Inspection on 15/09/06 for Cosin Lodge

This inspection was carried out on 15th September 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 found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cosin Lodge 08/08/07

Cosin Lodge 08/11/05

Cosin Lodge 20/05/05

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Cosin Lodge Cambridge Avenue Willington Co Durham DL15 0PW Lead Inspector Ms Kathy Bell Unannounced Inspection 15th September 2006 09:30 Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 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 Cosin Lodge DS0000062455.V301088.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 Adults 18-65. 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. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cosin Lodge Address Cambridge Avenue Willington Co Durham DL15 0PW 01388 748702 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) londonroad@tiscali.co.uk Milbury Care Services Limited Miss Caroline Ann Cadywould Care Home 4 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (4) of places Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th November 2005 Brief Description of the Service: Milbury care services are the owners of Cosin Lodge which is based in Willington, County Durham. The home is situated in a quiet residential area within close reach of the town centre and shops, pubs etc. The home was first registered in January 2005. It is registered to provide 24hr care (but not nursing care) for 4 residents who have a mental disorder or learning disability. The home is a purpose built bungalow with each pair of bedrooms having direct access to a shared bathroom. The home is fully adapted to meet the needs of residents who are physically disabled as well. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during two days in September 2006. The Inspector, Kathy Bell, met the residents and staff. She looked around the building (although not every bedroom) and checked some of the records. Discussion with some residents was limited, either because they did not want to speak to the Inspector or because of communication difficulties. However staff had completed questionnaires with three residents: some of these clearly contained the residents views but in some cases staff had had to answer for them. The questionnaires and comments from residents during the inspection showed general satisfaction with the home and some very positive feelings about some aspects of it, particularly the good relationships with staff. This place is very good, its fine. The inspector also spent time observing and sitting in the lounge with some residents and sharing two mealtimes with them. She spoke with two of their relatives and three of the care managers responsible for residents. Not all of these had been able to have regular contact with residents, because of family commitments or the geographical distance. One relative said she was generally pleased with the care, another was quite satisfied. Two care managers had noticed improvement in the general well being of their residents since they moved into the home-110 improvement. The current weekly charge for the home is £1650. This information was provided to CSCI in June 2006. What the service does well: The home provides a pleasant place to live in, with plenty of space in most areas and adaptations to make it suitable for people with mobility problems. There are plenty of staff on duty so that they can provide people with the individual attention they need. Staff have learned to communicate well with people with special communication needs. They have developed good supportive relationships with residents. Residents are treated as individuals, with each of them choosing different activities in and outside the home. Staff have had plenty of training so that they can work safely and meet residents needs. Cosin Lodge DS0000062455.V301088.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. The summary of this inspection report can be made available in other formats on request. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents needs were assessed before they were admitted so that the home could be sure it could meet their needs. EVIDENCE: All the residents had been assessed by care managers before they were admitted and written assessments completed. Staff also said that they had spent time with one resident before her admission, at her day placement, learning about her needs and how she communicated. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Care plans describe in detail the help each person needs, but although they have usually been updated when needs change, they have not all been regularly reviewed to make sure that they are up-to-date. This means that staff cannot always be sure they are providing the care needed at that time. But there is less risk of this happening in this home because there are few staff changes and any casual staff would usually be working alongside another member of staff. Where residents choices have been limited, by guidance intended to help staff respond to behavioural problems, there was not enough evidence to show that people outside the home, relatives or care managers, who could act as advocates for residents, had been consulted. This is essential to make sure that residents are protected. Since the inspection, the company which runs the home has told the Inspector of the systems they will set up to make sure that they record when care managers have agreed to any restrictions. Apart from this, residents could make choices about their daily lives. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 10 The home manages any risks which might be involved in residents going out and taking part in activities they enjoy by providing enough staff to support them. But they need to review their assessments of these risks every six months to make sure nothing has changed. EVIDENCE: Each resident has a care plan which sets out the help they need and how staff must look after them. These include information on personal care needs, health, communication, nutrition, any aids or adaptations needed and how to help residents make choices in their daily lives. The care plans had often been updated when changes had happened but this had not always happened. For example, a resident had been advised to use a piece of equipment to maintain or improve her walking ability. Staff had begun recording when she had used it. The record showed that she had not used it for some weeks but staff explained that this was because she had been unwell. Although staff seemed aware that they were not trying to use this at the moment, the care plan should have shown whether or not staff were to try and encourage the resident to exercise in this way. Care plans had not always been reviewed at regular intervals either. Staff have been able to discuss with one resident what is in his care plan and agreed the changes he wanted. This is good practice. Guidance on how to respond to particular behavioural problems were available in the office used by staff but not in individual care plans. These had been written out by the manager and she told the inspector that they had been written on the basis of advice from a behavioural therapist. The original written advice from the behavioural therapist had not been kept in the home. The manager believed that she had sent copies of the guidelines to care managers but one care manager was not aware of these and relatives did not seem aware of the details. Special care must be taken when restricting the choices of the most vulnerable residents, who are less able to say and do what they want independently. Homes should always discuss any restrictions with care managers, relatives and any other advocates and record discussions and agreement. One resident chooses to spend much of his time in the lounge with staff and other residents while another prefers to stay in his room more. Staff respected his choice not to meet the Inspector. His care manager felt that staff were encouraging him to make choices in his daily life. Residents who could comment said that they chose how to spend their leisure time in the home, in discussion with their key workers. Staff wrote out a plan for the week so that other staff knew what the resident had chosen. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 11 There are written guidelines to tell staff how to keep residents safe, for example, when going out. A care manager confirmed that restrictions on one resident going out independently had been agreed before his admission. There were written assessments of any risks which there might be for residents in the building and these explained what staff needed to do to keep residents safe without restricting them. For example a resident might be able to help in the kitchen, but only with staff supervision. There are enough staff provided on duty to make this possible. But these risk assessments had not been reviewed for some time to make sure that nothing had changed. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents take part in a range of activities, which suit their individual interests and abilities. They use local facilities in the town where they live. Where possible, they have been able to keep up contact with their families and staff provide support to make this possible. The home provides satisfactory meals and residents can make choices about what they eat. EVIDENCE: Records in the home and discussions with staff and a resident showed that each resident has a very different programme of activities. These matched their individual abilities and interests. One attends college, and others have attended college for particular courses. They regularly go out and about in the Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 13 local community, including to a pub. They are also involved in the running of the home, going shopping with staff and, if possible, taking responsibility for domestic tasks. Staff showed their knowledge of what one resident enjoyed which matched her care managers description of her interests. One resident attends a social club. Two go to sporting events, supported by staff. Staff have a number of different activities in the home to offer a resident who is deaf and blind and described how they had gained information on what was available before she was admitted. The manager described a number of trips out during the summer months and residents have recently had short break holidays. These were chosen in discussion with residents as far as possible. Relatives confirmed that they were able to keep up contact with residents. In one case, staff take the resident home for visits so that they can provide care for her while she is there. This is a good level of service. The menus kept show a satisfactory, varied diet and staff record what each person has eaten. One resident who could comment said that he goes shopping with staff and they buy meals for the times when he wants an alternative to the main meals on offer. Residents have the equipment they need to help them eat independently and staff were available to sit with them and give help if they needed it. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 18, 19, 20 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. Staff provide the personal care each person needs. The home is active in making sure that changing healthcare needs are met. Medication is handled safely but might not be being stored at the right temperature. Staff have not had the external training in handling medication which is recommended although they have had basic training in the home. EVIDENCE: The care plans include detailed information about how to care for each person. They recognised the importance of promoting independence. The home has obtained specialist advice about how to support people who need special hoisting equipment etc. and the equipment is available in the home. A care manager confirmed that comprehensive assessments about bathing needs, speech and language etc had been obtained and had found her resident looking well cared for when she visited. The inspector saw staff using a hoist to move one resident from her wheelchair to a sofa and she appeared comfortable and confident while they were doing this. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 15 The home also seems to look after psychological needs well. One relative said that staff knew how to handle her daughter and her behaviour had been more settled since she had been in the home. A care manager said that staff seemed to be managing well the autistic part of her residents personality, providing him with support and reassurance when necessary. Records showed how staff followed up healthcare needs, both those to do with changing long-term conditions and routine things like dentist appointments. A care manager commented that healthcare needs were definitely met for her resident. Staff have been able to provide daytime care for a resident during a hospital admission. The home seems to have satisfactory systems for looking after medication in general. A sample of records showed that staff were recording correctly when they had given medication. Staff have only undertaken one days training and training within the home before they began to handle medication but all are enrolled on a distance learning course which will start when they have completed their National Vocational Qualifications in care. Medication is kept securely but is in a small room which becomes quite warm. Staff must monitor the temperature to make sure that medication is kept at a suitable temperature and if it cannot be stored correctly, action must be taken about this. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory formal procedure so that complaints are dealt with but needs to do more to develop the understanding of residents about their rights to complain and how they could do this. The home has a number of procedures to protect residents from abuse but needs to improve on this by consulting more widely with people who can act as advocates for residents when any behavioural programmes restrict residents choices or freedom of movement EVIDENCE: The care provider has a formal procedure for dealing with complaints which is satisfactory. The manager said that this had been given to relatives. A list of contact names and phone numbers has been given to the two residents who can make use of this if they wish. The manager is aware of the need to develop other means of explaining how to complain to two other residents. Some residents may not be able to express unhappiness as a complaint: staff need to consider how to respond as seriously to these concerns. Two residents who commented said that they knew who to take any complaints to. All the staff have completed training in adult protection and the induction training for new staff also provides basic training in this. Although the senior person on duty on the first day of inspection was not aware of exactly what to Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 17 do if an allegation was reported, she could contact senior staff for advice if necessary. Guidance on how to respond to particular behavioural problems were available to staff. The manager believed that she had sent copies of the guidelines to care managers but one care manager was not aware of these and relatives did not seem aware of the details. Special care must be taken when restricting the choices of the most vulnerable residents, who are less able to say and do what they want independently. Homes should always discuss any restrictions with care managers, relatives and any other advocates and record discussions and agreement. Satisfactory records are kept of any money handled for residents. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 24 and 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. The home provides a comfortable place to live which meets peoples needs. On the day of inspection it appeared clean and staff have the equipment and training they need to maintain hygiene. EVIDENCE: The home was designed to meet the needs of people with physical disabilities. Each pair of bedrooms share a large bathroom equipped with special bath, hoists etc so that staff can provide personal care safely and with dignity. The home has a large kitchen/dining room and a separate lounge. There is a private garden which all the residents can use. The building seemed clean on the day of inspection. Staff have received training in infection control and they confirmed that they were supplied with enough gloves and aprons to maintain good hygiene. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 32, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staff either have or have nearly achieved the recommended qualification for care staff. Enough staff are on duty to provide one-to-one care when this is needed and to enable residents to enjoy activities in and outside the home. The homes recruitment procedures help make sure that only suitable people begin work in the home. Staff receive the training they need to work safely and to meet residents needs. EVIDENCE: Four of the staff have achieved NVQ 2 in care (25 ) and the others are working towards this qualification. The National Minimum Standards recommend that 50 of staff should have this qualification. Staff appear to have the personal qualities needed for this work, forming good relationships with residents. They have developed their skills in communicating with a resident who is deaf and blind. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 20 Staffing levels are high to enable staff to provide one-to-one care when necessary. One resident needs a member of staff to sit next to her at all times to communicate with her and apart from a short period when they were clearing up after lunch, one person was always there for her. Generally three staff are on duty through the daytime on weekdays, when one resident is at college, and four at weekends. Night staffing is one waking person and a sleep in. The company obtains a Criminal Records Bureau/POVA check and references for staff before they are employed to help them make sure that they only recruit people who are safe to work with vulnerable people. Staff receive training in key areas such as food hygiene, first aid, moving and handling, protection of vulnerable adults, fire safety, infection control and challenging behaviour. They have also had training in areas such as epilepsy and autism which they need to know about to care for particular residents. Some records suggested that some staff may need to develop more their understanding of challenging behaviour as a way of communicating needs, preferences and frustrations. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 37, 39 and 42 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to the service. The manager has the necessary experience in the care of people with learning disabilities and has almost completed the qualifications recommended for managers. Although the management of the home carries out regular visits to check the home is running well, they have not yet set up a system to find out the views of residents, relatives etc. In most ways, the home is a safe place to live but staff need to make sure that regular checks are carried out to keep it that way. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager has many years experience in caring for people with learning disabilities. She has managed the home since it opened in 2005. She has finished the Registered Managers Award and has nearly completed the NVQ 4 in care, which together are the recommended qualifications for managers of care homes. She has clear expectations of the quality of life people should have in a care home. But she may need to consider how best to involve residents representatives in decision-making about their care. Senior staff in the organisation which runs the home carry out a monthly visit to check that the home is run properly. As part of their systems for checking that the home is meeting the needs and expectations of the people who live there and who place people there, they need to set up a system for finding out their views. Staff do find out some of their views in informal ways in reviews and in residents meetings but need to do this in a way which makes sure nothing is missed. The home was purpose-built and designed to provide a safe place to live, with low surface temperature radiators and thermostatically controlled hot water. However staff had not been checking that the thermostats were working because the thermometer had broken. Regular maintenance has been carried out on the gas system and portable electrical appliances were checked in June. Staff were carrying out regular checks of the fire safety system but not all staff had been involved in a fire drill which is an essential part of preparing them for what to do if a fire breaks out. Staff had been recording weekly checks of wheelchairs and bed rails but the record ended in early August. The manager believed that staff had continued to check these but had not been recording it. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 2 3 3 3 X 2 3 3 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 X X 2 X 3 X 2 X X 2 X Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 24 No 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 YA6 Regulation 15 Requirement Care plans must be reviewed regularly and kept up-to-date. Any restrictions must be agreed by care managers, relatives etc if residents cannot give consent themselves. Risk assessments must be reviewed regularly. Staff must monitor the temperature where medication is kept and take action if it is not being kept at recommended temperatures. The home must try to provide information on how to complain in a way that each resident can understand. Staff must act as advocates for residents when necessary. The system for reviewing the quality of care must include seeking the views of residents and their representatives. All staff must take part in a fire drill every six months. Staff must check the temperature of hot water used by residents. Timescale for action 01/12/06 2 3 YA9 YA20 13 13 01/12/06 01/11/06 4 YA22 22 31/12/06 5 YA39 24 31/12/06 6 7 YA42 YA42 23 13 01/11/06 01/11/06 Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 25 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 YA20 Good Practice Recommendations Staff should have accredited training in the safe handling of medication. Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Cosin Lodge DS0000062455.V301088.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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