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Inspection on 19/09/06 for Chegworth Nursing Home

Also see our care home review for Chegworth Nursing Home for more information

This inspection was carried out on 19th September 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.

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

What has improved since the last inspection?

Work has been undertaken to address the issues raised at the last inspection with regard to gaining residents views of the home and the services that they receive. A questionnaire has been developed although it was considered that this could be improved and made more " user friendly ". Residents do, however, have the opportunity to air their views at meetings held for them and their relatives are always invited to social events held in the home where they can meet the Registered Provider and senior staff. Concerns about medication administration have been partly resolved. There is now information on the medication sheets to help staff identify individual medication however it was noted that this was missing in one instance. Ideally all medication should be supplied individually packaged and The Registered Provider has agreed to look into this. An extensive redecoration programme has started since the last inspection and communal areas have been re carpeted and decorated. Some of the resident`s bedrooms have been refurbished and the others will be done. Those that have been done look fresh and attractive and residents have been encouraged to personalise them so that they look homely.

What the care home could do better:

As already stated, there are still some outstanding concerns regarding the administration of medication in the home that should be rectified in order to minimise the risk of any errors. It was noted that there was not always evidence that relatives had been informed if residents wished to undertake any activities, which could compromise their safety. This information must be included in care plans in future. The Registered Provider is frequently in the home however, in order to fulfil his obligations in accordance with the regulations, these visits must be documented and include information as to those issues considered at that particular time.

