Inspection on 19/12/05 for Crawshaw Hall Medical Centre

This inspection was carried out on 19th December 2005.

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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Crawshaw Hall Medical Centre 19/06/07

Crawshaw Hall Medical Centre 17/07/06

Crawshaw Hall Medical Centre 10/05/05

Crawshaw Hall Medical Centre 15/09/04

Crawshaw Hall Medical Centre 20/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Crawshaw Hall Medical Centre Burnley Road Crawshawbooth Rossendale Lancashire BB4 8LZ Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 19th December 2005 10:00 Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 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 Crawshaw Hall Medical Centre DS0000022511.V255597.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 and 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. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Crawshaw Hall Medical Centre Address Burnley Road Crawshawbooth Rossendale Lancashire BB4 8LZ 01706 228695 01706 215670 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) Mrs Eileen Karoo Mr Adrian Mark Andrew Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21), Physical disability (21) of places Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Staffing for service users requiring nursing care will be in accordance with the Notice issued dated 7 December 2001 The registered provider shall at all times, employ a suitably qualified and experienced person who is registered with the Commission for Social Care Inspection as manager of Crawshaw Hall Medical Centre Within the overall total of 21 a maximum of 10 service users requiring personal care who fall into the category of PD. A maximum of 21 service users requiring nursing care who fall into the category of either OP or PD. Within the overall total of 21 a maximum of 1 service user requiring personal care who falls within the category of OP. The total number of service users within these categories must not exceed 21 (twenty one). 10th May 2005 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Crawshaw Hall Medical Centre is registered to provide either nursing or personal care for up to 21 residents. Older and younger adults may be admitted to the home. Accommodation is provided in single rooms on the ground and first floors. A large communal lounge with dining area us located on the ground floor. There is a smaller lounge on the first floor where smoking is permitted. A passenger lift facilitates access to all areas of the home. The property is a grade 2 listed building with extensive grounds. Crawshaw hall is situated on the outskirts of Crawshawbooth with shops and a public house. There is a reasonable bus service to the area. Crawshaw Hall Medical Centre DS0000022511.V255597.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 over 6.75 hours. One additional visit was made on 1 July 2005 to monitor compliance with the requirements issued at the last unannounced inspection. At the time of this inspection 20 residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty and residents were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? Records relating to wound care have improved and contain detailed information about the care and condition of the wound. Care plans were reviewed monthly. Records for the management of medication were up to date. These included details of medication received into and taken out of the home and disposed of. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 6 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. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these standards were assessed. The key standard was assessed and met at the last inspection. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 (Adults 18-65) 7 and 14 (Older People) Care plans were clearly written and addressed identified care needs. Residents were encouraged and enabled to make decisions about their lifestyle. EVIDENCE: The individual care plans of three residents were inspected. These clearly identified the personal care needs of each resident and explained how these needs were met. Appropriate risk assessments had been carried out. Information about how identified risks were dealt with was also included in the care plans. Care plans were reviewed monthly and updated when necessary. Residents and their relatives were invited to be involved in reviewing care plans. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 10 Residents were encouraged to make decisions about their lifestyle and activities. These were recorded in their individual care plans. Advocacy services were used by a number of residents. Information about how to contact these services was displayed in the home. Residents were encouraged and supported to manage their own finances. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the 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, 16 and 17 (Adults 18-65) 12, 13, 10 and 15 (Older People) Residents were encouraged to make decisions about their lifestyle. The daily routine met the needs of the residents. The meals were wholesome and menus offered variety and choice. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 12 EVIDENCE: Residents were encouraged to pursue their own interests and educational activities. Visits to the local shops and pubs were arranged. Independence was promoted and residents were encouraged to help with household tasks e.g. setting the tables, making drinks and making their own bed. The daily routine was flexible in order to meet the needs and preferences of the residents. Visitors were welcomed into the home at anytime. Local clergy regularly visited the home. The meal served at lunchtime looked wholesome and appetising. Members of staff offered assistance to residents in a sensitive and patient manner. Lunch was unhurried allowing residents time to chat and enjoy their meal. All the residents asked said they had enjoyed their lunch. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) 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 20 (Adults 18-65) 8 and 9 (Older People) The healthcare needs of residents were identified and addressed. Medication was generally well managed promoting good health. EVIDENCE: Appropriate risk assessments including, moving and handling, falls, pressure sores and nutrition were in place. Records of the visits of other healthcare professionals e.g. GP, chiropodist, etc. were included in the care plans. A wound care chart for one resident provided detailed information about the care and condition of the wound. At the time of the inspection one resident was self-medicating. A risk assessment relating to this had not been carried out. Qualified nurses administered all other medication. Records relating to the management of medication were seen to be up to date. However, hand written instructions on the medication administration records should be signed and witnessed. A Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 14 contract with a licensed waste carrier ensured all unused medication was disposed of safely. Medication was stored correctly. The temperature of this area was checked and recorded daily. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 (Adults 18-65) 16 and 18 (Older People) Complaints were taken seriously and investigated. Members of staff had a clear understanding of adult protection issues, which protects residents from abuse. EVIDENCE: Complaints were taken seriously and investigated. Detailed records of complaints, the investigation and action taken were kept. A comprehensive complaints procedure was in place. Policies and procedures relating to the protection of vulnerable adults were in place. This issue was discussed with four members of staff. They were aware of the procedure and said they would report any concerns immediately. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 (Adults 28-65) 19 (Older People) The home was clean and well maintained. This meant the residents had a homely place to live. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 17 EVIDENCE: At the time of the inspection the home was clean, tidy and well maintained. This provided a safe and comfortable environment for the residents. The proprietor was advised to compile a plan for the routine maintenance and redecoration of the premises to ensure that standards were maintained and further improvements made. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, and 34 (Adults 18-65) 27, 28 and 29 (Older People) Staffing levels were appropriate to meet the assessed needs of the residents. Less than 50 of care assistants had achieved NVQ qualifications. Recruitment procedures were not thorough potentially putting residents at risk. EVIDENCE: It was evident from discussion with four members of staff and the proprietor that training opportunities were available. However, only two care assistants (14 ) had achieved NVQ level 2. Examination of the duty rota confirmed that a sufficient number of staff were on duty for all shifts to meet the assessed needs of the residents. However, one member of staff, who was providing personal care, was under the age of 18 years. The manager was informed that staff under the age of 18 years are Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 19 not allowed to provide personal care and the role of this person must change with immediate effect. The commission received a job description for this role on 3 January 2006. The files of three members of staff appointed since the last inspection were examined. Only one of these files indicated that all the required preemployment checks to ensure protection of the residents had been completed prior to appointment. One of the files had evidence that a CRB check had been obtained following appointment. A CRB check had not been obtained for the other employee and a work permit did not specify permission to work at Crawshaw Hall Medical Centre. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 (Adults 18-65) 31, 33 and 38 (Older People) The home has an experienced and competent manager. A system for obtaining the views of residents was in place. Appropriate procedures were in place to safeguard the health, safety and welfare of residents. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 21 EVIDENCE: The registered manager is an experienced nurse and has completed the NVQ Registered Manager’s Award. He maintained an up to date knowledge of current practice by reading articles in the nursing press and various care publications. The home had achieved the nationally accredited Investors in People award. Resident’s were encouraged to express their opinions about the quality of care and facilities at resident’s meetings and informally at anytime. A suggestion box had been placed in the hallway. The proprietor was advised to produce an annual development plan to help monitor the quality of the service and further improve outcomes for residents. Fire safety training was included in the induction programme. A fire risk assessment had been carried out. General risk assessments for the home were in place along with clear instructions about how to deal with these risks. A member of staff qualified to administer first aid was always on duty. Crawshaw Hall Medical Centre DS0000022511.V255597.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 Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 2 34 2 35 X 36 X CONDUCT AND MANAGEMENT 37 3 38 X 39 2 40 X 41 X 42 3 43 X Standard No 6 7 8 9 10 LIFESTYLES 11 12 13 14 15 16 17 Score 3 3 X 3 X X 3 3 X X 3 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 2 X Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 23 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 YA20 Regulation 13(4)(c) Requirement Timescale for action 27/01/06 2 YA32 The registered person shall ensure that – (c) unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. A risk assessment must be completed for all residents who self-medicate. 18(1)(c)(i)(ii) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users – (c) ensure that the persons employed by the registered person to work at the care home receive – (i) training appropriate to the work they are to perform; and (ii) suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. 50 of care assistants must have an NVQ level 2 or be working towards this by the date given. 18(1)(a) The registered person shall, DS0000022511.V255597.R01.S.doc 31/03/06 3 YA33 19/12/05 Page 24 Crawshaw Hall Medical Centre Version 5.0 4 YA34 19(1)(b) Schedule 2 having regard to the size of the care home, the statement of purpose and the number and needs of service users – (a) ensure that at all times suitably qualified and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. Members of staff under the age of 18 years must not provide intimate personal care. The registered person shall 27/01/06 not employ a person to work at the care home unless (b) he has obtained in respect of that person the information and documents specified in (i) paragraphs 1 to 7 of schedule 2 A CRB check must be obtained prior to appointment. A valid work permit stating Crawshaw Hall Medical Centre must be obtained. 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 YA20 YA24 YA39 Good Practice Recommendations Hand written instructions on the medicines administration records should be signed and witnessed. A plan for the routine maintenance and renewal of the fabric and redecoration of the premises should be produced. An annual development plan should be produced. Crawshaw Hall Medical Centre DS0000022511.V255597.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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. Crawshaw Hall Medical Centre DS0000022511.V255597.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!