Inspection on 02/07/08 for Ashington Grange

This inspection was carried out on 2nd July 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashington Grange 20/06/07

Ashington Grange 20/01/06

Ashington Grange 09/09/05

Ashington Grange 24/02/05

Ashington Grange 15/07/04

Ashington Grange 28/01/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Ashington Grange Moorhouse Lane Ashington Northumberland NE63 9LJ Lead Inspector Aileen Beatty Key Unannounced Inspection 2nd July 2008 09:00 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 Ashington Grange DS0000040474.V368082.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. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashington Grange Address Moorhouse Lane Ashington Northumberland NE63 9LJ 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) 01670 857 070 01670 854 144 ashingtongrange@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Home Properties Limited Mrs Ann Mielnik Care Home 59 Category(ies) of Dementia (34), Old age, not falling within any registration, with number other category (25) of places Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 25 2. 3. Dementia - Code DE, maximum number of places 34 The maximum number of service users who can be accommodated is: 59 Of the following age range: Aged 55 and above Date of last inspection 20th June 2007 Brief Description of the Service: Ashington Grange is a two storey purpose built care home which is situated in a residential area and is approximately one and a half miles from the centre of Ashington. The home provides care for residents who have dementia and general nursing care for up to 59 older persons. The home also offers social and personal care for older people. The home is divided into two units called the Charlton Wing and the Milburn Wing. Each unit has its own facilities including single bedrooms, 10 of which are en-suite. Each unit has two lounges and dining rooms and there is safe access to the garden areas. Car parking areas are provided at the front and sides of the building giving level access to the home. The home shares the site with another home, which is owned by the same company. Fees range from £388.47 and £409.25 per week. Information about the care provided and facilities in the home are available in the service user guide and statement of purpose in the home. A copy of the most recent inspection report is also available. Ashington Grange DS0000040474.V368082.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 the people who use this service experience adequate quality outcomes. Before the visit: We looked at: • Information we have received since the last visit on 17h December 2007. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. 18 service user and visitor surveys were returned to CSCI. The Visit: An unannounced visit was made on 2nd July 2008, by two inspectors, Aileen Beatty and Janet Thompson. During the visit we: • Talked with people who use the service, relatives, staff, the manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe & comfortable. We told the Manager what we found. What the service does well: Bedrooms are nicely personalised, making it a homely environment for residents. There is a regular letter and news bulletins to keep people up to date with what is happening in the home. There are still strong links with local activities organisation, which means there is a good range of activities available. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 6 Care records are well organised and kept up to date meaning that healthcare needs can be monitored effectively. The home is clean and tidy and most areas of the home are well maintained. There is good evidence of regular audits carried out by the manager to ensure the home is being run properly. Relatives and service users are complimentary about most staff and the manager who they feel is very approachable. “The door is always open”. Specialist support is sought where required for example from the challenging behaviour team, ensuring all health needs are met including psychological needs. Residents say they feel well cared for, “the staff are so lovely but they are so busy” “yes, I like it here, we are well looked after” “well it’s not like home but I feel safe” “I like most of the staff, some of the names I don’t know” “she’s lovely (passing carer) makes sure I’ve got everything” What has improved since the last inspection? What they could do better: The home uses a lot of frozen vegetables at mealtimes. These could be replaced by more fresh vegetables. Waste bins are not foot operated which is a requirement for effective infection control. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 7 Some toilets do not have grab rails to assist residents. The organisation of the medicine fridges and location of trolleys make stock rotation and organisation of the medicine round more complicated than necessary. The water temperature at the staff hand washing sinks is too hot to allow effective hand washing to take place. The laundry and upstairs office/treatment room could be tidier and are a bit cluttered. Some towels and linen are old and frayed. All toilets would benefit from picture signage as well as word. 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. Ashington Grange DS0000040474.V368082.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 Ashington Grange DS0000040474.V368082.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): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their representatives are given good information and opportunities to visit the home and decide whether it is suitable. EVIDENCE: The service user guide and statement of purpose remain detailed and contain all of the required information. This includes information about staffing, who the home can care for, social activities, arrangements for religious observance, fire safety, complaints, care planning, information about meals and mealtimes and the homes environment. The manager and deputy continue to carry out pre admission assessments and visit prospective residents at home or in hospital before admission. Short visits from an afternoon, to overnight, and then extending gradually can be offered Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 10 to help some residents to get used to the home. They may wish to stay for a meal, but not overnight initially for example. Four care plans were read and all contained pre admission information, and one contained a short stay care plan, as the move was temporary. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users needs are generally set out in individual plans of care, meaning health needs are usually met. Residents are treated with respect and their dignity maintained. EVIDENCE: All residents in Ashington Grange have an individual plan of care. The care plans for three residents were read during the inspection. The format of care files is good, with information being easy to find and well organised. The care of two residents was case tracked by the inspector, meaning observations were made to see whether the care provided matched the care outlined in the care plans. The care described did match the care given to the residents and the carers’ accounts of their care needs. