Inspection on 08/02/06 for Alde House

This inspection was carried out on 8th February 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Alde House 30/04/09

Alde House 02/05/07

Alde House 03/10/06

Alde House 22/06/05

Alde House 17/12/04

Alde House 06/07/04

Alde House 16/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Alde House Alde House Church Lane Penn High Wycombe Buckinghamshire HP10 8NX Lead Inspector Mike Murphy Unannounced Inspection 09:30 8 February 2006 th 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 DS0000022950.V280871.R01.S.doc Version 5.1 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. DS0000022950.V280871.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Alde House Address Alde House Church Lane Penn High Wycombe Buckinghamshire HP10 8NX 01494 813365 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) Stumpwell Housing Association Limited Mrs Violet Bassam Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places DS0000022950.V280871.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 2005 Brief Description of the Service: Alde House is a care home for older people situated in Penn, Buckinghamshire. It has fifteen places. The home was opened in 1972 and is managed by Stumpwell Housing Association Limited. The home has been adapted for its present use and comprises the original house and an extension. There is a large and pleasant garden to the rear with views over the surrounding countryside. The home is on two floors and there is a passenger lift to the first floor for residents with impairment of mobility. The home is mindful of its origins in Penn and priority is given to people who either live in the village, have lived there in the past, or still have family or friends in the area. The home endeavours to meet a range of needs and draws on the resources of health and social care professionals and other services in the local community as required. DS0000022950.V280871.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over two mornings. On the first day, on the 26 January 2006, by two inspectors, and on the second, on 8 February 2006, by one. The registered manager was not available on the first day and the senior care worker in charge facilitated the inspection. However, the Chair of the management committee, who is also the responsible individual (on behalf of the managing organisation), dropped in to the home during the course of the morning and briefly met with the inspectors. On the first day the inspection focussed on care matters, and on the second on managerial, finance and staff matters. The methodology for the inspection included discussions with residents, staff and managers, examination of care plans, medicine administration records, maintenance records, and other documents, and a walk around the home. As on previous occasions, the inspection finds this home to provide good care to residents. Residents described the staff as caring and were particularly appreciative of the quality of the food. Residents looked well cared for and staff were well organised and attentive to residents needs. On the other hand, however, the inspection finds weaknesses in some systems, particularly care planning, fire safety and some aspects of recruitment procedures. These need to be addressed. Weaknesses in fire safety and recruitment should be easy to rectify. Those in care planning will require a co-ordinated approach covering new forms, staff familiarisation, training and supervision, and periodic audit of practice. As on previous inspections the home is well maintained and provides a safe, comfortable and varied environment for residents. The manager was reviewing staff training needs and, although a programme had not yet been drawn up for the current year, was looking at using a wider range of resources or training providers. The manager was also looking at increasing the range of activities for residents. These initiatives, together with action on the matters identified on this inspection, should provide further improvements to the care of residents. The inspectors would like to thank the residents, staff and managers for their time and hospitality during the course of the inspection. DS0000022950.V280871.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? What they could do better: DS0000022950.V280871.R01.S.doc Version 5.1 Page 7 The home needs to be more systematic in its approach to care planning – to include assessment, formulation of a care plan, implementation, evaluation and review. The introduction of any new care planning system must be accompanied by a programme of staff familiarisation with the new method, staff training in all aspects of care planning, staff supervision, and periodic audit of practice. 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. DS0000022950.V280871.R01.S.doc Version 5.1 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 DS0000022950.V280871.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards in this section were not fully assessed on this unannounced inspection. They were assessed on the announced inspection which was carried out in June 2005. EVIDENCE: DS0000022950.V280871.