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Inspection on 01/10/07 for The Beeches Residential Care Home

Also see our care home review for The Beeches Residential Care Home for more information

This inspection was carried out on 1st October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Staff are caring and responsive to the perceived needs of service users, and welcome visitors. Service users relatives are encouraged to visit and become involved in the social activities of the home. A recent "summer fair" event, held in the homes gardens was popular with service users and staff and well attended by relatives and visitors. Staff were helpful and cooperative with the inspection process, and offer a welcome and hospitality to guests. Recently admitted service users felt that they had been warmly welcomed to the home and enabled to settle in quickly.Service users were complimentary about the provision of food at the home, and observation of the lunchtime period showed that thought and care had been given by the catering staff to ensure that all service users individual needs were met and service users were well nourished.

What has improved since the last inspection?

There is now a Registered Manager for the home and it is evident that she is taking her role seriously and instigating the necessary improvements. Most previous requirements and recommendations have been fully met or are in the process of becoming fully met. The Registered Owner, Manager and staff are commended for the effort they have put in to improve the service since the last inspection Care plans and daily notes including detail of healthcare provision have all been improved in terms both of organization and content. Staff are now enabled to keep records up to date through having them more easily available. Clarity of personal care records has greatly improved. Activities at the home have been increased and service users were seen to be offered a number of different things to do during the morning. Staff are generally working well as a team and there is a good atmosphere at the home.

What the care home could do better:

The heating around all areas of the home must be maintained to an adequate level at all times. Health and Safety issues still need to be prioritized and all staff need to be made fully aware of the full implications of Health and Safety legislation and their personal responsibilities in this area. Healthcare issues as detailed on this report should be addressed and resolved promptly. Service users should not be kept waiting for essential drugs, the administration of which effects their immediate wellbeing. Staff training has been implemented to good effect but there is a shortfall in standards in that essential updated training and refresher training (for example in Moving and Handling), have not been achieved in time to retain an adequately trained team of staff on each shift. Staff supervision, formal and informal, should be improved. Staff could enhance the quality of their communication with service users with dementia, with a greater input of training and guidance from trainers or more experienced staff.There were indicators of a need for staff management on shift to be addressed in terms of the appropriate times for breaks and how lunchtime breaks are staggered. The assessment and review by the District Nurse, of two of the bedsides in use, is outstanding. It is acknowledged that the Registered Manager undertook appropriate risk assessment of these but the formal responsibility remains a nursing judgement.

