Inspection on 29/11/06 for 2 - 4 Wraxall Road

This inspection was carried out on 29th November 2006.

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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2 - 4 Wraxall Road 25/10/07

2 - 4 Wraxall Road 21/12/05

2 - 4 Wraxall Road 18/05/05

2 - 4 Wraxall Road 20/10/04

2 - 4 Wraxall Road 05/04/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 2 - 4 Wraxall Road Cadbury Heath South Glos BS30 8DN Lead Inspector Andrew Pollard Key Unannounced Inspection 29th November 2006 09:30 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 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 2 - 4 Wraxall Road DS0000020293.V313824.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 Adults 18-65. 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. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2 - 4 Wraxall Road Address Cadbury Heath South Glos BS30 8DN 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) 0117 9600430 0117 9605295 www.brandontrust.org The Brandon Trust Mr Ian David Cameron Care Home 14 Category(ies) of Learning disability (14), Physical disability (14) registration, with number of places 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 14 persons aged 18 years and over with physical disability and learning disability who require nursing care Staffing Notice dated 03/03/2000 applies Manager must be a RN on parts 5 or 14 of the NMC register. Date of last inspection 21st December 2005 Brief Description of the Service: Brandon Trust operates 2 - 4 Wraxall Road, which is registered to provide nursing care to 14 adults with a learning disability and a physical disability. The property is located in a quiet residential area, close to local shops and amenities. The houses are purpose built and equipped for disabled people. There are 14 single bedrooms of various sizes. There are parking spaces and grounds to the side and rear of the house. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Due to profound and multiple disabilities, residents are unable to express their views verbally. Several staff were consulted about their roles and responsibilities, their training needs, and how they assist and support residents. Staff were also observed assisting and supporting residents. A range of records relating to the day-to-day running and management of the Home were inspected. A selection of resident’s care records and care plans were also inspected. Ten Commissions for Social Care Inspection (CSCI) comments cards were returned. These had been completed by resident’s relatives or representatives to make their views known about the home and have been used as additional inspection information. The responses were universally positive. A general inspection of the environment was also carried out. This report has been written using all available evidence including a visit to the home. What the service does well: What has improved since the last inspection? Fire alarm tests are regularly carried out to ensure alarms are working. 2 - 4 Wraxall Road DS0000020293.V313824.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. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents would be given relevant information in written or verbal form about the home. Residents’ care and social needs are assessed and met. EVIDENCE: The statement of purpose and service users’ guide contained a range of detailed, helpful information about life in the Home and the service that is provided, including information about daily life. The documents include colour photographs of the Home to further show what type of service is provided. However, the complaint procedure does not contain contact details for the commission and the staffing details are out of date. There have been no new admissions in either house. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 9 At the previous inspection assessment records were reviewed. The assessments included information about each resident’s range of complex care needs. The Home is starting to carry out assessments based around the concept of ‘person centred planning’ so staff seek to advocate the views and wishes of residents with family involvement to be at the centre of all care provided. All ten relatives that responded to the survey said the staff made them feel welcome when they visited. All files contain a copy of the contract. No residents are able to sign any documents. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans enable staff to provide individualised care. The format, evaluation and review of care plans are inconsistent. The home’s philosophy promotes residents’ individual needs. Residents are supported to take reasonable risks. EVIDENCE: 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 11 The staff on duty discussed how they support residents and seek to interpret their needs and wishes. The staff conveyed an understanding of the resident’s range of needs. Staff also demonstrated a good understanding of how to try and support residents through their body language, gestures, and a long-term knowledge of them. Residents and staff communicated in a warm and good-humoured way. All the staff on duty were patient and sensitive when assisting residents and talked to them in a respectful manner. Each resident has a named nurse and support staff “key workers” who with relatives and the multidisciplinary team devise and evaluate care for the residents. Nine of the ten relatives said they were consulted about important matters concerning care and other decisions related to their relative. Four residents care plans, including a range of risk assessments, were examined. The care plans contained detailed information about how staff should support the resident’s physical, mental and social care needs. However the case files were not of a consistent format or easy to navigate. It appears that new Trust documentation should have replaced older proformas but the process was incomplete. There were a considerable amount of old records held in the files. Numerous risk assessments were seen including moving and handling assessments for each resident detailing how best to assist each person with their mobility needs. The risk assessments in place demonstrated what actions must be taken to minimise risk when supporting residents in a range of daily activities. Most but not all of the risk assessments seen had been reviewed and updated. Some elements of care plans had been formally reviewed and updated but a number had not been reviewed for a year. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to live a fulfilling life by taking part in appropriate social and leisure activities. The menus are varied and offer choice and a balanced diet. EVIDENCE: 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 13 Depending on their wishes individual residents are encouraged to engage with the local community. They are encouraged and assisted to attend local community services and facilities. Residents go out to the local shops accompanied by staff. At present no one is able to go out independently. Each resident has a timetable of activities showing a range of therapeutic, social and recreational activities. Some residents have the opportunity to attend activities such as cinema, pubs, city farm and hydrotherapy. Staff work hard to support residents to go to social venues helping to ensure a varied and fulfilling life. One resident attends the Blackhorse centre and people visit the local drop-in centres. There are training and support staff from Spectrum and the Workers Educational Association who visit on a regular basis and work with residents on a range of therapeutic and recreational activities. The home has access to a minibus, which it is hoped will be replaced with a new model in the near future. Outings are arranged, as are annual holidays to places such as Blackpool and Pembrokeshire. Some residents are more suited to day trips and a number of people go to stay with relatives. All ten relatives consulted said they could visit at any time and see people in private if they wished. It was suggested that a relative forum could be set up, as the majority of residents relatives are regular visitors to the home. There are risk assessments in place for residents that aim to demonstrate what actions must be taken to minimise risk when supporting residents in a range of daily activities. The kitchens were clean, tidy and food being stored in the fridge was dated to when it had been cooked. The residents’ menu record was inspected and indicated that residents were being offered a well balanced diet. There were choices of dishes for each day and the menu was nutritionally balanced. Each house has a takeaway supper on alternate weeks. Staff were observed assisting residents to eat their lunch in a sensitive manner. Due to health needs residents require a puréed or soft diet, and meals were served in a reasonably presented way. Individual residents also require peg and naso-gastric tube feeding. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff provide appropriate personal and nursing care in a sensitive manner to maintain residents health and well-being. Proper arrangements are in place for residents to access primary and secondary healthcare services. The system in place for the administration, storage and disposal of residents’ medication is not in accord with the Trust policy. EVIDENCE: 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 15 Care plans include a range of information about residents’ complex physical and health care needs. There were notes in residents care records that showed interventions by medical and Para-medical practitioners. It was reported by staff, that the GP who visits residents is supportive and knows individual residents well. A comments card completed by medical staff from the local surgery was positive about the quality of care the Home provides for residents. Residents are supported to access primary and secondary health care. Visits by Physiotherapists, opticians and dentists are carried out in the home when required. However no formal annual health check is carried out. It was suggested that the manager consider the introduction of the “OK Health Check” to help develop health action plans. A multidisciplinary team review is held six monthly to review care and medication regimes. The trust policy for the administration of medication is not being followed. Staff are putting medication into pots in advance of administration and the drug cupboard is not always secured to allow care staff to give medication. The Medicine Administration Record (MAR) is not always signed at the time the medication is given. A recent drug error has taken place in that medication was not administered or records properly completed. However the manager’s investigation was unable to determine who was responsible. It was difficult to determine the start dates of PRN medication in bottle or packets so thus a stock check was impossible. Each person has a medication profile sheet including a photograph. The medication administration charts were legible. Records were being kept of all medication being received into the Home, and medication being returned to the pharmacy. However the returns container was not secure which would allow medication to easily be removed after it had been logged as disposed off. The disposal record did not record the date on which the bins were emptied or removed. The part filled sharps box did not have the lid properly secured, creating a potential needle sick hazard. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are robust policies in place to manage complaints or allegations of abuse. There is inadequate evidence of staff training and awareness of Protection of Vulnerable Adults matters. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 17 EVIDENCE: A copy of the complaints procedure was seen in the service user guide, which was clearly written but did not contain contact details for the Commission. The complaints log has no recorded complaints. Eight of the relatives who commented were aware of the complaint procedure. All ten respondents said they had never had cause to complain. There are policies and procedures in place relating to the issue of protection of vulnerable adults from abuse. The Trust does provide training to ensure staff are up to date in their understanding of the principles of the protection of vulnerable adults from abuse. However examination of the records showed only one person had such recorded training. There have been no allegations of abuse. Each resident has a ledger sheet and receipts to record credits, debits and balances of money held for safekeeping. The balances are checked daily. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home is generally safe, clean, satisfactorily maintained, and suitable for the needs of residents. The home has a range of specialist equipment for the benefit of residents. One shower bath is not safe for use. Bedrooms are individualised and are suitable to meet the needs of the residents. EVIDENCE: The Home is located close to private houses, a junior school, and a short distance from local shops and nearby bus stops, making the Home part of the local community. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 19 The Home is a purpose built nursing home, designed around the needs of the residents for which it is intended. There are adaptations in place throughout the Home to assist residents as well as visitors who are disabled. The entrance of the building provides easy access for wheelchair users and there is similar access to all areas. There are grab rails positioned along the corridors and handling and lifting aids in bathrooms and toilets. The bathrooms are spacious in size to provide easy access and the baths are specially adapted to assist residents. The grey shower bath is unsafe due to the brakes being inoperative. The standard of the decoration and the quality of fixtures and fittings was satisfactory in bedrooms and most of the communal areas, however in general some of the décor is looking tired and a rolling programme of upgrading will need to be put in place to maintain standards. Rooms had been furnished and decorated to reflect resident’s different interests. There were visual stimulation aids as well as relaxation aids such as wall lights and mobiles seen in many rooms to provide additional stimulation and relaxation for residents. Bedrooms were decorated in different colours and this helped to create an individual feel to rooms. Both kitchens are due to be upgraded in the near future due to wearing of surfaces and edges particularly the kitchen unit doors. The laundry is suitably equipped and the machines are in working order and regularly serviced. The overall standard of cleaning throughout the houses is good. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff are competent and are trained to meet residents needs and recruitment procedures help to protect residents from harm. The home is adequately staffed with appropriately trained and experienced staff to the benefit of the residents. Good NVQ training arrangements are in place for care staff. EVIDENCE: None of the staff records or employment documentation was available as neither the manager or deputy manager were on duty on the day of the inspection. However the recruitment procedures and records were found to be satisfactory at the last inspection. Training records of nurses and care assistants were reviewed. There was evidence that demonstrated that registered nurses had attended clinical 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 21 training and updating over the last year. The care assistants’ records also demonstrated staff had attended training sessions over the last six months. The majority of care staff are on National Vocational Qualification programmes to both level one and two. The trust produces a prospectus of training and learning activities each year, which offers a wide range of relevant courses for the staff. The Home is registered to provide nursing care and there is a registered nurse on duty at the home over twenty-four hours. Five care staff work each day shift, two on each house and one floating. Two care staff work the night duty, one registered nurse is available on a ‘sleeping in shift’ the two care assistants work a waking night shift. The majority of the staff are long standing and have considerable experience working with this resident group. The nurse staffing levels are in accord with the notice issued by Avon Health Authority. The manager works mainly supernumerary hours. At present there a 130 hours of vacancies so there is relatively high use of bank and some agency staffing. Continuity of supply is maintained where possible. The home also employs housekeeping staff. Nine of the ten relatives who responded to the survey considered there were sufficient numbers of staff on duty. The staff were good humoured and respectful in their interactions with residents who looked relaxed and settled in their surroundings. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 40, 41, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are various methods and systems in place to obtain residents’ or their representative’s views. The home has good Health and Safety arrangements, which help to protect residents, staff and visitors. EVIDENCE: There is a health and safety policy for staff to ensure the safety of residents 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 23 and staff is maintained. The fire logbook was checked and showed weekly tests of fire alarms being carried out. The fire fighting equipment was being checked and serviced regularly. There were records to show staff attended fire safety update training in the last twelve months. The gas safety certificate could not be found. Service records were available that showed the moving and handling equipment in the Home had been serviced within the last twelve months. However one of the wheeled shower baths needed repair as the brakes did not work and this poses a potential risk to residents and staff. A second such bath was in good order. There are a range of Brandon Trust as well as ‘in-house’ policies and procedures in place that support and guide staff, in their care practices, health and safety matters, employment issues, and the general running of the Home. In the past year the staff have carried out a quality-monitoring audit of the care and service that is provided to residents. Resident’s representatives are also being consulted about their views of the care and service. In the absence of the manager the report detailing the outcomes was not available. The ten relatives who completed comment cards all stated they were satisfied with the overall care provided. The last nursing staff meeting was in November for which records were seen. There are also periodic whole house meetings and both meetings address issues of quality review on the agenda. As previously noted it was suggested that a relative forum be set up as a trial venture. 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x X X 3 3 3 2 x 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 25 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 YA1 Regulation 4&5 Requirement Update the complaint procedure to include contact details for the Commission and update the staffing details. Ensure all care plans are regularly reviewed and updated. Repair or replace the grey wheeled shower-bath. Send a copy of the gas safety certificate. 4. 5. YA9 YA20 13.4 13.2 Ensure all risk assessments are regularly reviewed and updated. Follow the Trust policy on administration of medication. Provide secure storage for medication awaiting disposal and keep accurate records of such. 6. 7. YA23 YA42 13.6 13.4 Ensure all staff attend protection of vulnerable adults training. Ensure the lid to the sharps container is properly secured. 28/02/07 30/11/06 10/01/07 30/11/06 Timescale for action 10/01/07 2. 3. YA6 YA29 15. 23.2 (c) (P) 10/01/07 10/01/07 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 26 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 YA19 Good Practice Recommendations Facilitate an annual health check for all residents in accord with standard 19.4 Introduction of the “OK Health Check” to help develop health action plans. 2. YA6 Present case files and documentation in a common format and order. Reduce and back file old documentation. Set up a relative’s forum. Highlight or box the first dose of PRN medication on the medicines administration chart to facilitate accurate stock checks. 3. 4. YA15 YA20 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 2 - 4 Wraxall Road DS0000020293.V313824.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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