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9 The home’s current care plan format and standards of practice are weak and do not support good standards in the provision of care to residents. This can put residents at risk. The homes practice in the storage and administration of medication is generally good but weaknesses need to be effectively addressed in order to ensure that residents are protected from errors in administration. EVIDENCE: Three care plans were examined. The content and quality of care plans varied. All had basic details and a photograph of the resident. A copy of key health information relevant to the needs of the resident was on file. Records reflected an awareness of the need for risk assessments in relation to falls and moving and handling. The home had been in contact with the falls team based at Wycombe hospital. However, two out of the three moving & handling risk assessments examined did not include the height or weight of the resident, even though there is space on the form for this. In one case the name of the resident had not been entered on the form so the reader could not be certain that the risk assessment referred to that particular resident. DS0000022950.V280871.R01.S.doc Version 5.1 Page 11 There was a lack of continuity in care plans. Problems noted on assessment were not always carried forward to the care plan, daily notes or reviews. In one care plan plain A4 lined paper had been used to record progress. Many entries in the care plans examined were unsigned and undated. The overall picture was of uneven practice - in some cases this bordered on poor practice. The home can do better. For example in one case, a good plan of care based on a good falls assessment was in place. However, in another, the file had a ‘Pre-Assessment record’ which, although completed, was undated and unsigned, the moving and handling risk assessment did not have the resident’s name, height or weight, and the care plan had not been amended to incorporate a problem with swallowing which was noted elsewhere in the file. Daily records were brief and mainly comprised of a record of physical care provided. The overall structure of care plans lacks coherence. The standard of care planning stands in contrast to the ethos of the home, the care observed and the residents own accounts of the care they receive. The home has a warm, positive and caring ethos. The staff are well organised, know the residents well and provide good care. The residents report good care and express a high level of satisfaction with the home. On this inspection for example comments from residents included “It is very good here, the food is excellent, the care is very good, I am putting on a lot of weight” and “It’s a very good home, good caring staff, food excellent, I like to go for a walk every day” and “It’s fine here, good care, nice to see life go by, I like to watch people come and go”. No adverse comments on the quality of care were received. The gap between the residents experience of care and the home’s present standard of care planning needs to be addressed. The weaknesses outlined above may mean that residents needs are not being fully assessed or taken into account, are not being systematically addressed or reviewed, that the potential for failure in communication is high, that the need for accountability isn’t fully acknowledged, and that care plans do not fully record the care provided. The problem is acknowledged by the home and the registered manager has been in contact with external consultants with regard to a solution. A new deputy manager has recently been appointed and these two developments should enable the home to address the problem in the near future. The home uses the Boots Manrex monitored dosage medication system. The medication administration (MAR) sheets were examined. Several gaps were noted on the MAR sheets. A blister pack that contained Procylidine medication for a particular resident was checked and it was noted that the tablet had been administered but not recorded. There were inconsistencies in the recording of handwritten entries of prescriptions recorded on MAR sheets. Two staff members’ signatures were not always evident. Scribbled out entries were also DS0000022950.V280871.R01.S.doc Version 5.1 Page 12 noted. It was noted that a second member of staff did not countersign amendments to the frequency and dosage of medication on the MAR sheets and that amendments were not always clearly recorded. A detailed and very good protocol for the administration of Alendronic Acid (Fosamax) had been developed. The controlled drug register for Temazepam medication was checked. Tablets in the packet corresponded with balance recorded in the register. The home’s arrangements had been inspected by a pharmacist on 23 January 2006. DS0000022950.V280871.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Residents have opportunities to participate in a range of activities which provide mental and social stimulation and help maintain individual interests and contact with family and friends. The quality of the food in the home is highly appreciated by residents and aims to meet nutritional needs. EVIDENCE: The pace of life in the home seems to suit the residents living there at the time of the inspection. Reference to social interests in care plans varied: in some a general statement summarised the residents interests, others had no reference to social interests. On Sundays there is a religious service, on Mondays a trip out is frequently organised, on Wednesdays residents play scrabble or participate in a poetry reading, the hairdresser visits on Thursdays, and there is a religious service on Friday mornings. At other times the manager may lead an exercise group, those who are able may go for a walk or staff may play board games with residents. DS0000022950.V280871.R01.S.doc Version 5.1 Page 14 The registered manager is intending to increase the range of activities and towards this end had ordered a resource manual and was in discussion with an art co-ordinator with a view towards running group art sessions in the home. Residents may have visitors at any time. The home maintains good relations with families. Information for visitors is available in the foyer. The home values its local connections, particularly through the church and local schools. The home respects residents wish for autonomy. Finances are usually managed by the resident’s family but some cash may held on residents behalf by the home. There is a system for dealing with this. A notice on advocacy is on the notice board. Residents may have personal possessions with them. Every resident spoke highly of the standard of catering in the home. Food is freshly cooked in the kitchen by two cooks. The home was awarded a silver award for good practice by Chiltern District Council. Breakfast is usually cereals, toast, tea and fruit juice. Lunch is the main meal of the day and consists of two courses. Supper is either soup and sandwiches or a light cooked dish such as quiche. Hot drinks and biscuits are served at coffee time, tea time and in the evening. Staff assist as required. At the time of the inspection one resident was requiring pureed food. Mealtimes are not hurried. DS0000022950.V280871.