Inspection on 17/08/05 for Elmcroft Care Home Ltd

This inspection was carried out on 17th August 2005.

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

Elmcroft Care Home Ltd 20/11/08

Elmcroft Care Home Ltd 27/05/08

Elmcroft Care Home Ltd 20/06/07

Elmcroft Care Home Ltd 04/07/06

Elmcroft Care Home Ltd 07/02/06

Elmcroft Care Home Ltd 22/03/05

Elmcroft Care Home Ltd 04/02/05

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOMES FOR OLDER PEOPLE Beckingham Court Brickhouse Road Tolleshunt Major Maldon EssexCM9 8JX Lead Inspector Diana Green Unannnounced 17 August 2005 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 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. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Beckingham Court Address Brickhouse Road Tolleshunt Major Maldon Essex CM9 8JX 01621 893098 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Elmcroft Care Home Limited Care Home 33 Category(ies) of Dementia - over 65 years (1), Learning disability registration, with number (3), Learning disability over 65 years of age (1), of places Physical disability (33), Physical disability over 65 years of age (33) Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Persons of either sex, aged 18 years and over, who require nursing care by reason of a physical disability (not to exceed 33 persons) 2 Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 33 persons) 3 Three named persons, aged 40 years and over, with a learning disability, who require nursing care by reason of a physical disability 4 One named person, over the age of 65 years, with a learning disability, who requires nursing care by reason of a physical disability 5 One named person, over the age of 65 years, who requires nursing care by reason of dementia 6 The total number of service users accommodated in the home must not exceed 33 persons 7 Persons of either sex, aged 50 years and over, with a terminal illness (not to exceed 3 persons) 8 Manager arrangements are to be reviewed within six months from the date of registration Date of last inspection 22 March 2005 Brief Description of the Service: Beckingham Court Rehabilitation and Specialist Nursing Centre provides nursing and personal care with accommodation for up to 33 younger adults and older people. The home also provides rehabilitation.Beckingham Court is owned by a private organisation, named Elmcroft Care Home Limited.The home is located in a rural location near to the village of Tolleshunt Major, Maldon. The home is a purpose built single storey building and was opened in 1989. There are 19 single en-suite bedrooms and 7 double en-suite bedrooms. The home has extensive views across open countryside and the surrounding gardens are attractive and accessible to wheelchair users. Beckingham Court is accessible by road and rail and the nearest station is in Witham, a short drive away. Parking is available in the large car park of the home. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 17/08/05, lasting 5 hours. The inspection process included: discussions with the manager, responsible individual, the cook, nine staff, eight service users and two relative/visitors; a tour of the premises including observations on residents’ bedrooms, bathrooms, the kitchen, medication/clinical room, sluice, communal areas and the laundry; and inspection of a sample of policies and records (including any records of notifications or complaints sent to the CSCI since the last inspection). Twenty standards were covered, and six requirements and three recommendations made. The inspection found that action had been taken promptly to address all but one previous requirements and recommendations made. The home is undergoing a transition since change of ownership and the appointment of a manager. The home is now fully occupied with mainly older people some of whom have complex nursing needs. It was evident that Beckingham Court provides a good standard of personal and nursing care for residents. The registered manager and staff were welcoming and helpful throughout the inspection. What the service does well: Beckingham Court provides an open, friendly and homely environment and good standards of nursing and personal care. Residents’ health needs are met appropriately and well monitored and prompt referrals are made to GP’s and relevant health professionals where required. The standards of catering are high ensuring the nutritional needs of residents are appropriately met. Staff are employed in sufficient numbers and skill mix to care for the needs of residents and are well supervised by the manager. The manager adopts a hands on approach and is well known to residents and staff. Residents spoken with said they felt at home and that staff were helpful and kind. One resident said “you couldn’t better it; Jean (the manager) sorts everything out”. A visitor spoken with said “it is a well run home and always clean”. The manager is well supported by senior management who undertake Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 6 regular visits to the home ensuring the premises are well maintained and residents are happy and well cared for. What has improved since the last inspection? What they could do better: The new manager, not knowing the area and facilities available, experienced some initial problems. Concerns were expressed with regard to the competence of some qualified staff both in terms of their assessment and nursing skills that was compounded by the use of agency staff. The manager needs to retain control of the assessment of potential residents to ensure their needs can be appropriately met at Beckingham Court. The recent improvements in staff recruitment and training/development and supervision need to be sustained. A reduction in the use of agency staff is also necessary to ensure the continuity of care for residents. Considerable developments are required in the provision of activities for both younger and older residents to include some entertainment and outings. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 7 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. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 1 & 3 Prospective residents are given the information needed to enable them to make an informed decision on their admission to the home. The admission procedure ensures all residents are assessed prior to admission ensuring their care needs can be appropriately met. This home does not provide intermediate care EVIDENCE: Beckingham Court has a statement of purpose and service user guide that had been reviewed since the last inspection. A copy of the service user guide was held in all residents’ rooms. Residents spoken with said they felt they had the information needed to enable them make a decision about moving into the home. An assessment of prospective residents was undertaken prior to admission. Recent assessments had been undertaken by the manager to ensure the accuracy of information and to determine if their care needs could be appropriately met at Beckingham Court. Evidence of pre-admission assessments was present on all of the four files inspected together with copies of care management assessments where relevant. Information on the person’s needs was recorded in detail and covered all care needs ensuring that staff were accurately informed on the residents’ needs. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 10 Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 7, 8 & 9 Residents health and personal care needs are consistently well met within the home. The storage, administration and recording of medicines has improved but further action is needed to ensure the safety of residents. EVIDENCE: New care planning documentation had been introduced since the last inspection. Considerable improvement in the standard of recording was evident from the four care files inspected. All contained care plans that covered all key needs (physical and social), provided good detail of the action required of staff to meet residents’ needs and demonstrated a good understanding of their needs. There was evidence that care plans had been agreed with the resident/relative on admission and at review. Assessments for moving and handling/mobility, pressure areas, continence needs and risk assessments for falls were recorded in the files inspected. Residents spoken with said that staff were caring and respectful towards them. Staff were observed to assist residents in a discrete and dignified way. The standard of personal care was observed to be good. Records showed appropriate and prompt referral to health professionals, and GP’s. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 12 The standard of personal care was observed to be good. Records showed appropriate and prompt referral to health professionals, and GP’s. The home has a physiotherapist who undertakes assessment and provision of physiotherapy for residents, training for staff and intensive rehabilitation programmes for specific residents. Profiling mattresses were provided as relevant for promotion of tissue viability and the prevention and treatment of pressure sores. Two exercise sessions were provided weekly. The home has a contract with a local GP practice that attends the home weekly to review residents’ needs and is also a dispensing practice. The manager had undertaken an audit of medication since her appointment. This had identified some overstocking of medicines and action had been taken to address this. A cooling unit had been installed in the clinical room ensuring medication was stored at a safe temperature. There were two residents that were self-medicating and lockable facilities had been provided for their use. Registered nurses at the home administered all medication. Some omissions in the recording were evident that the manager had noted through her audit and planned to address at a staff meeting that evening. The signature list for nurses was not current although the manager said this had been recently updated. The standard for receipt and recording of controlled drugs was in the main good. However one entry recorded the supply source as the pharmacy but did not detail the name of the supplying pharmacy. One omission of signature was noted on the administration record although it did contain the signature of the witness. A British National Formulary for staff advice was dated 2003 and the manager was advised to obtain a more updated copy. The manager reported some difficulties in obtaining advice on medication from the GP practice pharmacy. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, & 15 Social activities at Beckingham Court are limited and do not appropriately meet the needs of older people or younger adults. The manager is aware of the developments that are required. This home provides a good standard of catering that ensures residents’ nutritional and specialist dietary needs are well met. EVIDENCE: The home employed two staff to undertake activities with residents working 12 days per week and 1 ad hoc day. Neither had received specific training in provision of activities for older people or younger adults. There was no programme of activities on display and no activities were being provided on the day of inspection. Residents spoken with said they mainly spent their days sitting in the lounge where music was played or watching television in the lounge or their own rooms. A profile of the residents had been provided by some relatives and was evident in the care records. The manager said that family members had been asked to provide this information for other residents. There was currently no entertainment being provided but two weekly outings for two wheelchair users were being facilitated on a rotational basis. The manager reported some difficulties in accessing day care facilities for one younger adult and the offer to arrange a holiday for two younger adults had not been taken up by their families. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 14 Service users spoken with said they enjoyed the food and there was always plenty of drinks provided. One service user said that the quality of food was good but that they were not always provided with sufficient choice. From discussion with the cook it was evident that additional food and snacks were available on request during the day and out of hours. Menus were rotated four weekly with seasonal variations. A full choice was offered with fresh fruit and vegetables provided daily. Meals were served in the pleasantly laid out dining room or residents’ own rooms as they chose. Nutritional needs were assessed on admission and there was evidence that they were well monitored and specialist diets provided as required. Residents were observed to have sufficient time to eat with no attempt made to hurry them. Those spoken with said they found the meals provided were good and there was plenty to eat and drink. The cook reported some problems in sustaining an individual approach when catering for the increased number of residents admitted to the home in recent months. However an increase in staff hours had been agreed that should enable former standards to be achieved. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home’s complaints procedures ensures that residents, their relatives and friends are confident their complaints are listened to and action is taken to address their concerns. EVIDENCE: The home had a complaints procedure that included timescales within which complainants can expect a response and was on display in the home. A statement regarding complaints was included in the service user guide/welcome pack. The statement of purpose and service user contract included the arrangements for making a complaint and contact details of the Commission and advised complainants of their right to refer to the Commission at any stage. The commission had received one complaint regarding medicines administration that was upheld. A further complaint was currently under investigation. The standards for protection of legal rights were not assessed. The standard for the Protection of Vulnerable Adults was not fully inspected. However training had been provided for registered nurses in adult protection since the last inspection. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 24, 25 & 26 Beckingham Court provides a clean, well-maintained and homely environment for residents. Lockable storage facilities are not provided for all residents; money and valuables cannot therefore be stored safely within their rooms. The infection control practices ensure the health and safety of residents and staff. EVIDENCE: A partial inspection of the premises was made that included communal areas, bathrooms, a number of residents’ rooms, the kitchen, the laundry and sluice. The home was in a good state of maintenance and decoration. There was evidence of several residents’ rooms had been redecorated since the last inspection. Communal rooms were clean and well decorated and furnished to provide a homely environment for residents. Residents spoken with said their rooms were always kept clean. Efforts had been made since the last inspection to encourage residents to personalise their rooms with personal items resulting in their rooms having a very homely look. The manager was reminded that a record of the items must be kept. The gardens were well maintained and Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 17 provided a pleasant outlook with good access for residents. One resident said they were delighted with the view over open countryside from their room. Lockable facilities were now provided for residents who self medicate but there were no other lockable storage spaces for the remaining residents. The majority of beds were now adjustable that ensured the comfort of residents and the safety of staff when moving and handling residents. Records provided evidence that the building complied with the requirements of the local fire and environmental health department. The heating, lighting, water supply and ventilation met the relevant environmental and health and safety requirements as evidenced from the home’s records. Checks to minimise the risks from Legionella including samples for laboratory analysis had been undertaken recently. Rooms were centrally heated with controls in individual rooms and radiators were guarded as part of a risk assessment. The home was clean and hygienic throughout with no odorous smells. Care staff were observed to safe infection control practices. The home had a sluice disinfector as required of a care home with nursing. The laundry was equipped as required and well organised. Laundry and sluice facilities were located away from areas where food was prepared or eaten. It was a warm day and the kitchen door was ajar evidently due to the inadequate ventilation. Fly screens fitted to the door and windows were damaged and required renewal. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 & 29 The staffing levels (skill mix, number and competence) are appropriate to the needs of current residents. Recruitment practices for staff were thorough and ensured the protection of service users. EVIDENCE: There were twenty-eight residents at the home, an increase of eight from the previous inspection. The staffing levels were observed to be appropriate both in skill mix and number to meet the needs of residents. The home had introduced a dependency score tool to assist in determining the required staffing levels to meet residents’ needs. Additional catering staff hours had been agreed to meet the workload from the increased number of residents at the home. There were three care staff with NVQ level 2 and three care staff with NVQ level 3. Six further staff were booked to undertake Foundations in Care to begin during the next week. Some agency staff were employed, however the manager had recently successfully recruited one registered nurse and a bank nurse, subject to satisfactory CRB disclosure, references and other checks. Four staff files were sampled and all had appropriate checks undertaken prior to appointment. The standard for training was not fully inspected, however there was evidence that training in fire safety, health and safety, moving and handling, dementia awareness, food hygiene, administration of PEG feeds and POVA (Protection of Vulnerable People) had been provided. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 36, 37 & 38 The manager is an experienced and competent nurse who ensures staff are well supervised. Some action is needed to ensure the health and safety and welfare of staff and residents are fully promoted and protected. EVIDENCE: The registered manager of the home is an experienced registered general nurse, registered midwife, with experience in occupational health and acute surgery and has previous temporary management experience of a care home. The manager had been in post for several months and planned to undertake the Registered Managers Award in November 2005. An application for registration was being processed by the CSCI. Some initial difficulties had been experienced in the admission process and competencies of individual staff. However this was now being resolved and the manager, who was new to the local area, had spent time in investigating local health, social and advocacy services of potential benefit to residents. Residents and relatives spoken with Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 20 said the manager was approachable, helpful and addressed any concerns quickly. A formal system for staff supervision had been implemented and five staff had received supervision since the last inspection. Regular handover sessions between shifts were observed and ongoing supervision of care practice was evident. The homes’ record keeping policies and procedures safeguarded residents’ rights and best interests. Records were up to date and stored securely. However no record was maintained of residents’ personal possessions brought into the home. The home had a health and safety policy statement and there was evidence from the records and in discussion with the manager and staff that safe working practices were in place. All accidents, injuries and incidents were wellrecorded and appropriate action taken. An external contractor had been commissioned to undertake a fire risk assessment of the home in the next few days. Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 2 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x 1 x x 3 2 2 Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 22 yes Are there any outstanding requirements from the last inspection? 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 9 Regulation 13(2) Requirement The registered person must ensure that the record of receipt of controlled drugs includes the name of the supplier. The registered person must ensure that the administration of controlled drugs is confirmed by signature The registered person must ensure that a programme of social and therapeutic activities is provided to meet the needs of all residents The registered person must ensure open kitchen doors and windows are protected by securely fitting fly screens. The registered person must develop effective quality monitoring and quality assurance systems. This is a second repeat requirement The registered person must ensure that a record is made of residents personal items brought into the home Timescale for action Immediate, informed at inspection Immediate, informed at inspection 30/10/05 2. 9 13(2) 3. 12 16(2)(m) 4. 26 & 38 13(3) 30/10/05 5. 33 24 30/11/05 6. 37 17(2) Schedule 4 30/09/05 Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 23 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. 2. 3. 4. Refer to Standard 9 24 38 Good Practice Recommendations The registered person should obtain an updated copy of the British National Formulary for staff guidance The registered person should provide lockable facilities in all residents rooms The registered person should review the kitchen ventilation Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 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 Beckingham Court I56-I05 S63361 Beckingham Court V237494 170805 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!