Inspection on 28/06/07 for Albert House

This inspection was carried out on 28th June 2007.

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

Albert House 06/06/06

Albert House 24/01/06

Albert House 25/07/05

Albert House 09/03/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Albert House 22 Albert Road Colne Lancashire BB8 0AA Lead Inspector Mr Graham Oldham Unannounced Inspection 28th June 2007 10:30 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 Albert House DS0000061635.V338953.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. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Albert House Address 22 Albert Road Colne Lancashire BB8 0AA 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) 01282 862053 Albert House Residential Home Ltd Mr Peter Alan Perris Care Home 17 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (14) of places Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the overall total of 17, a maximum 14 service users may be accommodated requiring personal care who fall into the category of OP (either sex) Within the overall total of 17, a maximum of 3 (named) service users may be accommodated requiring personal care who falls into the category of DE(E) 6th June 2006 Date of last inspection Brief Description of the Service: Albert House is a residential care home providing 24-hour accommodation and personal care to 15 older persons and two (named) older persons who have a dementia. The registered provider Mr Perris is also the manager. Albert House is an extended detached house located on the main road in Colne town centre, within easy reach of shops, library, market and other amenities. There are two ground floor lounges (one with adjoining dining room accessed by two steps) and a separate dining room (adjoining the kitchen), which is the designated smoking area. There is one double bedroom with en-suite and 15 single bedrooms on the ground and first floors. A passenger lift gives access to the upstairs and mobility adaptations such as handrails and disabled toilet facilities. There is limited on-street parking at the side of the home and across the main road with a public car park a short walk away. There is limited parking in the garden courtyard at the rear of the home. There is a small garden area for residents to enjoy. A statement of purpose and service users guide are available for residents or their families to be informed of the facilities and services the home provides. The fees for Albert House range from £332 to £374 per week. This does not include hairdressing, newspapers or magazines and toiletries. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection, which included a visit to the home, took place on the 27th and 29th June 2007. Much of the information gained was obtained from talking to residents and staff members. The views of residents were obtained on a variety of topics. People living within the home allowed the inspector to call them residents. Two residents were case tracked. Case tracking gave the inspector an overall view of the specific care for the individual resident by checking their plans of care, other documentation and talking to staff about the care they gave each resident case tracked. Two staff members were questioned about the care of the residents case tracked and the training they had undertaken. Some of the views have been reported collectively with specific comments contained within the body of the report. The inspector took detailed notes during the inspection, which have been retained as evidence. Staff were directly and indirectly observed carrying out their tasks and interacting with residents. Paperwork examined included plans of care, assessment documentation, policies and procedures or documents relevant to each standard. A tour of the building was conducted. Two random inspections were made since the last key inspection. One to follow up requirements and recommendations made at the key inspection and one to follow up a complaint. Many requirements and recommendations were made during the random inspections due to the unresponsive nature of management. What the service does well: Resident’s case tracked said, “I like the food – its very good” and “The food is all right”. Four residents sat taking a meal said food said, ““The puddings are always nice. If you don’t like it you can have something else”. “The meal was very good and I enjoyed mine”, “The meals are usually good – there are things we don’t like but you can have something else”. All four were satisfied with what they were able to have. One said, “But sometimes they may only offer you a sandwich”. A further resident said choice was sometimes limited at teatime. Food served on the day of the inspection was warm, balanced and nutritious. Food was generally appreciated by residents and met their tastes. Both residents case tracked said they were treated “privately” and commented, “Everybody treats me nicely I have no complaints” and “the staff are very good”. Staff were observed to give care in a polite and discreet manner. The Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 6 good attitude of staff enabled residents to feel comfortable with the personal care they received. A visitor said, “There are no problems with visiting. I can talk to any members of the staff – they are very friendly and approachable. I would be able to talk to them if there are any problems. The girls are very kind. The residents are always eating and drinking. I don’t see the manager much during the week but he is here sometimes at weekend and I can talk to him then about care. They keep me up to date with care issues”. The one relative spoken to was encouraged to visit for the social benefit of residents. The complaints procedure was available for residents to voice their concerns. Adult abuse procedures and staff training helped protect residents from possible harm. Residents case tracked