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Standards in this section were not fully assessed on this unannounced inspection. They were assessed on the announced inspection which was carried out in June 2005. EVIDENCE: Standards in this section were not assessed on this inspection but it was noted that the complaints procedure still includes the following statement: ‘If a complaint remains unresolved it may be passed to CSCI – but this should not usually occur until internal procedures have been exhausted without reaching a satisfactory conclusion’ This statement is at variance with standard 16.8 which states that ‘The registered person ensures that written information is provided to all service users for referring a complaint to the NCSC at any stage, should the complainant wish to do so’. The home is asked to amend its procedure. DS0000022950.V280871.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home provides a comfortable, generally safe and well maintained environment for residents. Residents have access to a range of shared accommodation including a garden which overlooks open country. Overall, this supports the well-being of residents. EVIDENCE: The home is accessible, safe and is well maintained to meet residents’ needs. It was evident that a programme of routine maintenance and renewal of the fabric and decoration of the premises was taking place. It was noted that at the time of the inspection the flat roof was covered with an excessive amount of leaves. The grounds were tidy and well maintained. It was noted that a visit from the environmental health officer had recently taken place and the home had been awarded a silver food safety certificate for demonstrating good standards in food hygiene. DS0000022950.V280871.R01.S.doc Version 5.1 Page 17 The home has adequate numbers of bathrooms and toilets to meet residents’ needs, which are in close proximity to lounges and bedrooms. In one bathroom on the ground floor it was noted that two tablets of soap had been left in the bathroom. There was also a packet of wet wipes and a tin of talcum powder. It is recommended that such items should not be left in the bathroom as it looked as if toiletries were being shared which is not the case. Some bedrooms on the first and second floors were inspected. Bedrooms were clean, tidy and had been personalised by residents with family pictures, mementoes and small pieces of furniture. It was noted that a one bedroom door (bedroom 3) on the ground floor was wedged open. The registered manager should obtain the advice of the fire authority on having an appropriate door holding device fitted where the resident expresses a wish for the door to remain open. Staff explained that the resident occupying the bedroom chose to remain in her room all the time. It appeared that it was the practice in the home to allow those residents who remained in their bedrooms to wedge doors open. This creates a serious hazard in the event of fire. The laundry room is situated away from where food is prepared or stored. There are two washing machines and one drier. Walls in the laundry room were free from dust and it was evident that a cleaning schedule was in place and being adhered to. Red alginate bags were available for soiled linen and adequate hand washing facilities are provided. It was noted that the clinical waste bin was left open. It is required that the bin be kept locked at all times to prevent the spread of infection by rodents or other animals. Overall, however, on the day of the inspection the home was clean, pleasant, hygienic and free from offensive odours. A good standard of maintenance and cleanliness is evident in this home although, as noted above, this is sometimes compromised by a failure of attention to detail. DS0000022950.V280871.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 and 30 A number of care staff have acquired NVQ2 in care which should improve the standard of care provided to residents. The home needs to address weaknesses in its recruitment procedures to ensure that staff appointed are properly screened beforehand and do not put residents at risk. The outcome of the review of training which is currently being carried out should inform the staff training programme for the current year and provide increased training opportunities for staff and improved care for residents. EVIDENCE: Five staff have now qualified to NVQ 2 and three are awaiting places on NVQ courses. The home is performing well in relation to NVQ training for care staff. Two staff files were examined. Files were in good order. It was noted that in one case the employee appeared to have started work four days before a CRB was received but a POVA first had not been obtained. Copies of certificates of qualification were not on file in another case. A recent photograph was not on file as required under Schedule 2. It is noted that the application form does not require the applicant to state their current or former position, dates of