Inspection on 25/07/08 for Alnwick Road (4)

This inspection was carried out on 25th July 2008.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alnwick Road (4) 28/01/08

Alnwick Road (4) 12/10/06

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOME ADULTS 18-65 Alnwick Road (4) 4 Alnwick Road Canning Town London E16 3EX Lead Inspector Sarah Greaves Key Unannounced Inspection 25th July and 1st August 14:00 Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 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 Alnwick Road (4) DS0000066795.V364130.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 Adults 18-65. 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. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alnwick Road (4) Address 4 Alnwick Road Canning Town London E16 3EX 020 7511 4854 020 7511 4845 bertram.okeke@heritagecare.co.uk www.heritagecare.co.uk Heritage Care 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) Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th January 2008 Brief Description of the Service: Alnwick Road is a care home for six adults with severe learning difficulties that first registered in 1994. The home is divided into three self-contained flats, the largest of which also accommodates staff and administration offices. The exterior of the building is in keeping with the surrounding properties. The home is situated in Custom House, close to public transport and other amenities. Presently there are four residents at the home. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that people who use the service experience adequate quality outcomes. This unannounced key inspection was conducted in one day. We gathered information through speaking to the residents, staff members, the manager and one visiting health care professional (speech and language therapist). We read two care plans and looked at documents such as staff supervision records, the Adult Protection procedure, medication administration records, and health and safety certificates. We also toured the premises and looked at the storage of medication. The service was sent an Annual Quality Assurance Assessment (AQAA), which is a self-audit tool. This was satisfactorily completed within the agreed timescale and information from the AQAA has been used for the production of this report. The manager was not able to access all the information that we requested during the inspection visit. We agreed that some information could be sent to the Commission after the date of the visit; hence the end date for this inspection has been recorded as one week later on the 1st August 2008. What the service does well: The service demonstrated that a good understanding of the very individualised needs of the residents, which was reflected in the care plans, the personal activities plans and the communication with people by staff. The training programme and the staff acquisition of National Vocational Qualifications was good. We were pleased to observe the current joint working project with local health service practitioners (speech and language therapists), which should enable the residents to enjoy greater opportunities to express their needs and wishes. The service evidenced that it offered residents a range of carefully chosen activities. Alnwick Road (4) DS0000066795.V364130.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. 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. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are assured that their needs and wishes will be properly assessed and that they will receive comprehensive information about living at 4, Alnwick Road. EVIDENCE: We noted that the Statement of Purpose and the Service Users Guide needed to be updated to reflect recent specific changes at the service; for example, the appointment of a new manager and the fact that English Churches Housing Association is no longer the landlord. Otherwise, these documents were satisfactorily presented and the Service Users Guide was available in a pictorial format. At the time of this inspection there had been no newly admitted residents since the last inspection (although a resident had transferred from another Heritage Care registered care home). We found that residents had received a multiagency assessment of their needs by external health and social care professionals prior to moving into residential care. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 9 Residents received a pictorial style contract, which was well presented; this document carefully explained their entitlements as a tenant of a Heritage Care property. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the care plans were individualised and quite detailed, the service needs to make sure that reviews are conducted within the stipulated timescales. People are supported to make decisions and take balanced risks. The service needs to ensure that confidential information is kept safe at all times. EVIDENCE: We read two care plans during this inspection. We noted in the first care plan that a six monthly review had taken place in October 2007 and therefore the next six monthly review was now overdue. It was also observed that the monthly reports for January, February and May 2008 were produced but the other monthly reports were not available. The health action plan for the resident could not be read during the inspection (so that its relevance to other Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 11 individualised social care planning could be tested), as it could not be located on the service’s computer system. The second care plan was satisfactory although the health action plan was established in December 2007 and due for review in June 2008; this review was not evidenced at this inspection visit. We felt that the health action plan could have been more specific; for example, one of the objectives for this individual was to monitor their weight but there was no information recorded to state how frequently their weight should be recorded. We have advised that this objective should be discussed with the person’s General Practitioner (or other health care professional involved in their care, such as a practice nurse if applicable) so that clear information is gathered regarding the recommended weight range for this person and what action(s) should be taken if a concern is identified with their weight. The care plans indicated that residents made decisions about their lives; for example, one of the residents enjoyed walking and had become a member of a weekly rambling group. Another resident did not want to be disturbed (visited by the inspector) in their flat during the inspection, as they liked to relax on their own in the evening. We observed that residents chose when to eat their evening meal, which was a ‘Friday night take-away’ Chinese meal. Staff understood the person’s preference, which was to have the meal when he felt ready. The risk assessments in both care plans had been reviewed within the past six months and were of a satisfactory standard. We found that the service maintained confidential records in a secure manner within the staff office, which was kept locked when not in use. The service worked in accordance to systems to secure information stored electronically; for example, only authorised persons could access electronically held information about residents. However, we found that two care plans were left on a table in the communal lounge in one of the flats occupied by two residents. We were concerned that had a personal visitor arrived during the course of this inspection they could have mistakenly picked up and looked at a care plan for a resident that they had no connection to. We discussed this finding with the manager; it was acknowledged that the service does not want to detract from its homely environment by installing lockable cabinets in the lounge but it was agreed that an acceptable item of domestic style furniture with a lockable facility could be sought if the service wishes to continue to store care plans in the lounge. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to lead fulfilling lifestyles at home and in the community. A balanced menu was offered. EVIDENCE: Through reading two of the care plans and speaking to the manager, we found that residents were offered opportunities to engage in meaningful activities and participate in local community life. We were informed that residents liked to go out rambling, visit local amenities (such as the park, leisure facilities, cafes and shops), have outings in the service’s vehicle and receive relaxation sessions from the visiting aroma therapist. The service had several members of staff that could drive the Galaxy vehicle. Each resident had their own individualised activities plan, which included activities at home. For example, one resident was known to have experienced difficulties sleeping, therefore Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 13 their evening activities were designed to promote relaxation (such as listening to calming music or using the foot spa). We noted that the service encouraged residents to have contact with family members and friends. It was noted that some residents liked to take part in activities with people from different Heritage Care services, such as the weekly rambling group. At the time of this inspection three out of the four residents did not have verbal communication. The service was actively working with a speech and language therapist in order to enhance the existing ways that staff communicated with the residents. On the day of this inspection we spoke to a visiting speech and language therapist that was undertaking a detailed assessment of one of the residents. We noted that staff used Makaton sign language and other systems of communication, such as objects of reference. The speech and language therapist stated that her department wanted to offer on-going support to the service, which would include training for staff. We have described this project at the care home as an example of how staff were promoting the entitlement of the residents to be able to communicate their needs and views. We looked at the menu plan, which evidenced that residents received a varied and balanced diet, with fresh fruits and vegetables. It was noted that staff prepared some vegetables for the residents to eat with their Chinese takeaway, which was followed by a dessert. Residents were able to communicate to staff when they wanted drinks and light snacks. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although the service demonstrated that the personal and health care needs of individuals are identified and addressed, minor improvements to medication practices are needed. EVIDENCE: The care plans indicated that residents were assisted to receive their personal care in accordance to their identified needs and preferences. The manager informed us that all of the residents were registered with a local General Practitioner; other health care (such as dentistry and podiatry) were accessed as needed. There were no current concerns regarding the health of any of the residents. As previously stated within this report, there was active input by the local speech and language therapy services. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 15 A requirement was issued in the previous inspection report for the service to ensure that all staff with a responsibility for administering medication received refresher training. The manager stated that this training had been delivered and the random sample of staff plans that we looked at evidenced this to be the case. We checked the storage and administration of medication, which we found to be generally well managed. It was noted that the medication administration record for one resident did not evidence that the balance of a medication (fludrocortisone) had been reconciled. We were informed that this medication did not arrive at the same time as the monthly medications were checked in and had been received by a member of staff that had not yet received their medication training. We were of the opinion that this staff member should have summoned a medications trained colleague at the earliest opportunity so that the colleague could have checked that they were satisfied with the delivery (for example, correct amount of medication, no evidence of damage and accurate details on pharmacy label). It was also noted that one of the residents was prescribed a topical cream (aqueous cream) but the pharmacy label and the medication administration record stated that staff should ‘apply when required’. It was acknowledged that there was no specific guidance for the aqueous cream in the resident’s care plan. We would advise that the service records and signs specific instructions on the medication chart or records these instructions in the care plan, if the General Practitioner does not produce detailed instructions when issuing the prescription. The service produced a copy of a current British National Formulary medication guide. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service evidenced policies and practices to listen to residents (and their representatives) and protect vulnerable people from abuse. EVIDENCE: The service produced a satisfactorily written complaints procedure, which was available in a pictorial format. We had no concerns regarding the service’s management of complaints and noted that the care home had recently received a compliment from the relative of a resident following birthday celebrations organised by staff. We looked at the service’s Adult Protection policy and whistle-blowing policy, which were written in accordance to current legislation and good practice guidelines. Staff received annual refresher training in the protection of vulnerable adults. We spoke to two members of staff regarding their knowledge of Adult Protection issues and received clear and confident responses. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,28 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents would benefit from a more homely and welcoming environment. EVIDENCE: It was noted that some improvements had been made to the environment, although it was acknowledged by the manager that this needed to be an ongoing process. We found that the care home was clean and free from offensive odours; however, there was an evident need for the premises to be ‘spruced up’ with some new furnishings and curtains. We were informed that work was being undertaken in the rear garden in order for this space to be an inviting and pleasant area, but this had not been fully realised at the time of this inspection. The service had met a requirement to repair damaged kitchen work surfaces. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 18 Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assured that their care will be delivered by staff that are safely recruited, regularly supervised and suitably trained. EVIDENCE: We found that all of the staff had a minimum of a National Vocational Qualification (NVQ) at level 2 or above apart from one person that was currently enrolled upon NVQ level 2. Therefore the service had comfortably attained a staff team that exceeded the applicable National Minimum Standard for at least 50 of care staff to have a relevant NVQ or a recognised equivalent. There were no issues of concern in regard to the safe recruitment of staff. It was noted at the last inspection that the service had some difficulties in evidencing the training that staff had undertaken, which was due to staff not supplying copies of their training certificates to the manager. The service Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 20 provider electronically stored information about the training that staff had undertaken, although we noted that some of this information needed to be updated (for example, the manager knew that staff had been on specific training but it had not yet been entered centrally by the service provider). We were satisfied that staff were being supported to undertake their mandatory training and also to access other training that was relevant to the needs of the people living at 4 Alnwick Road (such as crisis intervention, understanding epilepsy and dealing with challenging behaviour). We noted that some progress needed to be made with the gathering of staff certificates so that the manager could be very clear regarding the training achievements of staff; we also found that the moving and handling training for one person was overdue. On-going work is needed with the administration element of staff training, but overall we felt that staff were accessing appropriate training. A requirement was issued in the previous inspection report for the service to ensure that all staff received sufficient one-to-one formal supervision. We checked the staff files for four members of staff and found that each person had received at least two supervisions since the beginning of 2008, which indicated that people would receive at least six supervisions each year, as stipulated by the National Minimum Standards for Care Homes for Younger Adults. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service demonstrated that it seeks the views of the residents in order to make improvements. Although positive observations have been made regarding the management of the service, a more robust approach needs to be taken to ensure the safety of the residents. EVIDENCE: At the time of this inspection the service identified that it proposes to deregister and become a supported living unit. The manager has not applied for registered manager status with the Commission for Social Care Inspection due to the significant planned changes to 4 Alnwick Road. The manager has a Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 22 National Vocational Qualification in Care at level 3 and also has a recognised management qualification, which is a Masters degree in Business Administration (MBA). We felt that the manager had made some positive changes to the service that were focused upon improving the quality of life for the residents. However, we were concerned that a requirement for the safety of the residents was clearly not met at this inspection. The service was consulting with an independent advocate in order to support the residents to make a meaningful choice regarding whether they wished to move into supported living. The advocate was working individually with residents to ascertain their views. The opinions of residents was also sought at the monthly-unannounced monitoring visits by the service provider, through either speaking to residents or making observations. A requirement was issued in the previous inspection report for the service to ensure that any items subject to the Control of Substances Hazardous to Health (COSHH) regulations must be kept locked up. Through our observations we were satisfied that the service had complied with this; however, we found a couple of aromatherapy oils had been left in an unlocked cabinet in a communal bathroom. These oils ought to be kept in a locked facility as aroma therapists advise that there are risks associated with unsupervised use of oils; for example, some oils should not be inhaled and other oils should not be applied directly to the skin and need to be diluted within a liquid or cream carrier solution. Although we do not have the expertise to comment on the particular oils found at the service, we have issued a requirement that these items are kept locked up to prevent any potential hazards. A requirement was issued in the previous inspection report for the service to ensure that the hot water cylinder is kept locked at all times for the safety of the residents. The manager stated that the service had complied with this; for example, many of the items stored in the cylinder cupboard had been removed so that staff did not have to regularly open the cupboard. However, we found that the cylinder cupboard was unlocked during this inspection. Although the Commission does not customarily repeat requirements, this requirement has been repeated on this occasion only, taking into account that the service had implemented measures to meet the initial requirement. Although opened food was labelled and dated we found out-of –date ham in one of the refrigerators. We checked the following health and safety records, which were found to be satisfactory: water hygiene risk assessment, professional maintenance of the fire system, and weekly checks for general health and safety, fire alarms and hot water. The service also demonstrated that refrigerator and freezer temperatures were checked daily. Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 1 X Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 24 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA42 Regulation 13(4) Requirement The registered person must ensure that the hot water cylinder cupboard is kept locked at all times for the safety of residents. This is a repeated requirement. 2. YA10 12(1) The registered person must ensure that confidential information (care plans) are stored securely at all times in order to protect the confidentiality and welfare of the residents. The registered person must ensure that (1) Medication is checked in by staff that have received training for this role (2) Staff are provided with written instructions for the application of prescribed topical medications. The registered person must ensure that (1) Food is checked daily DS0000066795.V364130.R01.S.doc Timescale for action 30/09/08 30/09/08 3. YA20 13(2) 30/09/08 4. YA42 13(4) 30/09/08 Alnwick Road (4) Version 5.2 Page 25 (2) to ensure that it has not expired The aromatherapy oils are securely stored. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Alnwick Road (4) DS0000066795.V364130.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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. 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