Care Home: Bellevue Residential Care Home

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What the care home does well The service offers individual care to residents who are becoming more dependent. Staff know the residents well and are able to recognise needs that at times the resident cannot express. The staff team is stable and well supported by the management arrangements. Encouragement is given for staff to undertake relevant qualifications and study. What has improved since the last inspection? At the last inspection five requirements were left, two of which were repeated from previous inspections. On this occasion evidence of action taken to meet all the requirements was seen. Medication practice was safe and a new post had been filled to ensure there was adequate staff to meet residents` needs at peak times of the day. External and internal maintenance had taken place, a fire risk assessment had been completed and a system for consulting with residents had been established to find out their preferences about the service. What the care home could do better: Some policies and procedures need to be expanded and updated to give staff full guidance on all aspects of their work. The service users guide needs some minor corrections to ensure correct information is being given. Some radiators in communal areas that are accessible to residents were not protected to prevent anyone being burnt. Medication that required storage in a refrigerator was stored in an unlocked plastic box in the domestic refrigerator in the kitchen meaning it was accessible to people not authorised to give medication. CARE HOMES FOR OLDER PEOPLE Bellevue Residential Care Home 51 Church Road Clacton on Sea Essex CO15 6BQ Lead Inspector Jane Offord Unannounced Inspection 29th April 2008 09:15 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 Bellevue Residential Care Home DS0000059848.V362947.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. Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bellevue Residential Care Home Address 51 Church Road Clacton on Sea Essex CO15 6BQ 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) 01255 473976 sandy@sahadew.fsnet.co.uk Anglia Care Homes Ltd Mrs Sandhya Sahadew Care Home 10 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number disorder, excluding learning disability or of places dementia (2), Mental Disorder, excluding learning disability or dementia - over 65 years of age (10) Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 10 persons) Persons of either sex, aged 65 years and over, who require care by reason of mental disorder (not to exceed 10 persons) Two named persons under the age of 65, who require care by reason of a mental disorder, whose names were made known to the Commission in August 2006 The total number of service users accommodated in the home must not exceed ten persons 10th May 2007 Date of last inspection Brief Description of the Service: Bellevue is a detached house situated in a quiet residential area of Clacton-onSea within walking distance of the seafront and local facilities within the town. The home offers accommodation and support to ten older people with a diagnosis of dementia or mental health problems. Accommodation is over two floors with a passenger lift providing access to facilities on the first floor. There is a lounge and dining room on the ground floor. The home has eight single rooms and one shared room. One room has en suite facilities and the rest have a hand washbasin in the room. There is a private rear garden with a grassy area and some flowerbeds that residents can access in fine weather. There is parking in the front of the house on the quiet road. The home charges fees between £383.00 and £450.00 per week. These do not include the cost of hairdressing, toiletries, newspapers and chiropody. Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this home is two star. This means that people who use this service experience good quality outcomes. This key unannounced inspection looking at the core standards for care of older people took place on a weekday between 9.15 and 13.15. The registered manager was on compassionate leave but the senior carer and the owner were present and assisted with the inspection process by providing documents and information. This report has been compiled using information available prior to the inspection such as surveys completed by residents and relatives/visitors and the annual quality assurance assessment (AQAA) completed by the manager. It also includes evidence found on the day of inspection. During the day a tour of the home was undertaken, a number of files, certificates and documents were inspected. The lunch serving was observed and a medication round was followed. A number of residents and staff were spoken with in the course of the day and care practice was observed. The home was clean and tidy with no unpleasant odours noted. The furnishings and décor were homely and comfortable and residents treated the place as their own moving around freely. Interactions between staff and residents were friendly and appropriate. Residents looked relaxed and well cared for. The meal at lunchtime smelt appetising and was served individually with help being offered sensitively if it was required. Residents spoken with said they had enjoyed their meal. What the service does well: What has improved since the last inspection? At the last inspection five requirements were left, two of which were repeated from previous inspections. On this occasion evidence of action taken to meet all the requirements was seen. Medication practice was safe and a new post had been filled to ensure there was adequate staff to meet residents’ needs at peak times of the day. Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 6 External and internal maintenance had taken place, a fire risk assessment had been completed and a system for consulting with residents had been established to find out their preferences about the service. 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. Bellevue Residential Care Home DS0000059848.V362947.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 Bellevue Residential Care Home DS0000059848.V362947.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): 1, 3, 6. Quality in this outcome area is good. There is sufficient information available and a robust assessment process for people who would like to use this service to be sure that their needs could be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an informative service users’ guide and statement of purpose that are generally kept displayed in the entrance hall. Some minor updates to the documents need to be done to ensure that the information is as up to date as possible. The owner said that copies of the documents were available to anyone making enquiries about living in the home. The admission policy was seen and said that each prospective resident would have an assessment of needs undertaken and assurance that those needs could be met at Bellevue before being accepted to live there. The policy also covered pre-admission visits to the home and the possibility of a four-week trial period initially. Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 9 The files for three residents were inspected and each one had a pre-admission assessment form completed. The areas of support and need covered included personal hygiene, continence, diet, mobility, tissue viability, pain and night needs. The person’s communication needs and mental state were also assessed. Records included the person’s past medical history and any known allergies. Surveys were sent out by CSCI prior to this inspection and nine residents and five relatives/visitors surveys were returned. Eight of the nine residents’ surveys said they had had sufficient information about the home prior to admission. The ninth survey said they had arrived at the home due to emergency circumstances. All five of the relatives/visitors’ surveys said they had adequate information to make an informed choice. The service does not offer intermediate care. Bellevue Residential Care Home DS0000059848.V362947.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, 10. Quality in this outcome area is good. Detailed care plans ensure that people using the service receive care in the way wish. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three files for residents’ were inspected and they all contained a care plan and a number of assessments and health records. Names and the contact details of health professionals involved with the care of the individuals, such as the GP, community nurse, dentist, community psychiatric nurse (CPN) and chiropodist, were recorded. There were records of professional visits and out patients’ appointments. One record showed that the resident had received an influenza injection from the community nurse so preventative care is being practised. Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 11 On the day of inspection the carer said they were expecting a visit from a GP for one resident who had been ‘under the weather’ for a couple of days. The resident was unable to tell carers what the problem was but carers, who knew the person very well, were able to recognise that there was a health issue that required professional advice. The care plans seen had a variety of interventions depending on the needs of the resident. Some interventions related to physical needs such as personal hygiene or continence, some were more specific for medical conditions like diabetes or Parkinson’s disease. Some care plans appeared incomplete and when asked both the senior carer and the owner said that before taking compassionate leave the manager had been in the process of archiving old documents and transferring the files into new folders. The carer was able to talk of care needs for residents that there were no care plans for and there was evidence in the daily records that these areas were still being monitored. All the files had a moving and handling risk assessment and there was evidence that they were reviewed and updated. There were records of dietary intake and weight records. The medication policy was seen and needs to be expanded to give full guidance to staff on areas of medicine management such as covert administration and altering medicines from the format licensed by the manufacturers. Staff spoken with said they had recently had updated medication training and this was confirmed by documents in the staff files looked at. The lunch time medication round was followed and practice was safe. The medication administration records (MAR sheets) had identification photographs of each resident attached and all the signature boxes were completed either with initials or a code if the medication had not been given for any reason. The numbers of tablets held were recorded in the ‘brought forward’ boxes so an audit trail was available. The home did not hold any controlled drugs (CDs) at the time of this inspection. Some medication requiring refrigeration was stored in a plastic box in the domestic refrigerator which meant it was open to people not authorised to manage medication. Care practice was observed and residents were treated with respect. Carers were patient and friendly in their manner, helping people to move from one area of the home to another to have a meal or a change of scene. Staff knocked on doors and waited to be invited into rooms. Bellevue Residential Care Home DS0000059848.V362947.