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 12 The health needs of residents appear well met. There are records of visits from professionals such as GP’s and psychologists to the home. Assessments are in place for moving and handling, dependency, falls, nutrition, pressure damage, continence, use of bedrails and a specific one for financial abuse from relative. Care plans are in place for all of the above including social care plan. They have been regularly reviewed. Care plans are suitably detailed, for example a nutritional plan, which suggests that the meal be served in peaceful surroundings, to have food and drink already on the table before they sit down, and noting that they like hot tea with meals. The care plans for two residents who has dementia were read. Surprisingly there were no care plans relating to their mental health or psychological problems for these two people. Staff were observed caring for residents. Some time was also spent in the lounge to see how residents spend their day. Staff were observed to be very approachable and friendly towards residents, and demonstrate a good knowledge of their likes and dislikes and personal routines. One resident was observed being taken out of the room to go to the toilet by staff. She was given a clear explanation of what was happening and given constant reassurance by staff. The care working carrying out domestic duties was careful not to disturb people who were ill and decided not to vacuum the corridor while someone was in bed. This demonstrates thoughtfulness, and sensitivity. There were long periods when no staff were in the lounge, and residents were sitting with the television on very loud and the radio was also on in the corridor. This was quite distracting and appeared to cause some agitation in some residents. The picture on the television was also very fuzzy and difficult to watch and did not appear to be on for any particular reason. The staff in the home seek specialist advice from the challenging behaviour team to help them manage aspects of behaviour that require careful evaluation and treatment plan. Care plans relating to behaviour are very detailed and show a formula used by staff to identify possible triggers such as personality traits, previous experiences and routines etc that might affect behaviour. It was noted that one resident had developed a phobia about mirrors, and staff had requested that the mirror in their room and bathroom be removed. They were waiting for this to happen, and it was suggested that a temporary cover could be used in the meantime to avoid any unnecessary distress. It is good that this issue has been identified but more proactive measures could have been taken to minimise chances of distress. A medication policy is available in the home. On the day of the inspection, the medicine trolley, cupboards and fridge were checked, and also medication records. There were some gaps in medication records, but these had already been underlined indicating that they had been picked up during routine audit. One drug fridge is used by both floors which means it is very full. This makes Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 13 stock rotation and auditing difficult. The medicines are kept upstairs so the nurse has to leave the floor for considerable times to collect, tidy, and return the trolley. A random check of controlled drugs found the correct quantity in stock. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The opportunities for socialising in the home are generally good, and meals are generally of a satisfactory standard. EVIDENCE: A new activity co-ordinator was interviewed and appointed on the day of the inspection. There remain good links with a local voluntary activity group, and regular resident meetings are held with this group (Mind Active). A meeting took place on the day of the inspection. The foyer area is now arranged in a way that encourages residents and visitors to congregate and it looks much more homely and inviting. Other areas of the home are being decorated to provided added stimulation, for example, a dining room is being set out in diner style, with film and music icon pictures displayed. This was being created during the inspection, and residents who caught a glimpse of the pictures began to show an interest and discuss them. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 15 Care records include a social history, and accompanying social care plan, detailing the specific needs of residents. Visitors are welcome at any time, and there is information readily available in locations around the home, describing what is happening in the home by way of events and news. Relatives are encouraged to share their views and the manager operates an open door policy. A number of people who completed the questionnaire about the home, said that the staff and manager are very approachable. On the day of the inspection, the menu had been amended as the cook was off. The menu stated that the options for lunch that day should be, stewed steak or ham risotto, followed by rhubarb crumble. The actual menu was stewed steak or Irish stew. Two versions of stew do not constitute real choice or alternative and the manager agreed. This was stewed lamb with the addition of some frozen mixed vegetables. Banana custard or yoghurt was for dessert, instead of crumble. The vegetables are all frozen except for the potatoes, which were fresh. The frozen broccoli and carrots were boiling in the kitchen at 10:30 am. The food was tasted and tasted good. The food was hot enough, and satisfactorily presented. Residents who needed assistance to eat were given help by a carer who sat next to them and offered appropriate assistance. There were a lot of feeding beakers in use, more than would perhaps be expected. This was fed back to the manager who agreed that this should be reviewed. Ashington Grange DS0000040474.V368082.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place to deal with complaints and good arrangements are in place to ensure service users are protected from abuse. EVIDENCE: There have been two complaints since this manager was appointed. Both are about care issues. The family are happy with the outcome from the first complaint, and the second is ongoing. A carer is being disciplined. The complainant is happy with the action taken. The manager carried out a relatives survey in May 2008. The results show that all the relatives responded to say they knew how to complain. Some named the manager as the person they would complain to. Most staff have had training in the protection of vulnerable adults, and a number are due to receive training which is identified on the training tracker in the home. Safeguarding issues have been dealt with appropriately by the home. Ashington Grange DS0000040474.V368082.