Inspection on 22/11/06 for Castle Court

This inspection was carried out on 22nd November 2006.

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

Castle Court 11/04/06

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Castle Court Arthur Street/Linton Road Castle Gresley Swadlincote DE11 9HG Lead Inspector Claire Williams Key Unannounced Inspection 22nd November 2006 0800 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 Castle Court DS0000066379.V315322.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. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle Court Address Arthur Street/Linton Road Castle Gresley Swadlincote DE11 9HG 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) 01283 223673 www.derbyshire.gov.uk Derbyshire County Council Janet Elizabeth Allcote Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th April 2006 Brief Description of the Service: Castle Court is a residential home situated in Castle Gresley. It is a purpose built home that provides personal care and accommodation for up to 41 older persons. All of the accommodation is situated on the ground floor, and all bedrooms are single apart from the provision of one double bedroom. All have en-suite facilities, and are fitted with patio doors, which lead out to a small garden area for each individual. There are three shops, which are local to the home. The home has separate lounge and dinning areas, a hairdressing room, smoke room, and an activities area. All areas are wheelchair accessible. Information about the service is provided in the Statement of Purpose and Service User Guide; both of these documents are made available to residents. Information included on the pre-inspection questionnaire received on 20/09/06 stated that the fees for the home commenced from £289.70 per week. Items not covered in the fees include hairdressing, chiropody, toiletries, and transport. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, carried out by one inspector, which lasted 10 hours. A review of the evidence available prior to the site visit was undertaken, for example, the pre inspection questionnaire, resident surveys (8 surveys received) and notification of incidents, are used to identify areas to be examined during the site visit. Records such as care plans (as part of the case tracking process, which is used to help determine how the home meets the needs of individual residents) were examined during this inspection. Time was spent taking with 12 residents and 7 staff members who were on duty and observing the daily routine. The inspector also had the opportunity to speak with 3 relatives. Some bedrooms were viewed during this visit and a brief tour of the building was undertaken. Other records such as medication records, and staff files were also examined. An assessment was also made of the progress by the registered persons to address the requirements made at previous inspections. The registered manager was on duty and assisted the inspector with the inspection. Following consultation with these people, it was agreed that they would be referred to as ‘residents’ for the purpose of this report. What the service does well: Castle Court is a purpose built home, that provides a very well maintained environment, which is furnished and decorated to a good standard. Resident’s rooms are personalised and comfortable and the home is spacious and fitted with all of the required equipment to enable individuals to retain their independence. During the last six months ‘snagging’ issues on the new building have been attended to. New and more appropriate sinks have been provided and some lightening is to be replaced. Residents are involved in developing a detailed care plan which informs the staff team about their delivery of care, and which is completed from the individuals perspective. This ensures that the individuals receive the level of care in a way they want and need. All members of staff have worked extremely hard to help residents settle into the new environment and to welcome new residents into the home. There is a friendly, and relaxed, but professional atmosphere in the home. Residents express high levels of satisfaction with the care and services they receive, including very good relationships with staff, who do very well in promoting residents daily living choices, lifestyle preferences and also with opportunities to maximise residents independence in consultation with them. Resident’s health needs are well met and they are treated with the utmost Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 6 respect. Residents commented that the food and meal provision is generally of a good standard. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, and 3 (Standard 6 is not applicable in this home) Quality outcome in this area is good. This judgement has been made using evidence available, including a site visit to the home. Residents have access to information that informs them about what they can expect from living at this home and receive an assessment to ensure the home is able to meet their needs. EVIDENCE: The feedback received from the discussions and the surveys, confirmed that residents had been given a file which contained information including the Service user guide. Residents can access the Statement of purpose, which is within the resource file that is located in the lounge areas. All perspective residents are now provided with a copy of the Statement of purpose in order to provide them with information about Castle Court. Information from the surveys generally supported that residents considered that they had received enough information to decide if the home was the right place for them to live. Case tracking was undertaken with four residents and individual’s care needs were discussed with two of those residents, including the arrangements for Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 9 their assessment. All files contained a full needs assessment which had been undertaken by a Care manager. In addition to this the resident is assessed by the home on the day of their admission in order to gain more information about their preferred routine such as their rising and retiring times. In discussions with the staff team it was evident that they were fully conversant with residents needs. The relatives of residents that were new to the home (as majority of the residents had transferred from two home that have closed.) stated that they initially visited the home for respite and then “due to liking it moved in on a permanent basis”. