Inspection on 05/02/07 for Broomy Hill Nursing Home

This inspection was carried out on 5th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Broomy Hill Nursing Home 06/01/10

Broomy Hill Nursing Home 30/08/07

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

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

CARE HOMES FOR OLDER PEOPLE Broomy Hill Nursing Home 43 Breinton Road Hereford Herefordshire HR4 OJY Lead Inspector Wendy Barrett Unannounced Inspection 14:15p 5 February 2007 th 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 Broomy Hill Nursing Home DS0000067471.V327100.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. Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broomy Hill Nursing Home Address 43 Breinton Road Hereford Herefordshire HR4 OJY 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) 01432 274474 Ashberry Healthcare Limited *** Post Vacant *** Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (40) Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Room 17 is occupied only if the service user or his/her representative has first seen it and documented his/her agreement. The home to accommodate one named service user between the age of 55-64 years with effect from the 10th June 2005 in category DE The Home may accommodate up to 5 service users up to the age of 65 years whose needs fall within the Statement of Purpose. Date of last inspection Brief Description of the Service: Ashberry Healthcare Limited was registered as the Provider at Broomy Hill in July 2006. A Care Manager has recently been employed at the home and was preparing an application for registration with the Commission when this inspection took place. The home is situated in a residential area close to the centre of Hereford city. The home provides 40 places for older people who have nursing care needs arising from mental health or dementia related conditions. One of the places is registered to accommodate a named resident who is between 55 and 64 years of age. Five places are registered for residents who are under 65 years of age and who have the type of needs falling within the home’s Statement of Purpose. There is information literature describing the service and copies of this are displayed at the home. The representatives of potential residents are given a copy when they come to view the accommodation. In December 2006, the fees ranged from £495-80p. per week to £650-00p. per week. There are additional charges made for hairdressing, chiropody and toiletries. Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been written with reference to information about the service and held by the Commission since the registration of the new Provider in July 2006. Residents, relatives and professionals were invited to complete survey forms, the Provider completed a pre-inspection questionnaire and an unannounced inspection visit was undertaken. What the service does well: What has improved since the last inspection? The residents’ accommodation is receiving attention so that it is a clean and attractive place to live. Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 6 The Provider’s representative is regularly monitoring all aspects of the service through regular visits. This supports the care manager in identifying any work that needs to be done to maintain good quality care in a safe environment. The staff feel that they are being supported by a new management team that helps them do their job well ‘we can see things (that need doing) now because we’re not stressed’. The comments of visiting relatives suggest that they are confident in the current care of their resident – ‘food is excellent – he’s eating really well’, ‘there are lots of activities – he made some pottery’, ‘all staff are very attentive – particularly to us when we visit’. What they could do better: The new Provider has done a great deal of work to improve this service in the short time since taking over. There are plans in place for future developments that haven’t been able to be addressed yet e.g. introduction of a wet room for residents to have a shower. It is reasonable that the new Provider needs a little more time to fully complete the planned work e.g. the new care manager has only recently started work and was preparing her application for registration with the Commission when this inspection took place. There should be more care staff who hold a recognised qualification, although this report does confirm that this is underway. The training experiences of individual staff should be more clearly planned and recorded to show how each employee is receiving the training they need at the necessary intervals. There will need to be a regular programme of individual staff supervision and appraisal now the home has a new care manager. When residents are prescribed medication ‘as required’ it is important that the staff have a care plan that helps them decide when this should be given to the particular individual. This is particularly important at Broomy Hill because most residents rely heavily on the staff and decisions to use medication should be as consistent as possible. A few recommendations are made to improve some of the records at the home. Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 7 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. Broomy Hill Nursing Home DS0000067471.V327100.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 Broomy Hill Nursing Home DS0000067471.V327100.