Inspection on 15/11/05 for Copper Beech House Nursing Centre

This inspection was carried out on 15th November 2005.

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

Other inspections for this house

Copper Beech House Nursing Centre 14/11/06

Copper Beech House Nursing Centre 14/06/05

Copper Beech House Nursing Centre 22/11/04

Copper Beech House Nursing Centre 04/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Copper Beech House Eastbourne Road Uckfield East Sussex TN22 5ST Lead Inspector Unannounced Inspection 15th November 2005 07:30 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 Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 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. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Copper Beech House Address Eastbourne Road Uckfield East Sussex TN22 5ST 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) 01825-769947 01825-769948 ANS Homes Limited Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48), Terminally ill (3) of places Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is fortyeight (48). The maximum number of service users to be accommodated with a terminal illness is three (3). That service users must be aged sixty-five (65) years and over on admission. 14 June 2005 Date of last inspection Brief Description of the Service: Copper Beech House is a purpose built home that was opened in 1998, and is one of a large group of homes recently purchased by BUPA, which operates nationally. The home is registered to provide care with nursing for forty-eight residents in the older person category, which includes providing care for up to three residents with terminal illness. The accommodation is on two floors and comprises of forty-eight single rooms all with ensuite facilities. There is a small kitchenette, good-sized dining room and separate lounge on each floor. An adequate amount of communal bathrooms with either a shower or assisted bath are provided. The home is situated on the outskirts of Uckfield, and is on a regular bus route. A short journey by bus takes you in to Uckfield town centre and to all the local amenities and shops. The Home has a pleasant garden with a patio area, which is easily accessed by wheel chair bound residents. The garden furniture is of a rustic nature and attractive in its setting. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 15 November 2005. It commenced at 0730 am and was conducted over 7 hours. There were fortyeight residents living in the home on this day. The methodology of the inspection included a tour of the building, inspection of documentation and records, the delivery of care for ten residents and informal interviews with eight residents, four relatives and six members of staff. It was a positive inspection where it was found that the standard of care has been maintained to a good standard. The feedback from residents, their relatives and the staff on duty was open and honest and the inspector would like to thank them for their time and their insight in to life at Copper Beach House. What the service does well: The comprehensive Statement of Purpose and Service Users Guide give prospective residents the information required to enable them to make an informed choice about where they live. The home continues to maintain comprehensive documentation and care planning, which enables staff to meet the needs of the residents. The health needs of the residents were seen to be met and the standard of care is of a good standard. The atmosphere of the home is pleasant with good interaction seen between residents and staff. The residents are enabled to exercise the choice and control of their every day life. There is a variety of good nutritious food offered. Meals are taken in comfortable and homely surroundings. The home is clean, safe and well maintained, which is appreciated by the residents and their relatives. There is a stable work force of reliable and caring staff, which work well together as a team. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 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. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 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 Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 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): , 2, 3, 4 and 5. EVIDENCE: The Statement of Purpose and Residents Guide were viewed, it was found to be up to date and contained information that prospective residents need to make an informed choice of where to live. Due to the recent change of ownership there will be a need to update the paperwork when all the information is in place. There is a written contract/statement of terms and conditions that all residents receive on admission to the home. This contract is confirmation of the room booked, the type of admission, either respite or permanent and the fees to be paid. The home use an assessment tool, which covers all the needs as defined in standard 3.3. Ten pre-admission assessments were viewed, which were found fully completed and informative. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 9 The assessment takes place at the prospective residents’ place of residence, and involve the relatives whenever and input from other relevant professionals is sought when required. Three of the eight residents spoken with, said they remembered someone from the home coming to see them before they left hospital and felt it was helpful to have met someone from the home before they arrived. As previously mentioned the pre-admission assessment identifies any specific needs of the prospective resident and this informs the admission process. These can then be discussed with the resident and their representative to ensure that the home can meet their needs. The statement of purpose also gives information regarding the services they provide. Prospective residents can visit the home to meet residents, to look at rooms that are available and the facilities provided before they make any decision regarding accepting a place. Unplanned admissions are avoided whenever possible but should they occur, then an assessment is undertaken within forty eight hours and a GP is requested to visit as soon as possible. