Inspection on 23/08/07 for Darna House

This inspection was carried out on 23rd August 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Darna House 24/05/06

Darna House 21/03/06

Darna House 25/11/05

Darna House 03/02/05

Darna House 03/11/04

Darna House 23/03/04

Darna House 02/12/03

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 HOMES FOR OLDER PEOPLE Darna House Groby Road Altrincham Cheshire WA14 2BQ Lead Inspector Kath Oldham Unannounced Inspection 23rd August 2007 8:20am 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 Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Darna House Address Groby Road Altrincham Cheshire WA14 2BQ 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) 0161 928 4342 0161 929 1914 Mr Simon Porritt Tracy Lynn Lidster Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. All service users shall be aged 60 years or over and require nursing care. Staffing levels as specified in the Notice issued under Section 25(3) of the Registered Homes Act and dated 2nd May 2000, shall be maintained. 24/05/06 Date of last inspection Brief Description of the Service: Darna House is a care home providing nursing care and accommodation for 20 residents. The home is a detached Victorian house situated on a tree-lined road in Altrincham. Bedrooms are on three floors with access to these by stairlifts. Accommodation is provided in both double and single bedrooms. The home is in close proximity to Altrincham town centre. The grounds include a large garden area. There is ease of access to public transport, the motorway, local shops and parks. The current fees are £612.00 per week. This includes all care, food and laundry. The only normal extra is hairdressing, toiletries and newspapers. If other extras arose, they would be agreed in advance. The home has a statement of purpose and service user guide, which were given to people living at the home or their families. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced, which means Darna House was not told we would be visiting, and took place on 23rd August 2007 commencing at 8.20am. The inspection of Darna House included a look at all available information received by the Commission for Social Care Inspection (CSCI) about the service provided since the last inspection. This included Darna House filling in a questionnaire about the home, which gave information about residents, the staff and the building. Darna House was inspected against key standards that cover the support provided, daily routines and lifestyle, choices, complaints, comfort, how staff are employed and trained, and how the service is managed. Comment cards were sent prior to the inspection for distribution to people staying at Darna House, the views expressed in returned comment cards and those given directly to the inspector are included in this report. We got our information at the visit by observing care practices, talking with people staying at Darna House; talking with the manager, the owner and staff. A tour of Darna House was also undertaken and a sample of care, employment and health and safety records seen. The main focus of the inspection was to understand how Darna House was meeting the needs of residents and how well the staff were themselves supported to make sure that they had the skills, training and supervision needed to meet the needs of residents. The care service provided to two residents was looked at in detail to help form an opinion of the quality of the care provided. The term preferred by people consulted during the visit was “residents”. This term is, therefore, used throughout the report when referring to people living at Darna House. The Commission for Social Care Inspection has received no complaints about the service since the last inspection. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 6 What the service does well: The home is well maintained, homely and comfortable. The garden is well stocked with plants for residents to use during the better weather. The home was clean and free from any offensive odours. encouraged to personalise their bedrooms. Residents were Darna House is a friendly, homely place and the people who lived there seemed happy and relaxed. The manager and staff know everyone well and treat everyone as individuals with different preferences and needs. The manager carries out an assessment of prospective residents and provides people with information to help them make a positive choice. The home had a stable staff team of care workers, many of whom had worked at the home for a number of years. All the residents who were spoken with said that the food was good and had no complaints. What has improved since the last inspection? The needs of the residents are fully assessed before admission to the home. This enables the manager to check if Darna House can meet residents’ needs and to ensure staff have the skills and experience to meet those needs. Where possible, the care plan is drawn up with the involvement of the service user or their representative so they are clear that the care and support they need is detailed. A full audit of all the care plans and risk assessments have been undertaken and a new format is now used at Darna House, which reflects the needs of residents. All staff have received Protection of Vulnerable Adult training which enables staff to recognise abuse and to know what to do if abuse is suspected. The Adult Protection Procedure is accessible for staff and contains the information relevant for making referrals to the local authority. Staff have signed to confirm in writing that they had seen and read this procedure, which makes them aware of the procedures to undertake if abuse is alleged. The personal identification numbers for the registered nursing staff are checked with the Nursing and Midwifery councils monthly Fitness to Practice list to promote good practice and to check nursing staff remain on the register. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 7 Each staff member has a training and development plan which identifies the training they have received. This supports the manager to plan for future training and to be able to see at a glance what training has been provided. 