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): 1,2,34 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their relatives have the information they need to decide if the home will suit them. The care manager carefully considers whether the service will be able to meet each potential resident’s needs, and residents and relatives feel this preparatory work leads to a comfortable introduction to the home. EVIDENCE: The new Provider has written new information literature to be sure it describes the type of service now being offered at Broomy Hill. Residents and their relatives are happy with the way they are received into the home and they feel the home is meeting their needs. A resident said ‘its been a pleasant stay’. A wife and daughter were visiting a resident during the Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 10 inspection visit. They described how the care manager had visited them at home before admission and they were given ‘very explicit’ written information that describes the type of service they could expect. They were able to have an introductory look around the accommodation before the admission. Residents, relatives and professional workers feel that the home is able to meet the residents’ needs –‘he’s eating really well’, ‘nice bedroom, great food, I can pick and choose’, ‘they (new management) are making considerable efforts to rectify chronic problems that have spoilt this home’. Information gathered during pre-admission assessment work is recorded in the residents’ files so that staff will know what care will be required. A relative also mentioned that she had been asked to help staff build up a life history of her husband so they would have a better understanding of him. Broomy Hill Nursing Home DS0000067471.V327100.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ care is provided in a way that takes into account individual needs and preferences. This work is recorded so that any changes can be identified and further action taken if necessary. Medication is only administered in the best interests of the resident although the procedure would be strengthened with a little more guidance for staff. EVIDENCE: Residents have a plan of care so that the staff know what care is required. Health care professionals and relatives feel that the plans are resulting in good care – ‘absolutely delighted with the care and attention’, ‘staff appear to work hard to provide a high standard of care’. A Nurse and two care assistants Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 12 were interviewed during the inspection visit. They were obviously familiar with each resident’s needs and wishes e.g. a Polish nurse felt that a Polish resident sometimes accepted advice more readily if the conversation took place in Polish, even though he could speak English. The plans are regularly reviewed so that they can be altered to take into account changes in residents’ conditions e.g. manual handling, nutritional and skin care assessments are reviewed at least monthly. The medication records of three residents were generally satisfactory. Although containers of new stock were being dated when brought into use the administration record should identify the first dose of the first day when the medication is given more than once a day. Otherwise, it isn’t possible to know exactly how much of the stock has been used when auditing balances. Some medication is prescribed ‘as required’. There are care plans to guide staff about when to administer this but the plans would be more effective if they were written with more attention to the individual resident’s situation. The use of medication is carefully managed to avoid over-use e.g. records showed how a resident’s paracetamol had been reduced, and another resident’s night medication was being gradually reduced. Broomy Hill Nursing Home DS0000067471.V327100.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff work hard to respect the wishes of residents and to help them continue to enjoy their preferred lifestyle. Meals are varied to suit individual needs and are served in attractive surroundings. EVIDENCE: An activities organiser works five days a week to help residents enjoy a variety of leisure interests. Records of this work showed that each resident was receiving opportunities to suit their abilities. A relative commented ‘always something going on’. Two musicians were entertaining residents during the inspection visit. Staff and residents were dancing and singing and obviously enjoying the occasion. One lady was met in her room. She said she preferred to spend her day privately. Even though many residents are heavily dependent on the staff, their Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 14 individuality is respected e.g. staff were respecting a resident’s preference to wear trousers and jumpers rather than skirts. A relative had been invited to help compile a personal profile which would guide the staff with this work. Staff felt that the new Provider was encouraging them to spend social time with the residents and this was helping them get to know them as individuals. Staff were observed sitting with residents at the meal tables – helping and chatting (to the residents) in a relaxed manner. The meals were varied e.g. some residents were having cooked breakfast, others were being helped to eat softened foods. Menus for the day were displayed at each table although it was noted that a fresh fruit salad was actually replaced with yoghurts. Although it is understandable that some changes will be necessary it is important to monitor these so that the overall nutritional balance isn’t compromised. Broomy Hill Nursing Home DS0000067471.V327100.