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Inspection on 11/07/06 for Clarence Park Nursing Home

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

This inspection was carried out on 11th July 2006.

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

The inspector 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

Clarence Park has a relaxed and friendly atmosphere; staff have a friendly rapport with the residents. In general staff morale is high, however more direction is needed. The premises are maintained to a high standard and residents spoken to said it was always clean and tidy.

What has improved since the last inspection?

Risk assessments are now carried out and documented if bed rails are needed. Written information relating to residents is securely stored.

What the care home could do better:

Following this inspection 8 requirements and 3 recommendations were made. These covered areas specific to care plans, medication, recruitment and health and safety. These areas were discussed with the manager during verbal feedback. Care plans need to be reviewed to reflect a person centred approach to care, they also need to include specific needs when identified and up dated when needs change rather than an entry being made in the daily record. The manager needs to look at ways of involving residents in drawing up their care plans and evidence their consent and involvement. Care plans need to include a nutritional assessment which will identify special dietary needs. Handwritten MAR sheets need to be signed by the person making the entry, preventing medication errors from occurring. As discussed with the manager, wardrobes must be secured to the walls as they pose a health and safety risk to residents. The upper storey window next to the lift must be restricted. Recruitment procedures followed allow `to whom concerned` reference letters. These are not confirmed and could be written by anyone. The manager must confirm the references are from the referee stated. The recommendations include medication and staff competency; the qualified staff need to ensure that medication is dated when opened and keep track of the expiry dates of medication; the manager needs to enrol staff on NVQ training.

