Inspection on 14/02/07 for Agincourt

This inspection was carried out on 14th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Agincourt 05/08/09

Agincourt 27/08/08

Agincourt 16/08/07

Agincourt 17/07/06

Agincourt 03/01/06

Agincourt 23/06/05

Agincourt 10/03/05

Agincourt 05/08/04

Agincourt 18/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Agincourt 116 Dorchester Road Weymouth Dorset DT4 7LG Lead Inspector Gloria Ashwell Key Unannounced Inspection 14th February 2007 13:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000026757.V330320.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. DS0000026757.V330320.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Agincourt Address 116 Dorchester Road Weymouth Dorset DT4 7LG 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) 01305 777999 F/P01305 777999 office@agincourt.plus.com Mr Derek Edwin Luckhurst Mrs Meryl Susan Hodder Mrs Roslynn Ann Camp Care Home 31 Category(ies) of Dementia - over 65 years of age (26), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (26), Old age, not falling within any other category (5) DS0000026757.V330320.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only room 7 to be used as a double. Date of last inspection 17th July 2006 Brief Description of the Service: Agincourt care home is registered to provide residential care for a maximum of 31 people, this includes 26 service users over the age of sixty five with a Mental Disorder or dementia and five service users in the category of old age and not falling within any other category. The home is situated on one of the main roads into Weymouth, approximately one mile from the town centre and half a mile from the sea front. It is close to a range of amenities including a post office, shops, pubs and churches. A ‘bus stop’ is on the road outside the home, for buses to and from Weymouth. Agincourt has been owned and managed by the current registered providers, Mr Luckhurst and Mrs Hodder, for approximately 16 years. Mrs Ros Camp became the registered manager in April 2003 and is responsible for the day-today running of the home with the assistance of a deputy manager. The home specialises in the care of elderly people who are mentally frail and most of the service users currently accommodated experience dementia or a related mental disorder. Service users bedrooms are on the ground and first floor of the home; many of the ground floor rooms have patio doors providing direct access into the back garden. There is a communal lounge on each of the two floors floor and a separate dining room on the ground floor. Assisted bathrooms are available on the ground and first floors of the home and many rooms have en-suite WC’s. A passenger lift links the ground and first floor. There is level access to most rooms; some first floor bedrooms are separated from the lift by steps. At the rear of the premises is an attractive garden pond with a water feature and flower borders, lawns and garden furniture and gazebo. The garden is fenced and secured and is well used by the current service users in the warmer weather. DS0000026757.V330320.R01.S.doc Version 5.2 Page 5 Laundering of clothing and household linen is carried out at the home and arrangements can be made for chiropodists, opticians and other health and social care professionals to visit individual residents. Fees are charged weekly; at present fees range between £450 and £500 per person. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link: http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1-A65A7AFD347B/0/oft780.pdf DS0000026757.V330320.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a statutory inspection required in accordance with the Care Standards Act 2000. The first part of this inspection was unannounced; the inspector arrived at approximately 13.15 on 14 February 2007, spoke briefly with the registered manager and toured the premises and spoke to residents and staff. The inspector later arranged with the registered manager to conclude the inspection on 20 February 2007; on that date documentation relating to care provision and the premises was discussed and examined. The duration of the inspection (both days combined) was 6 hours. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same resident were examined, and the resident spoken with. Additional information used to inform the inspection process included the monthly reports regularly sent to the Commission by the provider organisation. During this inspection compliance with all key standards of the National Minimum Standards was assessed. Since the previous key inspection the CSCI Pharmacy Inspector conducted a random inspection on 6 December 2006 to monitor progress on medicine handling requirements of the previous key inspection. What the service does well: People considering moving into Agincourt receive a full assessment and are provided with the opportunity to visit and spend time at the home to make sure that it is able to meet their needs. On the day of inspection the home was clean, of comfortable temperature and adequately staffed. The home is well equipped, attractively decorated in an essentially domestic style and is suitably furnished. The standard of care is generally good and there is an enthusiastic approach to staff training. DS0000026757.V330320.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? 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. DS0000026757.V330320.R01.S.doc Version 5.2 Page 8 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 DS0000026757.V330320.