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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Most areas of the home are clean and well maintained. EVIDENCE: The home is generally clean, with no odours. Bedrooms seem well personalised with pictures and personal belongings. Most areas of the home are well decorated, with some areas requiring freshening up, especially paintwork. This is already in the ongoing redecoration programme. There were a number of waste bins that were not foot operated. Three were identified in the sluice, visitor’s toilet and a bathroom. Some of the toilets did not have fixed grab/hand rails, and more signs identifying toilets in the corridor areas would be beneficial. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 18 A number of wheelchairs and frames were stored under the stairs. There did not seem to be any evidence of permission for this from the fire officer. Health and safety records were checked and internal checks are up to date and showed no problems except that staff hand washing sinks were not fitted with regulators so the water was 50 degrees plus. This is too hot for good hand washing procedures. The five year electrical safety certificate was not available. Communal areas in the home are clean, tidy and homely. There are murals in some corridors to add interest, such as palm trees with a sturdy deck chair beside it. The clock in the upstairs lounge is modern and glass and difficult for residents to see and read. The lounge area upstairs was previously a dining room and therefore has a non- slip laminate floor. The manager explained that this will be carpeted. There has been a reorganisation in the home since the last inspection. The home was previously divided into two halves, each with an upstairs and downstairs. These are now on two separate floors, which helps to solve a number of practical issues. The laundry was inspected and it was noted that some towels look frayed and faded. It is a bit cluttered and would benefit from being tidied, as would the treatment room/office. There are two industrial dryers and washers. A laundry assistant is employed 8am-4pm. Bins are not all foot operated which is required for infection control purposes. The manager has been spending time with domestic staff to ensure they use their time most effectively, and schedule deep cleans on a regular basis. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 19 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. Staff are trained and competent to care for service users and good recruitment procedures ensure they are free from harm. EVIDENCE: Qualified nursing staff, supported by care assistants’ work in the home. On the day of the inspection, all staff were courteous and polite to residents and visitors. Staff are recruited safely. The care records of two new staff were read, and these contain all of the required information such as references and criminal records checks. A record of training carried out is available, and the new manager is implementing a new system for recording staff training and development. There were the required number of staff on duty on the day of the inspection. Some relative surveys comment that there appears to be too few staff at times, and that staff appear very busy. On the day of the inspection, lunches were delayed upstairs due to a resident requiring transfer to hospital. Staff did, Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 20 however manage the transfer safely, and with a minimum of obvious disruption. It is acknowledged that these circumstances are unavoidable. Separate kitchen, domestic and maintenance staff are employed. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 21 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in the best interests of service users, meaning that their physical, social and financial bests interests are promoted. EVIDENCE: A new manager has been appointed since the last inspection, and has been through the fit person process with CSCI, meaning she is now formally the registered manager of Ashington Grange. The manager, Anne Mielnik, was previously the manager of another home, which was regarded by CSCI as an excellent service. She is very experienced and there have been a number of positive comments since she took up post about improvements made in the home. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 22 There are good quality assurance systems in place, meaning that the manager has already picked up a number of the issues identified during this inspection, such as gaps in medication records. Southern Cross Healthcare now has one large account for the deposit of all residents’ money. This account is arranged in such a way that individual interest can be applied. There is a cash float in the home of residents to access, and it was confirmed that there is sufficient available for residents to obtain access to a reasonable amount of money at short notice. Receipts are held, and all transactions in and out are recorded. Ashington Grange DS0000040474.V368082.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 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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 24 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 (1) Requirement Psychological care plans must be in place for residents with dementia to describe to staff how best to care for their individual problems as they are manifested. Medication records must be fully completed at all times so that there is an accurate record of medication that has been given. • Hand rails must be provided in toilets for the safety of residents. • A copy of the redecoration plan must be forwarded to CSCI with dates for completion. • The temperature of water in hand washing sinks must be regulated to ensure staff can wash hands effectively and safely. • Replace faded and threadbare towels. • Ensure the laundry and office/treatment room remain clean and clutter free to aid effective cleaning and infection DS0000040474.V368082.R01.S.doc Timescale for action 02/09/08 2. OP9 13 (2) 02/09/08 3. OP19 23 (2) (d)(j) 02/09/08 Ashington Grange Version 5.2 Page 25 control. 4. 5. OP26 OP38 13 (3) 13 (4) (c) Bins must be foot operated to reduce the risk of spread of infection. • Remove items stored underneath the stair well due to fire risk. • Confirm that there is a five year electrical safety certificate in place. 02/09/08 02/09/08 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. 3. Refer to Standard OP9 OP19 OP15 Good Practice Recommendations Review the practical arrangements for administering and storing medication to make this more time effective and make stock easier to monitor by staff. Staff should be made aware of the importance of monitoring background noise. A suitable choice of meals must be made available to service users and fresh vegetables used where possible. Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashington Grange DS0000040474.V368082.R01.S.doc Version 5.2 Page 27 - 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. 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