Inspection on 13/06/05 for Adepta John Paul House 7-9 Pound Lane

This inspection was carried out on 13th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Adepta John Paul House 7-9 Pound... 30/09/09

Adepta John Paul House 7-9 Pound... 02/10/08

Adepta John Paul House 7-9 Pound... 02/10/07

Adepta John Paul House 7-9 Pound... 25/05/06

Adepta John Paul House 7-9 Pound... 18/11/05

Adepta John Paul House 7-9 Pound... 09/12/04

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

CARE HOME ADULTS 18-65 John Paul House 7 - 9 Pound Lane Willesden London NW10 2HS Lead Inspector Sue Mitchell Unannounced 13 June 2005 14:20 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 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 Stationary 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. John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service John Paul House Address 7 - 9 Pound Lane, Willesden, London, NW10 2HS Telephone number Fax number Email 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 8451 6843 020 8343 8876 cfrederick@pentahact.org.uk PentaHact Lorenzo Domech CRH - Care Home 8 Category(ies) of LD - Learning Disability registration, with number of places John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9/12/04 Brief Description of the Service: John Paul House is one of a number of care homes formally managed by Hillstream Care Limited. The organisation merged with Pentahact in September 2004. The home is registered to accommodate 8 adults with learning disabilities. The property is situated on Pound Lane and there are good links with public transport. There are a number of shops close by. The property is detached and has a large driveway for off street parking. There is a large garden at the rear. The property consists of two floors and on the ground floor there are two bedrooms, a shared toilet and bathroom. There is an office, laundry room, lounge and large kitchen/diner. On the first floor are 6 further bedrooms for residents, bathroom with toilet, another toilet, a storeroom and a staff bedroom. Residents attend local day services and are supported to use communty facilities such as leisure centres, parks etc. The home has its own transport John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out during the afternoon and early evening when the residents came home from their day centres. There were four staff on duty with eight residents. The residents have a range of learning disabilities; some are autistic and some have challenging behaviours. The majority have little if no verbal communication skills and use Maketon or other signs, gestures and physical contact to express their needs. Staff were observed to speak clearly to the residents using signs as appropriate. The residents responded to the staff positively and carried out their requests such as putting something away, going to play outside etc. There was one resident in the home who was exhibiting a range of challenging behaviours, which the staff were managing in a sensitive manner. One resident was able to spend time with the inspector discussing his life in the home, his activities and forthcoming holiday etc. He spoke positively about the staff particularly his key worker. The inspector also spoke to all the staff on duty. The inspection focussed on looking at new admissions, care plans, health care and medication records and health and safety matters. The inspector did not tour the building on this occasion. What the service does well: What has improved since the last inspection? The home has improved its system of managing all its working care plan documents making it easy to access for staff and inspectors. They have improved their medication systems. The majority of the requirements from the last inspection have been met. They have also taken on board and implemented the recommendations. The resident’s lounge has been decorated and new furniture purchased. The staff lockers, which formally cluttered the lounge, have now been removed, making more space for the residents. Pentahact has appointed a NVQ coordinator to provide in house NVQ training which staff were very pleased about. John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 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. John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,5 Prospective residents and their families are able to make an informed choice about the home. New residents are assessed prior to their admission and supported to make the transition into the home. Contracts informing the residents about the terms and conditions of residence are in place in a userfriendly format EVIDENCE: The home has now developed its service users guide and each person has a copy on their file. The guide is in a format suitable for people with learning disabilities with colour pictures, large print and uses plain language. There are also new contracts in place for each resident as well as their license agreements. The contracts were written in an easy to understand format using colour pictures, symbols and simple language. The home has also updated its Statement of Purpose, but a copy was not available at the time of the inspection. The manager, who was not in the home at the time of the inspection, spoke the inspector afterwards and a copy was to be sent to CSCI. A new resident had been admitted the previous month and was still on her induction. The inspector was informed that the resident was having daily support from the staff in her previous home to settle her in and help the John Paul House staff understand how to work with her. There were details of the work undertaken by these staff in the daily records. There was information on this person’s daily routines, likes, dislikes and behaviour triggers. There were detailed daily records, which included how staff were managing her behaviour, John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 9 the resident’s daily activities and routines. The file, which had come from the previous home, contained a copy of the last review but there was no care plan, risk assessments or behavioural management guidelines for staff to follow. The shift leader was unable to find this information during the inspection. The manager contacted the inspector after the inspection and stated that this information was in the home and he would make sure it was accessible for staff. All information on new residents must be made available for inspection John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,8,9 Residents care plans identify their needs and how the home will support them to achieve their goals. Residents are supported to express their wishes about the running of the home, their activities through residents meetings and reviews. Residents are supported to take appropriate risks EVIDENCE: Two care plan files were sampled. There were also care plan folders in place for all current working documents. There were folders with individual’s personal profiles, daily records and various charts in them. The home has begun to implement Person Centred Planning for each resident. Both files sampled had details of person centred planning meetings and action/care plans, which were comprehensive and focused on individual’s needs as much as possible. Risk assessments were in place on both files using a new risk assessment profoma, which had been required at the last inspection. One file