Care Home: Beech Haven

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What the care home does well Residents spoken to liked living in the home and thought staff worked hard to provide good care. The standard of accommodation is good throughout the home and was very clean and tidy on the day of inspection. A GP who returned written feedback to CSCI wrote: "A good well run and very supportive care home". Staff members spoken to said they thought the manager did a good job and was approachable. The relative of someone recently admitted to the home said: "I`m impressed with the level of care so far." What has improved since the last inspection? An extension has been completed to provide extra lounge/dining room space and also more bedrooms with en-suite facilities. The new lounge is a lovely room and overlooks the large garden at the back of the house. Wood decking has been erected in the garden with garden seats and tables for residents and visitors to use. What the care home could do better: The recruitment records of two members of staff were checked and it was found that some important information and checks had not been obtained prior to these staff members commencing employment. This placed residents at possible risk and has resulted in a statutory requirement. A falls risk assessment should be undertaken on residents who have previously fallen so that risks are highlighted and measures put into place to reduce risk. When any risk assessments are undertaken all sections should be completed so that assessments are accurate. The inspector looked at two care files in detail and saw two incomplete assessments, which means there is no assurance that appropriate measures had been taken to safeguard the residents. The inspector noted that meals are served from the kitchen in the basement and taken to residents on unheated trolleys. The manager should monitor the temperature of food at the point it is served to residents to ensure the correct temperature is maintained. One relative commented in written feedback to CSCI that food and drinks served to a relative are not always hot. There was no evidence that staff had received training on the protection of vulnerable adults. The manager should arrange this training to safeguard residents. Staffing levels at night need to be carefully monitored to ensure that the present level of two carers for up to 29 residents is sufficient to provide the care that residents need. Two relatives said in written feedback to CSCI that they thought there should be more than 2 carers at night. CARE HOMES FOR OLDER PEOPLE Beech Haven 77 Burford Road Chipping Norton Oxfordshire OX7 5EE Lead Inspector Annette Miller Unannounced Inspection 9th January 2007 10.00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Beech Haven DS0000013064.V326369.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. Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech Haven Address 77 Burford Road Chipping Norton Oxfordshire OX7 5EE 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) 01608 642766 01608 644290 Maricare Limited Julie Kathleen Millership Care Home 29 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (29), of places Physical disability over 65 years of age (4) Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 29. 26th January 2006 Date of last inspection Brief Description of the Service: Beech Haven is situated on the outskirts of the market town of Chipping Norton and is on a bus route. The home provides accommodation and personal care for up to 29 male and female service users aged 65 and over. District nurses visit the home to provide nursing care. There are 29 single bedrooms situated on the ground and first floors, eight of which have en suite shower rooms and eight have en suite toilets. All rooms have wash hand basins. The home has spacious communal rooms consisting of four separate lounges, two of which are used as dining rooms. There is a large garden of approximately half an acre that is accessible to service users and visitors. Disabled access is provided. The fees for this home range from £520.00 - £650.00 per week. Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the 1st April 2006 the Commission for Social Care Inspection (CSCI) has developed the way it undertakes its inspection of care services. This inspection was an unannounced ‘Key Inspection’. It was a thorough look at how well the home is doing. It took into account detailed information provided by the manager and also any information that CSCI has received about the home since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection or who responded to questionnaires that CSCI sent out. 7 relatives and 5 health care professionals returned questionnaires and the majority of feedback was good. ‘Have your Say’ comment cards for residents were sent to the home but none was returned. During the inspection relevant documents were examined and a partial tour of the building was undertaken. The inspector looked at how well the home was meeting the standards set by the government and has in this report made judgements about the standard of the service provided. What the service does well: What has improved since the last inspection? An extension has been completed to provide extra lounge/dining room space and also more bedrooms with en-suite facilities. The new lounge is a lovely room and overlooks the large garden at the back of the house. Wood decking has been erected in the garden with garden seats and tables for residents and visitors to use. Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 6 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. Beech Haven DS0000013064.V326369.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 Beech Haven DS0000013064.V326369.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. (Standard 6 does not apply to this home.