Inspection on 29/05/07 for The Beeches

This inspection was carried out on 29th May 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Beeches 03/08/09

The Beeches 28/05/08

The Beeches 31/05/06

The Beeches 05/12/05

The Beeches 12/07/05

The Beeches 25/10/04

The Beeches 22/07/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Beeches Green Lane Newtown Stockton-on-Tees TS19 0DW Lead Inspector Jackie Herring Key Unannounced Inspection 29th May 2007 09:30 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 The Beeches DS0000000053.V341614.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. The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Beeches Address Green Lane Newtown Stockton-on-Tees TS19 0DW 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) 01642 618818 F/P 01642 618818 T L Care Ltd Mrs Valerie Smith Care Home 64 Category(ies) of Dementia - over 65 years of age (32), Old age, registration, with number not falling within any other category (32) of places The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate one named individual who is under the age category of 65 years. 31st May 2006 Date of last inspection Brief Description of the Service: The Beeches is a two storey 64 bedded purpose built care home providing personal care for older people and for individuals suffering from dementia within two specific units. Personal Care for older people is provided on the ground floor whilst care for people suffering from dementia is provided on the first floor. There is a patio and garden area available for use. The home has been operating since January 2002. It is situated within an urban setting with close access to the town centre and public transport. The vast majority of the bedrooms are single rooms all with ensuite facilities. There are two double rooms available within the home also with ensuite facilities. On the date of this inspection the standard fee for personal care at The Beeches was £ 390 per week. The fee for care on the unit for people who suffer from dementia was £408. The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a key unannounced inspection and was completed in one inspection day, nine inspection hours in total. As a key inspection, all of the key standards were examined. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. Residents were involved in discussion about their lives in the home; a number of records were looked at included resident records, medication records, staff files, training records and some maintenance records. Care staff were also interviewed and there was in-depth discussion with the manager. A number of relative surveys were also completed. Time was also spent looking around the home. This was a good inspection, with the manager, staff and residents welcoming the inspector. What the service does well: The Beeches continues to provide a very comfortable, warm and well maintained place for older people to live. The building is light and airy with a warm and friendly atmosphere. Residents’ rooms are pleasantly furnished, decorated and personalised with individual items of the residents own choosing. Information to residents continues to be available and well displayed. A helpful and friendly staff team who are generally well trained provides care and the home has been described as being well run and well managed. Residents said, ““They are nice people, lovely, treat me properly and with respect, yes they are kind”. Another said, “I am in fine fettle, I go out for walks and I would say if anything was troubling me”. One relative survey stated, “Friendly staff who have been here for some time and know and understand the residents, they welcome relatives at any time”. One resident said, “The manager Val is always around and will pop in for a chat”. A staff member said, “This is a well run and well managed home. The manager is very visible and is always there”. A relative said, “This is a friendly home, you can talk to anybody”. The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Beeches DS0000000053.V341614.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 The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre admission assessments are undertaken, ensuring individual residents needs are met at The Beeches. EVIDENCE: Four sets of residents records were looked at, all of which contained pre admission assessment along with the care management assessment. The manager confirmed that prior to resident’s being admitted into The Beeches, key staff would complete the home’s assessment to ensure that individual’s needs could be met by the home. It was also confirmed that reviews take place a short while after admission to ensure satisfaction with the service. One relative said, “I came for a look around and looked at several homes, this one seemed quite compact and is convenient for the bus or to walk”. The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although residents and relatives are happy with the care provided, assessments, care plans and risk assessments need to contain more personal and detailed information to ensure needs are fully met. The system for managing medication is reasonably satisfactory, however some slight review is needed to promote protection. EVIDENCE: Having looked at three sets of care records in detail and briefly looked at an additional one, it was agreed with the manager that this continues to be an area in need of more development. Whilst care needs are assessed, the records could be developed further, with more individualised information about the person, their lifestyle habits and preferences and more specific detail in terms of care needs. Examples of these were shared with the manager and during the inspection feedback and it was agreed that all of the records could be enhanced further. The current format is a bit burdensome in term of the amount