CARE HOMES FOR OLDER PEOPLE
Barkat 254 Alcester Road Moseley Birmingham B13 8EY Lead Inspector
Jill Brown Announced 5 July 2005
th 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. Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Barkat Address 254 Alcester Road Moseley Birmingham B13 8EY 0121 449 0584 0121 449 2726 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) Ms Seemia Butt Ms Seemia Butt Care Home 25 Category(ies) of Care Home registration, with number of places Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. That the home can accommodate up to three people under 65 years of age for reasons of mental disorder. 2. All of the senior staff undertake a course in the management of challenging behaviour by January 2005. Date of last inspection 19/01/05 Brief Description of the Service: Barkat House is a large detached property situated on the main Alcester Road in Moseley. It is within easy walking distance of the main shopping area of Moseley where shops, restaurants, public houses and churches can be found and a larger shopping area can be found by walking to Kings Heath. The home enjoys easy access to public transport routes leading to the city centre and beyond. Barkat House offers accommodation to 25 older people in single rooms on the ground and first floor. There is a passenger lift between the ground and first floor. Communal areas are located on the ground floor. There is a large lounge to the front of the house, a smaller lounge to the rear. Residents that smoke use the small lounge. The home has a separate dining room. The home has communal toilets and either an assisted bathing or a shower facility based on both floors. The ground floor also houses the kitchen, office, laundry and large storage area. The home has a dedicated garden for the use of service users. The home has a small amount of parking at the front of the building. Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Two inspectors undertook an announced inspection in July. Afterwards the pharmacist inspector called to inspect the drug administration. The report outlines the findings of these two visits. Five of the home’s residents were spoken to at this inspection two with interpreters. Three staff were spoken to. Care records were viewed for four residents and three staff records were inspected. The inspectors joined residents for the main meal. A full tour of the building was completed. The home has almost completed alterations to the property and some requirements were made about the new areas in use. A site visit will be undertaken to look at the registration of two new bedrooms. Fourteen comment cards were received; nine comment cards from residents, two from relatives, and three from professionals. What the service does well:
Residents have information about the home prior to admission and information for residents to keep was seen in a number of residents’ bedrooms. The homes assessment of residents prior to admission to the home was clear and identified risks. The home made an effort to ensure that care was provided in the way residents wanted by asking them. Details of their responses were seen in some care plans. Plans to manage risks to individual residents were good. Residents spoken to thought that the staff did a good job and were kind. The home takes residents from Asian, African Caribbean, white Irish as well as white British people and tries to ensure that their religious and cultural needs are met. They provide a traditional British meal and a Halal meal daily. The home was working with a project group from a university to assist some residents’ mobility by the use of physiotherapy. The majority of staff have had training in challenging behaviour Medicine management within the home is to a high standard.
Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 6 Residents spoken to said the food was good one comment card from a resident said ‘fine food fine beverages.’ Complaints and adult protection issues are managed well, with the home seeking appropriate advice when needed. What has improved since the last inspection? What they could do better:
The home must be careful that all new admissions fall within their category of registration. Where there is some doubt the person must not be admitted and clarification sought. If the person to be admitted is out of the home’s categories of registration then an application for variation must be completed before admission. Care plans were improving but some were not detailed enough to guarantee the care of the resident. A number of residents’ rooms had instructions to staff displayed and this failed to respect residents privacy and dignity and did not ensure rooms were homely.
Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 7 Some residents were able to arrange their own activities, others would join group activities but work was needed with residents that could not join in. Records needed to be kept of individual time spent with these residents. Staff did not always sit next to the resident whilst assisting to eat and this could result in residents feeling rushed. The new en suites had yet to have a call alarm fitted and grab rails and these were in use. An extra grab rail was needed in some of the communal toilets to ensure there was one either side of the toilet pan. Some improvements were needed for the storage of aids when not in use. Decoration, odour management and maintenance needed to be improved in a number of residents’ bedrooms. One resident’s room needed reorganisation to deliver care safely. The home’s rota did not demonstrate the appropriate level of senior cover at the weekends. Staffing levels will need to be reassessed when any new bedrooms are registered. Training was being undertaken, but a chart showing what staff had done was not available. Staff training was not currently meeting the required level. The home does not have a quality assurance system and this does not ensure that improvements are maintained. A number of requirements were made By the Food Safety Department and not all of these had been undertaken. Inspectors made requirements about the storage of food and access to cleaning equipment. An audit was required of the fire doors and the self-closing arms on doors as a number of these were not adequately closing. 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. Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5 The home collects sufficient and appropriate information so residents’ needs can be met. The home managed the cultural and religious needs of residents well. EVIDENCE: The home has provided the Commission with their statement of purpose and service user guides for the home. The home was reminded that these must be reviewed and updated on completion of the end of the building work and subsequent site visit. Service user Guides were seen in some resident’s bedrooms. Contracts were found on residents’ files and these contained the terms and conditions for their stay and stated the room that the resident was to occupy. Information from assessing social workers varied in the amount of detail prior to admission. The home however undertook its own assessment of need and identified risks appropriately. The inspectors noted that the home asked residents on admission what made a good day and what made a bad day for them. Some parts of the assessment of what made a good day could be seen
Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 10 in the care plans and this is commended. These parts of the assessment were also found in the day-to-day records of residents and staff were able to see them prior to delivering care. One risk assessment on a residents alcohol use identified all potential risks including aggression and taking medication. Strategies were identified for dealing with these issues. The home has residents from both African Caribbean and Asian cultures as well as white English and white Irish. The home has a multi cultural staff group. The residents that cannot speak English have at least one member of staff that converse in their first language. Arrangements are made for the religious needs of residents to be met with visiting churches, prayer mats and so on. The home has a main meal menu that offers a choice between traditionally English and Halal options. The home has several residents with challenging behaviour. Senior staff and several of the care staff have undertaken a course on the management of challenging behaviour. The home had taken one resident whose diagnosis does not fall within their conditions of registration although the resident and staff were happy about the management of his care. The home must ensure that all residents meet their conditions of registration. Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 The arrangements for care planning whilst improved were variable and therefore the home could fail to meet all residents’ needs. The home has installed good practices in medicine management and the staff were keen to improve practices further to ensure resident’s medication needs are met. Improvements were needed to ensure the privacy and dignity of the residents are fully respected and protected. EVIDENCE: Care plans although continuing to improve were variable some were very specific others were not. One care plan had information on what to do when a resident’s specified need fluctuated. Another had a clear short-term care plan for an illness. However others did not give clear instructions to staff. Concerns about residents care could be clearly tracked through records and there was evidence of short-term care plans when residents were ill. Residents were routinely weighed and food monitored where concerns were identified. Residents saw health professionals where their conditions warranted. The
Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 12 home was working with the research project for certain residents concerning whether physiotherapy could help certain conditions. Residents spoken to thought the staff did a good job. All the audits undertaken were correct demonstrating that medicines were administered as prescribed. The home does not see the prescription prior to dispensing but photocopy the repeat slip for reference. Residents are encouraged to self administer their own medicines and regularly risk assessed and routine compliance checks are undertaken to confirm compliance. Staff interviewed were keen to improve practice further and this was commended. Care plans were put on some bedroom walls and in some bedrooms furniture was labelled with where clothes go and this is not in keeping with maintaining the dignity of residents. Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Arrangements for activities and eating did not meet the needs of all of the residents in the home. Meeting relatives and individual choice were being met and these enhance residents’ lives. EVIDENCE: A number of residents at the home attend activities at either a day centre or go out to local facilities. Some group activities that have been tried recently have not been successful. Residents do not have individualised activity plans and records are not kept of staff time with individual residents. The two relative cards received suggested that there were no difficulties in visiting their family member. One card said that they were happy with the care their relative received. Residents at the home did not have a large amount of personal possessions but those they had were displayed in their rooms. Residents generally had a choice of when they wished to get up and go to bed. Two resident comment cards said that the food was good; one said ‘fine food and fine beverages.’ Residents spoken to said that the food was good. The inspectors joined residents for a meal and found both options were well cooked. Residents where needed were assisted to eat however the staff assisting did not sit down next to the resident to assist and this could result in residents feeling rushed or not being fully considered.
Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 14 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, & 18 The home has a satisfactory complaints and adult protection procedure that has worked well when needed and protects residents. EVIDENCE: The home had received no complaints since the last inspection and the Commission equally had received no complaints. The home logs complaints appropriately. The home has used the adult protection procedures since the last inspection. They notified all appropriate agencies and managed the situation well. The home has yet to ensure that all staff have the appropriate adult protection training. Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 15 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) 19,20,21,22,24, & 26 Whilst improvements were being made, the standard of the décor and maintenance was variable with some areas failing to provide a suitable and comfortable environment. A number of facilities in the home did not have all the required adaptations to maintain the safety of residents. EVIDENCE: The home had extended the accommodation provided to residents. This has included two extra bedrooms, improving the laundry facilities, storage facilities and making 4 existing bedrooms into en suite rooms. At the time of this inspection many of these areas needed to be completed and some outstanding maintenance work in other areas of the home was still required. The toilet areas in the en suites, which are in use must have appropriate aids for the residents of those rooms, hot water restrictors and the call alarm
Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 16 system must be extended to these en suites. Communal toileting facilities did not have grab rails at both sides of the toilet to assist residents. The main lounge and the smokers’ lounge had been decorated since the last inspection and these appeared much brighter. A hoist and wheelchairs were being stored in the main lounge and these prevented the homely appearance that the home was hoping to achieve. A number of carpets in the home had been replaced. The home had aids for residents as they were needed, and there was a range of walking aids for residents. The home was generally clean tidy and fresh. Some individual bedrooms had an odour, the home were aware of this and were looking to change the floor covering in these rooms. Décor in several bedrooms needed to be improved and there were some maintenance issues such as repairs to radiator covers and a hole in the wall. One resident’s room needed rearranging to ensure safe care for the resident. Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 17 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) 27,28,29 & 30 Arrangements for the recruitment of staff were not robust enough to protect residents of the home. Staffing levels were adequate but managerial cover at weekends was variable and this could put residents at potential risk. EVIDENCE: The home has the appropriate number of staff on duty but management and on call staff must be shown on the rota especially at weekends. The homes staffing arrangements must be reviewed in line with any increased registration for numbers. It was noted at this inspection that many of the care staff first language is not English and the home have a duty to ensure that this does not impact on the care of the residents and must be mindful of this when drawing up the rota. The pre inspection questionnaire showed that the 29 of staff had achieved an NVQ2 in care this must be improved to meet the target of 50 of qualified by the end of 2005. The home continues to improve its records on staff recruitment, proof of identity, visas and CRB checks. However there are still gaps and staff are still being taken on without the CRB being in place and without consultations with the Commission. New staff were found to have induction with a more senior member of staff and records of this were kept. Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 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) 33, 35, 36, 37 & 38 Improvements had been made in the home since the last inspection. Responses to requirements made by agencies, on a number of occasions, were slow and this could put residents at risk. EVIDENCE: The home did not have a quality assurance system and this affected the home’s ability to monitor its performance and make improvements. The home had records of residents’ money. They had different systems of managing money in accordance with resident’s needs. The home was finding some difficulty in assisting residents open a personal bank account and the Commission is discussing with the home ways in which this can be managed. Staff were having regular two monthly supervision and this ensured that their development and support needs could be met.
Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 19 Records were found to be well kept although it was noted one had been altered with Tippex and this is not allowed. The home kept good fire records and had good information on the outcome of fire drills. The emergency lights were not separately signed for and this must be undertaken. A number of fire doors were not closing properly against the rebate, some bedroom doors self-closures needed to be adjusted so as not to knock residents over. Lifting equipment was maintained and inspected appropriately. Water quality was tested. A five-year wiring certificate was in place. The Landlords Gas Certificate had some outstanding work required and this must be attended to. The home had small electrical equipment checked for safety. The home has had an inspection from the food safety department and some requirements were still outstanding. A number of these requirements were awaiting the completion of the laundry. However the following from the food safety inspection must be attended to ensure safe food hygiene: The home must undertake the food risk assessment (HACEP) The pest controlling light must be re-sited, and additionally, cleaning staff must not walk through the kitchen to gain supplies without changing their aprons, and gloves and cleaning equipment must be stored separately to food. A chest freezer must have replacement seals and be defrosted Frozen meat must be bagged, sealed and dated, and fresh meat from the Halal butcher must have the date it was frozen on. Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 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. 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 3 3 3 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 2 3 2 2 x 2 x 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 1 x 3 3 2 2 Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 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 op4 Regulation Care Standards Act 2000 s24 Requirement All potential residents must meet the homes conditions of registration or a variation sought. Timescale for action 31/08/05 2. 3. op7 op10 15(1) 12(4)(a) One resident identified must be subject of an application to vary the homes registration. Care plans must in all cases give 05/09/05* clear instructions to staff as to how care is be given. Care plans must not be displayed 15/08/05 on bedroom walls. Labels on wardrobes and chest of drawers must be removed. The home must develop an activities programme for service users of the home and keep a record. (this requirement remains outstanding 31/05/05 Records must be kept of individual time spent with residents unable to join activities. feeding of residents must be undertaken in an unhurried manner. The Registered Manager must 4. op12 16(2)(n) 31/08/05 5. 6.
