the home. Records relating to the health and safety of people living and working at the home were generally well maintained with appropriate training undertaken by staff in safe working practices. Records relating to the home’s fire risk assessments were not available during this site visit. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 23 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 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 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 3 17 X 18 3 2 X X X X X X 3 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 3 X 1 X 3 3 X 2 Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13 (2) Requirement Arrangements for the safe storage, recording and administration of medicines received into the home must be improved to ensure the wellbeing of people living at the home. (Previous timescales of 31/10/06 and 29/04/07 not met). 2. OP19 23 (b) The external fabric of the home must be kept in a good state of repair. This relates to the poor condition of the window frames at the front and side of the premises. 31/10/07 Timescale for action 31/08/07 3. OP27 18 31/08/07 There must be at all times suitably qualified and competent staff are employed at the home in sufficient numbers to meet the support needs of service users. (Previous timescales of 31/10/06 and 29/04/07 not met). Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 25 4. OP33 24 A system for reviewing the quality of care must be established to ensure the service improves the health and personal care, interests and preferences of people receiving a service. 31/08/07 5. OP38 13 (3) A fire risk assessment must be in 31/08/07 place following consultation with the Fire Service to help ensure the health and safety of people living and working in the home. 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 OP9 Good Practice Recommendations The registered person should consider the need to have sight of the original prescription signed by the doctor and that a copy is retained to be able to validate instructions for medicines. Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Bellevue Residential Care Home DS0000059848.V340124.R01.S.doc Version 5.2 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. 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