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Inspection on 10/08/06 for Chelston Park Nursing Home

Also see our care home review for Chelston Park Nursing Home for more information

This inspection was carried out on 10th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

There is evidence that service users are pleased with the care they received at Chelston Park. Service users met with during the inspection made positive comments about the care received in the home. "I am very happy...couldn`t fault it here." Another person said "the staff look after me well." Comment cards indicated that all service users who responded were satisfied with their care. They knew who to talk to if they were not happy and would know how to make a complaint although few had done so. All service users felt the home was "always" or "usually" fresh and clean.Medical support was available and activities are provided to suit a high proportion of service users. There is evidence of considerable investment and commitment to training in the home. The home reports having, 30 staff of which 75% have NVQ 2 or above. 8 staff either have NVQ3 or equivalent or are studying towards this level. There are opportunities for Registered Nurses to up-date their skills and to study at a professional level. Training is managed and recorded in an efficient and effective manner reflecting an overall training plan for the home. Training is delivered in a flexible and creative manner utilising in-service training, medical representatives and external courses and trainers. The home has an Investors in People award. The gardens of the home are very pleasant and are accessible and used by the service users and their visitors.

What has improved since the last inspection?

The environment continues to improve and to reflect investment in the home. Attention has been paid to the requirements and recommendations of the last inspection report.

What the care home could do better:

The management of hot water must be reviewed as some water is leaving taps above 50 degrees. Measures must be in place to protect service users. A review of the medication records revealed some poor recording. There were some gaps on the recording charts. The management of prescribed creams in the home must be improved and implemented according to current best practice. The management of self- medication is not sufficiently robust. The storage of oxygen must be reviewed. Care plan documents are continuing to develop. A plan for the psychological care of service users should be include when appropriate. Efforts should be maintained to complete all care records in a timely and appropriate manner. Any room that contains potentially harmful chemicals should be locked when not occupied.While some service users liked the food some did not and it is recommended that the catering staff undertake further consultations with service users to improve their satisfaction.