Barkat op15 op18 12(1)(a) 13(6) 31/07/05 30/09/05
Page 22 E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 7. op19 23(2)(b) ensure that staff have the relevant training in adult protection. (this requirement remains outstanding since 30/04/05) The Registered Manager must 30/09/05 ensure that water damage evident in some areas is repaired (this requirement remains outstanding 30/04/05) A radiator cover must be repaired and a check made on others. All toilets must have the provision of two grab rails. All en suites must have access to a call alarm and have grab rails fitted. 31/08/05 05/09/05 30/09/05 8. 9. op21 op24 23(2)(n) 23(2)(n), 16(2)(c) 23(2)(d) 10. 11. op26 op27 13(3) 18(1)(a) The Registered Manager must ensure that an audit of each bedroom against the standard is undertaken and ensure that the service users have access to all the required furnishings unless their risk assessment proves that this would be unsafe for service users. In this case this must be recorded in their care plan and subject to review. The home must continue to refurbish bedroom areas to bring up to standard. (this requirement was oustanding since 01/07/04 ) The home must take steps to 30/09/05 improve the odour in a number of bedrooms A senior member of staff must 15/08/05 be on duty during waking hours including weekends. The rota must take into the full needs of the residents. 12.
Barkat op28 18(1)(c) (i) The home must have a plan to achieve 50 qualified NVQ2 31/08/05
Page 23 E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 staff by December 2005 13. op29 19(4) All new staff must have a CRB check any variation in this must be discussed with the inspector. (this requirement was outstanding since 28/02/05) and All existing staff must have a relevant CRB. 14. op30 19 schedule 2 (4) 18(1)(c) The Registered Manager must ensure that staff files: Have copies of the member of staff’s relevant qualifications. Demonstrate that staff have met the National Training Organisations targets. (This requirement remains outstanding since 01/07/04 ) The home must set up a method of quality assurance and this must be reflected in the homes business plan. (this requirement remains outstanding since 01/07/04 ) Tippex must not be used on records. Emergency lighting checks must recorded separately. Outstanding work outlined on the Landlords Gas Certificate must be undertaken. An audit and apppropriate remedial action must be undertaken on fire doors. Outstanding requirements from the Food Safety Department must be actioned. Frozen meat must be appropriately wrapped and dated.
Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc 06/07/05 31/07/05 31/08/05 15. op33 24(1)(2) (3) 30/09/05 16. 17. op37 op38 17(2) 23(4)(c) 31/08/05 06/07/05* 05/08/05* 31/07/05* 31/07/05 31/07/05 Version 1.30 Page 24 Seals on a freezer must be replaced. Cleaning staff must not walk through the kitchen. 31/07/05 31/07/05 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 op9 Good Practice Recommendations The medicine policy must include instructions as to what to do in the event of a drug administration error. The homely remedy policy must specifically name medicines the home wishes to purchase. Protocols for “when required” medicines must be written which include indication, dose, time interval between doses, maximum daily dose, appropriate recording and review date. The prescribing doctor must sign these. The home must see the actual prescriptions prior to dispensing to check the dispensed medication and Medicine Administration Record (MAR) chart for accuracy. 2. op22 It is recommended that the home houses the aids in a different area to the main lounge. Barkat E54 S16738 Barkat V230354 050705 AI - Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Birmingham and Solihull Local Office 1st Floor, Ladywood House 45/46 Stephenson Street Birmingham, B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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