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (The home does not provide intermediate care so Standard 6 does not apply) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents (or their representatives) are provided with information about Agincourt and are encouraged to visit in advance of admission to establish their impressions of life at the home and the standard of available accommodation. Prior to admission, the needs of each proposed resident are assessed and the home then writes to prospective residents confirming the ability to properly care for them, thereby ensuring that the persons needs can be properly met. EVIDENCE: The records of a recently admitted resident included details of pre-admission assessment which had been carried out by the deputy manager when she visited the prospective resident at a previous address. DS0000026757.V330320.R01.S.doc Version 5.2 Page 10 In advance of making the decision to enter the home the closest relatives of the prospective resident received a letter from the manager, confirming that Agincourt would be able to meet the persons’ needs and they then visited Agincourt to view the premises because the prospective resident was too frail to do this personally. DS0000026757.V330320.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of care is adequate. The written plans of care are undergoing extensive improvement to ensure they reliably provide staff with sufficient information upon which to base their care practice. Further improvements must be made to standards for medicine handling and recording to ensure residents receive medicines as prescribed and that there is a reliable audit trail for all medicines in the home. EVIDENCE: Since the previous inspection the home has worked hard to improve the standards of care records and the new system of care planning documentation is now in use for most residents. DS0000026757.V330320.R01.S.doc Version 5.2 Page 12 During this inspection the care records of 4 residents were examined. There were indications that when it is fully implemented the system will provide staff with the necessary information to enable them to properly care for residents but at present some records remain incomplete by omitting reference to essential aspects including assessment of nutritional need, risk of pressure sores and risk of falling. An associated requirement is contained in this report. In general, medication administration records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts - those wishing to do so can manage their own medicines in accord with a risk assessment process; none of the currently accommodated residents manage their own medicines. Medicine handling is carried out by care staff trained in this work. Some areas for the further improvement of medicine handling and recording standards were identified during the inspection: When a medicine is prescribed for ‘as required’ administration the medicine administration record (MAR) should state the potential reason for administration (e.g. as required for abdominal pain). All handwritten instructions for medicine administration must be signed and dated by the author and countersigned by another member of staff who has checked the entry for accuracy. When a variable dose of a medicine is prescribed (e.g. “give 1 or 2”) the amount actually administered on each occasion must be recorded. When a prescribed medicine is not administered the reason for omission must be accurately recorded. Caution should be exercised when tearing off the perforated edges of MAR sheets; many sheets in current use had been damaged to the effect that only parts of the names of the prescribed medicines remained, and errors in administration could accordingly take place. One service user had not received 3 consecutive doses of a prescribed medicine because the home had run out of supplies; reliable ordering systems must be developed and implemented to ensure that this circumstance is not repeated. This report contains requirements and recommendations for the improvement of medicines handling. DS0000026757.V330320.R01.S.doc Version 5.2 Page 13 During the second day of inspection a care worker was heard speaking to an elderly resident in a demeaning manner. The inspector drew this to the attention of the registered manager who said that the member of staff had resigned from employment at the home; the manager later confirmed that she had spoken to the care worker regarding this incident of unacceptable behaviour. DS0000026757.V330320.R01.S.doc Version 5.2 Page 14 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 adequate. This judgement has been made using available evidence including a visit to this service. The quality of daily life in the home is adequate with residents enabled to maintain as much independence as they are able to. Social and leisure activity assessment of each residents individual ability and preferences is ongoing; when completed it will provide staff with guidance on what type of activities to provide for each resident. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals are appetising and of good quantity and quality although there is no routine choice of menu. Residents are properly nourished. EVIDENCE: Most currently accommodated residents are too frail to engage in lengthy conversation; the inspector spoke to 3 of the more able residents who all indicated satisfaction with the home, including the meal provision, staff and premises. DS0000026757.V330320.R01.S.doc Version 5.2 Page 15 Arrangements are under way for a senior care worker to be dedicated to the provision of social and recreational activities and each service user is to be assessed to ensure that appropriate activities are provided. Once a month a visiting entertainer leads a music session, and on alternate weeks a visiting therapist leads a physical exercise session. Visitors are welcome at any time and a visitor spoken with during the inspection confirmed satisfaction with the home. The inspector noted the serving of lunch in the dining room and that residents were evidently enjoying their meal. Most residents take meals in the large dining room on the ground floor; others receive them in their bedrooms. Residents said they were very satisfied with the quality, choice and quantity of food provided; one resident stated “the food’s lovely”. There is a set menu which does not include alternative options; the manager said that alternatives including omelette and other quick meals are always available. DS0000026757.V330320.R01.S.doc Version 5.2 Page 16 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 adequate. This judgement has been made using available evidence including a visit to this service. The complaints procedure provides information on the procedure to follow to persons wishing to make complaint and service users know how to complain. The home has a policy/procedure for the prevention of abuse and staff receive training in the understanding and prevention of abuse but a recent incident had not been properly reported or investigated; failure to follow established protocol may place residents at risk of harm. EVIDENCE: The home keeps records of all complaints received and investigated. Since the last inspection three complaints against the home have been received and investigated - all have been successfully resolved. While examining accident and incident records held by the home the inspector noted that a recently recorded incident involved one service user being described as “very upset” after an approach by another service user who is reported to have “hurt” the other. Following the inspection the manager reported the matter to the local Social Services office and it was accordingly investigated, with no further outcome. DS0000026757.V330320.R01.S.doc Version 5.2 Page 17 This report contains a requirement for this incident to be promptly referred to the local Social Services Department and to the Commission to ensure investigation according to established protocols for the protection of vulnerable adults. DS0000026757.V330320.R01.S.doc Version 5.2 Page 18 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, 22 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Agincourt is a well-appointed and comfortable home. On the days of inspection the home was generally clean, pleasant and hygienic and there was evidence indicating that this is the usual standard of provision. EVIDENCE: Agincourt is a partly traditionally built house, significantly enlarged by a purpose built extension. It offers good sized bedrooms, bathrooms equipped for the use of persons requiring assistance and comfortable communal rooms. On the days of inspection the home was clean, tidy and comfortable throughout; there was an unpleasant odour in a ground floor bedroom – the registered manager stated that the floor covering of the room is believed to be the cause and arrangements have been made for its replacement. DS0000026757.V330320.R01.S.doc Version 5.2 Page 19 There is an ongoing programme of redecoration and updating, to ensure the premises remains in good condition and continues to provide residents with comfortable and safe accommodation. There is an outstanding requirement for the provision of access into the home to enable persons with impaired mobility to independently access the building; there are steps at the front door and no alternative means of suitable access. The requirement is repeated in this report. DS0000026757.V330320.R01.S.doc Version 5.2 Page 20 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 employs enough staff to meet the needs of residents and to ensure their safety and comfort and the good condition of the premises. Recruitment practices ensure the protection of residents from potentially unsuitable staff. Staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: Senior staff lead the care teams and at all times the home is in the overall charge of an experienced care worker. Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. Staff are enthusiastic about their work and feel they provide a good standard of care to residents and are properly supported by the management and training provision. DS0000026757.V330320.R01.S.doc Version 5.2 Page 21 The records of 2 recently employed staff members were examined and found to contain all essential information including two written references, an interview assessment, health details, evidence of identity and of induction training (using the Skills for Care process). At present 10 of the 16 care staff employed by the home hold a National Vocational Qualification in care so the home exceeds the standard for at least 50 of the care staff to hold an NVQ in care. Members of catering and household staff also hold NVQs in their respective skill areas. The provider organisation has an enthusiastic approach to staff training; recent topics have included Health & Safety, moving and handling, dementia care and fire safety training. DS0000026757.V330320.