Inspection on 21/03/06 for Bury Metro - Spurr House

This inspection was carried out on 21st March 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bury Metro - Spurr House 07/05/08

Bury Metro - Spurr House 02/11/06

Bury Metro - Spurr House 15/11/05

Bury Metro - Spurr House 19/01/05

Bury Metro - Spurr House 11/08/04

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

CARE HOMES FOR OLDER PEOPLE Bury Metro - Spurr House Spurr House Residential Care Home Pole Lane Unsworth Bury Lancs BL9 8SA Lead Inspector Diane Gaunt Unannounced Inspection 21st March 2006 10:15 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 Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bury Metro - Spurr House Address Spurr House Residential Care Home Pole Lane Unsworth Bury Lancs BL9 8SA 0161 253 7505 0161 2536106 c.hesketh@bury.gov.uk 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) Bury M.B.C. Mrs Christine Hesketh Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 36 service-users to include: Up to 36 service-users in the category OP (Older People, who do not fall in to any other category). The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 19th January 2005 Date of last inspection Brief Description of the Service: Spurr House provides residential care for up to 36 older people. Within this number respite care can be provided for up to 5 residents at any one time. A day care service is also provided for up to 10 older people each day. The home is situated close to local shops and offers easy access to the local motorway system. Car parking facilities are available. The home is a single storey building with ample wheelchair access. The building is divided into four units; each unit has its own lounge, dining room and kitchen where residents and visitors to the home can make drinks and snacks. The home also has a conservatory and a large lounge with wide screen TV, video facilities, and a CD music system. Thirty six en-suite bedrooms, four assisted bathrooms and one assisted shower are provided. Hoists, aids and adaptations are available for residents’ use. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 7½ hours. The home had not been told beforehand that the inspector would visit. The inspector looked around the building and looked at paperwork about the running of the home and the care given. In order to find out more about the home the inspector spoke with ten residents, two relatives, two senior care officers, three care assistants, the day care activities organiser, the cook, the administrator and the hairdresser. The registered manager was on sickness leave and the deputy manager on annual leave. Five requirements listed at the end of the report had not been fully met since the last inspection, although action had been taken towards meeting each one. What the service does well: What has improved since the last inspection? Since the last inspection corridors had been carpeted, some bedroom furniture and carpets had been replaced and bedrooms were being decorated. Bleach was no longer kept in the laundry. Fire equipment and exits from the building were checked every week. Water temperatures were regularly checked and adjustments made, but there still problems with the water. Managers regularly checked the call bell system to make sure staff answered call bells quickly. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 6 Staff visited people before they moved into the home to make sure the home could meet their needs, and kept a copy of the information from this visit. Where social workers had assessed people before they moved in, copies of their assessments were also held on file. Once residents moved into the home staff found out what food they liked and disliked and made a note on their care plan. A temporary day care activities organiser had been appointed. Improvements had been made to the written records filled in by staff when dealing with medicines and tablets at the home. Controlled drugs were stored more safely. What they could do better: Staff should make sure they write an assessment of the risk involved whenever bedrails are used on resident’s beds and whenever residents look after their own medicines, creams or sprays. They should also get written agreement to the assessment. Working safety locks must be fitted to bedroom doors so residents can be as private as they wish in their rooms, but able to leave their rooms quickly in an emergency. More electric sockets must be provided in bedrooms so residents have somewhere to plug in their electrical equipment. More bedroom furniture should be replaced and the appearance of bathrooms and toilets improved. Water must be provided at a safe temperature and hot enough for residents to wash in. Staff must have refresher training in how best to help residents to move, how to make and serve food safely and what to do if there is a fire. An up to date record of everyone’s training should be held at the home so the manager can make sure all training is renewed when necessary. Recommended training should be given to staff whilst they await a place on an NVQ course. More aprons should be bought for residents to use at mealtimes and staff should help residents to change any stained clothes after meals. Policies and procedures about the home’s involvement with residents’ medicines and tablets should be checked and changed if necessary. Medicine or tablets should not be given to residents without their agreement unless a doctor has agreed to this being done. The fridge used to keep medicines and eye drops cool should be kept at the right temperature. When Bury MBC look after resident’s money they should let them know from time to time how much money they have got. Arrangements should be made so residents can receive interest on the money Bury MBC looks after for them. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 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. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 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 Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed on this occasion. EVIDENCE: Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Systems were in place to facilitate the safe handling of medication; record keeping had improved but needed further minor improvements to meet the standard. EVIDENCE: A full medication inspection was undertaken by the CSCI pharmacist inspector on 21 February 2006 and details of this additional visit can be obtained on request from CSCI. One requirement and five recommendations were made at that visit and were followed up during this inspection. It was pleasing to note that improvement had been made in that medication receipt was recorded and administration records were clear, accurate and complete. A note regarding self administration of medication had been made on a care plan but a signed risk assessment was not held on file. With regard to recommendations, handwritten entries were seen to be double signed; controlled drugs were stored in the controlled drugs cupboard; and the refrigerator temperature was recorded. However, records showed that the correct temperature (2oC –8oC) was not always maintained. The deputy manager was in the process of reviewing the medication policies and procedures and the GP and a relative had been contacted with regard to agreement to covert administration of medication. Staff were awaiting a reply in order to meet the recommendation. Residents Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 11 spoken with during the inspection said they were satisfied with the arrangements in place with regard to administration of medication. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Suitable activities and occupation to meet the needs of residents were provided. Visiting arrangements at the home were informal and family and friends were encouraged to maintain contact promoting personal relationships. Residents benefited from being able to exercise choice and control over their lives. A varied and nutritious diet was enjoyed by residents in pleasing surroundings. EVIDENCE: Spurr House employed two part time activities organisers, one to work with residents and the other to work with day care clients. The residential activities organiser was on leave at the time of the inspection. However, residents were invited to join the craft activity arranged for day care clients and were seen to enjoy it. A range of both individual and group activities were offered at the home including manicures, games, crafts, quizzes, singalongs, reminiscence sessions, exercises and baking. In addition, musical entertainers visited the home. Residents spoken with were very complimentary about the entertainers and said how much they also enjoyed the singalongs and reminiscence. Some said they also would enjoy playing cards, dominoes and draughts on occasion. A record was kept of each session and who participated in them. On the three days that the activities organisers did not work activities were not provided. The manager may wish to consider involving a carer in activities on these days. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 13 Trips out were also arranged by the activities organiser and some had attended and enjoyed a poetry reading at a local day centre. Arrangements were also made for residents to go shopping, both locally and farther afield. The local community was also brought into the home: a librarian visited and brought a selection of old toys to prompt reminiscence; representatives of local churches visited to offer communion to those who wished to take it. The home had an open visiting policy and relatives interviewed said they were made to feel welcome and were offered refreshments. Residents could see their visitors wherever they wished, either in the lounges, dining rooms (outside of mealtimes) or their bedrooms. The choices residents made each day varied, dependent upon their mental frailty but residents who were able generally chose what time to get up, go to bed, what clothes to wear, what to eat, where to spend their day and whether or not to participate in activities. There was evidence of each of these choices being made on the day of inspection. A resident who had recently moved in had been able to choose the colour scheme for her bedroom. Another resident had chosen to buy new furniture and carpet herself. Residents also chose whether or not they wished to manage their money or whether relatives or Bury MBC would do so on their behalf. All those spoken with were happy with the arrangements in place. Information about local advocacy was displayed on the notice board by the office, along with information about Citizens Advice Bureau should residents need this service. Menus inspected were seen to provide a nutritious and varied diet over a 4 week period. Two choices of meal were served each mealtime and there was evidence the cook would provide other individual choices on request. The menus were under review at the time of inspection and the cook was increasing the regularity of popular meals. Food likes and dislikes were recorded in care plans and the cook was aware of them. She personally served meals to residents in the units and so had become familiar with their preferences. Fresh fruit was occasionally served as a dessert e.g. bananas and custard, apple crumble, but was also cut up and offered as a snack in the afternoon. Food served during the inspection was sampled, it looked, smelt and tasted appetising. It was hot when served. Residents were seen to enjoy the food and some commented ‘dinner was nice’. Senior staff were informed at handover if a resident did not eat their meal and their intake was monitored. Residents spoken with said the food was very good and considered portions were generally big enough. At teatime it was noted that residents were given two sandwiches, the cook said that she returned to each unit later to offer more but residents were observed eating their dessert before she returned. In order to ensure more sandwiches are available the cook may wish to leave a plate on each unit for carers to offer to residents before they eat their dessert. Staff interviewed said that if residents were hungry in the evening they were able to make a snack or pop out to the chip shop. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 14 There was some flexibility of mealtimes, particularly breakfast which was served as late as 11.00am if residents chose to have a lie in. Staff commented that residents were not always ready for a cooked meal at lunchtime if they had got up late. The inspector was informed there was no reason why these residents couldn’t be served with their meal later and staff would be advised to offer this service. Special diets were catered for and at the time of the inspection the cook was providing kosher, vegetarian and health related diets. Three people required diabetic diets and four had soft/liquidised diets. Staff gave appropriate assistance to those needing it although it was noted that one carer did not sit beside residents whilst assisting. It was noted that in three instances where residents had spilled food on their clothing they had not been assisted to change after their meal. The inspector was advised that one of these residents didn’t like to change clothes during the day. Staff also said that there were insufficient aprons for residents to wear whilst they were eating their meals. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 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): None of these standards were assessed on this occasion. EVIDENCE: Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed on this occasion. EVIDENCE: Although not inspected on this occasion it was noted that improvements continued to be made to the building. Since the last inspection corridors had been carpeted, some bedroom furniture and carpets had been replaced and bedrooms were being decorated. There were plans to refurbish bathrooms and toilets in the near future. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 17 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): 28, 29 and 30 Training had been provided for all staff but further development was needed to ensure a fully trained and competent workforce was provided. Recruitment information and checks needed to be improved to ensure residents’ safety and protection. EVIDENCE: The central personnel department held information in relation to the recruitment of staff. A random sample of files for existing and new staff were inspected in May 2005. A copy of the action required was forwarded to the Responsible Individual and Personnel Department. This identified the information needed to ensure the safety and protection of residents supported by the authority. Action identified included: • Both parties should sign Contracts/Terms and Conditions. • References received, which evidenced little information in relation to the applicants suitability had not been followed up or an alternative sought. • Application forms must be completed by the applicant and in full, detailing their full employment history. • Evidence of the CRB checks including reference numbers and date of application should be held on file Following an inspection of another of Bury MBC’s registered care homes in January 2006, a requirement was made for the Responsible Individual to provide CSCI with information as to the action taken in response to the May 2005 file inspection. This requirement is due to be met by the end of March 2006. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 18 Induction training in line with National Training Organisation standards was provided for care staff within the first six weeks of their employment. Foundation training was not routinely provided within the first six months of employment and although the home aimed for staff to begin NVQ level 2 training during this period, this was not achieved. With regard to qualification training, 13 care staff had achieved NVQ level 2 and all senior care officers had NVQ level 3. 50 of carers had therefore gained an NVQ. The inspector was informed there were plans for more staff to attend NVQ training in the future and this was included in the home’s business plan. Up to date information regarding completed training was not readily available at the home and information sent by the Personnel Department on the day of inspection was out of date. However, it was established that no further health and safety refresher training had taken place since the last inspection. There were plans for the manager and deputy to attend moving and handling training. Since the last inspection, the majority of staff had completed training with regard to the Protection of Vulnerable Adults, those who hadn’t were completing workbooks on the topic. Two senior staff had attended a 1st line management course and arrangements had been made for a senior to attend A National Service Framework and ageism course, and four carers to attend a dementia care mapping course. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 19 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 and 35 The home was run efficiently to ensure resident’s needs were met. Residents were regularly consulted for their views in order for the home to be run in their best interests. Residents’ monies were held safely and securely and administered efficiently but were not managed to the maximum benefit for residents. EVIDENCE: The registered manager was very experienced in working with older people living in care homes. She also had managerial experience in other homes owned by Bury MBC prior to working at Spurr House. She had achieved NVQ levels 2, 3 and 4 and had successfully completed the Registered Manager’s Award. She was supported by a deputy who also had these qualifications. Both the manager and deputy also attended relevant short courses in order to keep their practice up to date. The manager is also an NVQ assessor. The home held the Investors in People Award, which was awarded in January 2004. They also had a number of quality monitoring procedures in place. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 20 These included: regular residents/relatives meetings and staff meetings; involvement of residents/residents in writing and reviewing care plans; and staff supervision – although records indicated this had not been provided 6 times per year. Service-user questionnaires were periodically circulated and the results displayed on the notice board. The inspector was informed they had last been circulated in December 2005 but, due to the manager’s sickness absence, results had not yet been collated and published. Previous results were on view and generally indicated positive feedback about the service. Residents and relatives considered the manager and deputy to be approachable and that matters raised with them were addressed. There was evidence that action had been taken in response to issues raised by residents in meetings. In addition to the above initiatives the home had an annual business plan which addressed such areas as staff performance and review, training, and environmental issues. The plan was seen to be updated on an ongoing basis. The home acted as corporate appointee for eleven residents. They also managed personal monies handed to them by relatives for residents’ use. The inspector checked a number of balances selected at random and all were found to be correct. Written records of all transactions involving residents’ monies were maintained and receipts were held for transactions which staff were involved in. Records were audited on an annual basis by Bury MBC Finance Department. Residents’ monies were held in a Bury MBC bank account. Residents did not benefit from interest on their savings although they were advised to move their money elsewhere when it amounted to a significant figure. Neither were they regularly informed as to how much money was held for them, although those interviewed said if they asked for a balance it was provided. They were able to access their monies via the office whenever they needed to. Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 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 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X X Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 Requirement The registered person must ensure that risk assessments for those people who are self medicating are held on file. Timescale for action 03/04/06 2 OP10 16 Working safety locks must be 30/04/06 fitted to all bedrooms doors and keys provided to residents unless risk assessment indicates otherwise. (Previous timescale of 30/12/04 not met) Two accessible double electric sockets must be provided in each bedroom. (Previous timescale of 30/12/04 not met) 31/05/06 3 OP24 16 4 OP29 19 The responsible individual must 31/03/06 furnish CSCI with details of action taken with regard to information held on staff recruitment files. Foundation training to meet NTO standards must be provided for care staff within the first 6 months of employment. All staff must receive refresher DS0000008468.V270289.R01.S.doc 5 OP30 18 30/06/06 6 OP38 13 31/05/06 Page 23 Bury Metro - Spurr House Version 5.1 training in moving and handling and food hygiene at recommended intervals. (Previous timescale of 30/12/04 not met) 7 OP38 23 All staff must attend an annual fire lecture and have an annual fire drill/practice. (Previous timescale of 30/12/04 not met) Action must be taken to ensure that water is delivered at a safe and satisfactory temperature (40°C - 43°C. (Previous timescale of 30/12/04 not met) 31/05/06 8 OP38 13 31/05/06 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 OP8 Good Practice Recommendations Signed and agreed risk assessments should be held on file with regard to use of bedrails or other arrangements made for a residents’ safety. Sufficient aprons should be provided for residents at mealtimes and staff should ensure stained clothing is changed after meals. The medication policies and procedures should be reviewed. The decision to use covert administration should be fully documented. The NMC guidance on covert administration should be considered. The drugs refrigerator temperature should be monitored to ensure the correct temperature range (2oC –8oC) is maintained. DS0000008468.V270289.R01.S.doc Version 5.1 Page 24 2 OP8 3 4 OP9 OP9 5 OP9 Bury Metro - Spurr House 6 7 8 OP21 OP24 OP30 The ambience/appearance of bathrooms and toilets should be improved. Bedroom furniture should be upgraded. An up to date training matrix should be held at the home and used by the manager as a monitoring tool to ensure all staff receive the necessary training. Residents should be regularly informed of the amount of money held for them by Bury MBC and consideration should be given to how residents could receive interest to their individual savings as advised by Department of Works and Pensions and CSCI. 9 OP35 Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Bury Metro - Spurr House DS0000008468.V270289.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!