CARE HOMES FOR OLDER PEOPLE Clarence Park Nursing Home 7 / 9 Clarence Road North Weston Super Mare North Somerset BS23 4AT Lead Inspector Juanita Glass Unannounced Inspection 11th July 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 Clarence Park Nursing Home DS0000040907.V302476.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. Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clarence Park Nursing Home Address 7 / 9 Clarence Road North Weston Super Mare North Somerset BS23 4AT 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) 01934 629374 01934 626207 www.notarohomes.co.uk Notaro Homes Ltd Ms Sharmaine Marie Lawrence Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 35 Patients aged 50 years and over requiring nursing care. Manager must be a RN on parts 1 or 12 of the NMC register Staffing levels detailed in the letter to Mr N Notaro from the CSCI dated 7th September 2004 apply. Date of last inspection Brief Description of the Service: Clarence Park provides care and support to older people who have nursing needs. It comprises of two houses joined together and extended close to the seafront in Weston super Mare and opposite Clarence Park. Local shops and amenities are close by and the town centre is just under a mile away. Inside, the home is well laid out, level throughout with ramps and lifts giving access to the upper floors. Twenty-one of the single, and all four of the shared bedrooms have en suite facilities. With a small garden at the front, the rear has been laid as patio around a central water feature. Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Current fees: £336.65 - £783.00 This key inspection was carried out by two inspectors, with a total of 20 inspection hours. The records for six residents and four members of staff were reviewed as well as medication, maintenance and health and safety checks. The inspectors spoke to 10 residents, 3 visitors and 5 members of staff during the inspection, and observed working practices. The general opinion of both residents and visitors was that the care provided was good with staff being praised for their commitment to the job. Residents stated that staff are generally polite although one resident said there were one or two ‘grumpy’ nurses but most were ‘ok.’ During the day staff were observed and it was evident that there was a lack of direction for care staff from the qualified nurse in charge. Care staff and domiciliary workers were left to work unguided; this meant call bells rang for long spells before being answered, whilst the qualified nurse sat in the office. Care plans were generic and not person centred with a lack of personal and individual needs. One actually said ‘him and his’ throughout when it was referring to a female resident. Care plans also lacked specific needs assessments such as catheter care, dying, sleeping or nutrition, although they had been identified in the daily record. Entries in the daily record were good and demonstrated staff awareness of residents needs. One care plan stated that staff must observe for triggers but failed to state what the triggers were. Instructions left by a physiotherapist were recorded in the daily record but no care plan implemented. Five of the six records reviewed for residents did not contain a nutritional assessment even though weight loss or lack of appetite had been identified. Residents and staff said they had plenty of meaningful activities with a regular newsletter and they felt they had control over personal choice. Staff said they had adequate support to attend both in house and external training. What the service does well: Clarence Park has a relaxed and friendly atmosphere; staff have a friendly rapport with the residents. In general staff morale is high, however more direction is needed. The premises are maintained to a high standard and residents spoken to said it was always clean and tidy. Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 6 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. Clarence Park Nursing Home DS0000040907.V302476.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 Clarence Park Nursing Home DS0000040907.V302476.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): 3 and 5. 6 does not apply Quality in this outcome group was good. Admission to the home only takes place if the service is confident that they can meet the assessed needs of the prospective resident. Prospective residents are given the opportunity to visit the home prior to taking up residence. EVIDENCE: Evidence was found in the individual care plans sampled that preadmission assessments were being carried out prior to admission to the home. These were very concise, however they do need to be signed and dated by the person carrying out the assessment. One relative and residents spoken to said that the preadmission assessment had been quite thorough and they felt the home had met their needs identified at the time. Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 9 Prospective residents and their representatives are able to visit the home prior to admission; this enables them to make an informed choice. One visitor spoken to confirmed that they had visited the home on behalf of their husband. They felt they had been given enough information and time when deciding whether to take up residence at home. Clarence Park Nursing Home DS0000040907.V302476.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 in this outcome was poor. Each resident had an individual plan of care. Residents would benefit if these were individualised and Person centred, residents also required care plans for specific needs. Residents have access to health care services that meet their assessed needs both within the home and in the local community. The home has a medication policy, which is accessible to staff, however medication records were not in line with current guidelines. Staff showed respect towards residents and allowed their privacy and dignity to be maintained at all times. EVIDENCE: The records for six residents were reviewed. All contained care plans, however they were more generic in fashion and lacked personal or individual needs. Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 11 Care plans reviewed did not show evidence of an understanding of Person Centred Care. Residents spoken to said they had not seen their care plans and had not been consulted on what should be in their care plans. It was also noted that care plans for specific needs such as catheter care, dying, sleeping or nutrition were lacking. Several records reviewed did not contain a nutritional assessment despite comments in the daily record identifying the need for an assessment. Changes in assessed needs were identified in daily records however care plans were not devised to meet these. Some care plans did show evidence of regular review however changes were not noted in the care plans, and some care plans had not been reviewed following admission some six weeks earlier. One care plan stated that staff should observe resident for triggers, however these triggers were not identified in the care plan so staff did not have a baseline to work to. However despite care plans not providing staff with adequate information concerning personal needs, residents stated that the home met their needs and that staff appeared to be aware of their assessed needs. Records reviewed showed that residents were assisted in accessing healthcare services within the home and in the community. Records showed attendance at dentists, opticians and the chiropodist; residents were also assisted to attend outpatients appointments and physiotherapy appointments. It was also noted that instructions left by a physiotherapist had not been written into the care plan. The home has a very clear policy and procedure for the receipt, administration and disposal of medication. On reviewing the records it was noted that staff were making handwritten entries on the MAR sheets and not signing these. Several MAR sheets were examined and noted to have entries without signatures. It was also noted that creams and ointments kept in residents rooms did not have a date of opening marked on them. During a review of medication a few items kept for homely remedies were past their expiry date. Staff need to keep track of expiry date on medication. During the day whilst observing staff and talking to residents it was noted that the majority of staff treated the residents politely and respectfully. A friendly and cheerful rapport was noted throughout the inspection and residents spoken to said that the majority of staff were cheerful, friendly and helpful. One visitor stated that she found the staff friendly and accommodating, she visited most days and felt welcomed. Another visitor stated that she visited daily and staff are always welcoming and enabled her to have lunch if she requested it. During the day one member of staff was noted assisting a resident at lunchtime without talking to them or passing the time of day, this was bought to the attention of the manager. • All care plans must be reviewed to show a Person centred approach to care. Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 12 • • • • Care plans must be implemented for specific needs. (I.e. catheter, dying, sleeping and nutritional) Handwritten entries on mar sheets must be signed by the person making the entry. Staff need to indicate the date medication was opened. Staff need to keep track of expiry dates on medication. Clarence Park Nursing Home DS0000040907.V302476.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 and 15 Quality in this outcome group was good. Residents benefit from a stimulating programme of activities. Residents are encouraged to maintain contact with family and friends. Residents are assisted to exercise choice and control over their lives. Residents receive a wholesome appealing balanced diet. EVIDENCE: Records reviewed and residents spoken to confirmed that the home provides a full programme of meaningful activities. Records showed that residents had taken part in reminiscence, board games, music and singalong, painting, garden games, musical movements and trips out that had included a trip to the Playhouse, and Wells Cathedral. Residents spoken to said there were plenty of activities to take part in and they were given the choice on whether to attend or not. Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 14 Visitors spoken to said that they were welcomed at any time during the day to visit friends and relatives, residents said that they were openly encouraged to maintain contact with their family and friends and were assisted to go out whenever possible. Residents spoken to said they felt they could continue to exercise choice and control over their lives. Records showed that people got up at varied times during the morning. During the day residents were observed exercising their own choice as to whether they joined in with the main community, or remained in their room. Those who chose to remain in their room were noted to have magazines books and various puzzles. One lady said she did not like taking part in the organised activities but had plenty to do in her own room. All the residents spoken to said that the meals in the home were good, they confirmed that they were given a choice of menu on the day. The mealtime observed was carried out in pleasant surroundings and at a leisurely pace. Residents were offered assistance when necessary and those residents who chose to eat in their own rooms were accommodated. The home can cater for residents with either cultural or medical dietary needs; the cook displayed an awareness of residents individual likes and dislikes. • All residents must have a nutritional assessment. Clarence Park Nursing Home DS0000040907.V302476.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 and 18 Quality in this outcome group was adequate. The home provides residents and visitors with the information needed to enable them to make a complaint or raise concerns. The homes policies and procedures protect residents from harm and abuse. EVIDENCE: The home has a complaints procedure, which can be seen on request. The complaints book contained three complaints since the last inspection. These complaints had been dealt with appropriately and a full record maintained of the complaint, the action taken and the outcome. One visitor spoken to however said they were not aware of the homes complaints procedure, but had raised concerns with the manager, which had been dealt with immediately. The home has a whistle blowing policy, which staff were aware of. All staff spoken to were also aware of the policies and procedures for reporting suspected abuse and harm. They were aware of the local authority’s policies and procedures if they felt they could not approach management. Clarence Park Nursing Home DS0000040907.V302476.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 and 26 Quality in this outcome group was adequate. Residents live in a comfortable, well-maintained environment, however some safety issues were identified. The home is clean, pleasant and hygienic EVIDENCE: Residents spoken to and rooms assessed as part of the inspection process showed that the premises is well maintained. Residents spoken to liked their rooms and many contained personal items including pictures and photographs. Residents have access to safe well-maintained gardens and the community areas are well lit and ventilated. During a tour of the premises it was noted that some wardrobes were not secured to the wall highlighting the potential risk of harm to residents. This was bought to the attention of manager and the Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 17 maintenance person had started to secure wardrobes before the end of the inspection. There were no malodours in the home, all areas showed evidence of a stringent cleaning programme all rooms were clean and tidy and one visitor spoken to said the home was always spotlessly clean even late at night when they visited. • • Wardrobes must be secured to the wall (also NMS38) Window by lift must be restricted (also NMS 38) Clarence Park Nursing Home DS0000040907.V302476.