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Inspection on 01/12/08 for Cameron House

Also see our care home review for Cameron House for more information

This inspection was carried out on 1st December 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cameron House 07/02/07

Cameron House 14/02/06

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service users are provided with a warm and homely accommodation appropriate to their needs. The service users are supported to personalised their bedrooms. The home has a registered manager who is responsible for the management of the service. The service has long standing staff and we observed that they had developed good relationships with the service users and their relatives. There is a good pre admission process in place that staff follow to ensure that the home can meet the service users needs prior to admission.

What has improved since the last inspection?

There is an ongoing programme of refurbishment at the home. A conservatory has been added to the building that provided the service users with added communal space.

What the care home could do better:

There is a lack of risk assessments and care planning to ensure that all the needs of the service users are appropriately met. The management of prescribed creams and ointments does not protect the service users. This poses high infection control risks to the service users. There is a lack of records relating to diet and fluids that can be to the detriment of the service users. Procedures need to be developed for managing medication and in particular large stocks of medication found at the service. The record showed that training in health and safety are inadequate and put the service users at risk of harm. The registered peron is failing to complete visits as required as part of their internal auditing of care.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cameron House 78 Pellhurst Road Ryde Isle Of Wight PO33 3BS     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anita Tengnah     Date: 0 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Cameron House 78 Pellhurst Road Ryde Isle Of Wight PO33 3BS 01983564184 01983811798 aqua2583@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Make All Ltd Name of registered manager (if applicable) Miss Sarah Margaret Floyd Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 18 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Date of last inspection Brief description of the care home Cameron House is registered to provide care for up to 18 older people who have a dementia. The home is one of two care homes owned by Make All Ltd and is managed by a registered manager - Sarah Floyd. The home is a detached period property that has been converted to provide accommodation on the ground and first floors and is situated in a residential area of Ryde. The bedrooms are mostly single with some double rooms, and access to the first floor is via a stair lift. There is off road parking at the front of the house with level access to the home. 18 Over 65 0 care home 18 Care Homes for Older People Page 4 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: An unannounced inspection visit was undertaken over one day on the 1st December 2008 as part of our inspection process. We sent out the Annual Quality Assurance Assessment (AQAA) to the registered person at the service. This is one of the means of collecting data from the service. We also sent out service users surveys to people living at the home. We spoke to a number of the service users, the staff and three relatives. We looked at the service users records and care plans and some staff records as maintained at the service and observed practices. We have used information as supplied by the home in their AQAA and other Care Homes for Older People Page 5 of 31 information that we have received since the last inspection. We also used an expert by experience for part of the day who observed staff practice and spoke to the staff and the service users on the day of the visit. Her observation will be reflected in the body of the report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 31 Care Homes for Older People Page 8 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a satisfactory process in place and the needs of the service users are assessed prior to admission. The home does not provide intermediate care. Evidence: We looked at the record of a newly admitted service user to assess the procedure that the home was using as part of their pre assessment of prospective service users. The record showed that the manager had completed an assessment and other information was sought from this persons previous home prior to admission. The assessment was detailed and contained information about their personal care needs, mobility and support that they would need. The manager stated that the service users relatives are offered the opportunity to visit the service and provided Care Homes for Older People Page 10 of 31 Evidence: them with information as per the statement of purpose. Staff reported that mostly family visited as the service users were not always able to do so. The manager stated that a care managers assessment was also sought as part of their pre assessment process. The manager confirmed that the home does not provide intermediate care. Care Homes for Older People Page 11 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans and records of care given are inadequate and must be further developed to protect the service users. The medication management is inadequate and action is needed to safeguard people from poor practice. There is a lack of risk assessments in order to promote and maintain safe practice. The service users are treated with respect and had positive comments about the way that they are treated. Evidence: We looked at the care records for four service users as part of this visit. We found that there were care plans in place and assessments for personal care and skin integrity such as Waterlow score. The staff reported that the care plans were available and used these for providing care. Although there were some information in the care plans, Care Homes for Older People Page 12 of 31 Evidence: these needed further development to ensure that they contained adequate details in the care plans to inform practice and ensuring that the service