CARE HOMES FOR OLDER PEOPLE The Beeches Residential Care Home 12 Higham Road Rushden Northamptonshire NN10 6DZ Lead Inspector Sarah Jenkins Key Unannounced Inspection 1st October 2007 07:30 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 Residential Care Home DS0000066337.V347102.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 Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Beeches Residential Care Home Address 12 Higham Road Rushden Northamptonshire NN10 6DZ 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) 01933 318498 01933 386811 Mrs Manonmany Wragg Vacant Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24), of places Physical disability over 65 years of age (4) The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total numbers of service users must not exceed 24 No service users with a physical disability may be admitted to the home when there are already 4 such service users in the home No service user with dementia may be admitted to the home when there are already 24 such service users within the home 23rd May 2007 Date of last inspection Brief Description of the Service: The Beeches home is centrally located in Rushden with easy access to shops and services. The home is a converted older property with character, and has a large and pleasant garden area. One wing of the home was built after the original building and is more modern. The home cares for elderly people some of whom have a physical disability and a large number who suffer from confusion, or diagnosed Dementia conditions. There are several areas where service users can spend their time during the day including a conservatory. There is mixture of single and shared room facilities (16 single rooms and 4 double rooms) 13 of which have en suite toilet and bathroom. At the time of the inspection, the fees charged at the home ranged from £375 £415 per week with extra charges for hairdressing, chiropody and newspapers. Further information is available from the home in the form of the Statement of Purpose and Service Users Guide and the most recent key inspection report is displayed on the homes notice board. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 3 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. The Inspector visited during the early morning to observe practices by staff and to meet with the night staff as well as the day staff and service users. A number of Service Users have diagnosed dementia conditions and thereby communication for many is difficult. Establishing Service Users choices and informed decisions is dependant to some extent upon the consistency of staff, service users relationships with staff, and the quality of communication. Feedback obtained from Service Users in this report was in part through observations of their relationships with staff, and also through interpretations of their general levels of happiness with their routines. The Inspector reviewed the history of the home prior to the site visit and the inspection was informed by this, and also by written feedback from some of the service users and from a number of service users’ relatives. No selfassessment questionnaire was available at this Inspection. What the service does well: Staff are caring and responsive to the perceived needs of service users, and welcome visitors. Service users relatives are encouraged to visit and become involved in the social activities of the home. A recent “summer fair” event, held in the homes gardens was popular with service users and staff and well attended by relatives and visitors. Staff were helpful and cooperative with the inspection process, and offer a welcome and hospitality to guests. Recently admitted service users felt that they had been warmly welcomed to the home and enabled to settle in quickly. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 6 Service users were complimentary about the provision of food at the home, and observation of the lunchtime period showed that thought and care had been given by the catering staff to ensure that all service users individual needs were met and service users were well nourished. What has improved since the last inspection? What they could do better: The heating around all areas of the home must be maintained to an adequate level at all times. Health and Safety issues still need to be prioritized and all staff need to be made fully aware of the full implications of Health and Safety legislation and their personal responsibilities in this area. Healthcare issues as detailed on this report should be addressed and resolved promptly. Service users should not be kept waiting for essential drugs, the administration of which effects their immediate wellbeing. Staff training has been implemented to good effect but there is a shortfall in standards in that essential updated training and refresher training (for example in Moving and Handling), have not been achieved in time to retain an adequately trained team of staff on each shift. Staff supervision, formal and informal, should be improved. Staff could enhance the quality of their communication with service users with dementia, with a greater input of training and guidance from trainers or more experienced staff. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 7 There were indicators of a need for staff management on shift to be addressed in terms of the appropriate times for breaks and how lunchtime breaks are staggered. The assessment and review by the District Nurse, of two of the bedsides in use, is outstanding. It is acknowledged that the Registered Manager undertook appropriate risk assessment of these but the formal responsibility remains a nursing judgement. 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 Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, Standard 6 was not applicable as the home does not offer intermediate care Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that the home will assess their care needs prior to admission and ensure that these can be properly met. EVIDENCE: The admission process has improved since the last inspection and was demonstrated through the records to be fuller and more thorough. The Inspector spoke with a recently admitted service user who expressed full satisfaction with the admission process including the information that she had, and the introduction to the home. Records demonstrated an assessment process that identified the needs and wishes of new service users. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 10 A detailed care plan and risk assessment had been drawn up prior to the service users admission. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 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. 