had monthly care plan reviews for January to December 2004 but not for January to May 2005. The manager should ensure that if it is the home’s practice to carry out monthly care plan reviews then key workers should do this. Another person’s monthly evaluations for 2005 had not been completed but key information had been noted for these months. The key John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 11 worker explained that she had recently become the key worker and was catching up on the filing and recording of information on this person. The home holds monthly residents meeting. The minutes were made available for inspection and recorded individual’s choices of activities as far as they were able to contribute. The resident who spoke to the inspector told her about the meetings and that he also went to York House with other representatives from the Pentahact homes for service users meetings. He said he enjoyed these meetings John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,17 The residents are supported to participate in activities in the local community and in the home. They are offered a choice of healthy options at meal times. EVIDENCE: The inspector was informed that two of the residents had recently been on holiday to Portugal. When asked they both said or indicated that they had had a good time. Staff stated that individually tailored holidays are planned for the other residents. One resident told the inspector that he was going on holiday with his key worker to Butlins in Bognor Regis and was looking forward this very much. He was hoping to go shopping to get some holiday clothes. The key worker said that she would be taking him shopping. All but one person attends a day service within Brent. The person who stays at home has one to one support to engage in activities of his choice such a going out into the community for drives, shopping etc. The home now has its own transport. There were details of the resident’s choice of activities in their care plans. The organisation also encourages representatives from each home to meet to discuss activities for everyone in the homes. The minutes of the previous meetings indicated that residents should make suggestions of what they would like to do. The responses were varied and included a trip to John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 13 Blackpool, the zoo, a disco, day trips, parties, bowling etc. The following minutes showed that these suggestions had been taken on board and there was a disco, a trip to Hyde Park and a barbecue planned for residents in all the homes. On the evening of the inspection the residents were observed in playing ball games in the garden with staff. One or two were going for a walk and some were to go out for a drive to the park. A resident who spoke to the inspector stated that he would like to start going to the Catholic Church again as he had friends there. This information was given to the key worker. The inspector did not observe the evening meal on this occasion. This was a cottage pie and vegetables, which had been prepared by staff. Residents were also offered a choice, which was recorded in the menu book. Two residents are diabetic and advice had been sought from the diabetes nurse and dietician on their diet. Residents do not all eat together due to lack of space; some prefer to eat alone or in smaller groups. One person did not like the meal on offer but would not accept an alternative. Staff were going to try and encourage home to choose something different later. Weight charts are now in place. John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 The residents care routines and preferences are recorded and followed by staff They receive regular health care checks from appropriate health professionals. They are protected by the home’s medication policies. EVIDENCE: The home has now written individual care profiles on each resident, which includes their daily routines, likes, dislikes, behaviours and personal preferences in activities. None of the residents require moving or handling but one uses a stick to aid his mobility. There were details of all healthcare appointments on the care files sampled. One file contained a record of all appointments for 2004 but the chart for 2005 was blank although there was a record of appointments in 2005. The home should decide the best way to record appointments without duplicating information. The residents attend appointments in the local community. Staff have now attended training on diabetes and have information on managing their diets. The staff stated that the home encourages all residents to have a low fat and sugar free diet. The home had met all the requirements relating to medication set at the last inspection, which is commendable. On inspection of the medication cupboard the inspector found that medication for one person had been opened out of date order with packets for three months all having been opened. Staff must ensure they check that the previous months supply has been used before John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 15 starting a new packet. One medication was found to be out of date and must be returned to the pharmacy. There must be regular checks of the medication to ensure it is in date. There was also unused medication (paracetamol) for one person, which was not prescribed on the MAR sheet. This must be checked with the GP and pharmacist. The home has a new contact with the local pharmacist starting in May 2005. The pharmacist now supplies a separate dossett box for mid day medication at the day centre. The shift leader discussed the issue of when the cabinet is not at the right temperature for liquid medication. The inspector advised him to purchase a locked tin, which could be kept in the fridge for any medication that required a cooler environment. John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Residents are encouraged to make complaints through residents meetings or in discussion with staff. They have a user-friendly complaint policy in place EVIDENCE: The home has not had any complaints since the last inspection. The new service users guide has a pictorial complaints policy for the residents’ information. The inspector spoke to one resident who raised a concern about staff going into his room. This was discussed with the key worker who said this was a common complaint from this person and she would discuss this with him again to reassure him. The home had been required to update its adult protection policy to include the contact details for the Harrow and Brent CSCI office and the Brent POVA team. The updated policy was not available in the home at the time of the inspection. This will be reviewed at the next inspection. John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,27,29 The residents live in clean a clean, well decorated and comfortable environment, which is free from odours. There is inadequate provision of suitable adapted bathing facilities for the residents with limited or deteriorating mobility. EVIDENCE: The inspector did not tour the premises on this occasion. There had been some redecoration of the ground floor lounge and office. New furniture had been purchased for the lounge. The staff lockers have now been removed from the resident’s communal areas giving them more space. The home was free from odours at the time of the inspection. The home