CARE HOMES FOR OLDER PEOPLE Chelston Park Nursing Home West Buckland Road Wellington Somerset TA21 9PH Lead Inspector Shelagh Laver Key Unannounced Inspection 10th August 2006 09:30 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 Chelston Park Nursing Home DS0000003249.V307525.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. Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chelston Park Nursing Home Address West Buckland Road Wellington Somerset TA21 9PH 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) 01823 667066 01823 666986 Chelston Park Nursing & Residential Home Limited Mrs Joanne Girdler Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Elderly persons of either sex, not less than 60 years, who require general nursing care Up to four persons of either sex, in the age range 40-59 years, who require general or nursing care. Up to six places for personal care Maximum of 30 nursing care place Date of last inspection 17th January 2006 Brief Description of the Service: Chelston Park is a large house that was adapted and extended to become a care home in 1986 (formerly known as the Pennant). The home offers general nursing care for persons over 60 years of age and has four places for persons aged between 40 - 59 years. Personal care only can be offered to persons who are at least age 65 years on admission. The home is spacious and comfortable and sits in large landscaped grounds. There are excellent views of the Blackdown Hills and Wellington Monument from some rooms. There are plans to develop and extend the home, including the kitchen during 2006. The home is well maintained and adapted for purpose. There are assisted bathing and disabled toilet facilities and adequate communal facilities. Staff are well trained and managed. Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over one day by two inspectors. This is the first inspection in line with Inspecting for Better Lives 2. A detailed pre-inspection questionnaire and associated documents had been provided by the manager prior to the inspection. Twenty two service users and visitor comment cards were returned to CSCI. Service users who returned comment cards stated that they always or usually received the support they needed. They felt that staff listened to them and acted upon their requests. Other information gathered from the cards is included in the relevant section of the report. A tour of the premises was made and the inspector met with service users in the communal areas and in private in their own rooms. Inspectors observed staff working with service users and spoke to them. The inspectors observed lunch being served. The manager was available to assist with the inspection and was able to discuss the plans for the development of the home. The Bungalow, a self contained unit in the grounds has been deregistered in preparation for the building of a 50 bed additional new provision. Service users from the bungalow were settled in the main building and were very happy with their new accommodation. This was overall a positive inspection. ` What the service does well: There is evidence that service users are pleased with the care they received at Chelston Park. Service users met with during the inspection made positive comments about the care received in the home. “I am very happy…couldn’t fault it here.” Another person said “the staff look after me well.” Comment cards indicated that all service users who responded were satisfied with their care. They knew who to talk to if they were not happy and would know how to make a complaint although few had done so. All service users felt the home was “always” or “usually” fresh and clean. Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 6 Medical support was available and activities are provided to suit a high proportion of service users. There is evidence of considerable investment and commitment to training in the home. The home reports having, 30 staff of which 75 have NVQ 2 or above. 8 staff either have NVQ3 or equivalent or are studying towards this level. There are opportunities for Registered Nurses to up-date their skills and to study at a professional level. Training is managed and recorded in an efficient and effective manner reflecting an overall training plan for the home. Training is delivered in a flexible and creative manner utilising in-service training, medical representatives and external courses and trainers. The home has an Investors in People award. The gardens of the home are very pleasant and are accessible and used by the service users and their visitors. What has improved since the last inspection? What they could do better: The management of hot water must be reviewed as some water is leaving taps above 50 degrees. Measures must be in place to protect service users. A review of the medication records revealed some poor recording. There were some gaps on the recording charts. The management of prescribed creams in the home must be improved and implemented according to current best practice. The management of self- medication is not sufficiently robust. The storage of oxygen must be reviewed. Care plan documents are continuing to develop. A plan for the psychological care of service users should be include when appropriate. Efforts should be maintained to complete all care records in a timely and appropriate manner. Any room that contains potentially harmful chemicals should be locked when not occupied. Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 7 While some service users liked the food some did not and it is recommended that the catering staff undertake further consultations with service users to improve their satisfaction. 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. Chelston Park Nursing Home DS0000003249.V307525.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 Chelston Park Nursing Home DS0000003249.V307525.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): 1, 2, 3, 4 & 5. Quality in this outcome area is good. This judgement has been made from evidence gathered before and during the inspection. Information is provided to enable prospective service users to make an informed choice. The Manager of the home or her Deputy assess thoroughly to ensure the needs of prospective service users can be met prior to a decision being made about admission EVIDENCE: The pre-inspection information indicated that there has been no alteration to the homes statement of purpose. The home makes available the statement of purpose and service user guide to all service users. Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 10 Prospective service users and their families/carers are welcome to visit the home. The manager or her deputy would make an assessment to ensure that care needs can be met at the home. Service users who completed comment cards stated that they had received enough information about the home prior to entering the home. Most people knew they had received a contract and examples of these were seen. Care plans were seen and those sampled demonstrated evidence of the homes manager making an assessment prior to admission. Examples of documentation contributing to the assessment was seen in service user files for example information from hospitals and social workers. There was evidence of the input by the District Nurse assessor and the community CPN when service users were assessed for their level of nursing care input/funding. Chelston Park Nursing Home DS0000003249.V307525.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. The quality in this outcome area is adequate and attention must be paid to the medication requirement. This judgement has been made from evidence gathered before and during the inspection. A good standard of personal care is delivered. Care planning is in place and has been reviewed following the last inspection. There are opportunities to further improve the care documentation. The privacy and dignity of service users was respected by staff and their care practice at the home. EVIDENCE: Service users were seen and spoken with during the inspection. Staff were observed to be relaxed and considerate with all service interactions. Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 12 Service users confirmed to the inspector that staff are kind and helpful. Written feedback from twenty two service users was made to CSCI via comment cards. All twenty two respondents felt that they received the care and support that they needed “usually” or “always”. Service users spoken to confirmed that staff treat them well and that their privacy is respected. Care plans were sampled; one service users admitted with a pressure sores was recovering with appropriate care. Pressure relieving equipment was seen in use and was documented in care plans as being in use. A form has been developed which confirms service user involvement in the care planning process and their access to their own care records. Contact with visiting professionals was documented. Monthly reviews are made. There was evidence that staff addressed service users short-term and long term health needs. The manager agreed that there was still some development work to be undertaken on the care plans The medication administration records were seen. There were unexplained gaps in the MAR charts. Prescribed creams in service users rooms were observed not to be named or dated. There are some service users who selfadminister some of their medications according to good practice. The recording of risk assessments for these people must be improved and regularly documented reviews must be implemented. The medications fridge was locked and the temperature is checked and recorded each day, this was within a safe range. Chelston Park Nursing Home DS0000003249.V307525.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 following the review of evidence gathered before and during the inspection. The home’s arrangement for meeting service users social needs was satisfactory. Service users were able to have choices in regard to their individual daily living. Service users are offered a choice of diet and the opportunity to eat together, in the much improved dining room facility. EVIDENCE: The home offers a range of activities. Visitors are welcome in the home at any time. Service users spoke of a barbecue held recently for all service users and their families. Service users are able to spend their days in a variety of ways. One lady said she liked to “stay up late and read”. Another enjoyed “the beautiful views.” Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 14 There are regular musical events in the lounge. The gardens of the home are very pleasant and service users enjoyed going outside for a cup of tea and using the gardens to sit in. A relaxed cat lives at the home. Good records of activities and service user participation are made in care plans. There is evidence of musical events, sherry parties and some outings. One service user was able to have her choice of garden plants outside her French windows. The feedback from the comment cards indicated that all but two service users who responded were able to participate in activities at some time. Three quarters of the comment cards indicated that service users liked the meals provided in the home. Service users spoken to during the inspection were asked about the food. Most said they enjoyed it and stated that there is always a choice. There are summer and winter menus. A sweet trolley at lunch-time provides a choice of milk puddings, cheese and biscuits, fruit or hot pudding. Special diets and preferences are catered for on an individual basis. Cooked breakfast is available for those who want it. Some service users were not happy with the food. Their concerns were around personal preference and taste not quantity or wholesomeness and it is recommended that catering staff investigate further. One inspector was shown the kitchen; it was clean, tidy and well organised on the day of inspection. There are plans to build a new kitchen. Lunch was pork and apple pies/sauté potatoes green beans and sweet corn. An alternative main course of faggots was provided. Chelston Park Nursing Home DS0000003249.V307525.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, 17 & 18. Quality in this outcome area is good. This judgement has been made from evidence gathered before and during the inspection. The home has a clear complaints procedure. Complaints are responded to promptly and records are kept. EVIDENCE: There is a documented Complaints policy and all complaints are dealt with initially within 7 days. There have been four complaints since the last inspection. All were responded to promptly and dealt with satisfactorily. All service users who returned comment cards knew how to make a complaint and who to speak to if they were unhappy. No issues of concern were raised with the inspector at this inspection. Three relatives responding to CSCI said they are aware of the homes complaints procedure and none had ever made a complaint. Chelston Park Nursing Home DS0000003249.V307525.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, 20, 21, 22, 23, 24, 25 & 26. The quality outcome for this area is adequate and will be good when the water management system has improved. Service users live in a clean and comfortable environment which meets their assessed needs. Service users have access to specialist equipment where it is required for their assessed needs. EVIDENCE: The home had been suitably adapted to meet the needs of the service user group. The conservatory and dining space has been refurbished to a high standard and now provide an attractive dining and living space. Families were seen talking to service users here during the inspection. Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 17 The home is being steadily upgraded. On the day of inspection the home was clean and attractive. Cleaning is carried out to a managed schedule. The laundry now has the Otex system to reduce the risk of cross infection and use low temperatures for washing. The sluice rooms were seen and were clean and well managed. A range of coloured mops and clear instructions enable cleaning to be carried out hygienically. It was noted, as good practice that hand cleansing gel is available throughout the home. Service users rooms were personalised, comfortable and well maintained. The building complies with the local fire and environmental health service requirements. The fire safety inspection reported on 19.01.06 gave a satisfactory standard of fire safety. The home has a large communal lounge; the room is well appointed and comfortably furnished. The home has appropriate domestic style lighting in the communal areas and had good ventilation. All windows above ground floor have been restricted in opening to a safe limit. The hot water temperatures are not recorded in every room and in some rooms checked were registering and some hot water outlets were registering above 50 degrees. The management of hot water must be reviewed and measures must be in place to protect service users. Chelston Park Nursing Home DS0000003249.V307525.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 The quality in this outcome area is good. The home has a dedicated trainer and staff training is provided to a good level and meets the range of needs of service users. There are a sufficient number of appropriately qualified staff on duty. EVIDENCE: Staffing was adequate on the day of inspection. The Registered Manager can authorise additional staff in the event of an emergency. The Registered Manager was available and there was also a Registered Nurse on duty. Staff spoken to confirm supervision and staff appraisals. Copies of duty rotas were sent to CSCI for this inspection and two weeks worked rotas were supplied as photocopies at the inspection, these indicated that minimum staffing levels were maintained. Domestic and catering hours also appeared adequate. There was evidence of considerable investment and commitment to training in the home. A notice board displays the training schedule for the year and includes reminders of up-dates for staff. The home reports having, 30 staff of Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 19 which 75 have NVQ 2 or above. 8 staff either have NVQ3 or equivalent or are studying towards this level. Training is managed and recorded in an efficient and effective manner reflecting an overall training plan for the home. There was evidence of investment in PREPP level courses for Registered Nurses. The home offers placement opportunities for student nurses and some are employed as part time members of staff. Training is delivered in a flexible and creative manner utilising in-service training, medical representatives and external courses and trainers. The home has an Investors in People award. Chelston Park Nursing Home DS0000003249.V307525.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, 32, 33,34, 35, 36, 37 & 38 The quality in this outcome area is good. The home is well managed. There is organised and methodical management and implementation of health and safety requirements with a requirement to review the management of hot water in the home. Service users finances are well managed. Records are maintained appropriately and are stored held. EVIDENCE: Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 21 The Registered Manager is Mrs Joanne Girdler. She is a Registered nurse and has relevant experience and qualifications. She has taken relevant updating and training to maintain her competencies and holds an Open University Management Diploma. Individual staff induction, training and supervision records were made available. It was confirmed to the inspector that all staff have received fire and manual handling training. Infection control training includes food hygiene and is run at two monthly intervals. This also covers COSHH and HACCUP and is managed by an outside trainer. Records were sampled for maintenance: Water is managed according to requirements to prevent Legionella. Cold water temperatures are checked. Electrical records: PAT 21.06.05. In house auditing of infection control, beds, and first aid boxes (09.09.05) are carried out. The home displayed the Registration certificate and appropriate Employers Liability Insurance. The kitchen was clean and well organised. The home has an emergency lighting system and an outside contractor services this annually with the main alarm. Annual Gas safety certificate 10.06.05. LOLER Six monthly servicing on hoists was last completed on 31/07/06. There were records of wheelchair servicing and checks. The nurse call had been serviced in May. There was evidence that medical equipment is maintained regularly. Bed rails are checked monthly. A sample of service users finances were reviewed and found to be accurate. Fire records showed regular alarm testing, staff training and maintenance of equipment. Chelston Park Nursing Home DS0000003249.V307525.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 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 3 18 3 3 3 3 3 3 3 1 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 13(4) Requirement Timescale for action 20/09/06 2. OP9 13(2) Water temperature management must be reviewed as discussed to ensure all service users are safe. All trained staff must comply 20/09/06 with NMC requirements and administer medications according to best practice. A sound system of monitoring and administering prescribed creams must be implemented. The self–medication documentation must be reviewed to ensure robust risk assessment and safe management. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations The treatment room door should not be wedged open; it should be locked shut when unattended. Chelston Park Nursing Home DS0000003249.V307525.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Chelston Park Nursing Home DS0000003249.V307525.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. Re-publishing this information is in breach of the terms of use of that website. 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