Inspection on 27/07/06 for Boucherne

This inspection was carried out on 27th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Boucherne 15/12/09

Boucherne 27/06/07

Boucherne 03/11/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Boucherne Holloway Road Heybridge Maldon Essex CM9 4SQ Lead Inspector Jane Offord Unannounced Inspection 27th July 2006 09:30 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 Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Boucherne Address Holloway Road Heybridge Maldon Essex CM9 4SQ 01621 855429 01621 854478 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) Boucherne Ltd Mr Christopher Tibballs Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 24 persons) 3rd November 2005 Date of last inspection Brief Description of the Service: Boucherne provides residential care for 24 older people (over 65 years). The home is situated in Heybridge, a short distance away from Maldon town centre. The period detached property has been extended to provide additional accommodation but has not lost it’s character and homely atmosphere. The home has a good-sized garden at the rear, with a smaller garden at the front. There is a car park for visitors to the side of the property. Accommodation is on two floors, accessible by stairs, a passenger lift and stair lift. Accommodation comprises both single and double rooms. All rooms seen were well furnished and decorated. Local shops are a short distance away and the home is on a bus route. Fees for the home range between £367.15 and £419.86 a week depending on the accommodation provided and the source of funding. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection that looked at the core standards for care of Older People and took place on a weekday between 9.30 and 15.30. The owners and recently appointed care manager were all available during the day to assist with the inspection process. The files, care plans and daily records of two new residents were seen as were the files of two recently appointed staff members, the duty rotas, a sample of the menus, the policy folder and the activities records. Some risk assessments, the complaints log and some maintenance records were also inspected. A tour of the building was undertaken and a number of residents, staff and visitors were spoken with. The serving of the lunchtime meal was observed and part of a medication administration round was followed. The controlled drugs (CD) register was seen and the CD stock was checked. The day of inspection was very hot but there was evidence throughout the home that care was being taken to ensure that residents were as comfortable as possible in the unusual temperatures. The atmosphere in the home was relaxed and friendly with cheerful interactions between staff and residents. The home was clean and tidy with attractive homely furnishings. What the service does well: What has improved since the last inspection? What they could do better: Some policies need the contact details of the Commission to be updated and the medication policy should contain guidance on the covert administration of medication. Some residents’ files do not record their final wishes. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 6 Some new staff have commenced in post before a clear criminal records bureau (CRB) check has been received. Risk assessments for hot water and unprotected radiators were seen. They covered individual residents’ rooms but had not been updated since January 2005 so some residents listed were no longer in the service. 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. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 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 Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 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): 3, 6. Quality for this outcome group is good. People who use this service can expect to have an assessment of their needs and assurance that they can be met prior to entering the home. This judgement has been made using information available including a visit to the home. The service does not offer intermediate care. EVIDENCE: The files for two newly admitted residents were seen. One contained a preadmission assessment completed before the resident arrived at the home. It covered information about past medical history, medication and cultural needs. Areas of potential need such as mobility, personal care, oral hygiene, continence, diet, night needs and communication were also addressed. The second file contained an assessment completed on the day the resident arrived at the home. The resident had lived in another part of the country so the manager had had to rely on information from the services being used. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 9 They said that they would often travel to visit a potential resident to ensure that information about their needs was accurate but it had not been possible this time. They said all residents come to the home on a four-week trial basis to ensure they find the service meets their expectations and that they get on with the resident group. