CARE HOMES FOR OLDER PEOPLE
Birkdale Park 6 Lulworth Road Southport Merseyside PR8 2AT Lead Inspector
Claire Lee Unannounced 9 August 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. Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Birkdale Park Address 6 Lulworth Road Southport Merseyside PR8 2AT 01704 566055 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) Mrs Carol Patricia Cunningham Mrs Diane Furnivall Care Home 25 Category(ies) of OP Old age 25 registration, with number of places Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 25 OP Old age Date of last inspection 9th February 2005 Brief Description of the Service: Birkdale Park provides nursing care for 25 older people. It is owned by Mrs C Cunningham and is managed by Mrs D Furnival.The home has been converted from a large house to a care home and is situated in a residential area of Southport. It is on the main bus route to town and is close to Birkdale village. Recreational areas comprise of a lounge to the front of the building and a conservatory overlooking the garden. This room is also used as a dining roon. The home has single and double bedrooms but all rooms are currently used to provide single accommodation. There is lift access to both floors and the mezzanine level (floor not serviced by a lift) has 2 bedrooms. These bedrooms are accessed by a short flight of stairs. The home has 2 bathrooms with adapted baths to assist those who are less independent and a call system with an alarm facility. Gardens are landscaped to the front and rear, the rear garden is spacious and enclosed. The home has ample car parking space and a minibus is available for hospital appointments and trips out. Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 2 days for duration of 9 hours. It was an unannounced visit and conducted as part of the regulatory requirement for care homes to be inspected at least twice a year. A visit was undertaken in June 2005 in response to an anonymous complaint and an action plan is being provided by the home. A partial tour of the building was conducted. A selection of care, staff and nursing home records were viewed. Discussion took place with the deputy manager, staff and 4 of the 19 residents and their views obtained of the home. There were no visitors at the time of the inspection. Satisfaction comment cards were also given to residents and relatives to complete at their leisure. What the service does well: What has improved since the last inspection?
Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 6 Residents have been approached regarding activities they would like and staff keep a daily record of events. Resident spoken with were happy with social arrangements in the home and especially enjoy chatting with staff. Hot water outlets to bathrooms are fixed with pre set valves to ensure water temperatures are delivered to a safe temperature. What they could do better:
The home has a service user guide however this must include more detailed description of the home’s facilities to include the rooms that are accessed by stairs on the mezzanine level. This remains an outstanding requirement from the previous inspection (timescale of 30.6.04 not met) A number of residents have not been provided with a contract stating terms and conditions of residency. The fee structure is also to be clearly stated to ensure residents are fully aware of who is responsible for payment. This remains an outstanding requirement from the previous inspection (timescale of 30.6.05 not met). Residents’ care and general health needs must be assessed in full prior to admission to ensure staff can provide the necessary care. With regards to care planning there is at present little written evidence that residents are involved with the drawing up of their plan of care. The ‘summary’ care plan sheet which records the main care issues could be given to the resident and/or their relative so that it is clear that it has been discussed with them. The involvement of the resident in this process must be developed further as this remains an outstanding requirement from the previous inspection (timescale of 30.6.05 not met). Medication is administered according to the home’s policy procedure however the temperature of the drug fridge must be recoded daily to ensure drugs are stored at the correct temperature. The home has 2 bathrooms with bath aids to assist those who are less independent. Staff interviewed confirmed that there is difficulty bathing some highly dependant service users because of difficulty getting the transportable hoist in the bathrooms. The home has a shower room on the first floor however this is not in use. Availability of a shower would provide necessary choice and provide a better ratio of bathing facilities for residents. The shower room must be included in the home’s refurbishment plans. This remains an outstanding requirement from the previous inspection (timescale of 30.6.05 not met). Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 7 3 staff files were viewed with regards to recruitment procedures. The members of staff had not received clearance from the Protection of Vulnerable Adults (POVA) register, which is a requirement prior to employment in order to protect residents from known abusers (timescale of 17.3.05 not met). New staff must be supervised until the Criminal Record Bureau check is received. 2 references must be also be obtained prior to appointing a member of staff. There was some evidence of staff attending an external training induction day however some new staff had not received any formal induction. This must be carried out for all new staff within 6 weeks of employment. Staff are mentored when they start working in the home however there was no written evidence to support this. Induction records must be maintained. 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. Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 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 Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 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 and 3 Prospective residents had limited information to make a choice whether the home was suitable for them. Not all residents had been provided with terms and conditions of residency with a full breakdown of the fee structure. Admission procedures must include a proper assessment for people moving in to the home. Without this there is no assurance that care needs will be met. EVIDENCE: The home has a service user guide and this is displayed in the main hall. The deputy manager confirmed that the information had not been updated following the last inspection to include a more thorough description of the home’s facilities. The 2 bedrooms on the mezzanine level must be included with reference to the fact that these rooms are for residents who are able to manage the 3-4 stairs leading to the first floor. There is no lift access on this level. A number of residents still require a contract stating terms and conditions of residency. Contracts seen stated an overall fee and this is to be broken down to ensure residents are fully aware of the fee structure and who is responsible for payment.
Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 10 A prospective resident’s family member was visiting at the time of the inspection and was viewing an empty room. They were pleased with the friendly atmosphere in the home and the information given by the nurse in charge. They were also able to review the information available in the main hall. Assessment information was seen for 2 residents who had recently arrived transferred from another home. This information had been obtained with the assistance of the home’s staff. An assessment had not however been completed for a resident who was admitted from his own home. Although staff knew this gentleman very well a full assessment must be undertaken to ensure care and general health needs are understood and can be met by staff. Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 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 and 10 Health, personal and social care needs of residents were set out in an individual plan of care however there was little evidence to show the resident’s and/or relative involvement with this process. This shortfall has the potential for care needs not to be identified. Medicines were administered according to the home’s policy however drug fridge temperatures were not recorded. This has the potential to put residents at risk. Attention paid to aspects of privacy and dignity was well managed by staff ensuring that residents feel respected. EVIDENCE: All residents have an individual plan of care that is clear, organised and easily read. A photograph is required for residents for verification purposes. This could be placed in their respective care or medicine file. Care plans identify key areas including, skin, nutrition, pressure areas, mobility, personal hygiene, risk management, mental state and family background. The care plans are standardised and information had been added to record individual needs. All care documentation was subject to regular review however agreement and consent from the resident and/or their relative to the care plan process had not been obtained. Each resident has a care plan
Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 12 summary, which gives an overview of the care provided. This information could be given to the resident. Supporting care documentation includes a waterlow score (an assessment tool for assessing pressure relief) and manual handling instruction. Risk assessments identify where a resident is at risk of falling and also where a fire door being kept open. Residents interviewed confirmed they could see their GP when they want and these visits along with other health professional appointments were recorded in detail. Wound care was being implemented and a file viewed recorded the treatment and progress of the affected site. A resident interviewed stated that she was pleased with the care she is receiving and that it is delivered by “very polite staff.” Care staff are involved with the key worker role (extra responsibility are assigned to senior care staff) though this was being reviewed due to a change over of staff and residents. Key worker records had not therefore been completed recently. A number of resident drug sheets were viewed and these evidenced staff signatures following administration. Residents are able to self medicate if they so wish however no one had requested to do so. Consideration should be given to auditing the drugs as many are overstocked. Controlled drugs not in use should be returned to the home’s pharmacist. A drug fridge is located in the office and the home must ensure the temperature of the fridge is checked and recorded daily to ensure medicines are stored correctly. Residents receiving the drug, Digoxin, should have their pulse checked and recorded prior to administration. Staff were seen knocking on bedroom doors before entering and spending time and assisting residents in an unhurried manner. A resident said, “the girls are great and have time for a good chat.” Residents were seen smartly dressed and enjoying having their hair done by the hairdresser. Although no visitors were seen at the time of the inspection a resident stated that she was able to see her family any time. Discussion with staff confirmed the importance of respecting residents’ privacy and dignity and that this formed an integral part of their care. Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 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 and 15 Daily life, activities and routine were based around what residents would like. The home had a friendly relaxed atmosphere with daily variation and interest for people using the service. The menu for the home is varied and residents receive wholesome well-balanced meals. EVIDENCE: The daily routine was seen to be relaxed and residents interviewed stated that they are able to have a bath during the morning or afternoon and go to bed at a time to suit them. Staff were observed spending good amounts of time with the residents and also encouraging them to be as independent as their condition allowed. This was observed in relation to assistance with walking and lunch. A number of residents stated that they were pleased with the home’s social side and enjoying watching TV and videos. The home does not have a formal entertainment programme however the manager records preferred interests and care staff record daily events. Consideration should be given to introducing outside entrainment, for example, a musician or PAT A PET. Some residents have fairly high dependency levels and are therefore are not able to go out however now the warmer weather is here they may well enjoy a local trip either in a wheelchair or the home’s minibus.
Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 14 The cook provides a good choice of hot and cold meals. The main meal of the day is served at lunchtime and there is always an alternative on offer. The kitchen was tidy and clean and the home had a good supply of fresh produce. A resident said, “the food is very pleasant and always served on time.” Another reported, “I like my food served very hot and the manager has arranged this for me with my written consent.” Fridge, freezer and hot food temperatures had been recorded for the week however it is recommended they are also checked over the weekend. Special diets are catered for and birthdays celebrated. A number of residents receive their meals in the conservatory however this room does become hot during the warm weather. If a resident wishes to have their meal in their own room then this is respected. Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 15 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 Complaints are handled fairly and promptly. Residents were confident that if they needed to make a complaint this would be listened to and acted upon. EVIDENCE: The home has a complaint procedure and discussion with residents confirmed that the manager was prompt to address any issues. They also stated that the manager was prepared to listen and offer advice and support. The Commission received an anonymous complaint in June 2005 and the home is responding with an action plan. Staff interviewed were aware of the correct procedure to be followed should a complaint arise. Complaints are logged however it is recommended that the complaint record should include more details of the investigation and outcome. Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 16 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 and 26 Residents live in pleasant, clean well-maintained home however the home only has 2 bathrooms. Another bathing facility would provide a better ratio for the residents. EVIDENCE: The home is subject to a full maintenance programme and residents interviewed were pleased with the general up keep. Emergency lighting is present throughout and subject to a full service and regular maintenance checks. Areas viewed were generally clean, bright and pleasantly decorated. Room 3 should however be painted as the paintwork is becoming chipped and the lounge carpet cleaned as this was marked with some food spillages. Residents have use of a lounge with attractive old wooden panelling and a large conservatory on the ground floor. The conservatory is used as a dining room however this room does become very hot during the warm weather (as evidenced during the inspection and through talking with staff) and blinds should be placed at the windows to lower the temperature. The home has 2
Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 17 bathrooms for up to 23 residents, one on the first and one on the second floor. Staff confirmed that there are difficulties bathing some highly dependant residents when moving the transportable hoist in these rooms. There is a shower room on the first floor however this remains not in use. The availability of this shower would provide necessary choice and increase the ratio of bathing facilities for the residents. The shower room must be included in the home’s refurbishment plans. Safety valves have been fitted to hot water outlets and staff record the temperature of the hot water to the ground floor bathroom. It is recommended this check be also undertaken to the hot water of the first floor bathroom to ensure it is delivered at a safe temperature. The rear garden is enclosed and residents were sitting out enjoying the sunshine. There is also a small attractive inner courtyard and ample car parking to the side of the premises. The laundry room is well equipped and the laundry assistant confirmed that the home has a good supply of gloves and aprons. Residents interviewed reported that personal clothing was laundered each day and returned promptly. Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 27,29 and 30 Satisfactory numbers of staff were on duty to meet the needs of the residents. Some new staff had not received an induction to ensure competency in their role, this has the potential to put residents at risk. The procedures for the recruitment of staff are not robust and do not provide the safeguards to offer protection to people living in the home. EVIDENCE: 19 residents were residing at the home and the staffing rota evidenced the numbers of staff on duty each day for August. These were satisfactory and on the day of the inspection an agency carer was employed to ensure correct numbers. Residents interviewed stated that the home does use agency staff to cover shortfalls however the home do their best to ensure the same agency nurse returns thus providing continuity of care. A registered nurse is in charge of each shift with 4 care staff during the day and 2 care staff at night. The senior cook is employed from 9 - 1.30pm Monday to Friday and the weekend cook finishes earlier at 1pm. Laundry cover had been arranged for the day however the permanent position of laundry assistant remains vacant and care staff assist with these duties. This post is being advertised and it is recommended it be filled as soon as possible. Housekeeping is 5 hours each day and the maintenance man works 32 hours each week. Residents were generally pleased with the care they receive however one resident raised some concerns and these were passed to the deputy for her attention. A resident said, “the girls are very friendly and it is nice to have the same people to care for us.”
Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 19 Recruitment practice was seen to be poor. 3 new staff files were viewed and they did not evidence the necessary police checks with regard to clearance from the Protection of Vulnerable Adults (POVA) register. This is a requirement prior to employment in order to protect residents from known abusers and was brought to the deputy manager’s attention. Once POVA clearance is received, staff must then be supervised until a satisfactory Criminal Record Bureau (CRB) check at enhanced level is obtained. 2 staff files only evidenced 1 written reference, 2 are required prior to appointment. Staff have training records and these evidenced details and dates of courses attended. A staff member interviewed reported that training had been given in safe working practice areas including manual handling, first aid, food hygiene and health and safety. The home offers a rolling programme for these courses. With regards to induction for new staff this must be given within 6 weeks of appointment. A member of staff attended an external induction training day however this was not the case for all new staff. The deputy manager confirmed that a number of staff had not commenced any formal induction programme and induction records were found to be incomplete. A new member of staff requires a manual handling update as part of her induction. Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 38 Safety certificates for equipment and services to the home were in date Staff receive fire prevention instruction and are therefore aware of fire safety issues. EVIDENCE: Inspection of records confirmed that the home employs suitably qualified engineers to maintain the home. Some certificates were due for renewal this month however these are covered by an annual contact. The home has fire prevention equipment serviced annually and staff receive fire prevention training. This was confirmed when viewing records and talking with staff. Some fire doors are wedged open and the manager had completed risk assessments for this action. Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 21 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 2 2 2 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 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 3 2 x x x x 3 STAFFING Standard No Score 27 3 28 x 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 x x x x x x x x 3 Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 22 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 1 Regulation 5 Requirement The servive user guide must include details of the homes facilities including mezzanine level (timescale of 30.6.05 not met) Residents must be issued with terms and condtions fo residency with a full breakdown of the fees (timescale of 30.6.05 not met) Residents needs must be assessed prior to admission Residents and/ or relative are to be fully involved with the care plan process (timescale of 30.6.05 not met) Residents require a photograph for verification purposes The temperature of the drug fridge must be checked and recorded daily The shower room must be made functional (timescale of 30.6.05 not met) All staff must recive a POVA first check and clearence prior to commencing employment (timescale of 17.3.05 not met). 2 references must be obtained prior to appointing a member of staff New staff must have an
F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Timescale for action 30.9.05 2. 2 5 30.9.05 3. 4. 3 7 14 15 30.9.05 30.10.05 5. 6. 7. 9 21 29 13 23 19 ongoing 30.11.05 ongoing 8. 30 18 30.9.05
Page 23 Birkdale Park Version 1.30 induction within 6 weeks of employment. Induction records must be maintained 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 An audit of the medicines should be conducted as many medicines are over stocked. Controlled medication not in use should be returned to the homes pharmacy. Residents receiving the drug, Digoxin, should have their pule checked and recorded prior to administsration To record fridge, feezer and hot food temperatures on the weekend To record in more detail any complaint received including the outcome of the investigation To provide blinds for the windows in the conservatory. To paint Room 3 and clean the lounge carpet To record the temperature of the hot water to the bath on the fist floor To employ a laundry assistant 2. 3. 4. 5. 6. 15 16 19 21 27 Birkdale Park F53 F03 S17226 Birkdale Park V226619 090805 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Burlington House, South Wing 2nd Floor, Crosby Road North Waterloo Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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