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is benefiting from a new Provider who is committed to improving the protection of residents. Some concerns that were present at the point of the new registration have been well managed and this suggests there will now be satisfactory attention in the future to ensuring the safety of residents. EVIDENCE: The new Provider has implemented a new complaints procedure and adult protection policies and procedures. A copy of the home’s complaints procedure is displayed at the home and all residents (or their relatives) receive a copy. When the new Provider took over the home there was some work to be done to investigate ongoing concerns about the everyday management and care. The Provider has worked co-operatively and effectively with the Commission and other agencies in addressing these issues. Appropriate action was taken at the home to safeguard the residents and there have been no recent formal complaints received at the home. It would be useful to ask staff to record more minor concerns so that these can be audited as part of the overall quality monitoring system. Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 16 During the inspection visit staff confirmed that things had much improved under the new management –‘things have improved – much more relaxed now. We were worried all the time’. There was confidence in the Provider’s representative and the new care manager – ‘I would go to Lorraine or Brenda if I was worried’. The effect of this was reflected in observations of the relaxed conversation between residents and staff and time spent by staff sitting and chatting with residents e.g. at the meal tables. A relative was very happy with the attitude of staff –‘all staff are very attentive’, ‘he gets ups when he likes – no pressure’, ‘the (new) manager always comes in and speaks to each one of the residents’. Three relatives were not aware of the home’s complaints procedure and one expressed difficulty communicating with foreign night staff. A training session on abuse awareness had been arranged for the week after the inspection visit and all staff had received written guidance on adult protection in their information packs. Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are benefiting from a higher quality of accommodation that is being maintained and equipped to ensure their safety and comfort. EVIDENCE: The new Provider has introduced a programme of refurbishment and redecoration. A considerable amount of work has already been done to improve the quality of the accommodation e.g. replacement floor coverings, new equipment to help staff in their work with residents e.g. new profiling bed, 4 new wheelchairs, new hoist and pressure relieving equipment. There is an ongoing programme of window repairs and replacements. Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 18 There are also plans in place for future improvements e.g. new wet room for showering residents. There has also been attention to the maintenance of essential services at the home e.g. electrical installation, central heating system and gas supplies have all been serviced during the latter part of 2006. The home was warm, clean and tidy at the time of the unannounced inspection visit. There was evidence of attention to infection control e.g. provision of protective clothing, liquid soaps and paper towels. Notices were seen in a sluice room that offered staff advice regarding MRSA, use of personal toiletries etc. There was little evidence of mal odour. This suggests that the staff are coping well with the significant challenge they face in managing continence. A visiting relative commented that the home ‘is always clean and tidy’ and two staff felt they had the equipment they need to care for the residents. They did mention that they would like a shower facility for residents and this is already included in the future programme of work. The staff are trying to make the accommodation as attractive as possible even though they have to consider the particular risks for the residents accommodated at the home. Dining tables were very attractively presented with clean cloth tablecloths and flower displays. Bedrooms are furnished to reflect the individual needs and preferences of each resident so that they are as homely as possible. Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are enough staff to care for the resident group and new staff are carefully selected before being offered a job. Relevant training opportunities are being provided but this needs to be arranged and recorded to show more clearly how each staff member’s training needs are being met. EVIDENCE: There are enough staff employed to respond to the residents’ needs. The Provider monitors any change in dependencies so that extra cover can be arranged to cope with this. Since the new Provider took over there have been some staff who have left and others who have been recruited. Two recruitment records were inspected and a staff member described her recruitment experience. New staff are being carefully checked to be sure they will be safe to work with the vulnerable residents e.g. criminal records bureau checks are completed. It is important to record any additional risk assessment work when making decisions about an applicant’s suitability e.g. one of the inspected records related to the employment of a staff member who had previously been employed at the Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 20 home. The home had only sought one reference because there was supportive information relating to the previous period of employment at the home. However, the record should include an explanation (risk assessment) for the acceptance of one reference rather than the usual minimum of two references. A pre-inspection questionnaire listed various training opportunities provided since the new registration in July 2006. This included statutory health and safety training e.g. manual handling, fire safety. It also included professional practice instruction