employment or reasons for leaving. The reference form does not require the referee to state the position, dates DS0000022950.V280871.R01.S.doc Version 5.1 Page 19 employed or reason for leaving. The position in which a person is or was employed is important information. The dates of employment allow managers to assess an applicants experience, continuity of employment and to enquire of the reasons for any gaps in employment. A statement on the reason for leaving is now a requirement following the introduction of POVA in July 2004. The registered manager had not yet developed a staff training programme for 2006. The registered manager said that the home had recently changed its induction programme and was now using a commercial package that covered all the basic subjects and which included video training. This was the first training priority in 2006 and the home was anxious to get that right. The next priority was foundation training for new staff and then the ongoing training for staff for the year. Staff were about to undertake an NCFE (Northern Council for Further Education) accredited certificated course in the safe handling of medicines at Oxford Cherwell Valley College. DS0000022950.V280871.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 The management of the home is appropriately focussed on the care needs of residents. It maintains a warm and supportive ethos. However, weaknesses in some systems could compromise this and need to be effectively addressed if they are not to have an adverse effect on the quality of that care. Procedures for the safe keeping of residents money are good and safeguard the interests of residents. EVIDENCE: The registered manager is experienced in the care of older people and has worked at the home as deputy manager for six years and now as manager for six years. The manager holds a City & Guilds Certificate in Community Care Practice and a NEBS (National Examining Board for Supervisory Management) Management Certificate in Supervisory Management. The registered manager is not responsible for any other registered service. The deputy manager and other staff are accountable to the registered manager. DS0000022950.V280871.R01.S.doc Version 5.1 Page 21 The registered manager reported that the home had carried out an annual survey of residents’ views earlier in 2005. It is expected that a larger survey of stakeholders will be carried out in 2006. The home maintains an ongoing programme of maintenance and redecoration. Policies are to be reviewed in 2006. The home had not implemented a number of the recommendations of the last announced inspection. The home’s procedure for the management of residents money is administered by the administrator and registered manager. Monies are not pooled. A balance sheet is maintained for each transaction. The balance is checked periodically by the administrator. Training in moving and handling was scheduled for February 2006. Training in fire safety was carried out in October 2005. Fire points are tested regularly by the maintenance man and the manager. The lift was last checked by an engineer in November 2005. PAT testing in carried out by the maintenance man. The home has a contract with Cannon Hygiene for the disposal of clinical waste. It was noted that the bin was not locked at the time of the inspection. The home’s electric wiring was tested in 2002. All staff have attended first aid training in 2005. The maintenance man checks the cleanliness and temperature of water storage tank as a precaution against Legionella. Hot water outlet taps in areas to which service users have access are regulated at close to 43 degrees Celsius and are regularly checked by the maintenance man. The home has received an award from Chiltern District Council for good practice in food safety. The registered manager said that infection control training for staff will be addressed in 2006. DS0000022950.V280871.R01.S.doc Version 5.1 Page 22 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 X 9 2 10 X 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 2 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 DS0000022950.V280871.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 7 Regulation OP15 Requirement The registered manager is required to address weaknesses in the home’s present system of care planning and care plan records. The registered manager is required to obtain the opinion of the fire authority with regard to holding bedroom doors open. The registered manager is required to ensure that staff files contain the information listed in Schedule 2 Timescale for action 30/06/06 2 13(4) OP38 31/03/06 3 Sch 2 OP29 08/02/06 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 OP16 OP36 Good Practice Recommendations It is recommended that the registered manager review the complaints policy and procedure to ensure compliance with this standard It is recommended that the registered manager establish a programme of personal supervision for care staff DS0000022950.V280871.R01.S.doc Version 5.1 Page 24 3 OP9 4 5 6 OP9 OP9 OP29 It is recommended that where a resident is prescribed a variable dose of analgesia or other medicine that the precise amount administered is recorded on the MARS sheet. It is recommended that the recording of medicines on MARS sheets transcribed from medical prescriptions be signed and dated by two members of staff It is recommended that a list of the names and signatures of staff approved to administer medicines be retained in the medicines folder It is recommended that the home’s recruitment procedures be reviewed to ensure that it is gathering all relevant background information on applicants DS0000022950.V280871.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 DS0000022950.V280871.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!