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. Personal and health care are generally good There have been improvements in overview and recording since the last inspection and service users can be confident that their best interests are being supported by staff. EVIDENCE: There have been improvements in record keeping since the last inspection and staff are enabled to keep records up to date through the new provision of office space close to the lounge and dining area. The Inspector observed staff popping into this area to update records in the course of their duties and the new arrangement seemed to be working well. Care plans and risk assessments on the records reviewed were properly updated and had sufficient information to enable staff to care appropriately and consistently for service users. There was evidence of service users choices The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 12 and histories in files and they had been involved in and agreed with the detail in their care plans. Service users who were able to express their opinions on this area showed full satisfaction in the care given by staff at the home and were confident that they were well looked after. There was evidence in the records that staff prompt doctors visits appropriately but staff thought that more input from some General Practitioners is sometimes needed. The Registered Manager was advised on the need to advocate for service users and promote their best interests at all times and was advised to follow this ongoing problem up with the surgery concerned. The need for bedrails in use to be properly assessed and reviewed by District Nurses has been an ongoing issue at the home. Although this process has been started there are still shortfalls that must be resolved by the next inspection to prevent further action being taken on this matter. The Registered Manager is urged to treat this as a priority. Medication was generally well managed and storage and recording were seen to be good. Administration of the 7.30 a.m medications was undertaken professionally by a fully trained staff member. Unfortunately, one service user did not receive their essential medication until 10.30 a.m and was seen to be distressed by this. Advice was given to arrange with the pharmacy the provision of printed Medication Administration Sheets, as handwriting all these every month is both time consuming and conducive to error. Some Medication Administration Sheets did not include details about the dosage of certain medications to provide the double check on accuracy. See also under “Environment” re temperatures around the home. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are enabled to enjoy an active lifestyle if they choose and there was evidence of increased opportunities for social activities. Service users were complimentary about the food provision, which is nutritious, well presented and appetizing. EVIDENCE: Service users were seen to be offered a variety of creative activities during the morning and generally felt that they had plenty to do. This area has been greatly improved since the last inspection. The Registered Manager was advised on the particular needs of some service users, as observed during the morning. Service users are encouraged to retain contact with friends and relatives and hospitality is offered to visitors. Service users choices, likes and dislikes are recorded in their care plans and those who were able to express their opinions to the inspector felt that the The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 14 staff took notice of them as individuals with their individual needs. Choices remain more limited for service users with dementia needs, as discussed with the Registered Manager but there was evidence of improvement and this should be built upon through further guidance to staff. Service users were offered a choice of meals at lunchtime. The choices were detailed on the menu board and also offered verbally at the time of serving. The puddings were displayed on a trolley to enhance service users capacity to choose. The meal served was appetizing, well presented and nutritious and staff on duty ate with service users to encourage the social aspect of the meal. The Registered Manager was advised that some service users may need a little more assistance with eating and that perhaps staff meals should be staggered to enable this. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that they are protected from abuse by a caring staff group and appropriate procedures, which will be followed in the event of any allegations. Complaints are investigated properly and responded to. EVIDENCE: Staff are aware of safeguarding procedures and the Registered Manager ensures that all matters reported are dealt with under safeguarding adults procedures. Some staff refresher training is booked. The home has received two complaints since the last inspection, one of which was referred through Social Services and investigated by a staff member from Social Services. This complaint was judged to be unfounded. The Registered Manager did additional unannounced nighttime checks as part of her own investigation into this matter. The other complaint received by the home was about a delay in the provision of personal care (toilet) needs. The Registered Manager investigated this and agreed the complaint was founded on this occasion. An apology was given and staff were supervised about the omission. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 16 Both complaints were properly dealt with through the homes complaints procedure and within the timescales for investigation. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Maintenance and decoration are properly addressed and the home is kept clean and tidy and odour free. There is a need to address heating issues in the conservatory and for staff to be alert to the problems of maintaining adequate temperatures for elderly people in an older building. EVIDENCE: The home is a converted older building with character and a pleasant garden area. Service Users expressed satisfaction with their rooms and the general areas of the home. The level of cleanliness and hygiene were good. At the time of the inspection there were known heating problems and the engineer had visited and was obtaining a new part in order to be able to The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 18 resolve the problem the next day. However the general and ongoing issues relating to heat control need to be addressed and staff need to be alert to the problem of temperature around the home. At the last inspection there were issues about service users overheating in the conservatory area, and since that inspection there has been an accident with a service user getting entangled in a free standing fan. During the current inspection a service user complained that she was too cool sitting in the conservatory and the measures temperature was slightly under the recommended level of at least 70 degrees Fahrenheit (21 degrees Centigrade). A bedridden service user was also in temperatures less than the recommended level due to the failure of her radiator and the fact that a staff member had left her bedroom window open. The downstairs bedroom area in the old part of the building was noted to be draughty and adding to the general problem of maintenance of adequate temperatures. The Registered Manager was reminded of the importance of maintaining adequate temperatures for older people and the need for staff to be reminded of this issue. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can be confident that staff teams are caring, trained and experienced. Training and supervision of staff remains in need of improvement to fully meet Standards. EVIDENCE: At the time of the inspector’s arrival there was one senior staff member on with two day carers and two night staff. The night staff were due off at 8 am when the Registered Manager arrived. Ancillary staff also arrived later including the activities coordinator. The inspector was informed that the medication round was late during the morning due to the pressure of work early on in the shift. The inspector discussed with the Registered Manager the fact that two staff were having a break at 7.30 a.m. when she arrived. The delegation of staff to duties at this time appeared to be in need of improvement. The Registered Manager agreed to investigate the issue. Staff training is being progressed and it was evident from discussion and records that this continues to be properly prioritized. Unfortunately at the time The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 20 of the inspection there were not enough staff with up to date training in first aid, Moving and Handling, or Protection of Vulnerable Adults procedures to ensure adequately trained staff teams on every shift. Staff felt there was a good atmosphere at the home and good support and training provision. Service users found the staff to be caring and kind. Observations of staff interactions with service users were of variable quality, being in some cases excellent, sensitive and warm; and in others more perfunctory. Advice was given to the Registered Manager on the need for all staff to fully understand the means of engaging service users in appropriate social interaction. Staff supervision both formal and informal is an area in need of improvement. Staff themselves would welcome this and the quality of work would be likely to be enhanced. Recruitment processes were reviewed through discussion with recently appointed staff and described as full and thorough. Staff records were well organized and all the necessary information was readily available demonstrating an appropriate recruitment process. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A new Registered Manager has been appointed and with the support of the Registered Owner, she has achieved improvements in a number of areas. EVIDENCE: The Registered Manager, with the support of the Registered Owner, has demonstrated a commitment to improving Standards at the home and the improvement plan from the last inspection was largely met. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 22 Staff and service users see the manager as approachable and helpful, and there were a number of aspects of organization and management that had been improved since the inspection in May, for example storage and content of the service users records. Advice was given on the need for confidentiality in the newly created downstairs office area. Advice was given on the need to ensure staff are appropriately supervised and that update or refresher training is planned in future before staff certificates expire. Health and Safety around the home has been improved although it is important that staff are mindful of potential risk at all times. For example the inspector observed non-hygienic practice in relation to tea and biscuits served during the morning break, and staff had not been alert to the risk to a service user from leaving her window open on a cool day. (see also under staffing re staff training: Moving and Handling; and Healthcare re bedsides) Service users finances are managed through the provision of “float” of cash available, and relatives are invoiced for expenditures. Advice was given on the need to draw up the details of the procedure for dealing with service users finances, for the staff procedure folder. The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP8 Regulation 13 Requirement A risk assessment must be carried out, prior to the use of bed rails to reduce the risk of injury. A suitably qualified and trained person must do this. Outstanding requirement: (This assessment should be carried out by the District Nurse) Service users medication needs must be fully met and medications must be given within reasonable time in accordance with the directions. To this end there must be sufficient staff available to meet service users needs at all times. Arrangements must be in place to ensure that service users are not put at unnecessary risk to their health and safety. This requirement relates to the need for adequate heating arrangements for service users in all areas of the home at all times. The arrangements for necessary heating, and cooling, particularly in the conservatory area must be reviewed. DS0000066337.V347102.R01.S.doc Timescale for action 30/11/07 2 OP27 OP9 13 01/11/07 3. OP19 OP38 13 01/11/07 The Beeches Residential Care Home 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 OP30 Good Practice Recommendations All staff should be properly trained and motivated to fully understand and meet the needs of Service Users with Dementia. All aspects of service users mental health and/or Dementia care needs should be properly recognized by staff and effectively responded to. The progress in staff training should be maintained. Refresher courses should be arranged prior to the expiry of staffs’ qualifications. Staff supervision should be fully implemented in accordance with the Standards. 2 OP30 3 OP36 The Beeches Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Residential Care Home DS0000066337.V347102.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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