CARE HOMES FOR OLDER PEOPLE Chegworth Nursing Home 23 Downs Side Sutton Cheam Surrey SM2 7EH Lead Inspector Alison Ford Key Unannounced Inspection 19th September 2006 10:30 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 Chegworth Nursing Home DS0000019083.V311954.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. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chegworth Nursing Home Address 23 Downs Side Sutton Cheam Surrey SM2 7EH 020 8642 9453 020 8642 8834 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) Bayswift Limited Mrs Puspavani Barkakaty Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Day care may be provided for a maximum of three people. Prior to any day care patients being admitted, the National Care Standards Commission must be informed in writing of the purpose of the placements, the facilities to be provided, together with the arrangements for staffing, needs assessments and care planning. A variation has been granted to allow one specified service user under the age of 65 to be accommodated subject to evidence of regular review of the situation and the service user’s assessed care needs. 20th December 2005 2. Date of last inspection Brief Description of the Service: Chegworth is a residential care home registered with The Commission for Social Care Inspection to provide personal and nursing care for up to thirtyseven older people. No other categories of registration apply. The home is a large, detached, domestic style house providing accommodation in twenty-nine single bedrooms, three of which have en-suite facilities and four, which have W.C facilities; in addition there are four double bedrooms. There are two lounge areas separated by an office area and nursing station. There is no designated dining room; residents choose either to eat in the conservatory or at cantilever tables in the sitting room. The usual facilities such as kitchen, laundry, toilets and bathrooms are all in place in sufficient numbers. The home is well maintained with a beautiful rear garden. Fees at the time of the inspection ranged from £514 - £750 per week. Any extra charges would be discussed prior to admission. Further information, a copy of the homes statement of purpose and the latest inspection report can be obtained from the home. The latter can also can also be obtained from The Commission for Social Care Inspection and via the internet. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was an unannounced visit lasting four and a half hours. During this time a partial tour of the premises was undertaken, many of the homes thirty-seven residents were spoken with and asked for their comments about the care that they receive and also five members of staff on duty. Discussions were held with the Registered Provider, the Registered Manager and her deputy and the homes clinical nurse teacher. Three relatives, that were visiting, were also asked about their views of the home, the care and support provided and the staff that work there. A sample of care plans were assessed and records that provide evidence that the health and safety of residents and staff is protected were seen. Personnel files of new members staff were checked to ensure that they contained all of the necessary documentation and staff training schedules were looked at. Menus and kitchen records were seen and the lunchtime meal was observed during the visit. No complaints or concerns have been received either by the home or by The Commission since the last inspection although one issue is still ongoing. What the service does well: This home provides a safe, clean and well-maintained environment for the residents who live there. The atmosphere is warm and friendly and residents find it homely and a pleasant place to live. Aids and adaptations are in the home to help residents and make their lives easier and a range of activities is arranged to suit their capabilities. Several residents commented on how much they enjoyed living in the home and how lovely the staff were. Their relatives agreed that they were always made to feel welcome and that they never had any concerns about the care that is provided. All of the residents looked exceptionally well cared for on the day of the inspection; clothing had been colour – coordinated, ladies had been helped to put make-up on and the hairdresser visits regularly A full and comprehensive pre-admission assessment undertaken by the matron or a senior nurse ensures that the healthcare needs of residents will be met and provides the basis for individual care planning. These care plans are subject to regular review and there is evidence of involvement of the residents and their relatives. A doctor visits regularly; he was there on the day of the Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 6 inspection, and is very involved with the home. Advice is gained from other healthcare professionals as required. A new chef has recently been appointed and residents considered that the food was tasty and well presented. A meeting had just been held with residents to discuss planned changes to the menu and they had been able to contribute their ideas and influence the range of dishes to be served. Residents enjoy the range of activities that are offered to them and there are photographs around the home of them enjoying various events. . A robust complaints procedure is in place however none of the residents spoken to have ever felt the need to use it. They were confident that the management team would deal with any issues promptly as they occurred. Staff training is given a high priority in the home and the continued employment of a clinical nurse teacher to work with care staff on a regular basis causes the home to exceed the minimum standard in this area. What has improved since the last inspection? What they could do better: Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 7 As already stated, there are still some outstanding concerns regarding the administration of medication in the home that should be rectified in order to minimise the risk of any errors. It was noted that there was not always evidence that relatives had been informed if residents wished to undertake any activities, which could compromise their safety. This information must be included in care plans in future. The Registered Provider is frequently in the home however, in order to fulfil his obligations in accordance with the regulations, these visits must be documented and include information as to those issues considered at that particular time. 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. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. A full and comprehensive pre-admission assessment, undertaken by a senior member of the nursing staff, ensures that this home is able to meet the assessed healthcare needs of potential residents and that they will be happy living there. This home does not offer intermediate care EVIDENCE: Five care plans of residents admitted since the last inspection were seen. All contained evidence of a comprehensive pre-admission assessment. Where they had been admitted through care management arrangements, copies of the relevant assessments had been obtained. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 10 The home uses a care planning system, “Standex” and the assessment forms the basis of subsequent care planning. There was evidence that relatives had also been involved in this process although it was noted that relatives had not contributed to a risk assessment for one resident who likes to stroll around the garden. While appreciating that residents should be given this opportunity there must be evidence that relatives are aware that it is happening. ` Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. Residents in this home have an individualised plan of care, which is subject to regular review in order to, ensure that their assessed healthcare needs remain met and they can be confident that staff will always treat them with respect. Medication policies and procedures are not always sufficient to ensure the total protection of residents. EVIDENCE: A sample of five care plans was reviewed. Risk assessments were generally in place for manual handling, prevention of pressure sores and maintenance of safety. These plans are reviewed monthly in addition to resident’s annual reviews There was evidence that relatives have been asked to contribute to these plans and are aware of their content. Although, as detailed in standard 3, care must be taken to ensure that relatives are always aware of all the risks being taken by residents. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 12 . A range of pressure relieving equipment was seen in use throughout the home and care plans contained evidence of regular monitoring of skin integrity and body weight. Other members of the multidisciplinary healthcare team such as the tissue viability nurse, dentists, chiropodists and opticians make regular visits to the home and these are documented. The majority of the residents are registered with the same GP who visits regularly and was in the home on the day of the inspection. Care staff were observed to be treating residents with respect and all of those spoken with agreed that staff were kind and caring. The majority of personal care is provided in resident’s own rooms although unfortunately there is a frequently used toilet in the lounge area. It is hoped that proposed plans will include suggestions as to how this can be re-sited. Two comment cards received prior to the inspection asked for a private seating area where relatives could visit residents and it is hoped that this too may be incorporated when plans are considered. In the meantime chairs and small tables have been put into the large entrance hall to provide extra seating. At previous inspections it was noted that all medication due at the same time of the day is included in the same blister package. A requirement was issued at that time to ensure that the nursing staff that administer medication were able to identify individual drugs. In response to this the pharmacist now includes a description of each drug on the card however, it was noted that in one case this had not been done. The requirement is therefore repeated with the recommendation that all drugs should be individually packaged. The senior staff in the home is aware of the need to consider the past lives of residents and recognise their achievements in order to gain a better understanding of them as individuals. A document has been produced to record this and it is hoped that this will be completed in the near future. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. Residents in this home are able to participate in a range of activities, which suit their needs. They are encouraged to maintain contacts with their families and friends and to exercise choices in their daily living in order to maintain their independence. A wholesome appealing diet is served which adds variety and interest to their lives. EVIDENCE: The activities programme in the home adds interest to resident’s daily lives. Various photographs are displayed on the walls showing visiting entertainers and events and outings that have been arranged. The local library supplies books and religious representatives visit regularly. Residents confirmed that they are supported to make choices within their daily lives and that their relatives and friends are always made welcome when they visit and offered tea. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 14 A new chef has recently joined the home and has held a meeting with residents to discuss the menus. They were able to make suggestions, which will now be incorporated and were looking forward to having some of their favourite dishes cooked for them. Residents are always told in the morning what will be served later in the day and choices are always available. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. Residents in this home are confident that the complaints procedure in use within the home will ensure that any complaints that they might make will be treated promptly and with sensitivity. Policies and procedures are in place to ensure the protection and safety of residents. EVIDENCE: There is an appropriate and comprehensive complaints policy in use in the home and details are in the service users guide. No complaints have been received about the service since the last inspection. All of those that were spoken with agreed that should they have any concerns these would be dealt with swiftly by the matron and her staff. The Registered Provider is often in the home and relatives commented that he was also very approachable should they have any problems. Regular training sessions take place to sure that staff are aware of how to recognise and respond to issues concerned with adult abuse. These would be dealt with according to locally agreed procedures. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 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): 19,26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. This home provides a clean pleasant and well-maintained environment, which meets the needs of its residents in a homely and comfortable way. EVIDENCE: The home is situated in the suburbs of Cheam and there is a bus route nearby. Some parking is available in the front and there is a large rear garden. A shaft lift ensures that the entire home is accessible to its residents and adaptations have been made throughout the home, which are suited to the needs of older people. The overall ambience is homely although some room sizes would not meet the requirements of a newly built home. The Registered Provider is hoping to extend the home in the future. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 17 There is a large lounge and a conservatory, which looks out into the garden. This area is also used as a dining room for some of the residents. All areas are well maintained and a programme of refurbishment and redecoration is currently underway. Carpet in corridors and communal areas has been replaced and some rooms have been refurbished. Others are still to be done. Automatic door closers are now fitted to all the bedroom doors to ensure residents safety in the event of a fire. Resident’s bedrooms are being redecorated and refitted and are attractively colour coordinated and they have been encouraged to personalise them with items of their own to make them feel more comfortable. The home was very clean and tidy and free from odour on the day of the inspection and, laundry facilities are sited away from areas used by residents. Bed linen and towels are sent out to a commercial laundry and personal items are washed in the home. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. Residents can be sure that there will always be sufficient staff on duty to care for them and that there are recruitment policies in place to protect them. In order to maintain the wellbeing of residents, the management team of the home make every effort to ensure that staff are suitably trained for the work that they do. EVIDENCE: The home is always staffed according to previously agreed levels by a mixture of trained nurses and care staff. They are supported by a range of domestic staff who ensure that the home is always clean and tidy and safe for residents to live in. It is considered that training within the home exceeds the standards recommended by the National Minimum Standards. 97 of care staff are trained to at least NVQ level 2 standard and several of them are looking to progress to study at level 3. Two carers have already attained level 3 qualifications and one has a level 4. Matron and her deputy are studying for the Registered Managers Award at level 4. The home employs a very experienced clinical nurse teacher on a regular basis to support and work alongside care staff and trained nurses to maintain and improve their standards of care. A training schedule is in place and she is Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 19 responsible for delivering a range of training within the home. A comprehensive induction programme is in place for all new staff and there is regular supervision and appraisal. Staff also have every opportunity to attend training sessions from external providers and several of these, relevant to the needs of residents, are planned for the future. Residents can therefore feel confident that staff are appropriately trained for the work that they do and that they have the skills and knowledge to meet their needs. A previous inspection had noted some concerns with recruitment practices however these have now been resolved. The files of two members of staff employed since the last inspection were seen and contained evidence that appropriate checks had been made prior to them starting work. The Registered Provider was reminded of his responsibility to inform The Commission should he wish to employ new staff without full clearance from the Criminal Records Bureau being obtained. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 20 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): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to the service. Residents can be confident that a competent person manages the home in their best interests and that their views will be taken into consideration. The management team of the home have policies and procedures in place to ensure the health and safety of residents and staff. EVIDENCE: The Registered Manager, a nurse, has been in post for some time and is very experienced in caring for this client group. She is supported by a deputy and residents are aware of the lines of accountability within the home. Staff meetings are held regularly so that all staff are aware of any new developments and are able to air their views. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 21 Residents / relatives meetings are held yearly so that they can contribute to the running of the home and relatives are invited to join the home for various activities throughout the year. A formal quality assurance form has been developed however it was recommended that in order to be more useful it would benefit from questions being made more specific and “user friendly”. The Registered Provider is frequently in the home however he must now find a formal way of recording these visits in line with regulation 26. The home does not take responsibility for the finances of any resident they all have a relative or representative to do this for them. All staff have undertaken training to ensure that their working practices are in accordance with current legislation and equipment has been maintained and checked appropriately. Policies and procedures are in place to maintain the health and safety of both staff and residents. Incidents and accidents are appropriately recorded, kitchen records are all well maintained and regular fire drills take place within the home. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 22 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 2 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 23 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 OP3 Regulation 15 Requirement Timescale for action 30/12/06 2 OP9 13(2) The Registered Manager must ensure that resident’s relatives must be made aware of any activities that they wish to pursue which may compromise their safety. The Registered Manager must 30/12/06 ensure that the pharmacist dispenses medication in a manner, which ensures that those administering it can always identify the individual drugs. (Previous timescale 30/01/06 not met) The Registered Manager must 19/09/06 ensure that approval is gained from The Commission prior to any employee beginning work without full clearance from The Criminal records Bureau. The Registered Provider must 30/12/06 ensure that there is evidence available to show that visits have been made in accordance with Regulation 26 3 OP29 19(1)(b) 44 OP33 26 Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP33 Good Practice Recommendations It is recommended that all medication should be supplied to the home individually packaged. It is recommended that the quality assurance tool in use should be made more “user friendly” and specific. Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Chegworth Nursing Home DS0000019083.V311954.R01.S.doc Version 5.2 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. 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