of paperwork and the manager believed that if the system were to be simplified then this would increase the confidence of the staff to complete, The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 10 update and evaluate more effectively. She said that further training would also be given. During discussion with a relative, they said they had not been involved in the assessment or care planning process but they were aware of reviews that take place. One resident discussed the district nurse visiting as they were, “having trouble with their legs” and also confirmed that the GP is contacted if they are unwell. Staff confirmed the involvement of District Nurses, GP’s and Community Psychiatric Nurses and said that they had good relationships with all and that a good level of support was provided. One resident said of their care, “They are nice people, lovely, treat me properly and with respect, yes they are kind”. Another said, “I am in fine fettle, I go out for walks and I would say if anything was troubling me”. The medication systems were looked at with two key staff members. It was confirmed that only more senior staff are involved in the administration and management of medication and that they have all completed the appropriate training. There was evidence of regular audits carried out by the manager who also completes regular observations of individual staff administering medication and they are also required to complete a questionnaire. The systems for ordering were good and in the main so was storage although the second cupboard on the first floor had some potential security concerns. This was addressed immediately. Up to date British National Formularies are required for each of the units. Some discussion also took place regarding the different schedules of medication and the manager agreed to review this and to ensure appropriate storage and recording of the different medications. The policy and procedures continue to be in need of review and updating to ensure that staff have the appropriate guidance to follow to ensure the safe handling of medication within the home. The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are in the main well managed for residents ensuring social, religious and recreational needs are reasonably provided for, these could be linked to a more detailed social and lifestyle assessment. Residents where possible are able to control aspects of their lives, their independence and make choices. Residents are provided with nutritious meals with variety. EVIDENCE: The pre inspection questionnaire detailed a small number of activities that take place for the resident who live at The Beeches. These included, having a monthly entertainers, local school visits, theatre outings and the involvement of an activities co-ordinator. During discussion with the manager and staff, they talked enthusiastically about the recent visits to the local community centre and being involved in activities there such as making hanging baskets. They said that they planned to continue this involvement. There were mixed views about the recreational and social activities with some people believing that more could be provided. One staff member said, “Sometimes it is the same games over and over, we need to do something else, certainly an area that could be developed further”. A resident said, The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 12 “There is not always enough time for staff to spend having a chat, there is not enough interaction”. It was recommended that the social assessment should form the basis of some of the individual and group activities. It was also recommended that some staff could be trained to deliver more effective activities for people with dementia. A number of visitor were observed during the inspection and it was also confirmed that resident were able to go out of the home. One relative survey stated, “Friendly staff who have been here for some time and know and understand the residents, they welcome relatives at any time”. Staff also confirmed that there are local churches should residents wish to attend, although this may depend upon staffing levels if an escort was needed. They also said that a priest does visit and provide Holy Communion. The menu was made available and it was a rolling menu and primarily consisted of traditional British food. Staff said that a member of staff goes around with the menu to offer choice and that alternatives are readily available. They also confirmed that fresh fruit was available. Resident said they were satisfied with the meals and staff also spoke positively about them and said there was plenty of choice and variety. The dining rooms are pleasant enough. The more specialist diets, such as soft and pureed would benefit from improvement to the presentation as discussed with the manager during the inspection. One resident said, “You have a choice and they will give you other things if you prefer, they bend over backwards to please you”. Another resident said, “They are very nice and show respect and courtesy but this is a two way thing, you have to treat them properly as well, they are very helpful”. The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are aware that if they had any concerns or complaints, these will be dealt with quickly and effectively and robust procedures are in place to protect residents from abuse although further staff training is needed. EVIDENCE: The manager said that the complaints procedure had been updated since the last inspection to include the name and contact details of the commissioning authorities and confirmed that this is on display within the main reception of the home. The procedure contained within the policies and procedure file had not been updated, however the manager confirmed this would be done. The pre inspection questionnaire detailed