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 Quality outcome in this area is good. This judgement has been made using evidence available, including a site visit to the home. Service users health care needs are fully met and they are effectively consulted about their care and treated with the dignity and respect. EVIDENCE: The staff and management team have worked hard to improve the systems in place in regard to the care plans. Good record keeping and care planning is essential to the well being of residents, and staff are to be congratulated for the progress they have made in this area since the last inspection. Three out of the four files examined contained a detailed care plan, which had been written from the individual’s perspective. The information enables the staff team to delivery the residents care in a manner that they require. Residents have both a day and evening care plan which is good practice as it enables the night staff to be aware of individuals needs throughout the night. Each resident had signed their plans in agreement and held a copy in their bedrooms in their information file. The inspector was informed that the plan for the fourth resident was in the process of being written as the resident had only recently moved into the home a few days before. The plans were developed by utilising the key working system, which has been introduced so that a staff member is Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 11 appointed to a small group of residents so that they can build up a relationship and work on a one to one basis with them. Residents who were able were involved in their care planning, including reviews with them on a regular basis, which were also recorded. Each file contained the required risk assessments in relation to moving and handling, falls, tissue viability, medication and nutrition. There was evidence to support that any risks identified were monitored and reviewed accordingly. Records were also maintained in respect of the arrangements for each resident to access outside health care professionals, including for the purposes of routine health care screening and individuals confirmed their access to these. The arrangements for the management and administration of medicines was examined and discussed with an assistant manager for those residents case tracked. These were generally satisfactory, with the exception of some omissions that included: one gap in one resident Medication Administration Record (Mar chart). A Mar chart with handwritten medication instructions that had not been countersigned by two people. Three gaps in the chart for the recording of the temperature of the medication fridge, and the administration of medication to a resident that was not in accordance with the GP prescribed instructions due to the residents wishes. These were discussed with the Registered manager who confirmed that she would address the issues and speak to the managers, as they are responsible for administrating medication. The Registered manager confirmed that training was currently being organised by the providers training department. Residents who have the capacity are encouraged to keep and take their own medication and an assessment was in place for this purpose and to assess any potential risks. The arrangements for personal care and support were discussed with residents and also staff’s approaches with them. All said that the care and support they received was ‘second to none’ and ‘they couldn’t wish for any better and that staff were ‘absolutely marvellous’ and treated them with ‘dignity and respect’ and consulted with them at all times. The relatives spoken with also spoke positively about the level of care provided and felt that their family member “was well looked after” and that the staff were ‘very good and caring’. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 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 Quality outcome in this area is good. This judgement has been made using evidence available, including a site visit to the home. Service users are fully consulted with in respect of their daily living arrangements and their rights to live meaningful, social lives in accordance with their chosen lifestyle. EVIDENCE: Discussions were held with residents about the arrangements for them to engage in leisure, social and religious activities, maintain personal and social relationships and also regarding food and mealtimes. Discussions were also held with staff and records examined in relation to these. Residents felt that the arrangements for the above were good, with regular provision of choice of individual and group activities both in and outside the home and that provision was frequent and varied. All said they were able to choose the frequency and type of activities they engaged in, in accordance with their lifestyle preferences and individual choices. An activity co-ordinator is employed who maintains records of activities engaged in by each service user. Residents spoke of how they had enjoyed the memorial activities and how they were looking forward to the Christmas lunch that was arranged for next week. A list of the activities available is displayed on the notice boards located by the dinning rooms. One survey received did state that it would nice Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 13 if activities were provided at different times of the of the day and this was passed onto the manager. At time of the visit the activity co-ordinator