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. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 8 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 Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 5. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents’ needs are assessed prior to them being accommodated at the home, and they are given written information as to what is provided at Darna House. EVIDENCE: A statement of purpose and service user guide are given to people enquiring about the home and are available on request to anyone living at Darna House. Two files for the most recently admitted residents were looked at. Evidence was seen on the two files of completed assessments prior to being offered a place. This enables the home to have sufficient detail about the resident so they can best meet their needs. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 10 The comment cards returned to the Commission stated that residents had received sufficient information about Darna House People living at the home felt that staff knew them well and understood what help they needed and what their preferred daily routines were. Staff were knowledgeable about the people they were caring for and it was reported that a handover report was given at every shift change so all staff were aware of any changes to residents’ condition. Standard 6 was not applicable, as the home did not have any intermediate care beds. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The manager and the staff team met the health and personal care needs of residents. EVIDENCE: Care plans were in place, which had been devised from the assessment process. The care plans, along with risk assessments, contained information to assist the care workers in caring for residents. Care plans and risk assessments need to be reviewed and updated monthly so that the changing needs of residents are accurate and clearly recorded. Additional detail within the care plans would make the care plans individual to the resident. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 12 Risk assessments had been undertaken for risk of pressure sores, risk of falling and other risks that were identified and specific to the individual person. In response to the question, “Does the care service support people to live the life they choose, a relative/friend indicated, “regrettably my cared for relative isn’t able to live the life they would choose if fully well in mind and body. However, the decisions the home makes are with my cared for relative’s best interest at heart”. The records demonstrated that people’s health care needs were recognised and met. Visits by medical professionals were recorded and treatments given evident. Correspondence and daily records also confirmed that people living at the home are supported in accessing routine and specialist health intervention and advice such as dentistry, podiatry, influenza injection and eye and hearing tests. General practitioner comment cards were positive about their experience of Darna House, identifying that communication between the home and health professionals is good. From conversations with residents it appeared they could exercise choice and control over their lives. Residents’ bedrooms showed they were encouraged to bring personal possessions into Darna House. Staff were knowledgeable about the people they were caring for and were aware of any changes to people’s condition. One resident said staff treated them well and they were satisfied with the care they received. The procedures for managing medicines within the home were satisfactory. The records for several people were examined and had been completed properly. Medication which needs refrigeration is kept in the fridge in the kitchen, which isn’t locked. All medication needs to be kept securely. Records of medicines received at the home and returns for destruction were kept. A list of staff signatures was available for the Registered Nurses responsible for administering medication. There were handwritten entries of medicines prescribed by the doctors and these had not been verified by a second staff member to ensure the entry had been correctly copied. This could result in people living at the home getting the wrong dosage of medication. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 13 To ensure the safe administration of controlled drugs, best practice indicates that two staff sign the administration records when giving residents this type of medication. This provides an additional safeguard. Photographs to assist in the identification of residents were not on all of the medication administration records, as is best practice. This needs to be arranged. Creams that are prescribed to residents are not signed on the medication administration records when administered by staff. A tick is indicated on the record. The signature of staff on the record would provide a complete record of prescribed medication. Interaction between staff and people living at the home was professional but also friendly and relaxed. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The day-to-day routine of the home, including mealtimes, was relaxed and informal and met residents’ needs and expectations. EVIDENCE: Feedback was positive about the food provided at Darna House. Several residents said the food was good and all the residents asked on the day of the site visit said they were enjoying their meal. In response to the question do you like the meals at the home, one resident added “very good”. There is a four-week menu plan. Examination of the menus showed that a nutritious and varied diet was provided. The menus indicate a choice at each meal. Residents said the meals were always good and were home cooked. The lunch shared with residents was home made and appetising. One resident said, “You can always depend on the meals being good.” Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 15 Residents said should they not like what was on the menu they would be given something they did like. Staff were seen to assist residents who required assistance at mealtimes in an sensitive and patient manner. A record is maintained of individuals’ likes and preferences for meals so staff are aware of what residents preferred meals are and they would not be given anything they didn’t like. The information provided by the manager to the commission before the inspection identified several activities at the home. A relative indicated, “The care home could organise some more activities for the residents so that there is more for them to do other than just watching TV”. Many residents are cared for in their room or choose to stay in their room. Residents were seen listening to music, watching television or having conversation with staff in their rooms. One resident spent the morning reading the newspaper, which they said they did every day. Staff are busy supporting residents and have no spare time to arrange activities. Thought needs to be given to increasing the activities within the home to provide some stimulation and occupation for the residents who want this. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Complaints are dealt with appropriately and residents are protected from abuse or exploitation through policies and procedures. EVIDENCE: The home has a complaints procedure, which is given to people when they come into the home. Staff were aware of the home’s complaints procedure. People living at the home indicated that they were aware of who to complain to and had not had reason to complain. Relative comment cards indicated, “I have not found it necessary to complain”. “On the few occasions that I have requested things to be done they have been done or an explanation of why it is done the way they do it”. It was reported that the complaints book did not detail any complaints or comments, which does not validate the procedures in place. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 17 The complaints procedure should be used, as part of the home’s development process to monitor the quality of service provided and it should be proactively encouraged to record comments about service delivery. The Commission for Social Care Inspection has not received any complaints since the last inspection. Darna House arranges training in the recognition of abuse and procedures to safeguard the residents, which all staff have attended. Staff spoken to were aware of the procedures to follow if they suspected abuse. Regular visitors to the home said that they had always observed staff treating residents with patience and respect. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home was clean and well maintained meeting the needs of residents. EVIDENCE: Access to the house is in response by staff to the front door. This ensures that no one enters the home without the knowledge of staff. A visitor’s book is placed in the hall and visitors to the home are encouraged to sign in and out of the book. This is to ensure that if there is an emergency situation everyone in the building is accounted for. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 19 There are gardens, which can be accessed at the back of the house; a chair lift is situated at the back door so residents with limited mobility can access the garden. The gardens are private and enclosed, so people living at the home are not at risk of becoming lost. The garden is a good size and was well kept with lawns and flowerbeds. The lounge was well furnished with comfortable seating. There is a call bell system within the lounge, which can be used to call for staff assistance or help. A tour of the building identified that bedrooms were personalised by residents or their families. A number of bedrooms require a coat of paint to refresh them. The manager said that a number of bedrooms needed new carpet and these would be fitted and bedrooms freshened up with a coat of paint. A comment card indicated, “The décor could be updated in certain rooms - this is minor”. A further comment card indicated, “Clean home”. Adjustable height beds are in place in some residents’ bedrooms. The manager said that these are being obtained, as they are needed, for individual residents. One resident said they had everything that they needed in their bedroom and had brought things with them from home to make it more their own. Residents said they were warm and comfortable and had everything they need. A sluicing disinfector has been installed since the last inspection. All public areas of the home seen were clean and tidy and free from any odours. Domestic routines keep the environment clean and odour free. Chair lifts are available to residents to support them to get to upstairs bedrooms. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home was sufficiently staffed with a staff group that was trained to undertake their duties, and recruitment procedure ensured that residents were protected. EVIDENCE: Fourteen residents were accommodated at Darna House on the inspection. There were sufficient staff employed to ensure that the residents’ health and personal care needs were met in a clean and comfortable home. The staff had received training in core skills, such as adult protection, medication administration, moving and handling and health and safety. Examination of the training record identified that staff had received updates to their moving and handling training as identified within health and safety guidance. This protects them and the people who are living at Darna House as techniques change and updates also act as a reminder in best practice guidance. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 21 Staff said that they had undertaken training in a range of topics, including food hygiene, infection control, moving and handling and other health and safety topics. A number of people living at the home have some degree of confusion. None of the staff were recorded as having had any training in this specialism to better inform them of best practice. This also needs to be scheduled within staff training sessions. Many staff had completed a National Vocational Qualification (NVQ) Level 2. This ensures that staff have the skills required to care for older people. The manager has obtained the Registered Manager’s Award since the last inspection. A relative said, “The staff are always helpful and cheerful”. Three staff files were looked at which contained a record of training received. Advice was given to ensure that the dates of the training are kept on this record, which accompanies the certificates of attendance. All staff files looked at contained the information and documents needed to ensure that the necessary checks had been made before staff started work at Darna House. All staff files looked at had a Criminal Record Bureau disclosure. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The management is approachable and there is a focus on meeting the needs of residents. EVIDENCE: The owner of Darna House visits at least once a week. In line with the requirement under Regulation 26, the owner should make an unannounced visit once a month and prepare a written report on the conduct of the care home. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 23 This visit should include interviewing some residents, their representatives, and staff working at the home in order to form an opinion of the standard of care provided in the home. A requirement to prepare a written report of this visit was reported on in the inspection undertaken on 21st March 2006 which has not been complied with. The manager has many years’ experience as the manager of Darna House. She has since the last inspection obtained the Registered Manager’s Award. The manager demonstrated that she knew residents well and had a detailed knowledge of their care needs. The manager operates an open management style, and encourages residents and staff to make use of the ‘open door’ policy. At the heart of this style of management is a person centred approach where the focus is on how the individual resident wants their care needs to be met. Discussions with the manager provided evidence of an open and transparent management style where any developments highlighted in the inspection visit were seen as an opportunity to improve the service. A quality assurance system is in place that seeks and acts upon the opinions of residents in terms of their day-to-day experiences and improvements that could be made. This needs to be extended to seek the views and opinions of professional that come to Darna House. Health and safety procedures presented as being effectively implemented. A selection of records relating to the maintenance of equipment and the fire detection systems was looked at. These were appropriately maintained. Staff confirmed they were provided with protective equipment, including disposable gloves and aprons, to minimise the risk of cross-infection. During the inspection no obvious risks to the health and safety of people living at the home were observed. Maintenance checks are undertaken and contractors contacted to ensure equipment is working correctly. The home does not handle the finances for any of the people living at the home, as they are assisted by their families or their representative. There were small amounts of money held on behalf of some residents for hairdressing. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 24 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 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP31 Regulation 26 Requirement Complete a report each month on the conduct of the home in line with regulations. Provide a copy to the manager and keep a copy at Darna House available to CSCI. (The previous timescales of the 30/05/06 and 03/07/06 had not been met). Timescale for action 30/09/07 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 OP7 Good Practice Recommendations Review the care plans and risk assessments monthly to ensure the changes to residents care needs are recorded. Further develop the recording in the care plans to include the individualised needs and preferences of residents so it is recorded when and how they prefer there care provided. Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 2 Refer to Standard OP9 Good Practice Recommendations Any details on the medication administration records that are handwritten should be signed and dated and an additional member of staff should also sign to agree the information. This will ensure that people receive the correct levels of medication. To ensure the safe administration of controlled drugs best practice indicates that two staff sign the administration records when giving residents this type of medication Ensure that on occasions where a variable dose of medication is prescribed, for example, one or two tablets to be taken, an accurate record is made of the actual dosage of each medication administered. To promote best practice and to aid in identification a photograph of residents needs to be in their care file and with their medication administration record. To ensure medication is kept securely obtain a lockable fridge for medication which needs refrigeration. Provide residents with the opportunity to take part in activity during the day on a regular basis as a means of stimulation and occupation. Further develop the complaints procedure through the routine recording of comments and complaints made to Darna House. Ensure that when prospective staff complete a job application they detail a full employment history with and include explanation of any gaps in employment. Send to professionals visiting or referring residents to Darna House a questionnaire to provide them with an opportunity to comment on the service, which can be then used to provide an audit to report on the quality of the service provided. 3 4 OP9 OP9 5 6 7 8 9 10 OP9 OP9 OP12 OP16 OP29 OP33 Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Darna House DS0000006707.V344066.R01.S.doc Version 5.2 Page 28 - 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!