e.g. wound care, dementia care. The picture was less clear when staff were asked about the training they had received and when the records of training were inspected. One care assistant hadn’t attended any training sessions since the new Provider arrived although she had achieved a national vocational qualification at level 2. She was due to start work on her level 3 qualification. Another care assistant was not aware of any plans for her future health and safety training. She was, however, due to start work on a national vocational qualification at level 3. It is clear that staff are being supported to obtain a relevant qualification although the home doesn’t yet meet the recommended target of 50 qualified care staff. Relatives express confidence in the staff –‘always been very satisfied with the care provided for my mother who is often very difficult to deal with’. Staff also commented on improvements in their working conditions –‘we have time to sit with the residents now’. Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 21 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): 31,36,37 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The new management team have already completed a considerable amount of work to ensure the safety and welfare of the residents, although there has been too little time since registration to confirm the consistency of this encouraging picture. The new Provider demonstrates competence and commitment to continue improving the quality of the service and has gained the confidence of staff and visiting health care professionals. EVIDENCE: Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 22 The Commission approved the application for registration of the new Provider in July 2006. This required a considerable amount of work by the Provider e.g. implementing new policies and procedures, preparing new information literature describing the service offered at the home, making arrangements with contractors to maintain essential services, reviewing working practices e.g. staff are being encouraged to make better use of the communal areas so that the residents will enjoy a more comfortable environment when they eat their meals. A new care manager has recently been employed. She was preparing her application for registration with the Commission at the time of this inspection. Staff employed at the home, and visiting health care professionals, express confidence in the new management team ‘making considerable efforts (to improve the service)’, ‘we (staff) feel more relaxed. We can relate better to the residents’. A Provider representative spends regular time at the home to monitor the service and support the Care Manager. Reports of these visits refer to direct contact with residents, relatives and staff and auditing of records at the home. There is an ongoing programme of work to improve the residents’ safety, and facilities to support the staff with their work e.g. new aids and equipment, new computer equipment to improve record keeping systems. The Provider will need more time to fully implement a quality assurance system at the home although there is current evidence of regular auditing as part of this work. Two staff said they were not receiving one to one supervision yet. One didn’t think there had been any staff meetings recently. The new care manager was already making arrangements to introduce a new programme to address this. Arrangements have been made to ensure compliance with new fire safety regulations e.g. the maintenance man has attended a training course and new signage has been purchased. The staff have up to date policies and procedures so that they know how to work in line with health and safety regulations. Infection control equipment and guidance notices on correct procedures were seen around the home. Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 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 3 3 3 3 3 x 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 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x x 2 2 2 Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 OP28 Regulation 18(1)a Requirement Timescale for action 30/06/07 2 OP37 19(5)c Schedule 2 (5) There must be a higher number of care staff holding a national vocational qualification to ensure that at all times suitably qualified persons are working at the care home. Records of individual staff 31/05/07 training records and future programmes must be further developed to confirm receipt of necessary training suitable to the work performed. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations The introduction of a method of identifying, on the medication administration records, the first dose administered from new supplies of medication would strengthen the auditing of stock balances. The medication ‘as required’ care plans should better reflect the individual situation of each resident. DS0000067471.V327100.R01.S.doc Version 5.2 Page 25 2 OP9 Broomy Hill Nursing Home 3 4 5 OP15 OP16 OP29 There should be a system of reporting changes to standard menus to management staff so that the overall nutritional balance of meals served can be more closely monitored. It is recommended that staff should record minor concerns dealt with from day to day so that the frequency of these, and any emerging patterns, can be audited. When the application of recruitment procedures involves an element of risk assessment, the process should be explained in the personnel record. Broomy Hill Nursing Home DS0000067471.V327100.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Broomy Hill Nursing Home DS0000067471.V327100.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. 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