was on annual leave, but residents were observed accessing the activities room, in order to do some art work or sewing, visiting the hairdresser in the salon provided, reading as part of the book club, and having a manicure by a staff member. Relatives consulted stated that there is a welcoming and friendly atmosphere in the home, and good links were being established with the local community. They confirmed that they were able to visit at any time, and enjoyed the bingo that was held every month, which was also attended by people from the local community. The inspector was invited to have a lunchtime meal. The Registered manager informed the inspector that new menus had been devised following consultation with the residents that was currently being checked by the catering manager to ensure it was varied and nutritious. Majority of the residents spoke positively about the standard of food and meals provided, and confirmed that choices were “always available”. However some feedback received stated that the food “could be improved”. Observations confirmed that the mealtime was relaxed and the tables were set with napkins and condiments. The inspector did note that only one vegetable was on offer to accompany the meal and some residents declined it as they “didn’t like it”, but no alternative was offered. Residents confirmed that meals were always presented in nice manner. The inspector spoke with one resident who is encouraged to be independent and who routinely makes her own dinner and receives “great satisfaction from this”. The chicken dinner that was made was shared with a friend and both commented, “it was lovely”. There were no residents accommodated with special religious or cultural dietary needs. Special diets are catered for. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality outcome in this area is good. This judgement has been made using evidence available, including a site visit to the home. Residents were confident in using the complaints procedure, and are safeguarded from abuse by the staff’s knowledge regarding recognising and reporting abuse. EVIDENCE: There is a clear written complaints procedure for the home, which is openly displayed. Residents spoken with knew how to complain, although all said they had no cause for complaint. The relatives spoken were also aware of the procedure and were confident that any issues would be addressed without hesitation. The complaints record was examined and there had been 10 complaints since the last inspection, all had been responded to appropriately and records maintained. The Commission for Social Care Inspection have not received any complaints for this service. Discussions were held with staff regarding the safeguarding of residents from abuse in care. All staff had received instruction/training in respect of recognising abuse and was conversant with the procedures to be followed in the event of the recognition or witnessing of the abuse of any resident. The Commission for Social Care Inspection have not received any Safe guarding adults referrals for this service. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23, 25 and 26 Quality outcome in this area is excellent. This judgement has been made using evidence available, including a site visit to the home. Residents live in a safe, comfortable, clean and well-maintained environment, which provides purpose built accommodation to a good standard and to the satisfaction of residents who are accommodated there. EVIDENCE: Castle Court is a newly purpose built home that provides a spacious and homely environment which includes: a choice of lounges, an attractive courtyard with available garden furniture, an activities room, hairdressing room and kitchens that can be used by residents and their families. The private and communal accommodation of resident’s case tracked was inspected and was found to be well furnished and decorated to a good standard and well maintained. Residents own rooms were well personalised and those spoken with expressed their satisfaction with these and the environmental standards throughout the home. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 16 All areas of the home were clean, odour free, well lit and ventilated and warm, although some problems, with the heating have been experienced, but an engineer was at the home to try and rectify these issues. The Registered manager is still responding to any issues with the building that are raised due to it being new and in response to individual requirements. The rooms are very well planned and all have en-suite facilities and are above the average size. The fixtures and fittings are of high quality, well maintained and adapted to meet the wishes of the present resident. Some snagging issues are still being addressed such as the sinks, which have nearly all been replaced so that they are at a convenient height, the taps have also been replaced and overflows so that plugs can now be used. There are suitably laundry facilities and also separate sluicing facilities. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 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): 27, 28, 29, and 30 Quality outcome in this area is good. This judgement has been made using evidence available, including a site visit to the home. Residents receive good standard of care from a committed and motivated staff team. Residents are safeguarded by the recruitment procedures. EVIDENCE: Details of staff employed, staff turnover, training and deployment were provided by way of the pre-inspection questionnaire. These were discussed with the Registered manager during the inspection and records were examined in relation to these, including staff duty rotas. The discussions held with the staff members confirmed that they now felt settled in this new home, and they commented on how they have got to know all of the residents. The staff felt that they were all working as a team and comments received included “we all work well together” “the staff morale is much better”. It was evident from the staff discussions that they were committed to their roles, and “enjoyed their job” and received “great satisfaction from working with the people in the home”. The staff members however did comment that they still think that they do not have much quality time with the residents and feel that they are “always rushing around”. The staff are responsible for undertaking the laundry tasks in addition to supporting the residents and they felt that this time takes them away from their ‘caring role’. The residents and relatives consulted with spoke positively about the quality of the care received, and all made comments praising the staff for their hard work and commitment to ensuring the residents are “well cared for”. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 18 The arrangements for staff recruitment and induction was discussed with the Registered manager and the personal files of four more recent staff employed were examined. All of the files contained the required information and there was evidence to support that these staff members had undertaken an induction. The inspector did note a gap in one of the staff member’s employment and this was discussed with the Registered manager. The staff members consulted confirmed that they have previously undertaken all of the training that is deemed mandatory and have recently received refresher training in moving and handling and fire training. However the staff files do not reflect the ongoing training that the staff have received and the Registered manager is in the process of trying to obtain evidence in the form of a training matrix from the training department. The Registered manager stated that she has arranged for all of the staff to attend all of the mandatory training so that this can be undertaken in the teams that they are now working in. The pre-inspection questionnaire stated that 16 care staff had achieved a National Vocational Qualification (NVQ) at Level 2 or equivalent, therefore achieving the required 50 target. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 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, 35, and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from the home being managed by an experienced manager who provides clear leadership throughout the home. EVIDENCE: The Registered manager has many years experience of working with this client group in various capacities and has achieved an NVQ level 4 in management. and care. She is motivated and committed to ensuring that the home is managed in the best interests of the residents and that they are consulted about the day to day running of the home. Since the previous inspection she has worked to improve the services and provide an increased quality of life for the residents. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 20 The residents, relatives and staff members consulted spoke positively about the management team and felt that they were supportive and approachable. There was evidence to support that a quality assurance survey had been completed previously in the year, and the results were displayed on the notice board. The results generally identified that residents were satisfied with the services they received. There was evidence to support that a representative of the registered provider visits the home on a monthly basis, and reports of those visits were provided. The arrangements for the management and handling of resident’s monies were discussed, and the records and the money was cross-referenced and found to be accurate. Details of the required maintenance of equipment were provided in the preinspection questionnaire and these were satisfactory. As mentioned previously the Registered manager is recording and reporting any faults identified with the building, and equipment and these are then reported and addressed by the contactors that installed them. Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 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 3 3 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X 4 X 4 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 (2) Requirement Resident’s medication must be administered as it is prescribed by their GP. Any changes in these arrangements must be discussed and agreed with the GP before they are implemented. The management team must ensure that the temperature of the medication fridge is monitored and recorded on a daily basis. Timescale for action 31/01/07 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 OP7 Good Practice Recommendations Residents should have a care plan completed within 7 days of their admission into the home. The residents care plans should contain information in relation to like and dislikes in respect to food and drinks. The management team should ensure that the medication DS0000066379.V315322.R01.S.doc Version 5.2 Page 23 2. OP9 Castle Court administration charts are signed after the administration of the resident’s medication. Two people countersign must countersign all handwritten medication instructions. All of the management staff should receive external medication training. An assessment of competency should then be completed following this training. The Registered Person should ensure that all residents are consulted on the variety of activities facilitated within the home and the times they are available. It would benefit the residents if two or three vegetables were available to accompany the main meal of the day. Resident dependencies should be continually monitored to ensure staffing levels continue to meet residents’ assessed needs Staff files should reflect the training they have undertaken. The management team should ensure that all staff are supervised as recommended in the National Minimum Standards six times a year. 3. 4. 5 6 7 OP12 OP15 OP27 OP30 OP36 Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Castle Court DS0000066379.V315322.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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