Inspection on 09/01/07 for Bethany House

This inspection was carried out on 9th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bethany House 16/12/08

Bethany House 15/12/05

Bethany House 12/04/05

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

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

CARE HOME ADULTS 18-65 Bethany House 3 Margaret Road Harrogate North Yorkshire HG2 0JZ Lead Inspector David White Key Unannounced Inspection 9th January 2007 09:00 Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 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 Bethany House DS0000063607.V322801.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 Adults 18-65. 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. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bethany House Address 3 Margaret Road Harrogate North Yorkshire HG2 0JZ 01423 501650 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) Franklin Homes Limited Mrs Maria Oakes Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2005 Brief Description of the Service: Bethany House provides personal care and accommodation for up to 8 adults who have mental health problems. The home is situated in a pleasant residential area of Harrogate and is within easy reach of the town centre its amenities and facilities. The people who live there have single bedrooms most of which are en suite. There is a variety of communal space available for their use. The accommodation is over four floors and accessed by flights of stairs. There is parking available on the road at the front of the house. The fees at the time of the site visit ranged from £310.46 to £1105.05 per week and do not include costs for personal transport, toiletries, hairdressing and chiropody. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced site visit undertaken on 9 January 2007. This visit was carried out by one Regulation Inspector and took 7 hours with 4 hours preparation time. The home was able to return the requested information before this site visit. Surveys were sent out and received from five relatives, one health professional and a General Practitioner (GP). The report includes information from the Regulation Inspector’s inspection record, which details the history of the home and relevant information about what has been happening in the home since the previous inspection visit. The site visit included an inspection of the premises. The visit involved looking at three residents’ care records, including residents’ assessments, care plans and medication records. Staff rotas, accident records and health and safety documentation were inspected. Four residents, two members of care staff and the manager talked about their experiences in the home and time was spent observing the interaction between residents and staff. The focus of the inspection was on a number of key standards and inspecting the case records of a number of residents to establish whether they corresponded with their experiences of life in the home. The manager was available throughout the inspection and the findings were discussed at the end of the inspection. What the service does well: Residents are encouraged to be independent and to make their own choices about how they live their lives. A number of residents are involved in activities and education services in the local community and this supports them with their occupational and learning needs. There are good care planning systems in place that focus on the strengths of residents and which give clear direction to staff as to how each resident’s needs are to be met. Care plans include information about what actions staff are to take if a resident’s mental health is deteriorating. This helps staff to be aware when a resident is becoming unwell, what actions to take and who to get in contact with to make sure that the most appropriate kind of support is offered. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 6 A health professional made comments in a survey that the home communicates well with their service and this helps to make sure that residents’ health care needs are being met. The home has a settled staff team who are very familiar with the needs of the residents and this helps residents to receive a consistent standard of care. The home is well managed in the best interests of residents so making sure that any concerns are dealt with and good standards are maintained. What has improved since the last inspection? What they could do better: The extractor fan in the top floor bathroom must be cleaned so that good hygiene standards are maintained and residents are not at put at risk from possible infection. Where there is a need for a resident’s weight to be closely monitored, improvements have to be made to the way this is being done so that issues around weight loss or gain can be addressed and residents’ health care needs are met. All staff need to have more formal fire training so that they are clear about all aspects of fire safety in making sure residents are safeguarded from fire risks. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 7 The registered manager needs to look at ways of improving the range of activities on offer at the home in order to encourage residents to have more opportunities to use the local social and leisure facilities. 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. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Proper pre-admission procedures are in place so that prospective residents can feel confident that their needs will be met by the home. EVIDENCE: Although no residents have been admitted into the home since the previous inspection visit it was noted in the care records of three residents that the home does have proper pre-admission procedures in place. All the care records contain information that have been obtained from other sources such as placing authorities before any decision is made about whether the home would be able to meet the person’s needs and the home also carries out their own assessment of the person’s needs to support this process. Prospective residents and their relatives are invited to spend time at the home before making any decision about moving in and one of the most recently admitted residents said that he was able to look around Bethany House with his social worker before he started living at the home. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are encouraged and supported to make their own decisions about their lives whilst taking into account any risks that have been identified. EVIDENCE: The care records of three residents show that these include detailed needs assessments, the personal history of each resident and a plan of care that is developed from the identified needs of each individual. The individual support plans are good and consider the strengths of the resident and focuses on their positive behaviours and achievements. The care records include good information about crisis plans explaining what to do if a resident has a mental health relapse and it is clearly detailed what actions staff are to take in response to specific behaviours. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 11 Residents generally feel that they receive support to be able to make their own decisions. This could be observed at the time of the site visit with staff encouraging residents to make their own choices about their daily routines. Each resident has an independent lifestyle and risks assessments are in place to promote this. The risk assessments are detailed and reviewed on an ongoing basis. There are clear strategies in place to manage any difficult behaviour and the residents said that these and other areas of their care are discussed with their key worker on a regular basis. In one instance a resident has been staying overnight in accommodation at the premises where he does some work experience. However the home are not always made aware that this is going to happen and have some concerns about the wellbeing of the resident. In order to address these matters a care plan review has been arranged with all the relevant parties including the resident’s care manager to make sure the resident’s interests are safeguarded and to look at ways of improving the communication between the home and the work placement area. Members of staff are well aware of the need to maintain the rights and confidentiality of the residents. The manager explained that on occasions it is not possible to share information with relatives about a resident’s care if as has happened on some occasions the resident does not wish for this to happen. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy activities and have involvement with the local community. The residents like the meals at the home although in some cases their weights could be better monitored so that any health issues can be addressed. EVIDENCE: The residents are encouraged to enjoy a varied lifestyle with the support of the staff team. Some residents have voluntary employment in the local community whilst others attend local colleges. One of the residents said that she enjoys the cooking course that she attends at college whilst another resident made comments that he is actively involved with the Open Country club and does conservation work. The home has a minibus that is used to take residents on trips around local areas and residents said these trips are “enjoyable” and they particularly liked a day trip to Whitby earlier in the year. A number of residents made comments that they would like more opportunities to go out on trips and Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 13 feel that sometimes there are not enough activities going off at the home and would like to do activities such as going swimming and visiting the local pubs and cinemas more often. The home does hold DVD nights although residents did say these are not held every week as is planned. The manager did explain that residents are not always interested in attending the activities that are arranged and most residents have a DVD system, music centres and a television in their bedroom. Also some of the residents have problems with managing their monies and do not budget for activities such as going to the pub and cinema. However having said this it would be beneficial to residents if a more structured activity programme is put in place and implemented to improve the range of opportunities on offer to them. The home has flexible visiting times and residents are encouraged to maintain their friendships and relationships with family and friends. Relative surveys indicate that they are very satisfied with the care and services on offer at the home. Residents feel that the quality of the food is “good”. They are able to choose an alternative meal if they do not like what is on the menu. One resident is in need of a specialist diet to address weight problems and a dietician has been accessed for advice and guidance. The care records show that weight checks are recorded, however in two cases these had not been done since June 2006. In one instance the last recorded weight check showed that a resident had lost half a stone in two months and the records clearly stated that this needed to be monitored to address any potential health problems and this was not being done. In another case a resident with a history of weight problems had put on nine pounds in three months and again this was not being monitored. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ receive personal support in a dignified manner and have access to health care services. EVIDENCE: Staff interact well with the residents and treat them in a respectful manner. Residents made comments that staff do not enter their bedrooms without permission and provide support in a sensitive way. Each resident is registered with a General Practitioner through whom specialist services are accessed. Residents receive support from staff in attending dental and other health care service appointments. One of the local dental practices no longer provides NHS services and this meant that some of the residents did not have a dentist. The manager has addressed this matter and alternative arrangements have been made for dental services to be provided through Ripon NHS Trust. Some of the residents visit a psychiatrist at the local hospital and have involvement with mental health services and a psychologist is going to be providing support to the residents at the home and is involved with the Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 15 assessments of residents. A health professional survey made comments that the home communicates well with other services. The records show that residents have regular physical health checks and reviews of their medication. The home has a good and well-organised medication system and medication procedures are being followed. Medication is stored securely, the Medication Administration Records are up to date and accurate and medications are received and disposed of correctly and this is recorded. A member of staff is allocated to monitor and audit the medication systems so that any discrepancies can be addressed quickly. Some residents administer their own medications when attending college or other local resources. Risk assessments are in place to support the residents to be able to do this safely. All the staff team receive appropriate medication training and are about to undertake some further training. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear complaints and adult protection policies and procedures are in place and understood by the staff to safeguard the interests of residents. EVIDENCE: The home has a complaints procedure that clearly details how complaints would be dealt with. Residents know whom they would need to speak to if they wish to raise concerns. Staff are well aware of residents’ rights and how to protect these. The home has a policy and procedure in place for the protection of vulnerable adults and staff have all attended abuse awareness training and receive regular updates. Staff have a good understanding of abuse issues and how to respond to it if it was happening. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely and comfortable environment. EVIDENCE: The home has a friendly and welcoming atmosphere and residents said that they all “get on with each other”. Accommodation is over four floors and can be only reached by stairs and there is no ramped access to the home so it would not be suitable for people with mobility problems. Residents made comments that they are pleased with the standard of their accommodation and most bedrooms have en-suite facilities with bathroom areas nearby for those residents in bedrooms without these facilities. The bedrooms are personalised and lockable to offer residents privacy. Since the previous inspection visit a shower unit has been installed in one of the bathrooms and the banister on the top floor has been extended and reinforced to reduce risks from one resident’s behaviour. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 18 The home is mainly clean and tidy although an extractor fan in one bathroom was covered in dust and needs cleaning to reduce risks of infection. There are separate laundry facilities where residents’ personal clothing and bed linen are looked after. The kitchen is well maintained and regular checks are carried out to promote safe food hygiene practices. The home has a fire risk assessment in place and it is recommended that the manager seek guidance as to whether this meets fire safety requirements. The home has systems in place for the monitoring of hot water temperatures and any problems are referred to the maintenance worker for the organisation. The home has an ongoing programme of re-decoration and refurbishment. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive good standards of care from a competent, trained, motivated and well-supported staff team. EVIDENCE: The duty rotas show that there is a sufficient number of staff on duty at all times. Duty rotas are planned around the needs of the residents to make sure that residents’ needs are being met. Residents feel that staffing levels are good and said that staff could always be easily accessed for assistance and support. The home has a very settled staff team and there is a low staff turnover and this helps the residents to receive a consistent standard of care from a committed staff team. Proper recruitment procedures are in place and although the home has not appointed any new members of staff recently, proper recruitment procedures have been followed in the past to safeguard the interests of the residents. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 20 The staff receive a range of training in a number of different areas and feel that this helps them to be able to do their job more effectively. This includes training on health and safety practices, managing challenging behaviour, nonviolent crisis intervention and basic mental health. More mental health training is arranged and a psychologist will shortly be providing some training to enable staff to have a better understanding and knowledge of the needs of people with specific learning disabilities. This will support staff in the care and support they are giving to some of the residents who have some learning disabilities as well as mental health problems. The home has an ongoing commitment to NVQ training and most of the staff have either competed or are in the process of completing the training. Staff said they receive supervision and appraisal on an ongoing basis and evidence of this could be seen in the staff files. Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 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 run in the best interests of the residents and overall proper attention is given to ensuring their health and safety. EVIDENCE: The registered manager has a lot of experience in running the home and has recently completed the Registered Manager’s Award to enhance her management abilities. The manager is very committed to providing good standards of care for the residents and following a recommendation made at the previous inspection visit has attended conferences and received training to broaden her knowledge and awareness of mental health issues. Both residents and staff describe the manager as “approachable and supportive” and one Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 22 person said she is “excellent”. Relatives made comments in surveys that the manager is very good at maintaining communication with them. The home is working hard to develop their quality assurance systems in looking at ways of improving the care and services provided at the home. Questionnaires have been sent out and returned from residents, relatives and others who have involvement with the home. The comments from the questionnaires are available and provide generally good feedback about the home. One resident made comments that the format of the resident questionnaires was unsuitable and inappropriate. As a result of this the resident has developed an alternative format of questionnaire, which the senior management of the organisation are hoping to use for seeking the views of residents in the future. Staff and resident meetings are held on a regular basis and people’s opinions and views are encouraged. Relatives and health and social care professionals are invited to attend care plan reviews and express their feelings about the care and services on offer. The home has proper arrangements in place to make sure that health and safety practices promote a safe environment for residents, relatives and visitors to the home. A random selection of the required health and safety certificates are up to date and satisfactory. All staff receive a range of health and safety training and accidents are clearly recorded in the home’s accident book to safeguard the interests of residents. However through discussion with the manager and staff it became clear that staff have only ever received inhouse fire training and have never had formal training from a fire safety officer and this also applied to the member of staff who is responsible for providing the in-house training. The manager has made arrangements for this training to take place and it is important that all staff receive this training so that they are fully aware of and up to date with current fire safety procedures, the use of equipment and fire safety legislation. Bethany House DS0000063607.V322801.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 YA17 Regulation 12 Requirement The registered person must make sure that residents’ weight is regularly monitored as specified in the care plans in order to address any potential health problems and to reduce risks to residents from weight gain or loss. The registered manager must make arrangements for the cleaning of the extractor fan in the bathroom on the top floor of the home to reduce potential risks from cross infection. The registered manager must make sure that all staff receive formal fire training from a fire safety officer so that they are fully aware of fire safety procedures and up to date fire safety practices and legislation. Timescale for action 09/02/07 2 YA24 23 23/01/07 3 YA42 13 28/02/07 Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA14 Good Practice Recommendations The registered manager needs to look at ways of improving the range of in-house activities that are available to residents. The registered manager should seek guidance from the fire authority about the home’s fire risk assessment to make sure that proper measures are being taken to promote fire safety in the home. 2. YA24 Bethany House DS0000063607.V322801.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Bethany House DS0000063607.V322801.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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