Inspection on 16/05/06 for Blenheim Lodge

This inspection was carried out on 16th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Blenheim Lodge 01/07/08

Blenheim Lodge 28/01/08

Blenheim Lodge 10/10/05

Blenheim Lodge 23/05/05

Blenheim Lodge 02/02/05

Blenheim Lodge 01/06/04

Blenheim Lodge 01/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Blenheim Lodge North Road Minehead Somerset TA24 5QB Lead Inspector Judith Roper Key Unannounced Inspection 16th May 2006 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Blenheim Lodge Address North Road Minehead Somerset TA24 5QB Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01643 703588 WEST SOMERSET HOME (BLENHEIM LODGE) Limited MRS LINDA MARY VAUGHAN Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit one service user on respite care as detailed in a letter to Commission for Social Care Inspection dated 22nd October 2004 from Social Worker. 10th October 2005 Date of last inspection Brief Description of the Service: Blenheim Lodge is registered with the Commission for Social Care Inspection to provide personal care for up to 34 service users over the age of 65 years. A Board of Governors who serve voluntarily administer the home as a Charitable Trust. The Registered Manager is Mrs Linda Vaughan. Blenheim Lodge is situated close to the town and seafront in Minehead. Blenheim gardens are nearby and enjoyed by many service users residing at the home. Accommodation is provided over three floors. A passenger lift is available to the first floor and there is a stair lift to the second floor. The home has three assisted bathrooms and two shower rooms available for service users. A call bell system is provided and grab rails have been installed in communal hallways. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day between the hours of 09.45 am – 4pm. Thirty two service users were at the home on the day of the inspection. The ethnicities of the service users are white/British and all residents are over 65 years of age. The inspector was able to see and observe staff interactions with many resident, attend a resident’s meeting and talk on a one to one basis with several residents and some visiting relatives. The registered manager Mrs Vaughn and her deputy Mrs. Cooper were both on duty and assisted the inspector during the inspection visit. The inspector would like to thank the duty staff for their time and hospitality shown to the inspector during her visit. The atmosphere at the home was relaxed and informal. Staff carried out their duties in a friendly and professional manner. The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. The inspector has found that on this visit the overall quality of the service is good. Records examined during the inspection were two service user care and support plans, medication administration records, maintenance records, contracts, staff recruitment files, quality assurance processes and supervision records. On request the home completed a pre-inspection questionnaire and forwarded examples of current menus, staffing and rosters. The total time spent in planning the inspection, carrying out the visit, travel and consolidation of evidence and report writing has been 15 hours. As part of the inspection process the service user surveys were distributed to current residents at the home. Twenty eight have been returned to date, an excellent return rate. Comments about the service are vastly complimentary although several of the respondents were not sure if they had signed a contract with the home. This is something that the home management needs to consider; when contracts are maybe signed on behalf of service users by relatives or placement agencies that the service users still retains a copy of their contract. What the service does well: Blenheim Lodge provides a homely atmosphere. Service users are encouraged to participate in the running of the home. Service users are offered choices in many aspects of daily living. Service users commented on the approachability of managers and a range of activities offered. The home’s location was a Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 6 factor that influenced many service users to move into the home. Feedback from service user comment cards identified that service users feel safe at the home and that they feel well cared for. On the day of the inspection relatives commented that they are made to feel welcome at the home and that they are kept informed of important matters. There are good records of the health and safety checks that are conducted at the home. The Registered Manager audits all accidents at the home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 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 the following standard(s): 2, 3, 4, 5. Standard 6 is not applicable. The overall outcome for these assessed Standards is good. The Registered Manager ensures that the home conducts a detailed good assessment of need prior to any service users being admitted to the home. The pre-admission process is well documented and is fully explained to service users. There are good opportunities encouraged for pre-admission visits in order for service users to test drive the home. EVIDENCE: The manager stated that each service user has a written contract/statement of terms and conditions with the home. In service user survey responses, not all service users remembered receiving a contract. It is advised that the management consider this and if relatives/placement offices have signed contracts on behalf of residents, that the residents also receive a copy of this contract. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 9 Prior to any service user moving to the home a detailed pre-admission assessment is carried out using the SHARP care plan system. This is to ensure that the home can meet the physical, psychological or minority ethnic needs of prospective residents. Documented evidence of full assessment recording was seen during the inspection. The Registered Manager and or the Deputy Manager usually conduct the assessments. Service users, relatives and friends are always invited to visit the home prior to admission. This is encouraged over repeat visits. Several service users gave testimony to visiting the home on many occasions prior to admission on service user survey responses. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 7, 8, 9, 10. The overall outcome for these assessed Standards is good. The home operates the SHARP system for care planning. The home ensures that all care plans are current and are reviewed on a regular basis. Care planning is good. Service users have access to appropriate health care professions. The home has made improvements in relation to the adequate administration, recording and storage of medicines. Service users state that they are treated with respect and their privacy is upheld. EVIDENCE: The inspector assessed two care plans. Care plans were detailed including Waterlow skin integrity assessments, nutritional screening, moving and handling needs, medication needs, risk assessments and written preferences and social needs. The staff have received regular updates in the use of the SHARP system and meetings have been held with staff at all levels to ensure the care plans are maintained and amended when needed. Care plans are Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 11 reviewed monthly or sooner if needed. It was evident that some service users have been fully involved and consulted in the development as much as they wish including their wishes in relation to death and dying. Service users have access to local health care professionals although some service users commented that local surgeries seem to be more reluctant to conduct domiciliary visits that in the past. Service users also confirmed that if they request to see their GP, the home staff contact the surgery for them immediately. The service user survey forms received state that the staff respect privacy and always knock on bedroom doors before entering. The inspector witnessed staff addressing the service users in an appropriate and professional manner. The home operates the Monitored Dosage System for medication management. The inspector viewed the medication administration records (MAR) sheets and they were competed in good order. The inspector observed a medication round at lunchtime. The home has installed safes in each bedroom for the storage of individual medicines. Some staff received further training in the administration of medicines at Strode College in 2005. A discussion was held with the home management regarding further security of the medicine trolley during a medicine round. There are good risk assessments completed for residents who wish to administer their own medicines. Homely remedies are authorised by G.Ps. It is recommended that this be reviewed by the G.P annually in order to follow best practice guidance. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 12, 13, 14, 15. The overall outcome for these assessed Standards is good. The home has good methods for evaluating activities and leisure opportunities organised by the home. Relatives are welcomed and encouraged at the home. The home promotes choice and control over their lives for service users to promote good outcomes for well-being. The vast majority of service users enjoy the meals that are provided. The meals appeared to be wholesome and service users have good choice in the meals offered. EVIDENCE: The home currently has a vacancy for 10 hours per week for an activities worker. In the meantime, activities are organised by management and care staff. There was a resident’s meeting being held at the home on the day of the inspection. These are regular, minuted events and get good attendances. Residents spoken with after the meeting said that they find these meetings useful. The focus of this meeting was to discuss the current range and frequency of activities/outings at the home and to gain feedback on how to improve this or to put on social events that residents would like to attend. This was a lively meeting with all residents contributing. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 13 Four relatives spoke to the inspector and commented on the friendliness of the home. Residents said that their friends and family members are made welcome when visiting the home. The inspector was advised that the home does not handle the financial affairs of any of the service users. Their families are mainly responsible for this. The home displays information in relation to Advocacy. Service users are able to bring personal possessions to the home and have access to their personal records in accordance with the Data Protection Act 1998. The home displays the main meal of the day on the menu board in the main dining room. Some service users said that they are asked every morning if they would like the choice for lunch or would they prefer an alternative. The home also consults with service users each afternoon as to what they would like for evening meal. The home received a routine environmental health (EHO) inspection in April 2006 and a return visit on the 15th May 2006. Some recommendations were made to the home on the April visit and where practicable, these have been acted upon. The home already has plans to upgrade the kitchen generally. Service user surveys indicted that the vast majority of service users were happy with the food at the home. The dining room at the home is nicely presented with napkins and condiments placed on the table. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 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 the following standard(s): 16, 18. The overall outcome for these assessed Standards is good. Service user feedback was that the staff and management are approachable if they had a concern or complaint. There is a healthy and good attitude in the home toward resident’s expressing their viewpoints, whether positive or negative in order for the service to continue to meet the needs of residents. The home has robust process to ensure that service users are protected. The home has a Complaint Procedure, Whistle lowing Policy and an Abuse Policy. EVIDENCE: The home’s complaints procedure is displayed in the home. Some services users stated that they feel that they are able to make comments about the service that they receive and would make a complaint if they felt it was needed. The service user surveys indicated that a vast majority of service users knew who to speak to if they were unhappy with their care. There have been no complaints received since the last inspection in October 2005. The home also has a Safeguarding of Vulnerable Adults Policy. Staff spoken to were aware of the home’s Whistle Blowing policy. The home has Policies and Procedures in the management of service user’s money and financial affairs. The inspector was advised that the home does not handle the financial affairs of any of the service users. Their families are mainly responsible for this. The home does keep small amounts of money for some service users on their behalf and this is stored securely with records kept Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 15 of all transaction with two staff signatures and wherever possible the service user’s signature. The inspector did not view the records in relation to this at this inspection. The records are also spot checked by the Registered Manager or the Deputy Manager. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 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 the following standard(s): 19, 20, 26. Blenheim Lodge is nicely decorated, has a homely atmosphere and is maintained to a good standard. The home is clean and pleasant and there are good systems in place for the management if cross infection and infection control. EVIDENCE: The overall outcome for these assessed Standards is good. The home has a programme of routine maintenance and renewal of the fabric and redecoration of the home. Since the last inspection a communal area to the rear of the building has been repaved with a new ramp and handrail installed to improve access from the dining room doors that open out onto the paved area. The grounds of the home are well maintained and appear safe and accessible. There are communal spaces providing comfortable areas for either private of group activities. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 17 On the day of the inspection the home was clean and tidy and free of malodours. Staff are provided suitable equipment and personal protective equipment for the management of cross infection in the home. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. The overall outcome for these assessed Standards is good. The home ensures that there are adequate numbers of staff on duty to meet the needs of the service users. More than half the care staff are trained to at least a minimum of NVQ level 2, which is an excellent staff training outcome. The homes recruitment processes are good and protect vulnerable people from the employment of unsuitable staff. The home provides staff with a suitable range of training opportunities. EVIDENCE: Current duty rosters were sent to the CSCI on request as part of the preinspection questionnaire. The duty rota that the Inspector viewed indicated that there is usually four to five care staff on duty on a morning and three to four care staff on duty on an afternoon/evening. Managerial hours are in additional to these staffing levels. Service user surveys indicated that service users felt staffing levels sufficient. The home employs domestic staff a cook and kitchen assistants. The home has more than half of the care qualified with an NVQ 2 or above. This includes some staff who are registered nurses, although nursing care is not provided at the home. At the time of the Inspection this equated to 50 of the workforce. Other staff are enrolled to undertake NVQ Qualifications. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 19 The inspector viewed recruitment files of recently appointed staff. These were completed in good order. A discussion was held in further improving recently changed staff application forms with regard to the wording in asking staff to declare current or spent criminal convictions/cautions. The home is committed to provide staff with training opportunities and keeps records of all the training that staff have undertaken. Records of current and planned staff training were provided for the inspector. The home provides a detailed induction for new staff. This is not yet Skills Council liked as best practice dictates but the management said the home has plans to upgrade the home’s induction to make it so in the near future. Progress against this will be checked at the next inspection visit. The home management is aware of the current needs to train more staff in holding a current first aid certificate. Judgement on this is provided under Standards 38 (health and safety). Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38. The overall outcome for these assessed Standards is adequate. Blenheim Lodge is run and managed by a competent Registered Manager and Deputy Manager. The ethos of the service is good being that of that of consultation, involvement and empowerment for residents and staff. Service user’s financial affairs are safeguarded. Staff are receiving more formal supervision since the last inspection. Equipment in the home is maintained well. There is a need for more staff to hold a current first aid certificate, as the current level of staff able to deliver first aid is poor. EVIDENCE: Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 21 The Registered Manager has a wealth of experience in care of older people and completed the Registered Manager’s award in November 2005. She also ensures that she keeps herself updated and attends refresher training when needed. Staff spoken with felt well supported and confirmed they would be confident in going to the management team with any concerns. The service users also spoke very well of the Registered Manager, Deputy Manager and the care team. The inspector observed staff on duty at the home interacting with service users in a professional and sensitive manner. The management of the home plans to job share, with the current Registered Manager and her current Deputy both being registered with the CSCI. An application to this effect from the home will be forthcoming to the CSCI. It was evident at the time of the inspection that service users are consulted and are encouraged to speak up. The home conducts Residents Meetings and service users are encouraged to participate in the running of the home. Service users commented that they feel that they are involved in decisionmaking and the vast majority did not wish to be further involved. The home has regular staff meetings. Provider Regulation 26 visits are conducted on a monthly basis by a representative of the Board of Trustees and a report of this visit is sent to the home. The home maintains high levels of occupancy. The home displays a current certificate of employer’s and public liability insurance. The inspector was advised that the home does not handle the financial affairs of any of the service users. Their families are mainly responsible for this. The home does keep small amounts of money for some service users on their behalf and this is stored securely with records kept of all transaction with two staff signatures and wherever possible the service user’s signature. The inspector did not view the records in relation to this at this inspection. The records are also spot checked by the Registered Manager or the Deputy Manager. Service users are able to bring personal possessions to the home and an inventory is maintained for each service user. The home management has worked hard to improve the frequency and formalisation in record keeping of staff supervision sessions since the last inspection recommended this. To further improve staff supervision in the home the inspector suggested to the manager’s that clinical supervision sessions, that already occur, be recorded as this will assist in demonstrating competency assessment records of staff in their daily duties. Records of equipment servicing in the home were maintained in good order. There is appropriate equipment provided in the home to met the health and safety and ability needs of current service users. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 22 The Registered Manager audits all accidents at the home on a monthly basis and details the time of the day they took place and possible reasons for the accident occurring. This is good practice. Following this the Registered Manager takes steps to address such accidents. Presently there are not sufficient numbers of staff in the home who hold a current first aid certificate. This leaves residents vulnerable should accident or injury occur. The manager was aware of this training need and has built this into the training matrix for the year. This training gap is required to be addressed to promote the health and safety of service users. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 1 Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 24 No 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 OP38 Regulation Requirement Timescale for action 16/12/06 13 (4) (c ) It is required that there are staff suitably qualified in delivering first aid on duty at all times. 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 It is recommended that G.P homely remedies written authorisation be reviewed annually. Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Blenheim Lodge DS0000016019.V294568.R01.S.doc Version 5.1 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!