Inspection on 26/02/07 for Ashley Lodge Nursing Home

This inspection was carried out on 26th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ashley Lodge Nursing Home 09/01/06

Ashley Lodge Nursing Home 11/08/05

Ashley Lodge Nursing Home 28/02/05

Ashley Lodge Nursing Home 13/09/04

Ashley Lodge Nursing Home 09/06/03

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Ashley Lodge Nursing Home 12/13 Carlton Road Ealing London W5 2AW Lead Inspector Mrs Rekha Bhardwa Key Unannounced Inspection 10:40 26th February 2007 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 Ashley Lodge Nursing Home DS0000010938.V318047.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. Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashley Lodge Nursing Home Address 12/13 Carlton Road Ealing London W5 2AW 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) 020 8998 9071 020 8810 4398 Mr and Mrs Kassam (County Point Limited) Mrs Nabat Tajdin Kassam Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0), Physical disability of places over 65 years of age (0) Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Elderly medically sick of either sex over the age of 60. Service Users to include OP, PD & PD(E), not to exceed 36. One named service user with Dementia can be accommodated, as agreed by the Commission for Social Care Inspection, on 20th December 2004, for as long as there is no deterioration which effects the well being of other service users. The home must advise the CSCI when the service user no longer resides in the home. 9th January 2006 Date of last inspection Brief Description of the Service: Ashley Lodge is a Care Home providing nursing care for thirty-six service users. The home is a converted detached house situated in a residential area. There are 28 single rooms and 4 double rooms on two floors. The floors are connected by a stairway and a lift. The living/dining area, which is narrow and small, does not allow for service users to eat meals at a dining table. Instead, small over-chair tables are placed in front of each service user at meal times. This living/dining area is subdivided into three smaller areas. There is a quiet room with a garden outlook that allows seating for three to four service users. Service users and others access the first floor by one of several stairways or via the lift. Ealing Broadway shopping centre is nearby. There is a well-maintained accessible garden to the rear of the home and car parking to the front of the home. The fees range from £551 to £650 per week, dependent on assessed needs. Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process. A total of 8 hours was spent on the inspection process. A tour of the home was carried out, and service user plans, medication records, management records, training records, staff employment records, administration records, maintenance and servicing records were viewed. 15 service users, 2 visitors and 7 staff were spoken with as part of the inspection process. The pre-inspection questionnaire completed by the home, plus the information provided via the CSCI questionnaires completed by service users, representatives and healthcare professionals have also been used to inform this report. What the service does well: What has improved since the last inspection? Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 6 There has been an improvement with the overall formulation of wound care plans. The Inspector noted that separate wound dressing care plans were available for each wound. Nutritional assessments were available and the equipment required for moving and handling had been identified in the moving and handling assessment. The medication policy and procedure had been updated to include a procedure to facilitate self- medication and manage service users who refuse medication and have swallowing difficulties. An annual survey had taken place for quality assurance and the results of these surveys had been published. Copies of the Regulation 26 Visit reports had been sent to the Commission. 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. Ashley Lodge Nursing Home DS0000010938.V318047.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 Ashley Lodge Nursing Home DS0000010938.V318047.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 The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their representatives are provided with information about the service, thus allowing them to make an informed choice about the home. Service users are fully assessed prior to admission to the home, to ascertain that the home is able to meet their needs. EVIDENCE: The home has a service user guide and a statement of purpose which is available to all service users who are admitted to the home. There have been no changes to both these documents since the last inspection. Pre-admission assessments were available in each of the service user plans viewed. These were thorough and gave a clear picture of each service users Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 9 needs. Copies of Social Services and Primary Care Trust assessments were also seen in some service users files. Ashley Lodge Nursing Home DS0000010938.V318047.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 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the service user plans are well completed and maintained up to date, thus giving a good picture of the service users needs and how these are to be met. Medications are being well managed at the home, thus safeguarding service users. Shortfalls identified should be easy to address. Staff care for the service users in a gentle, courteous and professional manner, thus respecting their privacy and dignity. Information in respect of service users wishes for end of life care is recorded, thus ensuring their needs and wishes in this area are respected and met. EVIDENCE: Samples of service user plans were viewed during the course of the inspection. Those viewed were individualised and up to date. Monthly reviews had taken place plus additional reviews when a service users condition had changed. Where new needs had been identified, care plans had been formulated to address this. Risk assessments for falls were in place, and Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 11 there was evidence of these plus the associated documentation being updated following any falls. Wound care documentation was in place and clearly documented the progress of each wound. Any pressure relieving equipment in use had been identified in the service user plan. The Inspector noted that for one service user the Waterlow skin assessment had been inaccurately completed. This was corrected at the time of the inspection. Assessments for moving & handling had been carried out and the specific equipment in use for each service user had been documented. Continence assessments had been carried out. Care plans had been formulated for any needs identified in the assessments. Nutritional assessments plus clear documentation for nutrition is in place. Where service users have been identified as nutritionally compromised, a programme for nutritional supplementation is in place. Service users are weighed monthly, and in some cases weekly weights have been implemented. Some marked