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 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. Quality for this outcome area is good. People who use this service can expect to have their health needs met and a care plan in place to support that, they can also expect to be treated with respect and be protected by the medication administration practice. This judgement has been made using information available including a visit to the home. EVIDENCE: The file for one resident had a care plan that covered mobility, continence, personal hygiene, night needs, swallowing difficulties and deafness. There was a section covering emotional/ spiritual needs and interests. Interventions were structured to encourage independence. One section was for, ‘Plans for the future’. In there it was recorded, ‘To stay as independent as possible’. The file seen for the other resident, who had arrived at the home only days before the inspection, contained a care plan from the previous and most recent care team who had been involved with them. The resident’s key worker said they were spending time with the resident to compile a care plan to help meet their needs but needed to help the resident settle into the home as well. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 11 The daily records for both residents were full and appropriate. They recorded any problems noted by staff or reported by the resident, records of visits, outings and contact with health professionals such as the GP, the optician, dentist or community nurse. The files had details of contacts for the next of kin and some life history work. Only one file had details of the resident’s final wishes. Residents spoken with said they were confident that the home would manage their health needs if the occasion arose. Two residents talked about times when they had been admitted to hospital from the home. They said the staff were very efficient and when they returned were welcoming. A community nurse was visiting to do some dressings for a resident and said they found the staff friendly and helpful. Residents were appropriately referred to the community team for assessment if staff had any concerns. Care practice was observed during the day and staff were polite and offered help in a sensitive way. They knocked on doors before entering a room and enabled residents to make choices about what they wanted to do and where they wanted to be. Residents and visitors were complimentary about the staff team and their commitment to the work. One resident said, ‘They are lovely, nothing is too much trouble’. Some residents self medicate and the home has an assessment protocol to establish if a resident can safely manage their medication. A lockable drawer is provided in the resident’s room for the safekeeping of their medicines. Reassessment of the resident’s ability to safely manage their own medicines is undertaken if there are any concerns raised. Medication for other residents is supplied to the home in monitored dose blister packs (MDS) by the local pharmacy. The medication administration records (MAR sheets) are hand written from the original prescription. The care manager said they were negotiating with the pharmacy to print future MAR sheets to avoid errors of transcription. The carers who administer medication have had training in the MDS from the pharmacist and also attended, ‘Safe handling of medicines’ a training course held at a further education college in Chelmsford. Medication is stored in two locked cupboards, one in the kitchen and the other in the office. Medicines requiring lower temperatures are kept in a sealed container in the refrigerator. Practice observed on the day of inspection was safe and hygienic. Residents were offered their medication during lunch but could opt to have it later in their own room, if they preferred. The carer had a system to ensure no medication was forgotten if the resident chose to take it later. A list of signatures and initials of all staff who administer medication is maintained in the policy folder. No gaps were noted in the MAR sheets recording. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 12 CDs were stored in a double locked cupboard in the office. The register was seen and the stock of CDs in the cupboard was checked and tallied with the records. The medication policy was clear but did not offer guidance on the covert administration of medication. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14, 15. Quality for this outcome area is good. People who use this service can expect to be encouraged to maintain contact with family and friends, be offered meaningful pastimes and receive a well balanced diet. This judgement is made with available information including a visit to the home. EVIDENCE: The residents spoken with all said that they enjoyed the activities being offered and appreciated the fact that they could choose whether to participate or not. Several people spoke of a recent successful garden party that the home had organised and there was a display of photographs on the notice board of the events of the day. The notice board also had some ‘thank you’ letters saying how much fun the day had been. Residents talked about other outings that had been organised including theatre trips and a visit to a llama farm where they had had tea after seeing the animals. A record is kept of the weekly activities of each resident, these can include going for a walk, having a massage, card making, taking part in seated exercises and having one-to-one conversation. One resident said they enjoyed being outside and the gardens were lovely. They had a lounger chair that the staff would set up for them and move from time to time to follow the shade in the garden. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 14 Holy Communion is celebrated in the home monthly and residents have a sherry morning each Sunday in the panelled lounge. A group of friends and relatives of previous residents have joined forces to become, ‘The Friends of Boucherne’ and offer time and support to the home and residents regularly. They will help with outings, gardening or visiting anyone who needs some company. One carer has done some training to give the seated exercise sessions and is interested in pursuing further training that will help residents with their mobility and dexterity. Visitors were seen arriving and spending time with their relatives and friends in all parts of the home. People were greeted warmly and offered refreshment, as the day was particularly hot. Visitors spoken with said they were always made to feel welcome and the staff kept them informed if there were any changes taking place in the home or with their relative. The main meal of the day is served at 18.00. The menus showed a choice of two main dishes and desserts each day for example fish pie or sausages and onions, steak and kidney pie or trout fillets all with a selection of vegetables. Residents are able to influence the content of the menus and there is a summer menu and a winter menu. One resident said that if they did not like either dish on the menu the cook would find an alternative to please them. Staff said that residents could have a selection of fruit, cereals, fresh porridge and/or a cooked breakfast to start the day. One resident said they often had a cooked breakfast rather than a snack at lunchtime. The meal at lunchtime on the day of inspection was soup, freshly made sandwiches or spicy chicken and salad followed by a light dessert and tea or coffee. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 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 the following standard(s): 16, 18. Quality for this outcome area is good. People who use this service can expect to have any complaint taken seriously and to be protected from abuse. This judgement was made using information available including a visit to the home. EVIDENCE: Previous inspections have found that the home has a written policy on abuse, whistle blowing and the most recent guidance issued by the Essex Vulnerable Adults Protection Committee (EVAPC). Staff spoken with said that POVA was covered in their induction training and later in NVQ 2 and 3 when they progressed to that. They were quite clear about their duty of care and what action they would take if there were any suspicions of potential abuse to a resident. The home has a complaints policy that is part of the Statement of Purpose, the Service User’s Guide and included in the Contract of Residence. It offers investigation into complaints and a report of findings but needs to be updated to reflect the name change from NCSC to CSCI. The complaint log was seen and contained one recent complaint from a resident. The complaint concerned the way one carer managed personal care for the resident on one occasion. The co-owner said they were investigating the complaint and intended to talk to the member of staff involved but faced a difficulty in that the resident had some memory loss and could not clearly recall the incident. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 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, 25, 26. Quality in this outcome area is adequate. People who use this service can expect to live in a well maintained, clean home but they cannot be assured that all risk assessments for their protection will be kept updated. This judgement has been made using information available including a visit to the home. EVIDENCE: Boucherne is an attractive old house that has been adapted and developed for its present purpose. The communal accommodation consists of three lounges and two dining rooms one of which is situated close to the kitchen. The second dining room has a kitchenette facility to ensure food remains hot when it arrives from the main kitchen and to allow for the preparation of hot drinks. There are three bathrooms for general use, two have assisted facilities and one has a seated shower unit as well. Residents’ rooms consist of twenty single rooms and two shared, all with en suite toilets. All toilets and bathrooms seen had liquid soap and paper towels available for hand washing. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 17 The whole house offered an environment that was attractively furnished and clean. There were no unpleasant odours on the day of inspection. The staff rota showed that there is a dedicated domestic rostered every day. Residents said that their rooms are thoroughly cleaned i.e. all the furniture moved, once a month with beds changed at least weekly. The dining tables were laid with cloths and napkins and the occasional tables in the lounges all had freshly laundered white linen cloths on them. The weekly and monthly cleaning programme was seen. It covered all rooms both communal and residents’ own rooms, the kitchen and bathrooms. It included cleaning carpets, curtains, turning out cupboards and defrosting refrigerators. The gardens extend around three sides of the building and are accessible by wheelchairs from several exits. There were a number of seating areas that were well shaded with umbrellas and canopies in the hot weather. On the day of inspection most of the doors and windows were open to afford the residents any breeze available in the exceptional weather. Staff were busy offering cold drinks to residents and visitors and assisting when necessary. The care manager was encouraging staff to have drinks too. Fans were being used in all parts of the home. Some radiators remain unguarded but the co-owner said there were plans to put guards in place before this coming winter. Risk assessments for hot water and radiators in all the rooms were seen. They had not been updated since January 2005 so the residents named for some rooms were no longer resident there. The laundry, which is located away from the main building in a wooden outbuilding, was visited. The washing machine was able to function at high temperatures and had a sluice programme for use with soiled linen. There was a colour coded basket system in operation to ensure clean and soiled linen were kept separate. On a fine day washing is dried on lines in the garden. Staff spoken with were aware of the policies and procedures in place to minimise the risk of cross infection. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 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. Quality for this outcome area was adequate. People who use this service can expect to be cared for by sufficient, well-trained staff who can meet their needs but they cannot be assured that all the required recruitment checks will be in place before new staff commence in post. This judgement was made using information available including a visit to the home. EVIDENCE: The duty rotas were seen and showed that there is a senior carer for each early and late shift supported by four carers during the morning with two carers for the afternoon and two carers for the evening. Two waking carers cover the nights. There is a cook and domestic rostered for each day and the care manager and owners are at the home most days. One of the owners is responsible for the day-to-day maintenance required in the home. There is a strong commitment to offering training to staff and after induction staff are given the opportunity to enrol on the next available NVQ course. The home employs twenty-eight care staff and fourteen of them have achieved NVQ 2 or higher. Staff spoken with said the NVQ training covered updates in fire awareness, POVA, health and safety, moving and handling, dementia care and medication administration. Training records seen for some staff showed they had also had training in first aid, infection control and safe food handling. Each new staff member has an induction programme that is undertaken over a period of weeks under the supervision of senior staff. It involves some ‘shadow’ shifts and questionnaires to ensure information has been fully understood. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 19 The files of two new staff members were seen. They both had documentary evidence of identification checks being made and each had two references. One contained a recent photograph of the member of staff but the other did not. Both had evidence that criminal records bureau (CRB) checks had been obtained but both were dated after the staff member had commenced work in the home. Part of the CRB check involves checking on the Protection of Vulnerable Adults list for the person. This check can be made separately and the information obtained within forty-eight hours. It is known as a POVA 1st and can be used if the CRB process is taking a long time. There was no evidence in these files that a POVA 1st had been obtained to cover the delay of the CRB checks. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 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, 38. Quality for this outcome area is good. People who use this service can expect to live in a home managed by a competent person, have their opinions sought and their welfare safeguarded. This judgement has been made using information available including a visit to the home. EVIDENCE: The co-owners have owned the home for a number of years and have a clear philosophy for the service they wish the home to offer. They have recently appointed a new care manager who has been in post less than a month. The manager has many years experience in managing care homes both in the UK and abroad. The owners said they felt that the approach of the new manager matched their aspirations for the home. Staff and residents spoken with all said the new manager was polite and easy to talk to. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 21 Residents said that their opinions are listened to when they express themselves to staff members. One resident said they had had their favourite meal included on the menu after talking with the cook. Another resident had negotiated an extra bath a week with the care staff. The Friends of Boucherne feed back some information to staff with residents’ permission. Meetings are held and activities and outings have been discussed one of the owners said and this was confirmed by staff spoken with. The home does not handle any monies for residents. The manager said either residents manage their own affairs or their families do. Some maintenance records were seen and showed that checks on electrical equipment had been done in the last year. The equipment included food mixers, televisions, kettles, lamps, radios and fans. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NONE. 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. 2. 3. Standard OP16 OP25 OP29 Regulation 22 (7) 13 (4) (a) (c) 17 (2) Sch. 4 Requirement Timescale for action 14/08/06 The complaints policy must be altered to include the name of CSCI not NCSC. Risk assessments for the safety 27/07/06 of residents must be maintained up to date. All recruitment checks required 27/07/07 under schedule 4 must be obtained before prospective staff commence employment and copies of documents kept in their files. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP9 Good Practice Recommendations Efforts to ascertain residents’ final wishes should be made and records kept in their files. The medication administration policy should include guidance on the covert administration of medication. Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Boucherne DS0000059320.V305803.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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