that there had been three complaints since the last inspection, which had been dealt with appropriately. Residents who were spoken to said if they had any concerns they would raise them with the manager or other members of staff. Members of staff said they were aware of the complaints procedure and were confident in following this procedure should the need arise. A relative said, “I am quite confident to raise issues and have done so, they come back with the answers and any issues have been sorted out”. A resident said, “There was some miscommunication initially, it is far better now, we got it worked out my way”. There have been a number of adult protection issues raised, all of which have been appropriately reported and investigated and the appropriate management The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 14 action taken. Staff confirmed they had received training on the topic of No Secrets and would know what to do if needed. Further training is planned for staff, as the manager believes this topic should be covered on a regular basis, thus keeping everyone updated. The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a home that is generally clean, safe, comfortable and well maintained although confidentiality around the ground floor “nurses Station” should be strengthened. EVIDENCE: The Beeches continues to provide a warm, well-maintained and homely place for people to live. There is a good amount of communal space and residents have freedom to move around their individual units. Of the bedrooms visited, there was much evidence of personalisation, with residents having their own personal belongings around them such as photographs, pictures and ornaments. In one of the bedrooms visited, the resident had their own phone, which had large numbers to enable her/him more ease of use. Housekeeping staff were observed on both inspection days and had the appropriate equipment to keep the home clean and hygienic. The staff were The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 16 working very hard to keep the carpets clean and looking nice. It was however noticed that some of the carpets were probably in need of replacement as they continued to be badly stained despite regular cleaning. The first floor lounge/smoking room needs to have the ventilation improved; the smell of cigarette smoke was evident in the corridors. There were no light shades in place in this room and the carpet had a number of cigarette burns. In a small number of areas there was the need to freshen the environment. The bath panel one of the ground floor bathrooms needs to be replaced. There continues to clearly be a lack of privacy and confidentiality around the “nurses station” on the ground floor and steps are to be taken to address this as on the first floor unit. The garden is accessible to the residents and the manager talked about plans to improve this area yet further. The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Good recruitment practices and generally a competent staff team protect residents, although development to the induction of new staff and more client specific training would enhance this further. EVIDENCE: A number of staff files were looked at during the inspection and contained the information needed to show that good recruitment procedures are in place and followed. This information included, evidence of identity, Criminal Record Bureau checks as well as two references. The Manager stated that no new staff commences employment without full clearance from the Criminal Record Bureau, which include Protection of Vulnerable Adults check. At the time of the inspection, the Skills for Care induction programme for new staff who had not achieved the relevant National Vocational Qualification. The manager said that there was a named individual within the organisation who was responsible for training and the induction process. The manager produced an in-house induction programme that had been implemented and confirmed that she would download the up to date information from the Skills for Care website. There were mixed views about the staffing levels with some staff saying that generally they were fine and other saying that at certain times of the day due to dependency levels and increased needs of residents they would benefit from The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 18 additional staff. One staff member said, “Mornings are fine as there are more staff, afternoons are more difficult and there is limited interaction with residents”. One resident who stays in their room most of the time said, “When they come in they do chat in passing, there is not enough time for them to sit and chat”. Another resident said, “It’s fine here, staff are very kind and helpful”. A training programme was made available and contained detail of a range of training including fire safety, moving and handling, first aid and No Secrets. It did not detail the client specific training that takes place such as dementia care. The pre inspection questionnaire detailed that 66 of care staff were qualified to NVQ Level 2. The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The Beeches is generally a well run home. The staff supervision system needs to be fully introduced to ensure all staff receives regular supervision. A number of the checking systems need to be improved to ensure ongoing health, safety and welfare of residents. EVIDENCE: The manager has the appropriate qualifications, skill and experience to manager The Beeches. It is very clear that she has been working hard to improve the communication within the home and to develop the way in which staff work. One resident said, “The manager Val is always around and will pop in for a chat”. A staff member said, “This is a well run and well managed home. The manager is very visible and is always there”. A