said, “I have a nice room” and “my room is quite good. I have some of my own things”. The environment was homely and provided good facilities for residents to enjoy. Two residents who were sat together said, “I have been here four years so have settled in. Son is in police force here. Comes in regularly sometimes in uniform. They can visit when they want. It’s all right here. I get up at six because I want to. It’s comfortable here. I like it here and have never regretted it. Not that feeling of routine – its relaxed. Bedrooms are nice and comfortable. I keep mine nice and tidy. It’s very clean. I have some things of my own. I have never thought of moving anywhere else so there is that. They wash our clothes for us. The laundry service is very good. The manager seems to pick girls who are nice and quiet and get on with it. The staff are very nice and I have no complaints”. The good atmosphere at the home ensured residents were happy with the service they received. Health and safety policies, procedures and the maintenance of equipment ensured residents and staff were protected from possible harm. What has improved since the last inspection? Some aspects of medication had improved to help protect the health and welfare of residents. The registered manager ensured there was a phone available for residents to use when they wished. The activities co-ordinators hours had been increased to help residents lead a more fulfilling life. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 7 The recruitment procedures had greatly improved to help protect residents from possible abuse. Members of staff had received a contract to ensure they understood the terms and conditions of employment. There was sufficient equipment for residents to enjoy their meals. The heating had been repaired to ensure residents were comfortable and warm. Staffing levels had been improved (And continued to improve) to ensure the care and wishes of residents were improved. There was a photograph of each resident to ensure they could be identified in an emergency and avoid possible identity mistakes. What they could do better: There must be a system for the assessment of residents to ensure residents are correctly placed. Resident’s plans of care must be developed fully and reviewed to ensure care staff are aware of the changing needs of residents. Medication policies and procedures must be updated to reflect current practice to minimise the possibility of mistakes. Staff administering medication must receive accredited training to protect residents from possible harm. Health care assessment must be undertaken using a professional tool and reviewed on a regular basis to ensure resident health care needs are met. Leisure activities must be discussed with residents and a weekly plan devised to ensure residents can lead a fulfilling life. The registered manager must complete necessary training to meet the requirements of the CSCI. Induction and foundation training and staff supervision must be ongoing to provide a more competent workforce. Quality assurance systems must be put in place to ensure the views and changing needs of residents can be addressed by management. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 8 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. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 9 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 Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 10 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): OP3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The assessment process did not ensure staff had sufficient information to be able to meet the needs of residents or develop plans of care. EVIDENCE: Two residents were case tracked. Plans of care contained assessment documentation. Not all the forms included in the process had been completed or enough information gained to ensure the service could meet the diverse needs of residents. Albert House DS0000061635.V338953.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): OP7, OP8, OP9 and OP10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Plans of care had not been developed with the assistance of service users and had not been reviewed on a regular basis Plans of care did not contain sufficient information about each individual to inform staff of residents needs. The health care assessment of residents was not sufficient to react to the changing needs of residents. Medication policies and procedures and the lack of staff training posed a threat to the health and welfare of residents. The good attitude of staff protected the privacy and dignity of residents. EVIDENCE: Two plans of care were examined during the case tracking process. Plans of care had not been developed with the assistance of family members or residents. One plan had been developed for when the resident was in hospital and did not address the needs of a person in a residential setting. Plans of care had not been reviewed for six months. Plans did not contain sufficient detail for staff to read and deliver effective care. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 12 One resident case tracked had been risk assessed for falling and pressure area care. The assessment had not been reviewed for over six months. The second resident had been assessed for pressure area care but this had not been reviewed for over six months. All residents must have a falls risk assessment, pressure area assessment and nutritional assessment. The assessments must be reviewed on a regular basis. Evidence was obtained from residents case tracked and within the plans of care that residents had access to specialists and professionals. The registered manager had contacted the district nursing service to attain some up to date forms and said he intended to update the reviewing system. The assessment of residents must be undertaken to meet their health care needs. Staff who administered medication had not received accredited training. The policies and procedures for the administration of medication were under review using the Royal Societies Guidelines but were not available for inspection. The registered manager was taking information from the local pharmacist to meet the standards. Medication policies, procedures and staff training needed to be improved to reduce the risk of any medication errors. Staff were observed carrying out personal care to residents. Staff were pleasant to residents and ensured their privacy was maintained when delivering care. Resident’s case tracked said care was given privately. The good attitude of staff ensured residents were comfortable with the personal care they received. Albert House DS0000061635.V338953.