Inspection on 17/08/06 for Bellevue Residential Care Home

This inspection was carried out on 17th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 10/05/07

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 Jenny Elliott Final Key Unannounced Inspection 17th August 2006 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.V306703.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.V306703.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 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 (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (10) Bellevue Residential Care Home DS0000059848.V306703.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) One person, whose name was made known to the Commission in February 2003, under the age of 65 years, who requires care by reason of mental disorder The total number of service users accommodated in the home must not exceed ten persons 25th November 2005 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 9 older people with either dementia or mental disorder and one person under 65 years of age with mental disorder. The home charges service users between £378 and £450 per week. Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information included in this report was gathered from two visits to the home, at these visits discussions were held with service users, staff and visitors and records held by the home were inspected. The home was not aware in advance of the visits to the home. Information provided by the home, and from other sources, since the last inspection has also been used to inform this report. What the service does well: What has improved since the last inspection? What they could do better: A number of key areas that were identified at the previous two inspections as requiring improvement, had not been addressed. These include the protection of vulnerable people through the homes recruitment processes. The care plans in place did not sufficiently identify or address the support needs of people living at the home, particularly those relating to their mental health. People living at the home continue to have little opportunity to make decisions about their lives. The service will be required to submit an improvement, which will be monitored by the Commission. Failure to improve on areas identified as needing improvement could lead to legal enforcement action being taken. Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 Page 6 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. Bellevue Residential Care Home DS0000059848.V306703.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.V306703.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service does not provide accurate information to prospective service users. The home obtained good information about prospective service users upon which to make an assessment of their needs. EVIDENCE: The pre-admission information provided to the home was detailed and included information about cognitive awareness, social interaction and leisure interests of the service user. There was evidence that the home had taken steps to consult with family members about one person’s life before coming to the home and their likes and dislikes. The home’s statement of purpose says that ‘the views of service users already living at Bellevue’ will be taken into consideration before a new person moves in. There was no evidence in the home to support this. Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 Page 9 It was noted through the inspection that the statement of purpose included information that contradicted with practice at the home. This means that it does not provide good information upon which a potential service user can make a decision. The document also contains information that would be more appropriate to an employment contract, such as procedures for staff to follow when requesting holiday or if too ill to work. Bellevue Residential Care Home DS0000059848.V306703.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home did not have comprehensive care or health plans in place. Practice in respect of the administration of medication did not protect service users. The approach of staff promoted the dignity of service users. EVIDENCE: The records of two service users were inspected in detail. The quality of information held was variable. Some of the detail obtained at assessment (see previous section) was reflected in care plans. But some of the guidance was too general, with comments such as staff should ‘encourage’ or ‘facilitate’ a service user to participate in activities of their choice. One care plan said ‘encourage [service user] to continue with the activities of daily living’. These instructions do not help staff to understand service users as individuals with their own aspirations and preferences. The approach of staff toward service users, observed at both visits to the home, was calm and kindly. Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 Page 11 The care plans inspected did not include clear information about how the person maintained their emotional and mental wellbeing, or what might trigger a deterioration in their health. There was some evidence that care plans were reviewed. Some reviews contained meaningful comments about the wellbeing of service users. Most of the comments, though, were ‘continue as planned’. It was noted that one service user had very long nails, and that their fingernails were very dirty. The records of medication administered were inspected in detail. There were a small number of omissions on the sheets, which meant it was not possible to tell whether or not people had taken their medication and if not why not. The records for one day relating to one service user had been ticked instead of initialled, this means that there is not a clear audit trail of administration which is important in the event of any future problems. One service user had been prescribed medication on an ‘as and when’ or PRN basis. There were no guidelines for staff about the circumstances where this would be appropriate. There was evidence that medication reviews had been sought on a number of occasions. These were mostly associated with episodes of increased anxiety or challenging behaviour. There was no evidence that any other management strategies had been agreed with professionals in respect of these behaviours. Accident records held by the home showed that one service user had had four falls in just over three weeks. The manager said that contact had been made with a number of health professionals in respect of the general health of this person, including nurse practitioner, district nurse and dietician. The falls prevention officer had not been consulted. There was no evidence on file of a risk assessment or management strategy to address this deterioration in health. The Commission had not been advised of these incidents. Bellevue Residential Care Home DS0000059848.V306703.