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, 15. Quality in this outcome area is good. People who use this service experience a lifestyle that matches their needs and expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents’ files were seen and each one contained contact details for the person’s next of kin. One included a family tree and life history so carers could offer individual contacts based on the resident’s previous experiences. The activity records recorded when a resident had a visitor or went out with a friend or relative. In the surveys received by CSCI prior to this inspection seven said there were activities they participated in, one said N/A and one ticked the sometimes box. Two surveys had a list of pastimes organised by the carers that included quizzes, hangman, board games, drawing, exercise and chatting. One member of staff was observed playing hangman with a resident during the morning. Residents were complimentary about the staff saying they were ‘very caring’ and ‘nothing is too much trouble for them’. Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 13 The activity records in the files seen showed that pastimes tended to be indoor occupations and included some domestic tasks such as laying the tables for lunch. One survey received said, ‘I would like to get out more’. At a recent residents’ meeting activities were discussed and some ideas from residents of the things they would like to do were, ‘a walk on the seafront’ and ‘attend a musical evening at the theatre’. The menus were seen and showed that there was a choice of main meal and dessert offered each lunch time for example toad-in-the-hole or chicken curry followed by rice pudding or strawberry ripples. A full roast dinner was on the menu for each Sunday with a choice of fish dishes every Friday. The tea menu had a selection of sandwiches, soup, crumpets or cake each day. The lunch on the day of inspection was beef burgers with chips and beans followed by bread and butter pudding or ice cream. It was all freshly prepared and looked and smelt appetising. Residents cleared their plates and said they had enjoyed the meal. During the recent residents’ meeting a discussion had taken place about meals and food preferences. One resident had expressed a liking for salads and wished they could be served more frequently. After lunch they said they had been given, ‘a beautiful egg salad with everything in it for supper last night’. The kitchen was visited and stores were seen. As the home is not large the kitchen is of domestic proportions and the stores are limited. The owner does a regular shop at the local supermarket rather than have deliveries that would take space storing them. The refrigerators and freezers have temperatures recorded to ensure they are functioning within safe limits for food storage and cooked, hot food is temperature probed before it is served. Records seen showed that staff had food hygiene training certificates that were within date. Bellevue Residential Care Home DS0000059848.V362947.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, 18. Quality in this outcome area is good. People who use this service can be confident that any complaint will be taken seriously and that staff training and knowledge will protect them from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a robust complaints policy that is generally displayed in the entrance hall and is available with the service users guide that is given to all residents. Neither CSCI nor the home has received a complaint since before the last inspection. In the surveys received by CSCI from relatives/visitors and residents, eight of nine residents knew how to make a complaint and some named the member of staff they would talk to, three of four relatives/visitors also knew about the complaints procedure. The home has a policy on the protection of vulnerable adults (POVA) based on the Essex Vulnerable Adults Protection Committee guidelines and procedures. Those procedures have now been superseded by Safeguarding Adults policies so the guidance needs to be updated to ensure that staff are aware of any changes in procedure or referrals. The home has a whistle blowing policy to protect staff who voice any concerns. Staff spoken with were clear about their duty of care and files showed that abuse training was up to date. There are no alerts outstanding for this service. Bellevue Residential Care Home DS0000059848.V362947.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. People who use this service live in a pleasant, homely environment that is clean and tidy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home was undertaken in the course of the day and everywhere was clean and tidy. Individual rooms seen were personalised with residents’ own pictures, photographs and small pieces of furniture. One room had ensuite facilities but all the others had hand washbasins. Some rooms had laminate flooring that looked smart. The owner said it was a way of managing some continence problems and avoiding unpleasant odours. The home received a grant from the local authority at the end of last year and used it to re-carpet and redecorate all the communal areas of the home, which were looking fresh and bright. Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 16 Some work has been done on the exterior of the home to upgrade window frames and repaint them. The rear garden, which is secure, has had some planting and the owner said they plan more to make it an attractive additional facility for the residents. Bathrooms and toilets seen had appropriate hand washing facilities. Baths had hoists available to assist the residents who were less mobile. The radiator in one downstairs bathroom and another in the lounge were not protected and hot to the touch. The radiator in the lounge was behind some armchairs but was still accessible. The laundry is upstairs and very tiny. The machines are industrial and have sluice and hot wash programmes however there is no tumble dryer so all laundry is dried outside in the garden. The carers say they manage by keeping an eye on the weather. The home has a suitable policy for managing soiled linen and uses alginate bags that are put directly into the machine to avoid cross-infection. The carers have protective clothing available for such tasks. Bellevue Residential Care Home DS0000059848.V362947.