CARE HOMES FOR OLDER PEOPLE
Brookdale View 1 Averil Street Newton Heath Manchester M40 1PD Lead Inspector
Geraldine Blow Unannounced Inspection 7th September 2007 10:00 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 Brookdale View DS0000021536.V342456.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. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Brookdale View Address 1 Averil Street Newton Heath Manchester M40 1PD 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) 0161 688 7600 0161 682 3004 brookdaleview@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Care Management Ltd Laura Ann Riley Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. The home accommodates a maximum of 48 older people. The maximum number of service users accommodated on the ground floor and requiring nursing care shall be 24. Service users requiring personal care only are accommodated on the first floor. Registration is subject to compliance with the minimum nursing staffing levels indicated in the Notice previously served in accordance with Section 25 (3) of the Registered Homes act 1984 issued on 8th October 2001. 12th September 2006 Date of last inspection Brief Description of the Service: Brookdale View Nursing Home provides accommodation for a maximum of 48 older people. The premises are owned by Nursing Home Properties (NHP) PLC and are leased to Southern Cross Healthcare Limited. The home is situated in the Newton Heath area of Manchester close to a local market, shops, public houses and other social areas and amenities. The home was first registered with the Commission for Social Care Inspection (CSCI) on 30th July 2002. The home consists of a large purpose built building set in its own grounds, which is shared by its sister home operating on the same site. Ample car parking facilities are available. The home offers accommodation in 48 single, en-suite bedrooms. Accommodation for residents is provided on two floors accessed via a passenger lift and stairways. There are two lounges and a dining room on each floor. The charges for fees range from £378.84 to £580 per week. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report is based on information gathered by the Commission for Social Care Inspection (CSCI) since the last inspection on 12 September 2006 and supporting information received in the Annual Quality Assurance Assessment (AQAA) submitted by the manager prior to this visit. Residents and General Practitioners (GP’s) were sent comment cards. Six resident comment cards were received, the residents themselves completed 1 of those and 4 were completed with the help their family and 1 with the help of staff. Three GP comment cards were received by the CSCI. This unannounced visit forms part of the overall inspection process and took place on Friday 7 September 2007. The opportunity was taken to look at all the core standards of the National Minimum Standards (NMS). This inspection was also used to decide how often the home needs to be visited to make sure that it meets the required standards. As part of the visit time was spent examining relevant documents and files, talking with the home’s manager, several people living at the home, a visitor, some members of staff and a tour of the building was undertaken. What the service does well:
A pre admission assessment of needs is carried out before a resident is admitted to the home to make sure that the home can meet all of their needs. As found at previous inspection visits the home was clean and provided a pleasant environment for the residents who live there. Staff were seen to be kind and patient with residents when carrying out their duties and the staff spoken to said that residents are encouraged to make their own choices about their day-to-day lives. Where able, residents were seen to be freely walking around the home. Some comments received from the residents’ comment cards include “the staff, although overstretched at times, could not be more caring and efficient” and “the home is meeting all my needs and I have settled in well”. The home has an open visiting policy, which was confirmed by a visitor and the staff spoken to. He said that the staff make him feel very welcome when he visits and give him a cup of tea and a biscuit. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 6 Systems were in place to support residents or visitors to make a complaint and all returned comment cards, stated that they knew how to make a complaint. The manager had a good awareness of the importance of offering appropriate activities and an activity co-ordinator was employed on a part time basis. It was encouraging that the home had the use of a mini bus, which was regularly used for trips out. An activity board displayed information of various activities, which included a trip to Southport, various in-house activities such as crafts, gardening, floor skittles, dominos and a game of play your cards right. Also the manager said that the activity co-ordinator was in the process of organising a trip to Blackpool illuminations, a shopping trip to the Trafford Centre and a night out to see the pantomime Aladdin. The returned comment cards supported the evidence seen that activities are provided. Policies and procedures were in place to protect residents from abuse and staff had received appropriate awareness training. Staff are encouraged and supported to undertake training to ensure that they have the necessary skills to meet the needs of the residents living at the home. There are good recruitment procedures to ensure that the staff employed are safe to work with residents. The manager had an in-depth knowledge of all the residents and during the inspection she stopped and spoke with any resident that she passed. The residents and staff benefit from her open door policy and staff spoken to said that she was very approachable and supportive. What has improved since the last inspection?