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 and 30 Quality in this outcome group was adequate. Residents benefit from adequate numbers of staff, to meet their individual needs. The home does not meet the 50 requirement for NVQ training. The service needs to review its recruitment procedure with regard to obtaining references. The service recognises the importance of training, and delivers where possible a program that meets any statutory requirements. EVIDENCE: Staffing records reviewed and residents, visitors spoken to confirmed that there are adequate numbers of staff on duty to meet the assessed needs of the current resident group. During the inspection and following discussion with residents it was noted that there are times when staff are not available to immediately answer call bells. One resident stated that she had been waiting a quarter of an hour for somebody to return to assist her down to lunch. This was not due to lack of numbers of staff on duty but a lack of direction from the nurse in charge on the shift. Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 19 Out of 16 members of care staff 6 have an NVQ 2 or above. This does not meet the 50 required; the manager needs to identify NVQ training for care staff. However residents and visitors spoken to said that staff were competent in meeting their assessed needs. Personnel records were reviewed for four members of staff employed since the last inspection. Three of the records contained undated references addressed to, ‘to whom it may concern;’ Accepting references of this type does not demonstrate good practice, as there was no evidence that these references were being followed up and confirmed. Other records required to evidence good recruitment practices were present in the personel files. The home encourages all levels of staff to maintain ongoing training. A plan of training for the next 12 months was seen and personnel records showed evidence of ongoing training appropriate to the needs of the current resident group. Staff spoken to confirmed that they were encouraged to attend training sessions, both within the home and on external courses. • • The manager must request references direct from referees, rather than accept ‘to whom it may concern letters.’ The manager needs to enrol staff on NVQ training. Clarence Park Nursing Home DS0000040907.V302476.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, 36 and 38 Quality in this outcome group was adequate. Residents benefit from an experienced, knowledgeable manager. Systems are in place for relatives of, visitors and residents to comment on the running of the home. Residents financial interests are safeguarded. Staff are appropriately supervised. Residents are protected by the health and safety checks in place, however the insecure placement of wardrobes was noted. Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 21 EVIDENCE: Sharmaine Lawrence has been manager of Clarence Park for approximately 3 years, she has completed the registered managers award. All those staff spoken to say that she expects a high level of commitment; they also state she is fair. Residents and visitors spoken to said that the manager was always approachable. Systems are in place for residents, visitors and relatives to comment on the running of the home and the Notaro group have expressed an interest in piloting the quality assurance process CSCI will be putting in place in 2008. This will enable them to carry out their own quality assurance within the group. The Notaro group maintains a secure system for safeguarding residents finances. All staff carry out an induction within the first week of the start of employment. A supervision agreement is signed and the responsibility for staff supervision is cascaded down from the manager through senior staff. Evidence of regular staff supervision was seen on the day of inspection. All health and safety checks were in place and up-to-date. The fire risk assessment for the building is available for inspection and the firelog showed that all recommended checks were being carried out. Accident records were maintained these also included a record of the follow-up carried out by staff to identify outcomes. During a tour of the premises as previously stated some wardrobes were identified as needing securing to the wall to prevent them falling on a resident. A requirement was made and the maintenance person commenced the job before the end of the inspection. Clarence Park Nursing Home DS0000040907.V302476.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 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 OP7 Regulation 15 (1) Requirement Care plans must be reviewed to reflect a person centred approach to care. Care plans must where possible be drawn up with the involvement of the service user Care plans must be drawn up for specific needs such as (catheter care, dying, sleeping and nutrition) Handwritten MAR sheets must be signed by the person making the entry All residents must have a nutritional assessment Wardrobes must be secured to the wall. Upper storey window by lift must be restricted. The manager must request references direct from referee rather than accept ‘to whom it may concern letters,’ even if received from employment agency Timescale for action 25/09/06 2. 3 OP7 OP7 15 (1) 15 (2) 25/09/06 25/09/06 4 5 6 7 8 OP9 13 (2) 12 (1) (a) 13 (4) (a) (c) 13 (4) (a) (c) 19 (1) (b) (c) Sch 2 25/09/06 25/09/06 30/08/06 30/08/06 30/08/06 OP15 OP19 OP38 OP19 OP38 OP29 Clarence Park Nursing Home DS0000040907.V302476.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. 3 Refer to Standard OP9 OP9 OP28 Good Practice Recommendations Qualified staff need to date medication when opened. Qualified staff need to keep track of expiry dates on medication. The manager needs to enrol staff in NVQ training Clarence Park Nursing Home DS0000040907.V302476.R01.S.doc Version 5.2 Page 25 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 Clarence Park Nursing Home DS0000040907.V302476.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. 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