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users were not given sufficient opportunities to exercise choice and control over their lives. Service users were not given sufficient opportunity for social stimulation. Meal times were congenial and meals presented were appealing. There were insufficient staff on duty to provide a satisfactory level of support to service users at mealtimes. EVIDENCE: One member of staff described activities that included reading the paper with individuals, music, quiz and passing the ball. They said that a quiz had taken place on the morning of the first visit to the home. There were checklists on the records inspected of daily activities, activities other than music, TV and conversation had occurred when service users were taken out by their visitors. One service user was observed helping with the dishes after lunch, and the manager advised that other people help with setting the table. These are seen as positive ways to include people in the daily life of the home. Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 Page 13 During both visits to the home time was spent in the lounge with service users. On both occasions service users were sitting in the lounge and the television was on, but no one appeared to be taking any account of it. Apart from when staff came to collect people for lunch or help them to the toilet, there was no interaction with service users. The home’s statement of purpose recognises the barriers facing people with mental health needs that might impinge on their right to experience ‘all aspects of life as any other human being’. It goes on to say ‘Bellevue will support all services in taking positive risks’, this was not evidenced in practice at the home. Discussion with the manager about service users finances, and inspection of the financial records, revealed that service users were not in the habit of spending their own money. Expenditure detailed in the relevant records included cigarettes, sweets, toiletries, shoes, and ‘personal items’. All of these items were purchased on behalf of the service user. This meant that they were unable to make basic choices in their life about how to spend their own money. This person was considered able to go out for short walks on their own, and although the manager said this was monitored in case they got lost there was no associated risk assessment or management strategy in their records. Dinner was observed during one visit to the home. One service user appeared to be oblivious to the fact that their dinner was in front of them. A member of staff gently reminded them that their dinner was there and they took a mouthful of food. The member of staff went away. I returned to the dining room five minutes later, again the service user sat at the time with no apparent awareness of their dinner. The member of staff who had reminded the service user about their dinner was sitting with another service user who was bed bound, and helping them with their meal. The other member of staff who was on duty at the time was cleaning the cooker. One service user who had been spoken to earlier said the food was ‘very tasty’. A visitor to the home said that the food ‘always looks good’ and that they see it being cooked ‘from fresh’. Bellevue Residential Care Home DS0000059848.V306703.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home addresses the immediate concerns of service users. The homes policies in respect of the protection of vulnerable adults were satisfactory. The homes practice in respect of service users finances were not satisfactory. EVIDENCE: Service users and relatives said, through questionnaires and in discussion, that staff listened to any concerns they had. The manager described a difficult situation where a service user was potentially at risk from a visitor. The manager described action they had taken, including consulting with other significant people in the service users life. The service users records did not reflect the action taken and there was no associated risk assessment, management strategy or associated guidance for staff about how to handle the situation. An anonymous concern had been received by the Commission about the number of falls one service user had had at the home. This was discussed with the manager at the second visit. Reference was made to the Care Home Regulations and the requirement for the home to inform the Commission of significant incidents, in addition to steps that should be taken to protect service users from the risk of falling. The home had not received any complaints since the last inspection. Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 Page 15 Procedures in place at the home in respect of service users finances (as described in detail under ‘management’ section) did not serve to protect service users. Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean and pleasant and generally well maintained. The home did not pay sufficient attention to ensuring the environment met the needs of service users. EVIDENCE: One of the people living at the home, gave the inspector a tour of the premises. The premises were clean and tidy throughout. A notice board in the hallway had wording that suggested it was there to help remind people where they were, who was working, and of the date and season. Unfortunately it was not fully completed and some information was incorrect. Similarly a calendar in the lounge was showing the wrong date. These are important details that should help people living at the home, some of whom were aware that they had poor memory recall and needed reminders and support to place themselves. The person that provided a tour of the premises, Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 Page 17 whilst often forgetting where they were, was able to place themself by referring to names and pictures on bedroom doors. The rear garden was mostly laid to lawn, with a wooden table and chairs and birdbath, and provided a pleasant area to sit in. The front garden was well maintained with a range of flowers and shrubs. The font of the house requires some attention to flaking paint. Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were insufficient staff on duty to fully meet the needs of service users. The home’s recruitment practice did not protect service users. Staff training was adequate. EVIDENCE: One member of staff, who had been at the home for just over a year, said that the other staff and manager had been very helpful when they first arrived. They said they had completed training on dementia, moving and handling, and basic food hygiene. There were certificates on file to support this. They also said that if there were any problems they could go to the senior or manager who will help, adding ‘they are nice’. The manager confirmed that one to one supervision sessions were not held with staff. The home’s statement of purpose states ‘Each staff member will receive supervision on a regular basis.’ The same member of staff described a number of activities undertaken with service users and a basic understanding of the frustrations experienced by people with dementia and mental health problems. The latest information provided by the home omitted to include an analysis of staffing levels using a recognised assessment tool. Observation at both visits to the home demonstrated that the two staff on duty were responsible for preparing meals and washing up in addition to the provision of care. This Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 Page 19 meant that at lunchtime, not all service users received the support they needed. The records relating to the newest member of staff were inspected. These showed that a Criminal Records Bureau Check had not been obtained until after the person started working at the home. The person had started, but not finished, a ‘Skills for Care’ induction programme. It was over a year since the person had begun employment at the home and the induction programme is designed to cover basic care and safety issues in the first few weeks of employment. The member of staff had completed training in respect of moving and handling, food hygiene awareness, protection of vulnerable adults, emergency first aid and health and safety. All of this training had been provided by the manager or the registered provder. This means there is no external influence, providing an objective view of practice within the home against good practice. The member of staff had also completed a multiplechoice test paper about dementia certified by the Alzheimers society. Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 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): 31, 33, 35 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The manager has the experience and qualifications required to run the home and supported staff. The home did not safeguard the financial interests of service users. The health, safety and welfare of staff and service users were not fully promoted. EVIDENCE: On the first visit to the home the manager was on holiday. As a result a number of key pieces of information were not available, and a second visit was made on their return from holiday. It was of more concern that staff were not aware of how service users could access their money. The manager advised later that money had been left at the home, and did not know why staff were not aware of this. Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 Page 21 The manager advised that she held money for one service user who had no relatives to act on their behalf. There were records held by the manager in respect of one service users personal allowance. These stated that £300 had been paid into the bank for the person, but the bank records were not available for inspection. The records available were clearly written and easy to follow. The attached receipts did not provide sufficient evidence of appropriate expenditure. Most of the ‘receipts’ were hand written ‘post it notes’ and not receipts from shops. There were two receipts from the hairdresser. Both of these receipts had £6.50 itemised but different totals that appeared to have had a number added (so that totals were £16.50 and £26.50) with a different colour pen. The cash balance was not available for inspection. The manager advised that she did not keep it separately from her own personal finances. The practices in place at the home in respect of service users finances are not robust, do not provide a clear audit trail and do not therefore serve to protect people. The Commission were advised of a service user who had had a number of falls whilst living at the home. The home had not reported to the Commission any ‘event in the care home which adversely affects the well-being or safety of any service user’ as they are required to do by The Care Home Regulations. This was discussed with the manager. The manager said they had not understood that incidents such as this required reporting under this regulation. These records are important to ensure that in the event of any incident adversely affecting a service user a clear audit trail is available. The manager advised that, in line with recent legislation, they were working with their insurance company to produce a fire risk assessment, but this was not yet in place. Bellevue Residential Care Home DS0000059848.V306703.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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 1 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X 1 1 X 2 Bellevue Residential Care Home DS0000059848.V306703.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 OP1 Regulation 4 Requirement The registered person must ensure that the Statement of Purpose describes the facilities and services provided by the home. The registered person must develop the care plans in the home to include specific detail regarding how the service users’ needs are being met, and to ensure that they meet mental health good practice guidance. Previous timescale of 31/03/06 not met. The registered person must make arrangements for the recording and administration of medicines received into the home. The registered person must ensure that service users’ wishes in respect of daily living and activities are respected. Previous timescale of 31/03/06 not met. The registered person must ensure that service users receive DS0000059848.V306703.R01.S.doc Timescale for action 31/12/06 2. OP7 OP8 15 31/12/06 3 OP9 13 31/10/06 4. OP12 OP14 12 31/12/06 5. OP15 16(i) 31/10/06 Bellevue Residential Care Home Version 5.2 Page 24 6. 7. OP18 OP35 OP27 OP15 13(6) 18 8. OP29 19, Schedule 2 9. OP36 18 (2) in adequate quantities, suitable, wholesome and nutritious food. The registered person must ensure that service users are not placed at risk of abuse. The registered person must ensure that at all times staff are employed at the home in sufficient numbers to meet the support needs of service users. The registered person must ensure that the home is proactive in respect of recruitment, adheres to the written policy and that records required by Regulation are obtained prior to appointment. Previous timescale of 31/03/06 not met. The registered person must ensure that staff receive regular supervision, which follows current good practice guidelines. This standard was not assessed at this inspection and is therefore carried over to the next visit. The registered person must ensure that the home’s records required by Care Homes Regulations 2001, and other legislation are updated and maintained. Previous timescale of 31/03/06 not met. 31/10/06 31/10/06 31/10/06 31/12/06 10. OP37 17 31/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Bellevue Residential Care Home DS0000059848.V306703.R01.S.doc Version 5.2 Page 25 No. 1. 2. Refer to Standard OP19 OP19 Good Practice Recommendations The registered person should ensure that information held around the home is correct and does not confuse people living there. The registered person should keep the issues regarding changes in floor height under review, and take further remedial action if required. Bellevue Residential Care Home DS0000059848.V306703.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: 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 Bellevue Residential Care Home DS0000059848.V306703.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. 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. 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