Since the last inspection visit in September 2006 both lounges on the ground floor have had a new carpet and the dining room on the ground floor has had new laminate flooring laid. The internal refurbishment of the home was continuing on an ongoing basis. A system called “Nutmeg” was in the process of being implemented. This consists of the nutritional value of each meal being calculated, to ensure that it is satisfactory to meet resident’s needs. A bar chart of the results is then produced, which will be put on display in the main reception, next to a copy of the menu. This is considered good practice. A choice of meals will continue to be offered to residents and staff spoken to said that drinks and snacks are always available on request. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 intermediate care is not provided at Brookdale View Nursing Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The home undertakes an assessment of prospective residents’ care needs prior to their admission. EVIDENCE: A pre admission assessment form is in use to ensure that prospective residents are only admitted on the basis of a full assessment and for those residents who are referred through Care Management arrangements a copy of the Care Management Assessment is obtained before admission is arranged. Following the pre-admission assessment the home confirms in writing to the prospective resident that the home is able/not able to meet their assessed needs. This is seen as good practice. However it was noted that the pre admission assessment did not include an assessment of any specific religious and cultural needs. A recommendation has been made to address this.
Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 10 Where possible, prospective residents and their family/representative are encouraged to view the home prior to making a decision about admission. The home does not provide an intermediate care service. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The health, social and personal care needs of residents were being met. EVIDENCE: Three residents were case tracked during this inspection visit and their care files were examined. Each resident had an individual plan of care which had been reviewed on a monthly basis. Some areas of the care plans were person centred and included individual preferences and specific care needs. However others parts were quite vague and did not clearly set out the individualised actions or personal preferences which needed to be taken into account by staff to ensure that residents’ individual health and personal care needs are fully met. For example “give a daily strip wash” and “ensure has a bath/shower once a week”. It is recommended that that all residents’ care plans are developed using a person centred approach. Appropriate risk assessments had been included, which included a risk assessment for the use of bed rails and the plans of care had been reviewed on
Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 12 a monthly basis to reflect changing needs and current objectives for health and personal care. Evidence was seen that where possible the plan of care had been drawn up with the involvement of the resident/representative. Each resident was registered with a General Practitioner and evidence was seen of referral to other specialised services according to individual assessed needs for example District Nurses, Tissue Viability Nurse, Dentist, Dietician and Chiropodists. It is encouraging that the manager undertakes regular audits of the care plans and every 3 months sends a review of pressure ulcers and any variants of weight loss to the Responsible Individual (RI). Evidence was seen that the Medication Administration Recording (MAR) sheets were recorded accurately; medication carried over from the previous month had been recorded and all deliveries and returns of prescribed medications had been recorded and accounted for so providing a full audit trial. However, it is recommended that 2 staff witness and sign for the disposal of waste medication. There is a copy of the GP’s original prescription so that staff can cross reference the medication received from the dispensing pharmacy with the medication prescribed by the GP. A tablet count was undertaken of medication that was not included in the blister packs. There were no discrepancies found. As identified in the previous inspection report a prescribed thickener, which is used to thicken drinks and soups for residents with swallowing impairment had been signed for on the MAR sheet. However the manager confirmed that the MAR sheet did not accurately reflect the correct number of thickened drinks given and the signature on the MAR was not necessarily the signature of the staff member who would have given the drink to the resident. In order to ensure that residents’ care needs are being met a record should be maintained of each drink / soup etc that has been thickened and any other liquid the residents have had to drink. It is essential that the person making the drink signs a record sheet. This does not have to be the nurse and it does not have to be signed on the MAR sheet. A separate drinks recording sheet may be constructed for each resident. In addition it is essential that the information received by the Speech and Language Therapist (SALT) for thickening the drinks should be readily available to all staff involved in the preparation of drinks / food for a resident. Recommendations have been made to address the issues. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 13 It was encouraging that the manager and the RI undertake monthly audits, on an alternate monthly basis and records are kept. This is seen as good practice. From observations made during the inspection and discussions with a visitor and members of staff it appeared that the nurses and care staff treat the residents with respect and dignity. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Activities were provided and residents were able to maintain contact with family and friends. EVIDENCE: As detailed in the previous inspection report an activity programme and photographs were on display of recent activities and the activity programme appeared to offer a full and varied programme. It was encouraging to note that a “client social history” was completed on admission to the home. The activity co-ordinator keeps an individual record of who attends the activities provided and details their participation in the activities and any unusual behaviour or increase/decrease in motor skills is verbally fed back to the nurses and care staff. This is seen as good practice. Staff and a visitor spoken to confirmed that the home facilitated open visiting and visitors could be received in the resident’s own room or any of the communal areas of the home. The visitor said that he is always made to feel
Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 15 very welcome and staff regularly phoned him to keep him informed of any changes or incidents that may have occurred. From speaking to the visitor and staff it appeared that residents are encouraged to exercise choice and control over their lives and that residents are encouraged to bring personal possessions into the home. As already detailed in this report the ‘nutmeg’ system is in the process of being implemented and a new menu has been piloted. An alternative to the main meal is available at each mealtime or any reasonable alternative is available to residents. Staff spoken to confirmed this. It was encouraging that a daily menu was on display. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The home encourages and supports people to raise their concerns and complaints and had the policies, procedures and systems in place to protect residents from abuse. EVIDENCE: As identified in the previous inspection report there was a complaint procedure, which was on display in the main reception area, and a copy was included in the Service User Guide, which every resident had been given. All returned resident comment cards completed by the residents, identified that they knew how to make a complaint. The manager said that she operates an open door policy and residents, relatives/visitors, staff and visiting professionals to the home are encouraged to raise any concerns or complaints with her. In addition she holds a weekly ‘managers surgery’ where she makes herself available on a set date and time, which is advertised in the main reception so that anybody can discuss any issue they have. There is a complaint file with details of any complaints, any investigation, including staff statements, copies of any correspondence and an outcome of the complaint. There were policies and procedures in relation to protection of adults from abuse and Whistle Blowing. The home had a copy of the Manchester MultiBrookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 17 Agency Policy on the Protection of Vulnerable Adults from Abuse. The manager was able to accurately describe the actions to be taken in the event of an allegation of abuse and Protection of Vulnerable Adults (POVA) awareness training was being provided on an ongoing basis. Staff spoken to confirmed that they had received the training. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All areas of the home were clean, comfortable, well maintained and equipped to meet the needs of the residents. EVIDENCE: The location and layout of the home was suitable for its stated purpose. CSCI received an anonymous concern that there were poor standards of hygiene for residents and there was not enough soap and face cloths for residents and that the home was generally unclean and had a strong malodour. No evidence could be found to support this concern. During this visit a number of residents bedrooms and en-suites were inspected. It was found that every ensuite had a wall mounted soap dispenser and residents had either a personal pump soap dispenser or a bar of soap in their en-suites. The manager confirmed that if residents did not have face cloths, wipes were used and then disposed of immediately after use.
Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 19 A tour of the building was undertaken and the home was clean, tidy and free from offensive odours. One visitor spoken to said that the “home is always this clean and tidy”. When asked about the cleanliness of his wife’s bedroom he confirmed that also was “lovely and clean”. The manager confirmed that there was a rolling programme of decoration and refurbishment to maintain standards. As already mentioned in this report various improvements had been made since the last inspection. The garden area was well maintained and accessible to residents. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number and deployment of staff appeared sufficient to meet the residents’ assessed needs and the procedures for recruiting staff were robust and provided adequate safeguards to protect residents. EVIDENCE: At the time of the inspection the home accommodated 46 residents, 13 residents assessed as requiring nursing care and 33 residents assessed as requiring personal care only. The numbers and skill mix of the staff appeared to be sufficient to meet the needs of the number of residents accommodated. The home employed 22 care staff, 5 of whom had achieved NVQ level 2.Three members of care staff were currently undertaking the training. A number of the care staff employed are from oversees and the manager is in the process of seeking validation for the level of qualifications of 4 of those staff. The staff files examined contained the appropriate documentation as required by Schedule 2 of The Care Homes Regulations 2001. Staff files contained photocopied documents, for example passports and certificates. However
Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 21 there was no evidence that the original documents had been seen. It is recommended that that all photocopied documents are signed to indicate that the original had been seen. The NMC website is regularly checked by Southern Cross for nurse suspension or exclusion from the register. These details are sent to the home manager who checks the information. In addition there is a computerised matrix that identifies when PIN numbers are due for renewal. The manager confirmed that all newly recruited members of staff must attend induction training prior to commencing work. There was a structured corporate induction in place, which has been recently updated inline with Skills for Care. The new induction is much more comprehensive that the previous one and existing staff are being encouraged to complete the new induction. Evidence was seen of ongoing staff training which included POVA awareness, medication training for senior carers and RGNs, Moving and Handling, Venipuncture, the Mental Capacity Act and further medication training. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems and procedures were in place, which appeared to safeguard and protect residents’ financial interests and the home was seen to promote the health, safety and welfare of the residents and staff. EVIDENCE: Residents and staff benefit from a committed manager who operates an open management style and encourages residents, visitors and staff to make use of the ‘open door’ policy. At the heart of this style of management is a person centred approach where the focus is on how the individual resident wants their
Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 23 care needs to be met. The staff spoken to said they were happy with the way the home is managed and felt that they were very well supported by the manager and the residents receive excellent care. As identified in the previous inspection report evidence was seen of a quality monitoring system to seek feedback from residents and the relatives of the residents who use the service. The administrator is responsible for sending out the satisfaction questionnaires on an ongoing basis. The completed questionnaires are sent directly to the company’s head office where the results are reviewed and feedback is given to the manager. To ensure that standards are maintained the manager undertakes regular audits, for example a review of pressure ulcers, a review of Regulation 37 reports, Health and Safety minutes and a review of any variants in resident’s weights. All the results of the audits are sent to the RI for him to review. In addition the manager holds regular resident/relative meetings, which are minuted as well as encouraging constant feedback by her open door management approach. Evidence was seen that the systems in place safeguarded resident’s financial interests. Southern Cross Healthcare Ltd have a national agreement with the Commission’s Provider Relationship Manager (PRM) regarding residents’ finances. Secure facilities were provided for money and valuables held on behalf of residents and receipts are given. The information provided in the AQAA demonstrated that the home’s maintenance certificates and records were up to date. Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 24 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 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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. 3. Refer to Standard OP3 OP7 OP9 Good Practice Recommendations It is recommended that the pre-admission assessment include an assessment of any specific religious and cultural needs. It is recommended that all residents care plans are developed using a person centred approach. 1. It is recommended that individual staff members sign for thickened drinks/soups they give to a resident. 2. It is recommended that the MAR sheet cross-references to where there is an accurate record of thickened fluids. 3. It is recommended that individual instructions for each resident requiring thickened drinks/soups is readily and easily accessible to staff involved in the preparation of drinks / food for a resident. 4. It is recommended that 2 staff witness and sign for the disposal of waste medication. It is recommended that all photocopied documents are signed to indicate that the original had been seen. 4. OP29 Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Brookdale View DS0000021536.V342456.R01.S.doc Version 5.2 Page 27 - 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!