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is properly managed and staff understand their work and receive training appropriate to their needs. Residents and their representatives are satisfied with the home and feel staff care for them well and put them at their ease. The home has implemented a quality assurance system to ensure that residents remain satisfied with all aspects of the home. The home does not manage the finances of residents with the exception of small amounts for occasional personal expenditure; records are kept in this regard providing evidence that appropriate safeguards are in place. All accidents are investigated and periodically audited to minimise risks of recurrence to protect residents from harm and injury. DS0000026757.V330320.R01.S.doc Version 5.2 Page 23 The premises and equipment are properly maintained in good condition and provide a safe and comfortable living environment. EVIDENCE: During 2006 the registered manager obtained the Registered Managers Award and is nearing completion of NVQ Level 4 in care. She has also obtained a Level 2 BTEC qualification in dementia and is planning to commence training for NVQ Level 2 in Customer Care. The registered manager is supported by a full time deputy manager and a secretary working 30 hours each week. The home has ongoing systems for quality assurance; satisfaction surveys are periodically issued and at least once a week the home is visited by the Registered Providers. To ensure continuity of approach the home operates in accord with an extensive selection of clear and appropriate policy and procedure documents, including those for care provision, management and the premises. With the exception of small amounts of money for occasional personal expenditure (below £50 per person) the home does not manage the finances of residents; residents who are unable to undertake this responsibility personally have nominated relatives, friends or other representatives to do this on their behalf. With regard to the personal expenditure monies, these are securely stored and receipts are kept of all transactions. Staff trained in First Aid and health care are on duty in the home at all times. All accidents are recorded; the home has a policy and procedure for accidents and periodically audits accidents to identify any trends or patterns (e.g. in time, place, person or activity) and subsequently to introduce measures to reduce the risks. In compliance with a requirement contained in the report of previous inspections, arrangements have been made for devices to be installed to all baths to regulate the temperature of hot water, and thereby to protect service users from risks of accidental scalding. The registered manager stated that installation of these devices is arranged to take place on 15 February 2007 (the day following this inspection); this report contains a requirement for the Commission to receive written confirmation of completion of this work. DS0000026757.V330320.R01.S.doc Version 5.2 Page 24 The premises are well maintained and there are regular checks/tests of all equipment. Assessments have been recorded for fire safety and the safety of the premises and working practices. DS0000026757.V330320.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X 2 X 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 X 3 X 3 X X 2 DS0000026757.V330320.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 & 13 Requirement Risk assessments, as detailed in the body of this report, must be recorded for those residents whose records did not contain them on the date of inspection. Standards for medicine handling and recording must be improved: All handwritten instructions for medicine administration must be signed and dated by the author and countersigned by another member of staff who has checked the entry for accuracy. When a variable dose of a medicine is prescribed (e.g. “give 1 or 2”) the amount actually administered on each occasion must be recorded. When a prescribed medicine is not administered the reason for omission must be accurately recorded. Reliable ordering systems must be developed and implemented to ensure prescribed medicines are available for administration. DS0000026757.V330320.R01.S.doc Version 5.2 Page 27 Timescale for action 01/05/07 2 OP9 13 16/02/07 3 OP18 13 (4) 4 OP22 13(4)(c) 5 OP38 13 (4) The registered persons must ensure that all incidents are properly recorded and reported to the appropriate authorities: Each allegation or suspicion of abuse must be reported to the Commission as required by Regulation 37 and referred through the ‘No Secrets’ local procedures as necessary. Previous timescale of 06/12/06 not met. A means of providing suitable access to the home for service users with impaired mobility must be introduced. Previous timescales of 28/2/06 and 30/09/06 not met. Written confirmation must be provided to the Commission regarding the safety of arrangements for regulating the temperature of hot water supplied to baths and showers. 15/02/07 01/07/07 12/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP9 Good Practice Recommendations When a medicine is prescribed for ‘as required’ administration the MAR should state the potential reason for administration (e.g. as required for abdominal pain). Caution should be exercised when tearing off the perforated edges of MAR sheets; many sheets in current use had been damaged to the effect that only parts of the names of the prescribed medicines remained, and errors in administration could accordingly take place. DS0000026757.V330320.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 DS0000026757.V330320.R01.S.doc Version 5.2 Page 29 - 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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