CARE HOMES FOR OLDER PEOPLE
Dale Park 221 Meols Cop Road Southport Merseyside PR8 6JU Lead Inspector
Mr Mike Perry Unannounced Inspection 29th December 2005 10:00 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 Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 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. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Dale Park Address 221 Meols Cop Road Southport Merseyside PR8 6JU 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) 01704 501780 01704 501782 Southern Cross Healthcare Services Limited Mr John Melvyn Price Care Home 54 Category(ies) of Dementia (54) registration, with number of places Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 54 DE Date of last inspection 14th June 2005 Brief Description of the Service: Dale Park is a purpose built home providing nursing care for 46 older residents with mental health needs related to dementia [the home is registered for 54 but shared rooms are used for single use]. The home is owned privately by Southern Cross Health Care and the Responsible Person is Mr Phillip Scott. The Registered manager is Mr John Price. The home is situated in Southport close to a retail park and with access to a bus route for the town centre. There are shops close by and a pub. Dale Park is divided over 2 floors and 4 units. Each floor has 2 lounges and 2 dining rooms. The first floor is accessible by a passenger lift and stairs. Two bedrooms have ensuite facilities. The home is equipped with manual handling aids and grab rails to promote independence. There is a car park to the rear of the home and there is an enclosed garden. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two days. During the visit, a partial tour of the premises took place and observations were made. A selection of the care, staff and service records were also viewed. The home manager, 6 nursing and care staff members, residents, 6 relatives and visiting professionals were spoken to during the visit. Leaflets were also left in the home to enable residents and others to comment on the service provided. Care Homes are routinely inspected twice yearly and this is the second inspection at Dale Park, the previous being in June 2005. The inspection concentrated on the requirements from the previous inspection as well as those standards not covered on that inspection. What the service does well:
Dale Park provides a good range of information about the services and facilities in the home so that residents and relatives are assisted in making a choice to move in. Senior staff assess residents prior to admission and also following admission to the home. This ensures that care needs can be planned for and met. The plans of care are drawn together with relative involvement to varying degrees and are generally easy to follow and provide a good description of the care. The staff maintain good communication with external health care support such as community nurses and General Practitioners [GP’s]. Referrals are made when required so that residents’ health needs are met. An example of this is the liaison with psychiatric services and the ongoing review of 2 residents who have particularly challenging needs. There was also a need during the inspection for advice to be sought from the infection control officer from the local hospital. The home is able to demonstrate an understanding of need for residents with dementia to exercise some control over their lives so that their rights are respected. For example staff interviewed were aware of individual residents likes and dislikes in terms of dress and food. Bedrooms displayed photographs and ornaments, which reflected individual’s history and personality. The relatives interviewed felt included in the care in the home and stated that they
Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 6 are always informed by staff of any changes. The activities organiser runs a ‘friends and family’ group so that there is an additional opportunity for relatives to have input into the home. There is a clear complaints procedure and the management have been open and helpful during a recent complaint investigation undertaken by the Commission. The home has good standards when recruiting staff to work in the home. Staff files seen were very inclusive and covered all of the necessary checks needed prior to employment. Dale Park is part of the Southern Cross portfolio of care homes and as such has ongoing systems in place to help ensure and improve the quality of the work they do. They take time to collect the views of residents and relatives so that care can be improved. The home has an experienced and well-qualified manager who ensures good continuity around the management of the systems in the home such as Health and Safety for example. What has improved since the last inspection?