relative said, “This is a friendly home, you can talk to anybody”. The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 20 The management of resident’s personal allowances was looked at and generally found to be in order. One of the amounts did not balance and the manager and administrator were looking this at. There was evidence of regular audit of the resident’s personal allowances. Supervision was discussed with the manager, and it was confirmed that although this was taking place that it was not always at the required interval, she also discussed the need to cascade some of the responsibility for this to other key staff, who would need to be trained. Mandatory training was discussed and the records looked at are as detailed that regular training takes place; this was also confirmed through discussion with staff. One staff member said, “Training is always in progress, I have just updated mine”. The pre inspection questionnaire detailed that the maintenance and servicing of equipment such as fire systems and emergency call systems are up to date. A random sample of in house maintenance records were looked and these need some further action. There is the need to ensure that safety check take place as the required regular intervals, such as weekly fire equipment checks. It was noted that the water temperature were not being properly recorded and were not being checked at the required frequency. Where problems are identified with the equipment steps must be taken to address these in a timely and safe way, this includes the thermostatic mixing valves. A sample of policies and procedures were looked at and they continue to be in need of review and updating. The manager agreed that this had been ongoing for some time and agreed to take immediate steps to address this. The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 2 X 2 The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 14 Requirement Further development must continue to be completed in regard to residents assessments of need and must include lifestyle and preferences including focus on social, leisure and religious needs. Resident/their relatives where possible must be involved in the assessment and care planning process. Care plans must be developed and implemented for more specific areas of need and must be evaluated on a monthly basis. 2. OP9 13 Review of a small number of medication matters must take place. There must be increased security for the storage of medicines within the first floor unit, up to date copies of the British National Formulary must be available and the review of different schedules of medication must take place to ensure they are being appropriately stored DS0000000053.V341614.R01.S.doc Timescale for action 30/10/07 01/06/07 The Beeches Version 5.2 Page 23 3. OP19 23 4. OP30 18 5. OP38 13 and recorded. There must be an up to date policy and procedures, which are relevant to the service to ensure that staff have the correct information and guidance for the safe handling of medication ensure residents are protected. A small number of environmental 01/10/07 improvements must take place to ensure the environment is a safe and pleasing place for residents to live. This includes the need to replace the bath panel in the ground floor bathroom, the need to replace a number of carpets including the first floor smoking room, the need to improve the ventilation to the first floor smoking room and fit light-shades. All new staff must complete the 01/09/07 Skills for Care induction ensuring they have the minimum standard of competency to meet the needs of the residents. The health and safety and 30/06/07 maintenance systems and records must be improved. The hot water mixer valves must be serviced and maintained in accordance with the manufacturers recommendations and the hot water temperatures must be recorded weekly and adjusted to the required temperatures. Weekly fire checks must also take place ensuring health, safety and welfare of residents. The policies and procedure must be fully reviewed and updated ensuring that staff have the correct guidance to follow and the health, safety and welfare of the residents is promoted. 31/10/07 6. OP38 13 The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP12 Good Practice Recommendations A named Key worker should be appointed for each resident and recorded on file. A more formal programme of activities within the home together with a list of outside opportunities should be developed and posted around the home. This helps to focus both staff and residents; gives people something to orientate them as well as look forward to. These activities should be linked to individual social assessments. The planned programme for Training/instruction in Adult abuse and the adult protection procedure should take place, ensuring that all staff have received this training. Staffing levels should remain under review to ensure that there is sufficient staff to meet the needs of the residents. Review of the management of resident’s finances must take place to ensure that they are correct and balance properly. Care staff should receive supervision at least six times a year. Care staff should receive training in the care of people with dementia with priority given to those working on the specialist care unit and other service specific training should be provided and recorded, which will further enhance the care given to residents. Further consideration should be given to increasing the level of confidentiality around the nurses station on the ground floor, as has effectively been completed within the first floor unit. 3. 4. 5. 6. 7. OP18 OP27 OP35 OP36 OP30 8. OP37 The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 The Beeches DS0000000053.V341614.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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