changes in weight loss had been recorded, and explanations in relation to this were available. Written consents for the use of bedrails were in place along with the completed risk assessment. The GP carries out a fortnightly visit to the home, plus attends at other times as required. There was evidence of input from the Tissue Viability Nurse, Chiropodist, Optician and other healthcare professionals. Both GPs had completed CSCI comment cards and had expressed their satisfaction with the care provision at the home and with the effective management. Medication management and records were sampled during the course of the inspection. All receipts, administration and disposal had been recorded. A list of registered nurse signatures and initials was available. Fridge temperature records were within safe ranges. Homely remedy arrangements had been agreed in writing for each service user. Dates of opening had been recorded on all liquid medications. Controlled Drug administration was being correctly recorded in the register and balances checked were correct. Appropriate finger pricking devices for service users requiring blood glucose monitoring were in use in line with current legislation and good practice guidance. Medications policies and procedures were in place and the correct method of disposal in line with current legislation was being practiced. The medications policies and procedures had been updated since the last inspection. A system for auditing medication is in place. The Inspector noted that for two residents that had been prescribed medication on alternate days on one occasion had been administered the medication on two consecutive days. This Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 12 was brought to the attention of the Registered Manager who stated that this would be further investigated. Staff were seen caring for and conversing with service users in a polite, gentle and professional manner. Service users spoken with said that the staff are very kind and they were being well cared for at the home. Staff spoken with said that there is good teamwork and staff work well together. Service users can have their own telephone, either landline or mobile, and several rooms viewed had telephone facilities. Written information in respect of the wishes of the service users and their representatives in the event of any deterioration in the service users condition is in place, and can be reviewed at any time. Policies and procedures are available for staff in relation to end of life care. Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are activities provided for service users with a programme in place, and service users specialist needs are also catered for. The home has an open visiting policy, thus encouraging service users to maintain contact with family and friends. Information regarding advocacy services is freely available, thus ensuring the service users right to independent representation is respected. The food provision in the home is good, offering variety and choice, to meet the service users needs. EVIDENCE: The home has a full time activities co-ordinator. Service user plans for social and leisure needs area available. There is a good standard of social activity provision within the home. Information regarding service users individual hobbies and interests is ascertained following admission. The activities coordinator provides activities to meet the needs of the service users, and has worked with members of staff to enable activities to take place each day throughout the home. The outcome of the activity sessions in relation to each service user is recorded, to provide information regarding service users responses to activities. Outings and entertainments are arranged for service Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 14 users, to meet their interests. Service users spoken with said that they enjoy the activities and can choose if they wish to join in or not, with their choice being respected. The home has a weekly activities programme, which is displayed in the main lounge. Some of the service users in the home visit the local Stroke club. The home has an open visiting policy and visiting is encouraged. Visitors spoken with said that they are made welcome at the home and refreshments are offered. Service users can choose to receive their visitors in their own rooms or in one of the day rooms, depending on their own wishes. The daily menu is displayed in the lounge area. Choices are available. Service users choices are recorded. The Inspector viewed the lunchtime meal, and service users were interacting well and enjoying their food. Service users spoken with expressed satisfaction with the food provision and confirmed that they are offered choices. Service users stated that the Chef is very accommodating and will provide different alternatives to meet the service users wishes. The kitchen was clean and tidy and all records viewed were up to date. There was a good supply of foodstuffs. Meals are well presented and drinks and snacks are available throughout the 24 hour period. A cooked breakfast option is available. The provision of meals for service users who require a ‘soft’ diet, and a diabetic diet is also available. A list of service users who require this these diets is available in the kitchen. The Registered Manager stated that there had been no Environmental Health Inspection since the last inspection. Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear complaints procedures in place to address any concerns raised by service users and their visitors. The system in place for protection of vulnerable adults is robust, thus safeguarding service users. EVIDENCE: The home has a clear complaints procedure and all concerns and complaints are documented and addressed. No complaints had been recorded since the last inspection. Service users and representatives spoken with said that the Registered Manager addresses any concerns raised promptly and thoroughly, and is very open and approachable. The home has policies and procedures in place for the protection of vulnerable adults, and these dovetail with the Ealing Safeguarding Adults documentation. Staff spoken with said that they would report any concerns and were aware of Whistle Blowing procedures. Staff had received POVA training and the Registered Manager stated that further training had been planned. There have not been any POVA allegations since the last inspection. Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 16 Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is maintained to a good standard, thus providing a good quality clean, safe and homely environment for service users to live in. Communal rooms are available on the ground floor, providing the service users with a choice of venue. Equipment is available for assisting service users as required, thus providing for the service users needs. Individual accommodation is personalised, maintaining a homely feel. Clear infection control procedures are in place and being adhered to, thus safeguarding service users. EVIDENCE: A tour of the home was carried out. There is a redecoration and refurbishment plan, and areas were in the process of being redecorated. Where carpets had been damaged they were in the process of being replaced. A Fire Officer from the London Fire and Emergency Planning Authority inspected the home on Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 18 8/11/06. A report of this visit was available. No requirements or recommendations were made at this visit. Some of the bedrooms on the ground floor have en-suite facilities. There are assisted bathing and shower facilities on each floor. Toilet facilities are situated near the communal areas. There are rails in the corridors and also in the bath, shower and toilet facilities as required. The home has one passenger lift and suitable moving and handling equipment was available on each floor. Any repairs are reported and promptly addressed. There is a call bell system throughout the home. All bedrooms viewed had been personalised. All the beds are adjustable and the rooms are appropriately furnished. There is a lockable space in each room. Service users can have a key to their room if they are able to manage, and assessments are in place for this. The Registered Manager stated that plans are in place to purchase profiling beds for some of the service users. It is her intention to replace all beds with profiling beds over a period of time. The temperature in the home was satisfactory. Emergency lighting is in place and records evidenced that this is regularly checked and serviced. Hot water temperatures are checked and recorded. Legionella testing was up to date. The home was clean and tidy throughout. Protective clothing to include gloves and aprons were seen on each floor. The laundry room was clean and tidy and all equipment was reported to be working. The pre-inspection questionnaire completed by the home indicated that staff had received training in infection control. Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was adequately staffed to meet the needs of the service users. Systems for vetting and recruitment practices are in place and protect service users. There is a comprehensive ongoing training programme, providing staff with the skills to meet the needs of service users, to include specialist care needs. EVIDENCE: A duty roster was available. This detailed the number of nursing and care staff on duty and where additional staffing is required. The Registered Manager reported that staffing is based on the service users dependency levels. The home does not use agency staff. Where shifts need to be covered this is undertaken by the existing staff team. The home has in place a core stable staff team. The home is clean and fresh, and each unit has their designated domestic staff. Staffing levels in the kitchen, laundry, maintenance and administration departments were satisfactory. The pre-inspection questionnaire detailed that more than 50 of care staff are trained to NVQ level 2 or hold and equivalent qualification. Further training in NVQ has been planned. Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 20 Staff employment files were sampled. They contained all the required information under Schedule 2 of the Care Homes Regulations 2001. Induction training is based on the Skills for Care Common Induction Standards. This was comprehensive and was being completed by new care staff. Training records were available. Staff spoken with confirmed that they had been receiving training. Specialist training in topics to include skin & wound care, safe administration of medication and other relevant subjects had been undertaken. Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 & 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The management approach of the home creates and open, positive and inclusive atmosphere. The Registered Manager has a clear sense of leadership, and relates well to service users, visitors and staff. Systems for quality assurance are in place, thus providing an effective ongoing process of procedure and practice review. Shortfalls in relation to care plan audits should be easy to address. Systems for the management of health and safety throughout the home are good, thus safeguarding service users, staff and visitors. EVIDENCE: The Registered Manager is a first level registered nurse with several years experience of managing care homes for older people. She has completed the Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 22 Registered Managers Award, NVQ level 4. The Registered Manager has an open and proactive approach to managing the home, and staff spoken with said that the Registered Manager is supportive and approachable. Regulation 26 visits take place, with reports being formulated and copied to CSCI. Customer Satisfaction Questionnaires had been completed and the results of these surveys had been collated and published. The home has a quality assurance system in place and has been assessed and accredited with ISO 9001 status. An external audit of the home takes place annually. Weekly medication audits take place. Service user plans are viewed randomly by the Registered Manager and shortfalls are discussed with the named nurse. However there is no record of the audit and how shortfalls are to be addressed. The need to ensure that all audits are recorded was discussed with the Registered Manager. There was evidence of regular staff meetings taking place and minutes of each meeting were available for inspection. An annual operating business plan was available and viewed by the Inspector. The Registered Manager stated that personal monies are not managed by the home. Personal monies are managed by the service user if possible or their representative. Staff supervision records were sampled. These were up to date and had been signed by the supervisor and the supervisee. The records evidenced that care issues plus training and development needs are discussed. Servicing and maintenance records were sampled and all viewed were up to date. Fire drill records viewed indicated that both night and day staff receive regular fire drill training. A fire risk assessment was available and is reviewed annually. Training information provided in the pre-inspection questionnaire detailed that all staff had received health & safety training to include moving & handling, fire safety, First Aid, Infection Control, COSHH and food hygiene. Regular hot water temperature checks were being carried out and recorded, with evidence of remedial action being taken where any problems had been identified. The systems for health and safety are in place and are being well managed. Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 3 3 3 3 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 3 X 3 Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 24 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. 2. Standard OP9 OP33 Regulation 13(2) 24 Requirement Medication must be administered as prescribed by the GP. Where care plan audits are undertaken there must be recorded evidence of the audit and how and when shortfalls are to be addressed. Timescale for action 01/04/07 01/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West London Area Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Ashley Lodge Nursing Home DS0000010938.V318047.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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