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, 30. Quality in this outcome area is good. People who use this service are supported by adequate numbers of correctly recruited and trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last inspection concern was raised that care staff had domestic duties to complete as well as supporting the residents. Since then the owner has employed an additional member of staff between 11.00 and 13.00 each day to facilitate the preparation of lunch and assist residents who require help with their meals. The duty rotas show that between 8.00 and 14.00 there are two carers on duty and the same between 14.00 and 20.00. There is one waking and one sleeping member of staff cover night duty. The manager is generally present in the home daily, in a supernumerary capacity. Staff spoken with said they felt the level of staffing met the needs of the present resident group. It gave them time to spend socialising with people who enjoyed having a chat and some individual attention. The home employs nine staff, eight on a permanent basis and one on bank. Five of the staff hold a National Vocational Qualification (NVQ) at level 2 or above. This means the recommended percentage of 50 in standard 28 of the national minimum standards (NMS) has been exceeded. Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 18 The files of two new members of staff were seen and both contained evidence that identity checks had been undertaken prior to employment. Criminal record bureau (CRB) checks were retained in the files and there were two references for each person. There was documentary evidence of a full induction programme being completed by new staff members and this was confirmed in discussion with staff who added that they had done a number of ‘shadow’ shifts before being added to the staff complement. There were certificates to show training had been done in moving and handling, food hygiene, management of medication, fire awareness and dementia activities. One carer said the present fire panel was being updated and when that was complete more fire training was planned to ensure all staff understood the new panel. Bellevue Residential Care Home DS0000059848.V362947.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 good. People who use this service live in a well managed home and have their finances and welfare protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is owned and run by Mr. and Mrs. Sahadew. Mrs. Sahadew is the registered manager and in her absence Mr. Sahadew, who is the responsible person, is supporting the staff team. Both people have a registered nurse qualification and Mrs. Sahadew has achieved the registered managers award. They have a number of years experience managing care homes. Staff spoken with found them approachable and supportive. Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 20 A quality assurance system has been set up and the owner said they had just recently given out questionnaires to relatives/visitors and were waiting for them to be returned. The questionnaires asked for ratings on the comfort of the home, the cleanliness, the quality of meals, the staff attitude, the laundry service, activities offered and the response to any concerns. Two responses had been returned and all the questions were ticked either good or excellent. CSCI had nine surveys returned from residents prior to this inspection. Several of them had been completed with help from relatives or carers. The owner said that due to the level of understanding for some residents it was difficult to achieve a good level of participation in written surveys. They were seeking some guidance from the Alzheimer’ Society about the best way to collect residents’ opinions. In the meantime residents’ meetings were held regularly. The minutes of the latest meeting held on April 4th 2008 showed that seven out of the ten residents attended and a wide range of subjects was discussed. The records of personal monies for four residents were seen. There were details of all transactions and receipts were kept. The balance of money in each case was checked and tallied with the records. At the last inspection a requirement was left for a fire risk assessment to be completed. The risk assessment was undertaken by external consultants and was seen during this inspection. The fire alarms were inspected in October 2007 and there was a record of monthly fire equipment testing. Other documents seen included a certificate for lift safety, an environmental inspection certificate and the gas safety certificate from September 2007 valid for a year. Bellevue Residential Care Home DS0000059848.V362947.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? None. 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 OP9 Regulation 13 (2) Requirement Provision must be made to store medication that requires refrigeration safely to protect it from being accessed by people unauthorised to do so. All radiators that residents have access to must be protected to prevent anyone burning themselves. Timescale for action 29/04/08 2. OP19 13 (4) (a) (c) 31/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Bellevue Residential Care Home DS0000059848.V362947.R01.S.doc Version 5.2 Page 24 - 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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