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): OP12, OP13, OP14 and OP15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Leisure activities provided were suitable to resident’s tastes and helped provide a fulfilling life. Visiting was open, unrestrictive and encouraged socialising with family and friends. Residents were able to exercise choice to retain some independent living. Food served at the home met residents nutritional needs. EVIDENCE: Two residents case tracked were satisfied they had choice within the daily routines undertaken by staff. Staff spoken to were aware of their responsibilities in promoting independence. Staff were observed allowing residents choice such as meals or movement around the home. Residents were able to maintain some independence with the choices they were offered. One visitor was observed entering the building and was welcomed by staff for the social inclusion of residents. Leisure activities were provided but this was mainly on an irregular basis. A daily list of activities and the activities residents engaged in should be recorded to ensure residents received leisure activities to help provide a more fulfilling life. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 14 Food was generally described as good. Two residents case tracked said food was good. One lady complained of a lack of choice at teatime. The registered manager said this was due to staff not looking to see what the alternatives were. Residents were observed to be fed in a discreet and individual manner. The kitchen was clean and tidy and environmental health checks completed. There was a record of food taken by residents. The food served met resident’s tastes and were nutritionally balanced. Albert House DS0000061635.V338953.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): OP16 and OP18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and staff training help protect residents from harm and abuse. EVIDENCE: Three complaints had been made to the service and the Commission for Social Care Inspection since the last key inspection. A random inspection was undertaken in May 2007 to look at some of the issues. The registered manager had undertaken to meet some of the requirements and recommendations made at the inspection but had not completed all the work required. There was a complaints procedure, which met the Commissions guidelines. Resident’s case tracked did not have any complaints. Residents or their families were able to voice their concerns. There was a copy of adult abuse procedures for staff to follow in the event of any possible abuse issues. There was a copy of the ‘No Secrets’ document and a whistle blowing policy. The service used the Lancashire County Council adult abuse procedures to follow a local initiative. No allegations of abuse have been made during the last year. Some staff had attended a protection of vulnerable adults course. Two staff spoken to were aware of abuse issues, the whistle blowing policy and complaints procedure. Residents were protected from possible abuse. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 16 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): OP19 – OP26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in a clean, tidy and safe environment. The good facilities provided a comfortable setting and met resident’s environmental needs. EVIDENCE: A tour of the building was conducted on the day of the inspection. The Home was warm clean and tidy. All communal rooms were bright, decorated and furnished in a domestic style. There was sufficient furniture to meet the requirements of residents. Bedrooms visited had been personalised to resident’s tastes and contained items brought from home. Water temperatures were checked on a regular basis and regulated to prevent scalding. Radiators were guarded to further protect residents. There had been many improvements since the last key inspection including new double glazed windows and carpeting to many areas of the home. Baths were suitable for residents with disabilities and toilets also had handrails fitted. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 17 There were new tables and chairs in the dining room. Toilets and bathrooms were equipped with paper towels and a hand washing solution. Residents were observed using their frames and wheelchairs to roam at will around the house. Toilets were situated near to the lounges and main dining room. There was a record of routine maintenance. The constant improvement of the décor and furnishings provided a homely environment for residents. The laundry was equipped with two washing machines and a gas dryer. There was an infection control policy and some staff had undertaken training. In this area. Residents case tracked were satisfied with the laundry service. Although the siting of the laundry was not ideal it did not appear to pose a health and safety threat to residents or staff. Infection control policies and procedures protected the health and welfare of residents. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 18 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): OP27, OP28, OP29 and OP30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were sufficient numbers of qualified staff to meet the needs of residents. The recruitment procedures protected residents from possible abuse. EVIDENCE: The staffing rota showed there were sufficient numbers of staff on duty on the day of the inspection. Past inspection and a complaint showed there had been a staff shortage, which had the effect in causing problems such as a lack of choice. The registered manager had recruited new staff. Staff employed at the home said the staffing situation was improving all the time and said it was a good place to work when fully staffed. More than 50 of staff had completed NVQ2 or 3 training. The improving situation will ensure the needs of residents are better met. Two staff files, including one for a new employee demonstrated there was a robust recruitment process now in place to help protect the health and welfare of residents. A recognisable induction and foundation course must be introduced for new staff to receive training to competently care for residents. Supervision had not been undertaken for some time. The registered manager produced a sample of a supervision form he intended to use. Part of the last complaint (staff not providing choice at teatime) could be undertaken during supervision, which would help provide a better service for residents. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP31, OP33, OP35 and OP38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The views of residents, staff and stakeholders were not obtained to assist the manager to react to the changing needs of residents. There was a safe system to protect residents from possible financial abuse. Electrical and gas appliances had been maintained to help protect the health and welfare of residents and staff. EVIDENCE: There was a manager who was registered with the CSCI. The registered manager had commenced NVQ4 and said he was about 60 – 70 of the way through it. The registered manager had undertaken periodic training to update his knowledge. NVQ4 training must be completed within a reasonable timescale to meet the requirements of the Commission for Social Care Inspection and help demonstrate his commitment to provide a good service. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 20 The registered manager said he did not handle the finances of any resident and any money required for hairdressing etc was provided by the service and added to the next monthly bill. The system protected residents from possible financial abuse. There was not any good systems in place to provide evidence the home seriously undertook quality assurance. Quality assurance systems will be addressed at the random inspection. The registered manager must undertake quality assurance to gain the views of all concerned with the home to provide a better service to residents. There was a health and safety policy. Staff spoken to said they had undertaken health and safety related training. Electrical and gas appliances and installation had been maintained to a good level. Fire alarms and other safety related equipment had been maintained. Health and safety policies, procedures and staff training helped protect the health and welfare of residents. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 4 X X 3 Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 22 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 OP3 Regulation 14(1) Requirement Timescale for action 31/08/07 2. OP7 15(1)(2) 3. OP8 12(1)(a) (b) 4. OP9 13(2) The registered manager must not provide accommodation at the care home unless a suitably qualified or trained person has assessed the needs of a resident. The registered manager must, 31/08/07 unless it is impracticable to do so shall consult with a resident and prepare a written plan as to how the residents need are to be met and (b) keep the plan under review. The registered manager must 31/08/07 promote and make proper provision for the health and welfare of residents and make proper provision for the care and supervision of residents. This includes the use of appropriate tools for nutrition, falls and pressure area care. The assessments must be reviewed on a monthly basis. 30/09/07 The registered manager must ensure medication policies and procedures are reviewed and developed further so that staff have clear guidance about all aspects of the medication service provided. Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 23 5. OP9 13(2) The registered manager must ensure staff who administer medication receive accredited training. 30/11/07 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. Refer to Standard OP9 Good Practice Recommendations The registered manager should ensure clear, personalised directions for the use and administration of when required and variable dose medication for all service users prescribed such items. When required and variable dose medicines should also be included in the residents care plan. The registered manager should establish a programme of activities, especially trips outside the home (12.3), and retain a record of such activities provided. The registered manager should ensure that persons employed at the care home receive training appropriate to the work they are to perform and ensure staff are appropriately supervised The registered manager should ensure he obtains NVQ4 in care and management as soon as possible. The registered persons should establish and maintain a system, (which provides for consultation with service users and their representatives) for reviewing and improving the quality of care at Albert House. (Timescale of 31/3/06 not met). 2. 3. OP12 OP30 4. 5. OP31 OP33 Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Albert House DS0000061635.V338953.R01.S.doc Version 5.2 Page 25 - 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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