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedure ensures that there is a proper assessment prior to people moving into the home. This ensures that care needs can be met. EVIDENCE: The manager visits people who ask to move into the home so that she can assess their current care needs. This is to find out if the home can provide the care that is required and is done in the person’s own home, or in hospital if that is their current situation. The manager encourages the involvement of family members if the person being assessed agrees to this. The inspector looked at the pre-admission assessment of two recently admitted residents and found relevant and comprehensive information, which was in sufficient detail to decide that the home was able to provide appropriate care. Emergency admissions are only considered when the manager is able to obtain sufficient information from the prospective resident and/or other people Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 9 involved with the person’s care before admission. This might need to be done by talking to the prospective resident and people involved with the person’s care on the telephone. This is to ensure the home can meet the person’s short-term care needs. If the person decides he/she would like to stay permanently, the manager carries out a full assessment to ensure the person’s long-term care needs can be met. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is good practice in the planning and delivery of care and this means that residents’ health and personal care needs are met. However, there are some aspects of record keeping that need to be improved to ensure that potential risks are identified. The manager showed a good understanding of this area of weakness and is implementing improvements. EVIDENCE: The inspector spoke individually to two residents and two relatives during the inspection, as well as a group of residents in one of the lounges. They all made good comments about the home. A relative said: “I wouldn’t mind coming in here myself”. He praised the staff for the care they gave to his relative and was pleased with how she had settled in. A resident said that she was treated with respect by kind and caring staff. 6 relatives said on the CSCI questionnaires that they were satisfied with the overall care provided; one said they were satisfied “sometimes”. The relative Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 11 of someone recently admitted to the home wrote: “I’m impressed with the level of care so far.” A few concerns were raised, for example, one relative thought there was a lack of privacy and respect, which related to a resident being washed whilst sitting on a toilet, another thought too many foreign staff eventually created communication problems and problems of lack of shared knowledge and experiences. These issues were discussed with the manager on the day so that staff practice could be monitored and improvements implemented where needed. Two GPs, one district nurse and two social services care managers said on the CSCI questionnaires that they were satisfied with the overall care of the residents that they had contact with. Individual plans of care for every resident are available and these set out the care that people need. Two care plans were randomly selected and were looked at in detail. They showed the care needs of each resident and the action that carers were taking to ensure the person’s care needs were met. The pre-admission assessments showed that each resident had fallen before admission, but a falls risk assessment had not been undertaken for either resident. This should have been done so that any risks were highlighted and measures put into place to reduce identified risk. Some of the care records written by carers were not signed and dated and the manager should inform them that this needs doing. This is so that any queries can be checked with the appropriate member of staff. Also, some risk assessments had not been finished, for example, four out of seven sections on a pressure area risk assessment were blank and a moving and handing assessment was not finished. This means that the residents were potentially at risk because they had not had a full risk assessment undertaken. The inspector looked at two medication administration record charts and saw that medication was given as prescribed. An NHS pharmacist had recently examined the home’s medication administration procedures and storage facilities as part of a routine check and found most procedures were good. The manager said that two good practice recommendations were made and action had already been taken to implement changes. Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of residents and this ensures that residents have a say about how they lead their lives. EVIDENCE: A resident said she knows what activities are available because the monthly programme is delivered to her room. She said staff had made Christmas ‘a lovely time’ and that the home was very festive and jolly on Christmas day. A relative also commented on this saying he had joined his relative for Christmas day lunch and staff had worked very hard to make the day enjoyable for everyone. There were no activities taking place on the morning of the inspection and many of the residents were asleep in armchairs in the lounges. Music was playing in a ground floor lounge and the television was on in another lounge. During the afternoon a video film was shown, although not many of the residents were in the lounge watching it. Activities are organised by the carers. Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 13 The home uses the ‘pat-a-dog’ scheme that involves a visitor bringing his/her dog to the home twice a month for resident to see and stroke. A local day centre offers places to residents when there are vacancies. At present one resident is attending. Three out of seven relatives who returned CSCI questionnaires said they thought their relative would benefit from more mental stimulation and two said they would like staff to sit and ‘chat’ to residents more. These comments were discussed with the manager so that she could review the activities programme and also check how well the carers interact with residents, particularly those that are less able to express their wishes. On the CSCI questionnaires seven relatives said they could visit whenever they wished and were always made welcome. The two relatives spoken to during the inspection also confirmed this. The inspector looked at a sample of menus and saw that meals are varied, although choices are not listed. The cook has a list of residents’ likes and dislikes that are taken into account when planning meals and an alternative meal can always be provided on request. Lunch on the day of inspection looked appetising and residents said they liked it. The inspector saw that many residents needed help to eat and that carers were attentive, giving one-to-one help when needed. However, one relative wrote on a CSCI questionnaire that food is not always cut up for residents who need this to be done. Another relative said she had seen a resident’s meal left with no assistance given. The manager should ensure that the good practice seen by the inspector is constant across all mealtimes. No concerns about the standard of food were raised during the inspection, although two relatives said on CSCI questionnaires that they thought the standard and variety of food could be better. One relative also thought food and drinks could be hotter. The manager explained that only a certain number of meals were taken out at a time on the food trolley so that the food stays hot. She said this issue was raised at the last residents’ meeting in November 2006 and thought the action taken had resolved the problem, but would continue to monitor food temperature to find out if further improvements were needed. Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure but this needs to be displayed prominently within the home so that all people using the service know how to make a complaint. EVIDENCE: The stages and timescales for dealing with complaints are set out clearly in the home’s complaints procedure, which is referred to in the Statement of Purpose and Service User Guide. The manager said these documents are given to every new resident, or a representative of the resident. However, three of the seven relatives who returned CSCI questionnaires said they were unaware of the complaints procedure. Since the last inspection CSCI has received information about one complaint, which was referred to the home to be investigated. The manager did not uphold the complaint and wrote to the complainant explaining the reasons for this decision. The inspector looked at the information on complaints held at the home and found this was the only complaint received. The inspector was told that adult protection training was ongoing, although the manager was unable to provide evidence of this. An update for all staff should be arranged as soon as possible so that residents can be sure they are adequately safeguarded. Training dates should be recorded. Beech Haven DS0000013064.V326369.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, 24 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is extremely good providing residents with an attractive and homely place in which to live. EVIDENCE: The home provides safe, comfortable and well maintained surroundings that are equipped to meet residents’ needs. The standard of décor and furnishings is extremely good and the home was clean, tidy and free from offensive odours at the time of inspection. A relative said in a CSCI questionnaire: “I have been impressed with the quality of care, cleanliness at all times and very caring staff.” The fire service and the environmental health department carry out routine inspections to ensure fire safety and food hygiene standards are met. Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 16 The inspector spoke to a resident in her bedroom who said she was pleased she was able to bring in personal possessions, including several items of furniture. She said these had helped to make her room feel like home. There is wheelchair access from the ground floor into the spacious back garden, as well as access directly from the newly built lounge diner. This room opens onto an area of decking where garden furniture is situated. This was constructed when the extension to the home was built and provides a very pleasant sitting area overlooking the garden. Events such as the home’s annual garden party are held in the garden during the summer. The home’s laundry is situated in the basement and has the equipment needed to provide an efficient laundry service. No concerns were raised with the inspector about this service. Infection control training is provided to ensure there are good procedures and practices in place to reduce the spread of infection. Beech Haven DS0000013064.V326369.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): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The deployment of staff during the day is sufficient to meet the needs of residents, but night staffing levels need to be carefully monitored to ensure residents have the care they need at this time. Recruitment procedures must be improved to safeguard residents. EVIDENCE: The home was full with 29 residents. There were five carers on duty during the morning, four during the afternoon and evening and two overnight. The manager was available from 9 am – 5 pm to deal with management duties. The support team consisted of the cook, maintenance person and two cleaners. The manager said this was the usual level of staffing, except occasionally there was only one cleaner on duty. 5 of the 7 relatives who returned CSCI questionnaires thought staffing levels were sufficient, whereas two thought staffing levels at night were low for the size of the home. The manager said she had recently worked a night and although it was busy, considers two carers are adequate to provide the care that residents need. She said that extra duties had been removed from the night carers, such as light cleaning and ironing, so that they had more time to assist residents. The manager confirmed she monitored staffing levels and provided extra staff when needed. Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 18 A resident said she was very happy with all aspects of her care and found staff kind and friendly. She said: “They never tick me off when I call them, which is quite often because I need help to the toilet.” 10 of the 16 carers currently employed have completed the NVQ level 2 in care and two carers are on this training. This indicates the importance the home places on staff obtaining the knowledge and skills needed to be able to provide a good standard of care to residents. The files of two carers employed since the last inspection indicated that the home had not undertaken all the necessary recruitment checks to ensure protection of residents. Criminal Records Bureau (CRB) checks had been requested but the outcome was unknown before the carers started their employment. This situation is permissible only when it is necessary to take such action because of a real danger that staffing levels will otherwise fall below numbers required to meet the home’s statutory obligations. In this situation an interim check made against the protection of vulnerable children and adults lists held at the Department of Health must be obtained before employment starts, but this was not done. A full employment history was not obtained and therefore gaps in employment were not checked. A heath declaration is required but this information was seen in only one of the files. The manager must ensure that the information and checks that are required are obtained prior to starting new employees. There is an induction programme to ensure that new staff members are given the right information to be able to do their jobs well. There is also a training plan to ensure that training is provided to staff throughout the year. During 2007 a range of training is planned, such as first aid, infection control and dementia care. Training records are kept and showed that staff attendance is good. Beech Haven DS0000013064.V326369.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is good leadership, guidance and direction given to staff to ensure residents receive consistent quality care. The systems for consultation with residents are good with evidence to indicate that residents’ views are both sought and acted upon. EVIDENCE: The manager has extensive experience of managing care services and comments from staff indicate that she is approachable and that the home is well managed. The manager confirmed that she regularly attends training updates on a variety of topics relevant to her role. Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 20 The manager has a higher national certificate in care service management and has obtained independent verification that this is similar to the registered manager’s award. However, confirmation has not been obtained that it is fully comparable, or that it includes a care qualification equivalent to NVQ level 4. Both the Registered Manager’s Award and the NVQ level 4 in care (or equivalent) are needed for Standard 31 to be assessed as fully met. A GP who returned a CSCI questionnaire wrote: “A good well run and very supportive care home”. Written feedback is sought annually from residents and relatives to assist in the development of the service for residents - next planned February 2007. Meetings for residents and staff are regularly arranged with minutes taken and circulated. The home has procedures for looking after small amounts of residents’ pocket money. Three accounts were checked and they were all correct and in good order. The home employs a part-time maintenance person to deal with day-to-day repairs and routine redecoration. Mandatory safety checks are done and the outcome is recorded. Health and safety procedures are good and relevant training is provided for staff. The names of five members of staff were selected at random to check that they had attended fire safety training and the records confirmed this. Beech Haven DS0000013064.V326369.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 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 2 4 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 Schedule 2 Requirement The manager must ensure that the recruitment information and checks that are needed to safeguard residents are obtained prior to a new member of staff commencing employment. Timescale for action 09/01/07 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 OP8 Good Practice Recommendations A falls risk assessment should be undertaken to reduce identified risk for residents who have a history of at least one fall. When risk assessments are undertaken for residents all sections should be completed so that the level of risk is accurately identified. This enables appropriate action to be taken to reduce identified risk. Monitor the temperature of food and drinks served to residents to ensure the correct temperature has been maintained. DS0000013064.V326369.R01.S.doc Version 5.2 Page 23 OP8 3 OP15 Beech Haven 4 5 6 OP16 OP18 OP27 The complaints procedure should be displayed prominently within the home so that people wishing to make a complaint know how to do this. The manager should arrange for a training update for all staff on the protection of vulnerable adults. Keep staffing levels under review, particularly night staffing levels, to ensure the number of carers on duty have sufficient time to provide the care that residents need. Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Beech Haven DS0000013064.V326369.R01.S.doc Version 5.2 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. 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