had been required to follow up the Occupational Therapist’s recommendation to provide a walk in shower on the ground floor to meet resident’s needs. The inspector was informed that this has still not been resolved with the housing association and there is an 18-month waiting list for funding for a shower. This not acceptable as one person’s mobility has deteriorated further since the last inspection and another person has had to be moved to the ground floor because of concerns about his mobility. Staff expressed their concerns to the inspector about both resident’s, who require 1:1 support to bathe and this can take up to an hour at a time. The manager John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 18 must ensure that regular risk assessments are carried out on these two people and that any aids or adaptations that are required for their safety are obtained. The manager must contact the Occupational Therapist to carry out assessments on both people to ensure that their physical care needs can be met within the current environment. The requirement regarding the walk in shower remains standing, as it is unresolved. John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The residents are supported by trained and competent staff. EVIDENCE: There were four staff on duty at the time of the inspection. The shift leader informed that inspector that all staff have had training in core skills such as moving and handling, health and safety, first aid, medication, food hygiene etc. One new member of staff stated that she had had training in these areas and was due to attend more. She was due go on the corporate induction next month. One staff member stated that she felt the new organisation provided good support and training and that she was due to attend NVQ 3. The inspector had been informed that Pentahact was employing their own NVQ coordinator and would be running NVQ’s in house. Staff said they were pleased with this as some colleges were too far away. A training programme was not available for inspection on this occasion. The inspector was unable to access staff files due to the absence of the manager. These will be reviewed at the next inspection. The shift leader stated that all befrienders and volunteers coming into the home have had CRB checks. John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The resident’s health safety and welfare is generally protected through regular checks and services of the premises and equipment EVIDENCE: The majority of certificates for appliances and equipment used in the home were made available for inspection. These were found to be up to date with no outstanding works. The shift leader stated that the electrical installation check had recently been carried out and they were waiting for the certificate. There are weekly call bell tests and quarterly fire drills. A fire risk assessment was not in place and is required. The Fire Brigade are due to visit the home shortly. A risk assessment review of the home had been carried out in August 2004 by external consultants. There were no issues for the home from the report. The home had been required to carry out premises risk assessments; these were still outstanding. The residents have comprehensive risk assessments in place. The home carries out fortnightly health and safety checks of the premises, reporting any faults or repairs required. There was a record of these reported John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 21 repairs. Three monthly risk assessments are also carried out. The home keeps detailed records of all accidents and incidents. They are prompt in reporting any significant events to the CSCI. The homes incident reporting procedure had been updated as required to include Regulation 37 reporting of significant events to the CCSI. John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 x x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 2 x 2 x Standard No 11 12 13 14 15 16 17 x 3 3 x x 1 3 Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 John Paul House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 23 Yes Are there any outstanding requirements from the last inspection? 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 2 Regulation 14 Requirement All information on new residents must be made available for inspection Staff must ensure they check that the previous months supply of all medication has been used before starting a new packet All out of date medication must be returned to the pharmacy. Regular checks of the medication must be carried out to ensure medication is in date All unused medication and or un prescribed medication must be checked with the GP and pharmacist regarding usage. The Protection of Vulnerable Adullts Policy must be updated to include the contact details of the Brent POVA team and local CSCI office (Previous timescale of 31.1.05 not met) The registered provider must ensure that the OT’s assessment recommendation to provide a walk in shower room on the ground floor to meet a service user changing physical care needs is carried out (Previous timescale of 1/3/05 not met) Timescale for action From June 2005 From 13 June 05 and ongoing From 13 June 05 and ongoing From 13 June 05 31.7.05 2. 20 13(2) 3. 20 13(2) 4. 20 13(2) 5. 23 13 6. 27,29 23(2)(n) Details on progress must be submitted with the response to this report Page 24 John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 7. 29 13(4)(c) 8. 29 13(4)23(2 )(n) 9. 34 Sch 4.6 10. 39 24 11. 12. 42 42 13(4)(a) 23(4) The manager must ensure that regular risk assessments are carried out on these two people and that any aids or adaptations that are required for their safety are obtained The manager must contact the Occupational Therapist to carry out assessments on both people to ensure that their physical care needs can be met within the current environment The manager must ensure that information on staff as per Schedule 4.6 is made available for inspection. The manager must ensure that CRB information staff is kept in the home. This information must be made available for inspection. (Not assessed ) A Quality Assurance policy must be in place. The homes policies and procedures must be uodated to reflect the new organisations current policies and procedures. ( Not assessed) Premises risk assessment must be carried out (Previous timscale of 28/2/05 not met) A fire risk assessment must be carried out From June 2005 and ongoing 31.7.05 Next inspection Next inspection 31.7.05 31.7.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 6 19 20 Good Practice Recommendations The manager should ensure that if it is the homes practice to carry out monthly care plan reviews then key workers should do this. The home should decide the best way to record health care appointments without duplicating information. The home is advised to purchase a locked tin, which could G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 25 John Paul House be kept in the fridge, for any medication that required a cooler environment. John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection 4th Floor, Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 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 John Paul House G62 G11 S62635 John Paul House V228159 140605 Stage 4.doc Version 1.30 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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