users needs are fully met. Assessments and care plans including dietary and moving and handling assessments must be completed to ensure that care is provided in a safe manner. We found that there were some reviews undertaken for the care plans in place, however these must be further developed to ensure that details of any changes are clearly recorded including action required to meet those needs. The care records showed that these reviews were last completed in June and July 08. The home has two service users with acute needs who were dependent on staff in providing all their care. The records of both of these people that we looked at did not contain adequate information and assessments were lacking. One of these people was receiving a pureed diet and there was no assessment completed by the speech and language therapist available. The care plans showed that both these people needed to have their diets and fluids monitored. The records of food and fluids showed that there were gaps of up to twelve hours where people had not received any sustenance. The records were inadequate in particular in relation to fluids taken in the evening and overnight. The care record also stated that one of the service users who had developed a pressure ulcer needed regular turning. There was no record such as a turn chart to show that this was carried out and the frequency that this was required, although the staff stated that this was done regularly. The care records for this person did not contain this information as required to demonstrate the care that has been provided. There was a lack of moving and handling assessments to ensure that care is provided safely. The staff reported that a hoist and sliding sheet was being used for the moving and handling of this person. However there was no assessment and the care plan seen did not reflect this. This posed the risk of lack continuity of care and the service users needs not being met appropriately. The home had minimal information about the daily care provided that were all recorded in a hard backed book. This was discussed as this poses serious breach of confidentiality as information for all the service users were recorded in one record. Information and record seen for three of the service users showed that they were doubly incontinent. There was no continence assessment available at the service and the manager stated that these had been carried out by external healthcare professionals. These must be sought and care plans must be developed with clear information about type of pads and their management, so that Care Homes for Older People Page 13 of 31 Evidence: the service users needs are met. There were no dietary assessments completed in particular for those at risk of malnutrition from the two records that we looked at and the people with acute care needs . This must be developed and care plans put in place in order to reflect the individual dietary support identified from their assessment to ensure that their needs are met. The manager reported that all the service users are registered with the local surgery and they were well supported by the local Primary Care Trust. It was evident from the records seen that the service users received regular reviews and staff made appropriate referrals as required for doctors visits. The two service users records showed that district nurses were involved in the treatment of their pressure ulcers as required. We looked at the medication management that the home undertook on behalf of the service users. The home was using the monitored Dosage System (MDS) that ran over a twenty eight days cycle. A record of medication administered was available on the MAR records kept at the service. We observed part of the lunchtime medication process. This showed that staff were following the homes procedure for administration of controlled medication. We undertook a random check of the medication received and found that these were satisfactory and the stock balance was correct. The manager stated that she carried out a regular check on medication and only the staff who had completed training in medication were responsible for them. We found that when medication was not given, the staff did not use the correct code to reflect the reason that the medication had not been administered. One of the service users record showed that they had refused their medication for 14 days and there was no record to show what action had been taken such as advice from Pharmacist or GP. We found that in the service users bedrooms and the communal bathrooms contained a large quantity of creams, emulsions and ointments that were not maintained safely and pose infection control risks and these being used as communal. These included creams that were in service users bedroom that were prescribed for other people. Other items included wound care dressings in the communal bathrooms and one expired cream. Care Homes for Older People Page 14 of 31 Evidence: One service user was prescribed Oramorph that was handwritten on the MAR sheet. We could not find a copy of this prescription for this medication. As discussed all medications that are transcribed onto the MAR sheets should contain two signatures to reduce the risk of error which is particularly important for controlled medication. Prescribed medication including creams, ointments and dressings must only be used for the named persons. We also found that the home had built up a large stock of some medication that the manager was aware of and would be dealing with this. We noted that the medicine trolley contained five loose sachets of an aperient. As discussed the staff must ensure that all prescribed medication must be dispensed from their original container and only to the named person. We noted that the Controlled medication cupboard did not meet with the current Regulation. This was brought to the attention of the manager and must be addressed. Further guidance about the safe management of medication can be obtained from the Royal Pharmaceutical guidelines. We observed the staff interaction with the service users throughout our visit. This showed that they had developed good relationship with them and they were treated with respect. We also spoke to two relatives as part of our visit and they were complimentary about the care that their relatives were receiving. Care Homes for Older People Page 15 