Inspection on 15/04/05 for Aston Grange

This inspection was carried out on 15th April 2005.

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

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

Other inspections for this house

Aston Grange 17/12/07

Aston Grange 01/06/07

Aston Grange 24/01/07

Aston Grange 08/05/06

Aston Grange 29/09/05

Aston Grange 04/08/04

Aston Grange 21/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Aston Grange 484-512 Forest Road Walthamstow London E17 4PZ Lead Inspector Vivienne Patchett Unannounced Inspection 15th April 2005 at 10:00am 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 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. Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Aston Grange Address 484-512 Forest Road, Walthamstow, London, E17 4PZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8509 1509 020 8509 1609 Aston Grange Limited Michelle Cunnington Care Home 45 Category(ies) of Dementia - over 65 years of age (29), Old age, registration, with number not falling within any other category (16) of places Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4th August 2004 Brief Description of the Service: Aston Grange is registered to provide care to 45 elderly people, 29 of whom have a diagnosis of dementia. Opened in October 2001, it is operated by ‘Aston Grange Ltd’, linked to ‘Carebase Ltd’, who own other care homes. Short-term respite stays are offered where there are vacancies between longstay placements. Each of the three floors is designed as a separate unit, the upper two accommodating residents with dementia. All residents have a single bedroom, with an en-suite lavatory and washbasin. There is one bathroom with a bath suitable for assisting people with limited mobility, a shower room, and a sluicing facility in each unit. A large lift links all levels. One of the seating areas on the middle floor can be used by residents to meet visitors in private. Meals are prepared in the kitchen on the second floor and served in the dining area on each unit. The ground floor sitting/ dining room also has a kitchenette area where residents or staff can prepare drinks and snacks. The building is on a main road in Walthamstow, near shops and transport links. There is limited garden area, but it has seating areas and space to walk. Overall space standards for residents are adequate, but office and storage space is limited. A bonus for visitors is a good-sized parking forecourt as the neighbourhood has restricted parking. Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The routine unannounced inspection of Aston Grange took place on Friday, 15th of April 2005 between 10 a.m. and 5 p.m. The registered manager and head of care helped the inspector during the inspection. In addition, the inspector spoke to residents on all three units, to two relatives and to a range of staff, including care staff, the cook, a handyman, two domestics, the activities organiser and the administrative officer. A full inspection of the premises was not undertaken at this time but all the sitting rooms were visited and two bedrooms seen. The inspector looked at various documents, such as care plans, menus, activities book, medication records etc. The inspector would like to thank staff and residents who contributed to the inspection. What the service does well: What has improved since the last inspection? The manager has almost completed a course in Dementia Care and has been implementing ideas from this to improve the service offered to all residents but particularly those with dementia. The manager and staff have been making an extra effort to make sure they listen to residents views and offer real choice and independence. A resident has been made Chair of the residents amenity fund. A mobile drinks bar has been introduced, serving alcohol to those residents who like this with their meals or at social gatherings. There have been changes to the menu offering increased choice for residents. Residents said the food had improved. A new structure for supervising staff has recently started. in the new system but it is still early days. Staff had training 12 week intensive training courses have been started for staff in a variety of topics. These are organised by a training consultancy and count towards NVQ Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 6 qualifications for care staff. There is a comprehensive rota showing when staff are employed or are on training etc. Staff said that they felt positive about recent changes, that their views were being sought and listened to. Some reported an increase in job satisfaction. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 7 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 Standards Statutory Requirements Identified During the Inspection Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 4. The home could do more to record the assessment undertaken prior to admission, particularly for self funding residents, and ensure that all of the wishes and needs of the residents are assessed and included in the care plan. The needs assessment should include all of the information listed in a standard 3.3 and be recorded. This will ensure that no resident moves into the home without his/her needs being fully assessed and allow the manager, staff and the resident to be clear that these needs can be met. It will also lay the foundation for a plan of care to be agreed with the resident and their relatives or representatives. EVIDENCE: The inspection of a sample of residents files showed a variation in the amount of information being recorded to show how the residents’ needs had been assessed prior to admission and how the home would meet these needs. Although the head of care had made a pre-admission assessment, the file for one resident admitted in January 2005 did not include a completed assessment or admission form or other information such as life history, strengths and needs etc. Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9, 10 Care plans needed further development to be more detailed to cover all aspects of residents’ health, personal and social care needs and to give guidance to staff on the action they are to take to provide care and meet needs. The manager, head of care and senior care staff should record any discussion or consultation they may have with residents, relatives and representatives to show their involvement in decision-making. Most residents are not assessed as able to take responsibility for their own medication and this is administered by staff, following the policies and procedures of the home to ensure the safety of residents. Arrangements are in place to ensure that residents privacy and dignity are respected. EVIDENCE: A system of care planning was in place and reviews were noted. However, there was no record of the content of the reviews and often no analysis of whether the care plan was being effective. The manager, head of care and other staff obviously had good knowledge of residents and their needs but this was not always reflected in the records. The daily logs written by care staff were not detailed and entries did not relate to care plan goals. Discussion Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 10 between the Inspector and head of care looked at ways of improving the report writing skills of staff e.g. by a buddying system and by linking the entries to the agreed care plan goals. Medication administration records seen were satisfactory and indicated an efficient system to protect the residents. The list of people authorised to administer medication needs to be amended. Residents and relatives spoken with during the inspection felt that they were treated with respect. Observation during the visit by the inspector confirmed that residents were treated with sensitivity and dignity and their privacy respected. Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Residents are given opportunities for stimulation through a range of leisure and recreational activities both within and outside the home. Visitors are encouraged into the home and residents are enabled to maintain links with the local community. The manager is making progress in increasing the opportunities for residents to exercise personal autonomy and choice in a variety of areas, including the menus and the use of independent advocates. EVIDENCE: Visitors came into the home throughout the inspection and were made welcome. The record of activities showed a variety of events which had taken place and different interests which residents could follow e.g. trips out to local clubs and musical events, in-house entertainers, aromatherapy and reflexology sessions, bingo and sing-along, music and movement, film shows. A newly introduced activity for those with dementia was doll therapy. The new entertainments/activities officer was planning a varied programme for the rest of the year, including visits out and seaside trips as well as in-house entertainment and fetes e.g. for VE day. A mobile bar has been established in the home and residents have requested a karaoke machine. There is an amenity fund and one of the residents has been asked to be a chair of its committee. Staff had been involved in fund-raising exercises, amongst staff, Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 12 residents, relatives and visitors, and other future events were planned. Although this enthusiasm is to be commended, the registered persons must ensure that sufficient finance is available to fund the core tasks of the home and meet the standards. Age Concern were brought in to act as advocate for one resident. The manager has given able residents the code to enable them to leave their unit and move about the home more freely. The cook has drawn up a new menu offering a vegetarian dish as a daily alternative choice for all residents. Culturally appropriate foods, e.g. AfroCaribbean dishes, are also included. Residents said the food had improved. Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents and relatives spoken to were confident that their comments and complaints would be listened to and acted upon. EVIDENCE: Relatives are involved in regular meetings to review the care being offered and for discussion of general issues in the running of the home. There is a comments, suggestions and complaints policy and a procedure for dealing with complaints. The inspector discussed with the manager whether the timescales for dealing with complaints should be reviewed to give realistic targets, particularly for more complex issues e.g. 28 days instead of 7. The procedure also needed minor amendment to update the CSCI contact details. The record of complaints was completed satisfactorily with a note of the action taken. Everyday complaints should be recorded as well as more formal ones. Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25, 26 The home was clean, well maintained and accessible for people with physical disabilities. However, more needs to be done to offer a suitable physical environment for people with dementia. The proprietor has applied for a variation in conditions of registration to enable the ground floor unit to also care for people with dementia. Alterations to the building to address this will be required before this decision can be made. The home meets the minimum standards for the physical environment with sufficient sitting/dining rooms, bathrooms and lavatories, and adequate bedroom sizes and ensuite facilities to meet residents needs. The manager has identified issues arising from the design of the building such as the lack of windows in the staff room and the smallness of the office space. There is also inadequate ventilation for the kitchen and the corridors and two bedrooms. EVIDENCE: Although purpose built as a care home, the original design did not incorporate any of the recommendations regarding a suitable environment for people with dementia as set out in relevant good practice guidance. The manager is Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 15 planning to redecorate and is intending to include the use of colour schemes recommended to help orientate residents with dementia. The manager is hoping to introduce other appropriate ideas gained through her training course. In addition an occupational therapist has been contracted to do an assessment of the home. The laundry has been extended to allow more space for storage and staff to work. The head of care’s office has been reorganised to create a small but functional seating area with a telephone. Bedroom sizes meet current standards and are equipped with appropriate furnishings and fittings. There is one bathroom and shower room on each floor, and eight separate lavatories in addition to the en-suite facilities of a toilet and wash hand basin in each bedroom. Rails and other aids suitable for people with physical disability are available in the corridors, en suites and toilets in the home. The bathrooms contain specialist baths and the shower-rooms have drop down seats and rails. The lift is large enough to take a person in a wheelchair and their carer. En suites are of a reasonable size for people with frames or for carers to assist. All radiators are covered to protect residents from injury and hot water outlets have individual thermostatic controls, although temperatures were not checked during this inspection. The maintenance man carries out regular tests of hot water outlets and emergency lighting. The ventilation in the corridors on all floors, and in the staffroom, kitchen and laundry room is poor, which means that heat and unpleasant odours can linger. The manager is investigating magnetic noise-activated doorstops for the fire doors to help the flow of air through the home. The windows in two bedrooms have been permanently locked on the advice of the fire officer. Although extractor fans have been fitted, one of the occupants complained about this lack of ventilation. Provision of extractor fans in these rooms to bring fresh air in as well as out or air conditioning units should be considered. Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 30 The manager, head of care and activities organiser demonstrated their intention to provide a high quality of individualised care for people with dementia and progress is being made. Staffing levels will be need continual review and the knowledge and skills of care staff will continue to need to be updated to ensure that these aspirations and the assessed needs of residents can be met at all times. EVIDENCE: During the day, two members of care staff are on duty on each unit/floor plus a senior carer. At night there are three waking care workers on the middle floor and two on each of the others. In addition there is the activities organiser, trainees employed for part of the week and ancillary staff such as, cleaners, cooks and a handyman. Care staff generally work on the same unit to provide consistency of care. There is a comprehensive rota showing when staff are employed or are on training etc. The activities coordinator was concerned that sufficient staff would be not be available to facilitate all activities she was planning, due to the constant demands on staff time. The manager, however, was of the view that there were sufficient staff available to meet the needs of residents and that she would be able to increase staffing levels as necessary e.g. to allow for residents to be accompanied for outside activities. 2-week intensive training courses have been started for staff in a variety of topics, including Infection Control for all staff, Supervisory Management for the Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 17 head of care and senior carers, Health and Safety etc. 12 members of staff are released for each course, which is organised by a training consultancy and counts towards NVQ qualifications for care staff. Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 36 The management of the home is efficient, organised and effectively facilitates the smooth operation of the service. Further general development is required in relation to recording assessments and care planning however. (See above comments on standards 3, 4 and 7.) Presently records do not always demonstrate how practice is informed, supported or evidenced in an acceptable manner. The new structure for supervising staff requires more work to be fully and effectively implemented. EVIDENCE: The manager has a City and Guilds certificate in the Advanced Management of Care and 6 years experience as a homes manager. She has almost completed a one-year diploma course in Dementia Care offered by the Alzheimers Society and Stirling University. She is due to complete the NVQ level 4 in care and management later in the year in order to meet standard 31. The manager has been implementing ideas from the dementia course, which is helping her to improve practice within the home, and the type of care offered to the Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 19 residents. She has been working with the Head of Care to encourage innovation and development, which has had positive effects and has led to an infusion of enthusiasm within the home. Seniors and care staff have had training in the new system of staff supervision. Staff supervision sessions were noted as taking place but no records kept of the content. Discussion took place with the manager, suggesting that staff should have named supervisors, that supervision contracts should be drawn up, according to the needs of the staff member, defining the length and frequency of supervision sessions and the areas to be included. The sessions should be minuted and a signed copy given to the supervisee and kept by the supervisor for the staff records. The dates should be planned ahead and both supervisor and supervisee should be able to set the agenda items. Annual appraisal forms had been sent out. Residents and relatives meetings are held periodically to get feedback on the day-to-day running of the home, with the last one held in January 2005. Families are also invited in for review of the care of their relative. Visits are being made on behalf of the proprietor by a senior manager within the Carebase Ltd organisation, as part of the quality assurance and monitoring system. Meetings of the managers of all homes take place periodically. Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 x 3 3 2 2 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x 2 3 x x x 2 x x Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 21 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 3, 4 Regulation 14 Requirement Timescale for action 1 May 2005 and ongoing 2. 7 15 The manager must: - ensure, in consultation with the service user and their representative, that the needs of residents are fully assessed prior to admission, recorded and regularly reviewed. - confirm in writing to the service user that the home is suitable to meet their needs. The assessment should include all of the information listed in standard 3.3. Written care plan to be 1 June generated from a comprehensive 2005 assessment and drawn up with each service user to provide the basis of the care to be delivered. The plans must be in sufficient detail to provide clear guidance to staff on the actions to be taken to ensure that all aspects of the health, personal and social care needs of the service user are met. The plan to be reviewed regularly, at least once a month, and updated to reflect changing needs and current objectives for health and personal care. The care plan to be agreed and signed by the service user, G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Aston Grange Page 22 whenever capable, and/or their representative. 3. 4. 16 22 The complaints policy and procedure to be amended to include timescales for dealing with more complex complaints and to update the CSCI contact details. All complaints to be recorded. The home to be decorated and organised to provide an environment suitable to meet the needs of people with dementia, as recommended in good practice guidance. The manager and proprietor to maximise facilities to ensure that there is sufficient ventilation in bedrooms and communal spaces. The manager to complete her NVQ 4 qualification in management and care. A schedule of planned supervision to be implemented for all staff - to start as part of the induction process, through the probationary period and then establish a regular pattern of supervision at least six times a year. A supervision contract to form part of the supervision procedure, defining the length and frequency of sessions and the areas to be included. Staff to have named a supervisor, be able to add items to the agenda, the sessions to be minuted and a signed copy given to the supervisee and kept by the supervisor for the staff records. (Previous timescale of 1/11/2004 not fully met) 1 July 2005 5. 19 23 1 October 2005 6. 25, 26 23, 13 1 June 2005 7. 8. 9. 31 36 10 18 1 December 2005 1 July 2005 Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 23 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 9 Good Practice Recommendations The list of people authorised to administer medication to include a sample of the signature, consisting of at least two initials, used by the people on the MAR charts and note the date that people are authorised and ceased to be authorised. (Previous timescale of 01/10/04 mostly met) Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection Gredley House 1-11 Broadway London E15 4BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Aston Grange G56 G06 S7241 Aston Grange V225291 150405 Stage 4.doc Version 1.20 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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