CARE HOMES FOR OLDER PEOPLE
Alexander House (Clifton Road) 12 Clifton Road Wimbledon London SW19 4QT Lead Inspector
Liz O`Reilly Unannounced Inspection 11:00 7 & 13 December 2006
th 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 Alexander House (Clifton Road) DS0000027217.V320811.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. Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Alexander House (Clifton Road) Address 12 Clifton Road Wimbledon London SW19 4QT 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) 0208 946 7147 020 8879 1110 Keychange Charity Mrs Elizabeth Dhliwayo Care Home 21 Category(ies) of Dementia (9), Old age, not falling within any registration, with number other category (21) of places Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: Alexander House is a registered care home for up to twenty-one older people including nine people who may have dementia. Twenty people are currently residing at the home with one person in hospital. The home is owned and managed by Keychange Charity, a Christian organisation which has ten other residential services in England. The home is in a residential area off the Ridgeway in Wimbledon, close to bus routes with links to rail services. It is fairly close to Wimbledon Village, Wimbledon Common and churches of different denominations. Alexander House is a three-storey domestic style property which has been extended to accommodate the current residents. A lounge, sun lounge, dining room, office, kitchen, toilets, bathroom and bedrooms are available on the ground floor. Bedrooms, bathrooms and toilets are available on the first floor of the extension, and on the first and second floor in the original house. A stair lift is provided on the staircase to the first floor in the original house. All bedrooms are single. Residents have access to a large well-maintained garden to the side of the home. Fees range from £469 to £602 per week. Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one regulation inspector and consisted of two visits to the home, discussions with residents and staff. At the time of this inspection seventeen residents were living at the home. Questionnaires were provided to residents and following visits to the home were sent to a sample of relatives and other professionals. Additional time was allowed for questionnaires to be returned to take into account the Christmas period. Judgements in this report are made taking into account evidence from all of these sources as well as observations made at the time of visits. What the service does well:
Alexander House provides a comfortable, homely environment. Residents made very positive comments about the service provided and felt they were well looked after. Two residents said that staying at Alexander House was the “next best thing” as they could not stay at their home. Another resident said that they were “very happy living here”. Staff were described as “always very friendly and helpful”, “kind” and “very patient”. Residents also felt they had an “excellent” cook. People liked being free to make their own decisions about day to day activity. Residents felt the quality of the food was “very good”. The inspector observed good interactions between staff and residents with assistance or advice provided in a discreet manner. Residents are well informed on their right to make a complaint if they are unhappy about something. Residents were seen to use the complaints system and records showed that where possible action is taken by the manager. Comments from residents indicated that they had confidence in the manager to deal with any concerns they have. Residents told the inspector that when the manager is on duty she is always available to talk to. Residents liked the Christian ethos of the home and enjoyed the monthly religious service. Residents also informed the inspector that they hade very much enjoyed a pantomime which had been performed at the home. Visitors to the home felt that staff “always” made them feel welcome and that staff “work as advocates” for residents. Family members felt they were kept well informed of any health care problems. Visitors said that staff were flexible about those family members who could not visit other than late in the evening.
Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 6 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.
Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 7 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. Alexander House (Clifton Road) DS0000027217.V320811.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 Alexander House (Clifton Road) DS0000027217.V320811.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, 5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Before admission the needs of all residents are assessed which ensures that staff have a good understanding of individual needs and that the home can meet these needs. Residents and relatives are encouraged to make visits to the home before making any decision about moving in. Feedback from residents indicated that they felt they were provided with enough information on the service before they moved in. EVIDENCE: Care management assessments carried out by social services were seen to be provided before individuals were admitted. Senior staff from the home also visit prospective residents to carry out their own assessments of the needs of each person which assists in making sure that this is the right place for the person. Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 10 Feedback from residents indicated that they felt well informed about what the home could offer before they moved in. A number of residents said that their family or friends visited the home on their behalf before they made a decision about moving there. Some of the residents knew about or were connected with the home in some way before they moved in. This home does not offer intermediate care and therefore standard six does not apply. Alexander House (Clifton Road) DS0000027217.V320811.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 & 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All residents are provided with a care plan which sets out individual needs and how these will be met. The care plans should be further developed. The health care needs of individuals are mostly met. Staff need to take care to record actions taken should there be any concerns about the health of any person. The majority of medication is well managed but regular checks need to be carried out to make sure that records are up to date and accurate. All residents felt they were treated with respect the majority of the time. Further work needs to be done on ensuring that all staff take note of and act on residents comments and requests. Staff need to make sure they are aware of the wishes of individuals about terminal illness and death to make sure that these wishes can be carried out. EVIDENCE: A sample of residents notes were examined and care plans were seen to be in place for each person. Residents or their representatives have signed the care plan to show their agreement. Assessments were seen to have some good information on the likes and dislikes of individuals and some information on the
Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 12 previous social history of the person. The care plans seen focused on the physical needs of individuals. Staff should look towards developing a more person centred care plan which includes not only the physical needs of the person but also the social, cultural, emotional and religious needs and wishes of the individual. Consideration should be given to requesting a more detailed life history from residents or their representatives which they are willing to share with the staff group. In one instance it was noted that the care plan and assessments had not been reviewed for over six months. Senior staff must carry out regular checks on care planning and assessment documents to make sure that reviews are carried out at least monthly. Daily notes are well maintained however staff need to make sure they record actions taken. In one instance staff recorded that a resident was complaining of pain but they did not record what action they took or whether it was effective. All residents are registered with local GP surgeries. Arrangements are in place for regular dental, optical and chiropody services to be available. Staff seek the advice and services of district nurses if necessary and referrals are made to other specialist health care teams such as the palliative care staff if needed. Staff should make sure that they record any visits by health care professionals including GPs. Staff monitor the weight of residents and it was noted in one instance that there had been a significant weight loss within one month. Staff must record what action has been taken if individuals are showing large weight loss or gain. Medication was seen to be stored securely. Staff keep records of all medication coming into and going out of the home. The record of medication given was not fully up to date and accurate. Staff had not signed for some medication which appeared to have been given and in one instance had signed that tablets had been given when they had not. One person had been prescribed a controlled drug and the recording for the administration of this medication was not accurate. The prescribed dose, the dose recorded as being administered on the record and the dose noted in the daily notes were all different. Staff must sign for medication at the time it is given. It is recommended that all medication records including those for any controlled drugs are checked at each staff change to ensure that any missing signatures are explained as soon as possible. Senior staff should carry out regular checks on the records to make sure they are up to date and accurate. Individual medication profiles should be maintained setting out all the medication prescribed, when it was prescribed and when discontinued. Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 13 All the feedback received from residents on staff respecting their dignity and privacy was mostly positive. Residents did however on several occasions qualify their comments by saying that “it depends who is on duty”. Residents felt that the majority of staff listened to them but one or two were less attentive. This is an area which should be addressed through training and individual supervision by the management of the home. Alexander House (Clifton Road) DS0000027217.V320811.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 good. This judgement has been made using available evidence including a visit to this service. Residents confirmed that they can have visitors at any time and feedback from visitors indicated that they felt welcome in the home. Groups from the local and religious community visit the home. Residents felt that they mostly had choice over their day to day lives. Residents enjoy the food provided but the manager needs to ensure that the gap between the last meal of the day and breakfast is not excessive and that residents are consulted again on the menu. EVIDENCE: The Friends of Alexander House visit the home on a regular basis and provide company and activity for residents. A monthly communion is provided in the home with tea and cakes after the service. Residents told the inspector that they enjoyed the social activities in the home some of the time. They also said that it was difficult for staff to provide activities which suited all of the residents. This is one area which keyworkers could be involved in providing individualised activities. Activities are available three times a week with quizzes, music and movement, skittles, card and board games. Some residents can walk on Wimbledon Common which is a
Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 15 very short walk away. Staff accompany residents to Wimbledon Village for shopping or for the exercise. A number of residents raised with the inspector a problem with the use of the television in the main lounge. The manager is aware of the problem and will be working to resolve the matter. The freedom of movement of residents is not restricted. Residents can should they choose leave by the front door at any time during the day. Residents told the inspector that should they choose to go out they inform staff for safety reasons. Feedback from residents indicated that they felt they made their own choices on a day to day basis. Positive comments were made about the food provided in the home. Residents said that the food “is lovely”, “good” and “very nice”. Two residents spoken to felt that the food had improved with the employment of a new cook. Residents reported that breakfast was at 8.30 am but that they could get breakfast later than this if they wanted. Lunch is at 12.30 and supper at 6 pm. A number of residents said that they were less happy with the suppers provided than any other meal. Although a hot drink and biscuits is provided at 8 pm more than one resident commented that they did feel hungry at times if supper is not to their liking. The inspector was informed that alternatives are available at supper time and that staff can get snacks from the kitchen at any time. However the manager must review, with the residents, the food offered in the evening to make sure that no one is left feeling hungry. A snack must offered to all residents between supper time and breakfast Alexander House (Clifton Road) DS0000027217.V320811.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 good. This judgement has been made using available evidence including a visit to this service. Residents are aware of the complaints procedure which is on display in the home. All staff have been provided with training on the protection of vulnerable adults which makes sure they are aware of different forms of abuse and their responsibilities to take action should they become aware of or suspect any abuse. EVIDENCE: Residents told the inspector that a complaints book was available and that should they have any complaints they can use the procedure. They also expressed confidence in the manager to deal with any problems they might have. The record of complaints shows that residents do use the system and that action is taken to resolve concerns. The record gives clear information on the complaint, the action taken and the outcome. All staff have received training on the protection of vulnerable adults. Staff are aware of their responsibilities to report any concerns they may have about the welfare of any resident. Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A number of areas are showing signs of wear and tear. The organisation is moving ahead with plans update the building and improve the facilities. All areas of the home seen at the time of this inspection were clean and tidy. EVIDENCE: The home is well maintained but Alexander House is not a purpose built home and a number of areas are showing signs of wear and tear. The organisation has consulted the CSCI about plans to up date the home. Residents are kept informed of the plans and discussed this with the inspector. Staff keep the home clean and tidy. Residents are encouraged to bring to the home personal items such as, ornaments, photographs, and furniture. This gives individual rooms a personalised appearance. Residents made positive comments about their personal rooms. They were also pleased to have been consulted on the colour of the new carpeting on the ground floor.
Alexander House (Clifton Road) DS0000027217.V320811.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): 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. Sufficient numbers of staff are on duty to meet the needs of the present resident group. A number of care staff have commenced or have completed NVQ training which helps in ensuring residents are supported by well informed staff. The appropriate checks are carried out on new staff before they commence work in the home. This assists in making sure that residents are protected. Staff felt that improvements have been made in the opportunities for training. However care must be taken to make sure that all care staff are provided with at least three paid days training each year and that staff are provided with regular updated training on moving and handling. Residents made positive comments about the staff group but felt that not all staff were as understanding as others. This is a training issue which should be addressed. EVIDENCE: Feedback from residents and other people involved with the home were mostly positive on the staff group and their approach. Staff were described by residents as “lovely”, “very good”, “the best” and “patient and helpful”. As noted previously a number of residents qualified this by stating that “it depends who is on duty” and “some staff listen to you more than others”. The issue of communication should be addressed. Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 19 The staff rota shows that sufficient staff are on duty throughout the day and night to meet the present needs of the people living in the home. The manager informed the inspector that five staff had or were in the process of NVQ level two or three training. Since the last inspection staff have been provided with training on the protection of vulnerable adults. The record of training provided by the manager did not show that all staff have been provided with three paid days training each year. It was also noted that a number of staff received moving and handling training some years ago. Staff must be provided with regular training on this issue to make sure that they are aware of changes in good practice which will ensure the safety of residents and staff. A number of staff completed introduction training on dementia in 2003. Consideration should be given to up dating and providing more advanced training in this area. Discussion took place with the manager on the induction programme for new staff and the manager was advised to look at the Skills for Care Induction pack. Residents benefit from a stable staff group who have a good knowledge of their strengths and needs. A keyworker system is in place. Staff told the inspector that the keyworker works with individual residents getting to know their individual likes and dislikes, spending time talking with them, and doing tasks such as shopping. The home keeps good records on staff which show that the appropriate checks have been carried out, including Criminal Records Bureau checks and references. The manager is aware of the need to obtain a full employment and education history for all staff employed from now on. Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 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. 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 manager has the experience and qualifications to run the home. Residents made positive comments on the approach and availability of the manager. Residents are provided with some opportunities to have their say about how the home operates. Good records are kept of residents finances. Staff carry out regular checks on the building and equipment to protect the health and safety of residents, staff and visitors. Work needs to be done to implement a quality monitoring system which takes into account the opinions of residents and others involved in the home. Staff must carry out weekly checks on the temperature of hot water throughout the home to ensure the safety of residents. Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 21 EVIDENCE: The home manager is a qualified nurse and has experience of running a home. She takes part in training courses to ensure that she keeps up to date with current good practise. At present she is completing the Registered Managers Award. Residents were complimentary about the manager and a number of residents felt that she was more approachable and available to them than previous managers had been. Residents expressed confidence in the manager to deal with any problems they may have. Residents meetings are held throughout the year where individuals can give their opinion on day to day issues about the home. The manager informed the inspector that a quality monitoring system was not in operation as yet. The organisation needs to introduce a system whereby they gain the opinions of residents and other people involved in the home. This information needs to be used to carry out an annual review of the care provided and set up a development plan for the service. The results of residents feedback need to be made available to residents and any prospective residents. Facilities are available for residents to deposit small amounts of cash in the home for safekeeping. Individual records are kept of any money held with clear information of any money deposited or withdrawn. Staff carry out regular health and safety checks. The fire alarm system is checked weekly and regular fire drills are carried out. A record of all staff taking part in a drill are kept which makes sure that all staff are given the opportunity to take part. Professional maintenance checks are carried out on equipment. It was noted that staff were not carrying out regular checks on the temperature of hot water. A record of weekly checks on the temperature of hot water accessible to residents must be kept to ensure that residents are provided with hot water at a safe temperature. Staff must also continue to check and the temperature of hot water before they assist anyone into a bath or shower. Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 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 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 23 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 Requirement The registered persons must ensure that care plans are reviewed every month. Timescale of 18/04/06 not met The registered persons must ensure that staff record any actions taken should any resident show significant weight loss or gain. Timescale of 18/04/06 not met. Staff must also record action taken and the outcome should any resident complain of pain. 3. OP9 13(2) The registered persons must ensure that accurate and up to date records are maintained for all medication administered. The registered persons must carry out a review, in consultation with residents, of the food provided. All residents must be offered a snack in the evening to ensure
Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 24 Timescale for action 01/03/07 2. OP8 12 (1) a 01/03/07 01/03/07 4. OP15 16(2)(i) 01/04/07 that the gap between the last food of the day and breakfast is no more than 12 hours. 5. OP30 13(2)(5) 18(1)© The registered persons must ensure that all staff are provided with regular training on moving and handling. All staff must be provided with training on effective communication. Records must show that all staff receive at least three paid days training each year. 6. OP33 24 The registered persons must 01/07/07 carry out an annual review of the care provided taking into consideration the opinions of residents and other stakeholders. Feedback from residents must be made available to residents and prospective residents. 7. OP38 13(4) The registered persons must ensure that weekly checks are carried out and recorded on the temperature of hot water accessible to residents. 01/03/07 01/07/07 Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 25 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 OP7 Good Practice Recommendations Staff should work towards developing a more person centred care plan which includes not only the physical needs of the person but also the social, cultural, emotional and religious needs and wishes of the individual. Consideration should be given to requesting a more detailed life history from residents or their representatives which they are willing to share with the staff group. 2. OP9 It is recommended that all medication records including those for any controlled drugs are checked at each staff change to ensure that any missing signatures are explained as soon as possible. Senior staff should carry out regular checks on the records to make sure they are up to date and accurate. Individual medication profiles should be maintained setting out all the medication prescribed, when it was prescribed and when discontinued. 3. 4. OP12 OP30 Consideration should be given to involving keyworkers in the provision of more individualised activities at the home. Consideration should be given to providing staff with more up to date and advance training on dementia care. Alexander House (Clifton Road) DS0000027217.V320811.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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
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