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an activity programme in place. However further development is needed to ensure that they meet the social needs of the service users. The service users are supported well in maintaining contacts with their family and friends. The meals are satisfactory. Development in how the service users are offered choices and management of the planned menus is inadequate. Evidence: The expert by experience who accompanied the inspector looked at the activity programme for the service users on the day of the visit. The manager reported that there was a list of activities that was available to the service users. These included arts and crafts, books readings, games such as ball and skittles, music and movement and videos. We found that there was appropriate music throughout the day that three of the service users we spoke to said was lovely and they liked . Although the manager said that magazines and newspapers were available, there were Care Homes for Older People Page 16 of 31 Evidence: none on the day of the visit. We observed that one of the relatives had brought in a newspaper and commented that their relative enjoyed looking through the paper. Other activities were movement to music once a fortnight and an external entertainer also attended the home every two weeks. The vicar also visited once a month but had not visited as planned on the day of the visit. The hairdresser attended the home at regular intervals. The manager said that the service users always looked forward to having their hair done. The home has an open visiting policy and we observed that people arrived at the home at different times of the day . There was a record of visitors as required that the home maintained, evidence from this supported the view that there was no restriction on visiting. Three visitors were spoken to on the day of the visit. They all said that their relatives always looked well cared for and clean. Comments were that the staff were very nice and treated their relatives with respect and were kind. We looked at the meals that the service users were provided with. We found that hot and cold drinks were available at all times. The home has a planned menu that ran over four weeks. We looked at the meals and the records of food provided to the service users. We found that the records of food did not correspond with the planned menu. It was reported that the cook on duty chooses what is provided and we found some records of meals served, however this was not consistent. We spoke to one of the carers was responsible for the teatime meals on the day of the visit . She was unable to tell us which week menu she would be following and what was for teatime meal. We could not evidence how meal choices were offered to the service users. This is particularly important, as due to their mental frailty the service users may not be able to fully participate in choosing their food. As discussed the home must develop a system of recording the service users likes and dislikes with the involvement of relatives and friends to ensure people needs are met appropriately. The lunchtime meal was observed and this looked balanced and nicely presented. The staff were available to offer support with meals as required. The manager reported that the staff knew what the service users liked and offered them choices. This Care Homes for Older People Page 17 of 31 Evidence: included one person who was a vegetarian and the home did provide her with a meal of her choice. The service users and a relative we spoke to said that the food was nice and always plentiful. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a satisfactory process for raising and investigating concerns at the service. The staff have completed training in safeguarding and were aware of their responsibilities to report to the manager . Evidence: We looked at the system that the home had in place to deal with any concerns raised. The service had a complaint procedure that the manager stated was available to all the service users and relatives as required. A complaint log was put in place. There was no record of any complaint that the home had received since the last visit. The relatives we spoke to stated that they would approach the manager if they had any concerns. Comments were that anything raised is dealt with at the time. Staff we spoke to said they would approach the manager if any allegation was made to them. The home did no have the updated guidance on safeguarding at the time of the visit. This was brought to the managers attention and she reported she would access and staff will be updated with its contents. According to the training matrix that was provided, this showed that the staff had completed training in safeguarding in November 07. Care Homes for Older People Page 19 of 31 Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users are provided with a homely accommodation that met their needs. The infection control procedures were in place. However action is needed to eliminate risk of personal items being used as communal. Evidence: We walked around the home as part of this visit. We found that the home was in a satisfactory decorative areas and homely. The service users bedrooms that we looked at were personalised and clean. It was evident that they were supported to bring with them items of personal belongings when they moved into the service. The manager reported that the home has recently finished an extension and a conservatory had been added. This has provided the service users with extra communal space. This area looked well furnished and led to a secluded garden that was accessible to the service users. We found that the staff practice indicated that they were aware of the infection control procedures and protective equipment such as gloves and aprons were available. The communal areas were equipped with appropriate hand washing facilities. Care Homes for Older People Page 21 of 31 Evidence: The home has an internal laundry that was in good state of repair. We noted that all items that may be hazardous to health ere maintained safely at the time of the visit. As discussed at the time of the visit, the creams and ointments were not maintained safely and posed infection control risks to the service users. We also found some toiletries that were left in the communal bathrooms and this was brought to the attention of the manager, that posed infection control risk if used as communal. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has adequate staff to meet the current needs of people accommodated. The recruitment process is good and checks are undertaken as required. There is an ongoing training and induction programme in place. However evidence of training and updates in health and safety was inadequate. Evidence: We looked at the staff roster and the number of staff allocated for each of the shifts. This indicated that there are three carers on the morning and afternoon shifts and two carers on night duty. The manager was not counted as part of the numbers and supported the staff. We looked at three staff records as part of this visit to look at the recruitment process. All the prospective staff completed an application form and references were sought as part of the process. All necessary checks such as Criminal Record Bureau (CRB) and POVA first were completed. The manager reported that following receipt of POVA first checks, the staff started their induction while they awaited for their CRB clearance. Care Homes for Older People Page 23 of 31 Evidence: There is an ongoing training programme in place. The manager reported that all the carers follow the skills for care induction. Training included dementia care and the manager reported that there was four staff remaining to complete this training. Information we have indicated that six staff had completed National Vocational Qualification(NVQ) 2 in care and three staff were undertaking NVQ 3 and another staff was undertaking NVQ4. Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a registered manager who has management responsibility for the service. There is a lack of internal audit to ensure that the home is run safely and in the interests of the service users. The financial arrangements for the service users money is satisfactory. The health and safety if the service users were not always protected through lack of risk assessments and care planning. Evidence: The service has a registered manager who is responsible for the day to day management of the service. Mrs Floyd has completed her NVQ 4 in care and the registered managers award (RMA). Staff and the service users, relatives we spoke to spoke highly of the manager. Care Homes for Older People Page 25 of 31 Evidence: We looked at the financial arrangements that were in place for the management of the service users personal allowance. The manager confirmed that the home did not manage any of the service users money. Invoices are raised for items such as clothes shopping, chiropody and hairdressing and these are sent to the people responsible as required. We also looked at the internal audit process that the home operated and seeking the views of the service users, their friends, relatives and others such as health care professionals and placing authorities. Positive comments had been received from the audit in 2007. We also looked at the record of unannounced visit that the registered provider must undertake on a monthly basis to evaluate how the home was meeting its commitments as per the statement of purpose. We found that the last record dated April and no further reports were available at the time of the visit. The registered person must ensure that unannounced visits as required by Regulation are completed and records of these are available at the service as required. As identified in previous section of the report, the arrangements for the safe keeping and management of creams, ointments were inadequate to safeguard the health and welfare of people using the service. We observed that one of the service users was transported in her wheelchair without any foot rests. This was brought to the attention of to the manager and resolved. There is inadequate risk assessments including moving and handling, continence, dietary needs to fully safeguard the service users and must be developed. The training matrix showed that training and updates in moving and handling were last completed in 2007. There is no evidence of updates in the matrix we have been provided with. The matrix also indicated that fire safety training was completed once a year, further information about fire training should be sought from the fire officers. Care Homes for Older People Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The registered person must 08/02/2009 ensure that appropriate care plans are developed and put in place to demonstrate how the individual care needs will be met. So that the service users receive the care as to their assessed needs. 2 8 14 The registered person must 01/02/2009 ensure that the home is conducted to make proper provision for the health and safety of the service users. This must include risk assessments for moving and handling, continence management. So that you can ensure that the service users are not put at risk of harm. 3 8 12 The registered person must ensure that a nutritional screening and accurate records of diets and fluids 08/02/2009 Care Homes for Older People Page 28 of 31 are maintained. So that you can ensure that they receive the care safely and according to their needs. 4 9 13 The registered person must ensure that contolled drugs are stored in a controlled drug cupboard which complies with the Misuse Of Drugs ,safe custody Regulations 1973. To comply wih the Law 5 9 17 The registered person must ensure that arrangements are in place for the safe handling, recording, safe administration and disposal of medication received into the service. So that the service users receive their medication safely. 6 33 26 The registered person must ensure that unannounced visits are undertaken at least monthly as part of the internal audit, a record of these visits are available at the service So that that you monitor the care and service to ensure that the home is run in the best interests of people accommodated. 7 38 13 The registered person must ensure that the home is 08/02/2009 08/02/2009 08/02/2009 31/03/2009 Care Homes for Older People Page 29 of 31 conducted in a manner that prevents unnecessary risks to the health and safety of the service users. So that you can ensure that care is provided in a safe environment, risks are eliminated. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - 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!