Since the last inspection there have been new assessment records developed which include better reference to needs of people with dementia. These are just starting to be used and should provide an improved assessment process. The ‘Service User Guide’ has been updated and includes information recommended on previous inspections. The care plans seen on this inspection were more inclusive and consistent in the way that they identified interventions for residents who have more disturbed behaviour or challenging needs. Those residents reviewed were more settled since the last inspection. The recommendations made previously regarding the access to the garden area and the provision of shower facilities have been actioned although work has not yet been fully completed. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 7 Overall the staffing in the home shows signs of being more consistent. There is less use of agency staff to cover routine work and the care staff interviewed felt part of a team able to support each other. Relatives interviewed felt that there was more continuity and were able to relate to key staff in the home. What they could do better:
Following requirements from the previous inspection there have been 2 inspections by a pharmacist from the Commissions and further requirements have been made. The pharmacist reports that management of medicines has much improved over the 2 visits but there are is still some work to complete. Staff generally showed a good awareness of residents and relative’s rights around access to care records but all staff need to be aware of the homes policies around this subject so that a consistent approach can be applied. There was some discussion around the need to review again the mealtime arrangements in order to improve the quality for all residents. Due to the difficult behaviour of some residents the meal times appear quite chaotic and in need of review so that individual social needs can be met in a better way. [Perhaps concentrating on the midday meal to begin with might prove more manageable]. The home is generally maintained in a clean state although there were areas noted that could be improved. For example one bedroom seen had not been cleaned effectively. From speaking to staff it was evident that occasionally short-term sickness is not always covered and this has left staff in difficulties in trying to ensure care standards are maintained [e.g. the evening prior to the inspection]. Although this eventuality occurs only occasionally the effect in terms of care and staff morale is evidently quite striking and the management must ensure that minimum staffing numbers are maintained at all times. Staff reported that the management are supportative and approachable but they would benefit from formal supervision sessions, which have not been carried out over recent months Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 8 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. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 9 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 Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 10 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3, (6 N/A) The information available for residents and relatives is appropriate and useful so that an informed choice can be made when choosing the home. The assessments carried out by the home are good and help ensure that the home can meet the needs of residents admitted. EVIDENCE: The home has a useful range of information guides available such as the ‘Service Users Guide’, which describes the facilities and services in the home. These are displayed in the entrance to the home. The guide has recently been reviewed and updated and new copies were available at the time of the inspection. Relatives spoken to said that they had been given copies of this document which had helped in both choosing the home and also assisted in the settling in period. The requirements from the previous inspection with regard to the
Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 11 inclusion of the results of the resident satisfaction surveys as well as including a copy of the latest inspection report from the Commissions [Inspecting body] have been carried out. There is a copy of the Service User Guide in each of the resident’s bedrooms. The manager or senior nurse in the home carry out assessments prior to residents coming into the home so that the home is better able to make a judgment as to whether needs can be met. The assessments seen were comprehensive and included assessments from health and social care professionals also involved with the residents care. Further assessments are carried out once the resident is admitted and from these a care plan is devised. The assessments include all routine daily living activities such personal care as well as more specific assessments covering risk, nutrition, pressure area care, and mental assessments. The social assessments display evidence that relatives are involved in the care. The manager provided copies of new preadmission and other care assessments that have recently been devised and contain even more detail and are specific to dementia care. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 12 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 Individual care plans are of a general good standard and display evidence of relatives being involved so that routine care is managed effectively. There is now evidence that the more acute and challenging care needs are responded to more effectively so that care is managed in a more consistent manner. There is good liaison with health care support services so that residents are referred appropriately EVIDENCE: Individual care plans were available for each resident. 3 care plans were reviewed and these were very well written and detailed the health and personal care needs of residents in a clear manner. They are reviewed on a regular basis. Relatives spoken to have some involvement with the care plans and, depending on choice, had contributed information and views. The care plans reviewed were for those residents who exhibited more challenging behaviour such as aggression or non-compliance with care. The management plan for these specific needs had varied on the previous inspection. It was clear that these residents were having their needs met more consistently and the care plans and records include observation charts
Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 13 [behavioural observation charts] that are able to more accurately contribute to the evaluation and development of the care plan. Staff interviewed were aware of the care needs of these residents who were now settled enough to partake more regularly in social activities which has improved their quality of life. In discussion with staff it is evident that the bulk of the care planning and recording is left to the 2 senior nurses on each floor although there is evidence that other nurses are now getting involved and this should continue. The staff in the home are careful to refer residents for health care reviews and this was evident from the regular visits by the GP as well as other health care professionals clearly recorded in the care files. The home has liaised effectively with support psychiatric services regarding the management of the more acutely disturbed residents and as well as ongoing medical reviews have also secured appropriate funding for special observations and staffing. At the time of the inspection the home was liaising with the infection control adviser from the local hospital trust whose feedback regarding the homes management in this area was good. The medication issues from the previous inspection were around the inconsistencies in the administration process. There have been two extra pharmacy inspections since that date by a pharmacy inspector from the Commission. There are requirements still outstanding and these need to be addressed. [Separate pharmacy report is available]. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 14 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): 14,15 The home is able to demonstrate an understanding of need for residents with dementia to exercise some control over their lives so that their rights are respected. The meals provided are wholesome and nutritious although there is a need to further review the social arrangements around meal times to improve the quality of the experience for residents. EVIDENCE: The personal exercise of choice and control over resident’s daily life in the home is a difficult balance to achieve given the lack of mental capacity of the resident group. There were examples however of how the home were trying to achieve a good balance. For example staff interviewed were aware of individual residents likes and dislikes in terms of dress and food preference. Individual bedrooms displayed photographs and ornaments, which reflected individual’s history and personality. The relatives interviewed felt included in the care in the home and stated that they are always informed by staff of any changes. The activities organiser runs a ‘friends and family’ group so that there is an additional opportunity for relatives to have input into the home. The general policy in the home is for open access for key relatives to care records. Not all staff interviewed were clear on this however and the manager
Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 15 should reiterate the policy to all staff. Staff were clear about the use of advocates to represent residents rights and the home have been in contact with ‘Care Aware’ who provide an advocacy service in this respect. The provision of diet and choice of food was assessed on the previous inspection and is satisfactory. The recommendation at that time was for the management to consider the social arrangements at meal times so that residents are able to enjoy their meal as much as possible. It was observed that the residents who display more difficult behaviours are impinging on the ability of other residents to enjoy their meal. There are some residents that would benefit from properly laid tables for example but staff report this is difficult due to the behaviour of other, more disruptive residents. The homes management have tried to review dining arrangements in the past but it is recommended that this be looked at again with a view to more creative management of particularly the dinnertime meal so that the quality of the mealtime experience can be improved. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 16 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): 16,18 There is an effective complaints procedure in the home so that residents and their representatives feel that they are listened to and their concerns are acted on. The policies and training of staff in the home evidence good awareness of issues surrounding the protection of vulnerable adults so that residents are protected from abuse. EVIDENCE: There is a complaints procedure clearly available in the residents’ information guide [service users guide]. Relatives interviewed felt that staff were approachable and issues were dealt with appropriately. A recent complaint investigation by the Commission was conducted under the local Protection of Vulnerable Adult Procedures. The management of the home were very cooperative during the investigation and displayed an awareness of good practise in assisting the inspectors. The investigation was carried out following some concerns raised by the local hospital following the admission to casualty of an elderly resident of the Home. The complaint had 8 elements to it, which basically outlined allegations of poor nursing care as well as lack of an appropriate escort and information supplied to the hospital. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 17 5 allegations of poor care were not upheld. 2 allegations were partly upheld. The allegation of lack of appropriate escort and information was upheld. There were 3 requirements following the investigation and the inspector was able to discus these on this inspection. It was pleasing to note that the manager has already actioned a new policy concerning the admission of residents to hospital which addresses the requirements. All staff have been made aware. Southern Cross have developed some new training material around abuse awareness and these follow good practise. Staff reported that awareness of these issues is covered in induction training. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 18 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): 19,26 The home is generally well designed and meets the needs of people who have dementia who live in a safe well-maintained environment. There is good awareness of infection control measures and the home is generally maintained in a clean state although there could be more consistency in this area so that residents are assured of living in a clean and safe environment. EVIDENCE: The Home is purpose built to meet the needs of people with dementia and has many good practice facilities such as level access to bedrooms and good day space. There is a rolling programme of décor and this is to recommence in earnest in the new year as some areas [Grasmere dayroom for example] are now in need of upgrading. The recommendations from the previous inspection regarding access to the garden and the provision of shower facilities have been actioned and will soon be completed. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 19 The laundry is maintained in a clean state and was fully operational on inspection. The staff working in the laundry was aware of the management of foul linen and understood basic infection control. There were no complaints from relatives regarding the management of the laundry. The home was generally clean although some areas needed more attention. For example one interview with relatives as carried out in a room that had not been cleaned for some days, as there was food spillage on the bedside table, which had hardened and was very difficult to remove as well as food debris on the floor. Relative’s interviewed stated that the home was generally clean however. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 20 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): 27,29 The staffing in the home is generally settled and minimum numbers are maintained. There are occasions when this is not the case however and resident’s care can therefore be compromised. The recruitment processes are good and ensure that residents are protected. EVIDENCE: For 46 residents in the home there were 2 trained nurses and 8 care staff on duty and these figures are generally consistent from reviewing the duty rota. The manager and activities person are additional to these numbers. An improvement over recent inspections has been a decrease in the use of agency staff so that continuity of care is more likely to be provided in meeting residents needs. Extra staff are provided to meet needs; an example being the provision of 1:1 cover for residents displaying particularly challenging behaviour. From speaking to staff it was evident that occasionally short-term sickness is not always covered and this has left staff in difficulties in trying to ensure care standards are maintained [e.g. the evening prior to the inspection]. Although this eventuality occurs only occasionally, the effect in terms of care and staff morale is evidently quite striking, and the management must ensure that minimum staffing numbers are maintained at all times. Staff interviews maintained that ‘ the home is not allowed to use agency staff’. This was dispelled by the manager who described the protocol for the use of agency staff. This should be communicated to all staff.
Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 21 3 staff files were inspected and the standards for the recruitment of staff are good. All files contained necessary details including POVA [Protection of Vulnerable Adult] and Criminal Records Bureau [CRB] checks. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 22 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, 36,38 The manager of the home has the experience and qualifications to ensure that Dale Park is run satisfactorily and that residents best interests are maintained. The quality systems in place ensure good monitoring and ongoing improvements take place so that resident care can be progressed. Staff feel generally supported but there is a lack of formal supervision for them so issues cannot always be addressed systematically. There are good health and safety systems operating so that residents and staff can feel secure in the home. EVIDENCE: Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 23 The Registered Manager is Mr John Price who was appointed in December 2002 having worked at Dale Park as the Deputy prior to this appointment. Mr Price has many years experience working with the older resident group and has held previous managerial positions within the care profession. Mr Price is a qualified nurse RMN, SEN (Gen) and also has a social work management qualification [CSWM]. Mr Price is to undertake Level 4 in NVQ Management in the near future. Staff interviewed felt generally supported and stated that the manager was approachable and helpful. They understood his position in terms of being ‘office bound’ for much of his time but expressed a wish to see more of him on a daily basis on the units. Staff felt that more formal staff supervision could be organised. In discussion with Mr Price it is evident that supervision sessions for staff have not been carried out recently The home has very good systems in place for monitoring and improving quality. There is an annual external independent QA audit conducted as well as various ongoing internal auditing processes undertaken by the company and staff in-house [medication audit, care plan audit, Health and Safety Audit] and the results are discussed at staff meetings as well as management meetings. The home is also keen to canvas the views of relatives and visitors o the home and the results of user satisfaction surveys are published. Positive comments seen by the inspector were: ‘I am extremely happy with care at Dale Park’ ‘Excellent – best possible care’ There is also a ‘Friends and Family’ forum held on a regular basis where relatives can have some input into the running of the home. None of the residents have the capacity to manage their own finances. The policy of the home is for relatives to manage this. The administrator manages personal allowances in house with input from relatives. Records are maintained and receipts kept for money spent. A finance manager from the company also completes a regular audit of the system. There are good systems in place for the ongoing management of health and safety in the home. Policies and procedures are continually reinforced with staff via the regular Health and safety meetings as well as dissemination of policies on a regular basis. Records seen, such as [fire, manual handling, electrical, gas], were all up-to-date [the electrical certificate is due for update in Feb 06].
Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 24 Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 25 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 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 26 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 OP9 Regulation 13 Requirement The administration of medicines must meet good practice so that medicines are administered and monitored in a consistent manner. The requirements and recommendations of the recent pharmacy inspection [22.12.05] must be carried out. Minimum agreed staffing numbers must be maintained at all times. Staff must receive ongoing formal supervision sessions to ensure that they are appropriately supported. Timescale for action 30/01/06 2 3 OP27 OP36 18 18 29/12/06 01/04/06 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 OP15 Good Practice Recommendations Arrangements for the management of meal times with respect to resident’s exhibiting disturbed behaviour need to be reviewed in the context of ensuring a better quality
DS0000017278.V275229.R01.S.doc Version 5.1 Page 27 Dale Park 2 OP26 experience of mealtimes for all residents. The cleanliness of the home should be maintained consistently with attention to all areas. Dale Park DS0000017278.V275229.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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