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 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, 10 and 11. All residents have an individual care plan, which meets their health, social and recreational needs. The residents are treated with respect and courtesy in all aspects of their care. There is evidence of training in place to ensure that all residents will be treated with dignity, respect and receive the appropriate care at the time of their death. EVIDENCE: Ten care plans were viewed, and were found to be clear and informative. All were found to have a comprehensive plan of care, which is generated from the initial pre-admission assessment. The care plans clearly identify the specific health, personal and social care needs of the residents. Areas that were identified as misleading in certain care plans were discussed with the deputy manager at the time of the inspection. The risk assessments were clear and were seen to have been updated on a regular basis. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 11 There is evidence of resident/representative consultation in individual plans. Five residents said they had been involved in the discussions regarding their care plan, and had been able to put over their feelings regarding their care. From the information gathered from the care plans and then meeting those residents, it was found that the health needs of the residents were met. Specialist equipment was found in place where required, e.g. air mattresses, cushions and various hoists with different slings. One resident said “staff were very caring and looked after her well”, another said that “the care was good most of the time”. A relative visiting said they “had no complaints regarding the staff or the care that their mother received”. The clinical rooms were clean and tidy and the equipment well-maintained. There are policies and procedures in place for the storing, administrating, disposal and receipt of medication. The temperature of the fridge and room are recorded daily and of an acceptable temperature to maintain dressings and medications. The Medication Administration Charts were found correctly completed in the main, however there is a need to ensure: That all medication brought forward from the previous month and written by hand are signed and dated. That all medications are given as prescribed - one medication had been out of stock for five days and gaps were noted in the administration of eye drops for certain residents. That all medications with a restricted life are dated on opening. That medication orders that are prescribed for use if required are signed by the person taking the verbal order or by the prescribing G.P and a care plan formulated for this instruction. A self-administering policy is in place, but there were no residents at this time self-administering their medication. Throughout the inspection it was observed that residents were treated with dignity and respect. One relative said that “ the staff always show respect to residents and nothing was too much trouble”. A resident remarked that” she felt the staff respected her feelings and that she never felt she was a nuisance”. The staff have had appropriate training in palliative care to ensure they have the necessary understanding and skill to deal with residents who are dying. There are policies and procedures in place to guide staff in the procedures used within the home. The home also have close links with the local hospice who have leased three beds from Copper Beach House specifically to meet the needs of residents who suffer from a terminal illness. The staff spoken with showed an empathy with this specialised area and were able to discuss the training and the importance of residents dignity, respect and wishes. The home has explored the routes available to them to ensure they can access Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 12 information concerning different cultures and religious denominations should it be required. There is evidence in the care plans that residents and relatives are given the opportunity to discuss their wishes in respect of their death. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 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 and 15. For the majority of residents, the lifestyle experienced in the home matches residents expectations and preferences and the activity programme in place meets their social, religious and recreational needs. Residents are encouraged to live healthy and fulfilling lives. Open visiting enables residents to maintain contact with families and friends. The meals in the home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Thirty hours of activities are provided a week and provide a large part of life at Copper Beach House. The activity programme consists of group activities, outings and one to one sessions. Group activities are well attended and supported. Three residents were very enthusiastic about the activities and one resident talked at length about the pottery she had made and the kiln recently brought, she says she is working on a pen pot for her son. The co-ordinators also spend time with the heavily dependent service users on a one to one basis. The feedback concerning activities was extremely positive from both residents and relatives. The staff spoken with also mentioned that the residents enjoyed the activities and especially the trips out. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 14 It was found from talking to the residents that they are able to choose the way they spend their time and are offered choice and flexibility on a daily basis. Copper Beach promotes an “open door” policy during the day. Residents spoke of visitors they had received and the home maintains a record of the contact each resident with relatives and friends. One relative said “due to work they visited at odd times and always found the staff friendly and informative”. It was also mentioned that they were able to stay for lunch or tea. Residents are able to handle their own finances if they wish to, and if they are able. In every bedroom there is a lockable facility to safeguard valuables. Residents are made aware of an advocacy service provided by Age Concern. Furniture and other belongings are welcomed by the home if the resident wishes to bring them with them. Certain rooms have been personalised and several residents mentioned that they had chosen the colour scheme for their room. When asked about the choice of getting up in the morning, five residents said they preferred getting up early as they wished to go to bed early evening. The menus are distributed to all residents and are also on display in the dining rooms. They demonstrated choice and variety and were indicated a well balanced diet. The menus rotate on a four weekly basis and change according to the seasons. The residents were open about the quality and choice of the food, and the majority said the choice was good and the food was always edible. One resident remarked that she “enjoys the food but does not always remember what’s on offer, but then reads the menu again”. Two relatives commented that the food always looks nice and there is a choice available. The dining areas are pleasant and well furnished with natural light and the tables are positioned to create a congenial atmosphere. Two residents were seen having breakfast in the dining room at 0830am. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 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. The complaint procedure is clear and enables residents and their families to share their concerns formally and confidentially. Staff interviewed had a good understanding and knowledge of Adult Protection policies and procedures, which protect the residents from harm and abuse. EVIDENCE: There are appropriate policies and procedures are in place and it was confirmed that these are followed when investigating any concerns raised at the home. The complaint book was viewed and this demonstrated that all complaints are recorded, along with the outcome and action taken by the home to resolve the complaint. The staff interviewed were knowledgeable of the complaint procedure and of how to start the process if the manager is not available. One of the residents referred to the service users guide when asked if they knew how to make a complaint, one resident said she would talk to the nurse in charge if she had a problem. One relative said that she was aware of how to make a complaint if she needed to, and felt that the staff were approachable. The Adult Protection policy in the home was found to be up to date and staff interviewed were knowledgeable about the systems in place to protect vulnerable service users. There is on-going training for all staff in adult Protection. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 16 Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 23, 24, 25 and 26. The home provides a comfortable, clean and safe environment for those living there and for those visiting. Residents are enabled and encouraged to personalise their room, and rooms are homely and reflect the residents’ personalities and interests. There is specialist equipment in the home for residents’ use to maximise their independence. EVIDENCE: The nursing home was purpose built over seven years ago following consultation with the Health Authority. All bedrooms have an ensuite facility The home is well furnished with good quality co-ordinated furniture. The residents are encouraged and enabled to personalise their rooms with furniture and pictures, and this was evident during the visit. All personal items are listed in the individual care plans. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 18 Residents are offered the choice of having a lock and key for their bedroom, risk assessments are in place for this. All rooms have a lockable facility for the storage of personal items and valuables. One resident said “she likes to keep all her personal items in a drawer and it keeps her feeling like she still has some control”. There is an ongoing maintenance programme and the home was found well decorated and maintained. The home provides adequate attractive communal space. The communal rooms are well used and provide adequate communal space. The lounge areas on the both floors were found warm, comfortable and homely. The dining areas were both clean and well decorated, and the garden and patio areas have both wheelchair access and seating. There are toilet, washing and bathing facilities to meet the needs of the service users. Including showers and assisted baths. Specialised equipment to encourage independence is provided e.g. handrails in bathrooms, hoists, wheelchairs and lifts to all areas of the home. The corridors are wide enough to encourage residents to self-propel themselves in wheelchairs. The lighting in the home is of domestic quality and there are above bed lights as well as the main ceiling lights. Heating is provided under floor and the home was found of a comfortable temperature. Water temperatures are controlled and monitored monthly and a record kept. Random temperatures were taken and were of the recommended level. Six residents said they were encouraged to bring in items of furniture and pictures and also mentioned their families were always bringing in new photographs and pictures. Three residents shared some photographs of their families. Polices and procedures for infection control are in place and are updated regularly. The home was clean and free from offensive odours on the day of the inspection. One resident said,” my room is cleaned everyday and the place is kept clean”. One visitor said that the “home had a good standard of cleanliness”. Good practice by staff was observed during the day and there were gloves and aprons freely available in the home. There are appropriate guidelines in place for staff to follow when dealing with a known infection and the necessary equipment is provided in individual rooms. Sluice areas and equipment was clean and hygienic. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 19 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 and 29. Staffing levels were adequate to meet the assessed needs of the residents. The residents are protected by a robust recruitment process. EVIDENCE: On the day of the inspection, there was sufficient staff to support the health and social needs of the service users as detailed in the care plans. The night shift staff and day staff interviewed confirmed that they felt the staffing levels were adequate at this time. They were also confident that if they needed extra staff they would be provided. Residents, who spoke with the inspector, commented that staff were helpful and willing to assist. They also mentioned that it was helpful for them when there was continuity of the same staff, which allowed them to get to know them. The recruitment practice is robust and it was confirmed that all staff have a criminal record check, POVA check and references in place before commencing employment. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 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, 36 and 38. Resident’s benefit from a Manager who is competent and runs the home efficiently and effectively. The ethos of the home is open and transparent enabling residents to participate in the running of the home, should they wish to. All aspects of resident’s health, safety and welfare are protected and promoted. EVIDENCE: The manager is a registered general nurse and will commence the NVQ level 4 management course in the New Year when she has completed her master’s degree in Gerontology. The manager informed the inspector that she regularly attends training sessions to update her skills and knowledge. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 21 The atmosphere of the home on this unannounced inspection was positive, calm and inclusive. The staff were observed doing their work competently and showing respect to their colleagues and the residents. The residents and relatives spoken to were appreciative of the manager and her staff. Regular staff meetings and supervision sessions encourage the staff to communicate their views and if appropriate acted on. Relative and resident meetings are held regularly and are well attended and beneficial. Handover sessions at every shift are greatly valued by the staff and enable staff to be brought up to date on any changes or problems. The responsible individual visits the home regularly and completes a document of her visit on a monthly basis. A quality assurance system is in place and has proved beneficial in the running of the home. The home has a comprehensive set of policies and procedures, which govern the running of the home. Staff are supported by the manager on a daily basis and more formally through supervision. They receive regular supervision and annual appraisals, which are in a written format and copies are kept in the staff files. Two staff members did say that they had not received an annual appraisal for some years, the manager acknowledged that they were behind with the yearly appraisals. The manager confirmed and the staff training records show that all staff are kept updated on the Health and Safety policies, the manual is available to all and clearly defined. The staff are issued yearly with certificates for Manual Handling, for Fire Safety and Food and Hygiene. All relevant legislation and procedures are in place and in accordance with the Standard. The records required by regulation for the protection of the residents are in place and accurate. Individual records and home records are kept secure and up to date and are maintained in accordance with the Data Protection Act 1998. The manager is very organised and has a thorough understanding of the National Minimum Standards and the accompanying regulations. Good practice was observed throughout the inspection in respect of health and safety. The first aid boxes are checked regularly, all fire exits were found clearly marked and free from obstruction. The equipment used for residents are regularly serviced and kept in good condition. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 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 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X 3 Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 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 OP9 Regulation 13 (2) • Requirement Timescale for action 15/11/05 2 OP36 18 (1) (a) (c) (ii) That all medication brought forward from the previous month and written by hand are signed and dated. • That all medications are given as prescribed - one medication had been out of stock for five days. • That all medications with a restricted life are dated on opening. • That medication orders that are prescribed for use if required are signed by the person taking the verbal order or by the prescribing G.P and a care plan formulated for this instruction. That all staff receive the 15/06/06 appropriate supervision and appraisals. Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 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. Refer to Standard Good Practice Recommendations Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Copper Beech House DS0000013975.V249170.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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