Inspection on 06/06/06 for Dercliffe Care Home

This inspection was carried out on 6th June 2006.

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

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

Other inspections for this house

Dercliffe Care Home 09/12/08

Dercliffe Care Home 15/01/08

Dercliffe Care Home 22/08/07

Dercliffe Care Home 31/01/06

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 Dercliffe Care Home Juno Street Nelson Lancashire BB9 8RH Lead Inspector Mrs Julie Playfer Key Unannounced Inspection 09:00 6th June 2006 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 Dercliffe Care Home DS0000065155.V292021.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. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Dercliffe Care Home Address Juno Street Nelson Lancashire BB9 8RH 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) 01282 603605 Dercliffe Care Home Ltd Mrs Dawn Quinn Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 32 service users in the category of OP (Older People). The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. 31st January 2006 Date of last inspection Brief Description of the Service: Dercliffe is registered with the Commission for Social Care Inspection to accommodate 32 older people aged over 65 years. The home, a former vicarage, is a detached property set within its own grounds in a residential area. The home offers 24 single and 4 shared bedrooms, all have ensuite toilets and hand wash basins. Various aids and adaptations including a passenger lift are provided to assist with self-help and mobility. There are 4 lounge/dining rooms, 2 additional sitting areas and a conservatory. The residents have access to the paved garden to the rear of the property and a paved forecourt at the front of the home, where some car parking is available. Dercliffe is situated close to local facilities, including shops, post office and a public house. A bus service is available approximately 5 minutes walk from the home. At the time of the inspection the scale of charges ranged from £324.50 to £366.00. Additional charges were made for hairdressing (£5), chiropody (£14) and optical services (£30). The registered manager made information available to prospective residents by means of a statement of purpose and service users guide. The service users guide was usually given to relatives and/or prospective residents on viewing the home or at the point of assessment. In addition, all residents accommodated in the home had been issued with a personal copy of the service users guide. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took place over eight hours on 6th June 2006. The previous statutory inspection was carried out on 31st January 2006. There have been no additional visits made to the home since the last inspection. On the day of inspection there were 30 residents accommodated in the home. Information was obtained from care records, staff records and policies and procedures. The inspector undertook a partial tour of the premises and spoke to the residents, the staff on duty and the registered manager. Prior to the inspection the registered manager completed a questionnaire, which provided useful information for the inspection. Questionnaires and comment cards had been sent to the home for residents and their relatives, 11 questionnaires were returned from residents and 12 cards were received from relatives/visitors to the home. What the service does well: What has improved since the last inspection? Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 6 Since the last inspection a locked trolley had been purchased to improve the storage arrangements for medication. A new care plan format had been introduced for all residents, which covered the residents’ health, personal and social care needs. Emphasis had been placed on the residents’ emotional needs and the maintenance of significant relationships. Out of date information had been removed from the complaints procedure, to ensure the residents had a clear procedure to follow should they wish to raise a concern. The number of staff with NVQ training had increased, which meant more staff had completed the necessary training to fulfil their role as a care worker. 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. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Systems were in place to carry out an assessment of needs and residents were encouraged to visit prior to admission, to assess the quality, facilities and suitability of the home. However, the information provided for residents had not been updated and did not reflect the new ownership of the home. EVIDENCE: Written information was available for residents in the form of a statement of purpose and service users guide. The statement of purpose was available for reference in the hallway and the service users guide was displayed in each of the bedrooms. However, these documents had not been updated in line with the change of ownership and did not contain information about the registered provider. Residents involved in the case tracking process were issued with a statement of terms and conditions of residence, which included details about fees, insurance and the complaints procedure. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 9 Residents’ files contained copies of assessments completed by health and social care professionals. From the documentation seen, it was also usual practice for the manager to visit and assess prospective residents before offering them a place at the home. Following the assessment prospective residents received a letter confirming that their needs could be met at the home. One resident visited the home prior to admission with his relative. This provided the opportunity to discuss his needs, meet the staff and residents and view the vacant room. Dercliffe did not provide intermediate care. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The care planning system addressed the personal and social care needs of the residents and provided detailed guidance for staff on how to meet these needs. The management of medication was not robust and had the potential to place residents at risk. EVIDENCE: From the case files seen it was evident that each resident had a plan of care based on their assessment of needs. The plans set out the action needed to be taken by staff to ensure all needs were met. It was apparent the plans had been reviewed once a month and agreed with the resident and/or their representative. The plans had been updated in respect to any changing needs. The plans were detailed and were written in a suitable format for both staff and residents. The care planning system addressed the residents’ cultural and spiritual needs and included a profile of past life history. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 11 The residents’ health was monitored and promoted and care records demonstrated that they had access to the necessary health care facilities. Specialist advice had been sought as appropriate in line with the needs of the residents for instance the continence nurse. Risk assessments formed part of the care plan documentation, however, risk management strategies had not been devised in respect to the prevention of pressure sores. In addition it was noted that nutritional assessments had not been undertaken. Residents spoken to felt their right to privacy was respected by the care staff and personal care was carried out with respect to their dignity. All residents were referred to by their preferred mode of address, which was documented on the care plan. Further to this it was observed that staff asked a new resident what he wished to be called. The home operated a monitored dosage system for the administration of medication, which was dispensed into blister packs by a local pharmacist. The policies and procedures relating to medication informed staff how to handle medicines in the home. An appropriate recording system was in place to record the receipt, administration and disposal of medication. However, there were shortfalls noted in the overall management of medication. These included shortfalls in the record keeping, especially in relation to controlled drugs and the administration of medication. In addition, there were no protocols seen in relation to the administration of medication prescribed “as necessary” and risk assessments had not been carried out for those residents who were selfadministering medication. Since the last inspection a locked trolley had been purchased to improve the storage arrangements for medication. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents were supported to maintain good contact with their families and follow their preferred daily routine. However, consultation with residents could be improved by meeting with them more frequently. Residents received a healthy and varied diet according to their assessed requirement and choice. EVIDENCE: The residents said the daily routine was flexible and they were able to get up and go to bed at a time of their choosing. One resident said “I always go to bed when I like, usually I’m the last one to go” and another person said, “I like to go to my room after tea and watch television”. This person was also observed to use her room during the afternoon of the visit to have a rest. The residents’ interests were discussed during the assessment process and were documented on the care plans. Activities arranged in the home included music and movement, aromatherapy, dominoes and hairdressing. Residents had mixed views about the activities provided in the home, none of the residents spoken to could recall participating in activities. Of the 12 residents who returned a questionnaire the majority indicated that the home “sometimes” provided suitable activities. One person also commented on the Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 13 questionnaire “there doesn’t seem to be any entertainment, more could be done”. Whilst the staff were observed to seek the views of residents during the visit and residents said they felt comfortable to comment on life in the home, there had been no residents’ meetings held since the previous inspection. There were no restrictions placed on visiting and residents were able to entertain their guests in the privacy of their bedrooms. All the relatives and visitors who returned comment cards said that they felt welcome in the home and all were satisfied with the level of care provided. Residents were encouraged to exercise choice and control over their lives. As such residents were supported to manage their own finances. Residents were also able to bring in personal belongings and arrange their rooms how they wished. The menu was on display in the home and the choice of meals was discussed with the residents. The residents were satisfied with the quantity and variety of meals and described the food as “very good” and “quite good”. Drinks and snacks were available at set times throughout the day and evening and at all other times on request. The inspector observed the meals served to residents on the day of inspection and noted that the food was plentiful, nicely presented and nutritionally balanced. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents had access to a clear up to date complaints procedure. Staff had access to an adult protection procedure, but had not received training. EVIDENCE: The complaints procedure was incorporated in the service users guide, which was available in all bedrooms. The procedure contained the necessary information should a resident wish to raise a concern with the home or direct to the Commission. Since the last inspection, out of date information had been removed from the procedure. The residents spoken to said they would talk to a senior member of staff if they wished to express a concern. There was a whistle blowing procedure and an appropriate procedure for staff to follow should they suspect or witness an incident of abuse. A copy of “No Secrets in Lancashire was also available in the home”. The staff on duty were aware there was a procedure, however, they had not received specific training on when and how to apply the procedure. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 15 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, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents were provided with a clean, pleasant and comfortable environment. EVIDENCE: Dercliffe is a detached house set in its own grounds. The home is located close to local shops and other amenities. Accommodation is provided in 24 single bedrooms and 4 shared bedrooms. All the bedrooms have ensuite facilities. The home also provides four bathrooms for assisted bathing, including a “parker” bath, a shower, and two conventional baths with chairlifts over. Communal space is provided in four lounge/dining rooms, two sitting areas and a conservatory. It was noted that several areas of carpet in the home were beginning to wear and there was no call point in the conservatory. Whist there were records maintained in respect to routine maintenance, there was no programme for future renewal of the fabric and decoration of the premises. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 16 It was evident from a tour of the home that residents had personalised their rooms with their own belongings and decoration was good throughout. The residents said their rooms were comfortable and warm. Residents had been provided with aids and adaptations to assist their independence skills, these included grab rails, handrails and raised toilets. The passenger lift provided access to first floor accommodation. The provision of specialist equipment was determined by the needs of the residents. There was a call facility in every room. The doors to residents’ bedrooms had been fitted with suitable locks and keys had been distributed to residents, as appropriate. Radiators had been fitted with guards. To prevent scalding the baths and showers had been preset valves to guarantee water was delivered close to 43 degrees Celsius. Preset valves had not been fitted to hand wash basins. The registered manager reported that the sinks in the kitchen had been blocked recently, but these were now operating properly. The home was clean and odour free at the time of the inspection. Further to this all bins had been emptied in the rooms seen on the morning of the visit. A resident said, “the home is always kept very clean”. The systems for maintaining hygiene included procedures for infection control. Plastic aprons and gloves were available to staff when undertaking care duties. There was a separate laundry room, which had sufficient and appropriate equipment to meet the laundry needs of the number of residents accommodated. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 17 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, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Arrangements were in place to ensure staff were employed in suitable numbers and received appropriate training in line with the needs of the residents. EVIDENCE: The registered manager had maintained a staff rota, which indicated which staff were on duty at any time on a particular day. All staff providing personal care were aged over 18 and all staff left in charge of the building were aged over 21. The number of staff on duty was sufficient for the number of residents living in the home. Arrangements were in place for all new employees to undertake an in house induction programme and complete a “Skills for Care” induction. The latter provided underpinning knowledge for NVQ level 2. At the time of inspection the equivalent of 57 of the care staff were trained to NVQ level 2. Training records indicated that staff also attended health and safety courses such as moving and handling and first aid. A recruitment and selection procedure for the employment of new staff was not available for inspection and the registered manager reported not all staff had been issued with a Code of Conduct set by the General Social Care Council. There had been no staff recruitment since the last inspection. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Whilst the relationships between the staff and residents were positive, the quality assurance systems required development to fully monitor the service received by the people accommodated in the home. Suitable arrangements were in place to maintain the health and safety of residents. EVIDENCE: Since the last inspection the manager had completed the registration process with the Commission. The manager has 24 years experience of working at the home and at the time of the visit was working towards the Registered Manager’s Award. However, the registered manager had not received a job description from the registered provider. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 19 Relationships within the home were positive and staff spoke about the residents with respect. The residents valued the help and support they received from the staff, who one resident described as “very good – all very nice” and another resident said they were “approachable any time”. There was a programme in place for staff supervision and the topics discussed during supervision were recorded on a suitable format. The home achieved an Investor’s in People Award in November 2001 and this was reaccredited in April 2005. Satisfaction questionnaires had not been distributed to the residents and their representatives since May 2005 and resident meetings were held infrequently. A means to monitor the all systems in the home and evidence of an internal audit were not seen during the inspection. Consequently an annual development plan based on the findings of the quality assurance systems had not been devised. Appropriate arrangements were in place for handling money, which had been deposited with the home by or on behalf of a resident. A random check of monies was found to be correct. Records were also maintained in respect to the amount of fees charged and received. There was a set of health and safety procedures available, which included the safe storage of hazardous substances. Staff received health and safety training, which included moving and handling, food hygiene, first aid and fire safety. Information was available in respect of infection control. Documentation was seen during the inspection which, confirmed gas and electrical systems were serviced at regular intervals. The electrical safety certificate was dated August 2003 and was valid for 5 years. The fire log demonstrated that staff had received instructions about the fire system and fire equipment was tested on a monthly basis. Health and safety maintenance checks were carried out every two weeks and records were made of all repairs. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 20 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 3 3 2 3 3 2 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 1 X 3 3 X 3 Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 21 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 OP1 Regulation 4 and 5 Requirement The statement of purpose and service users guide must be updated in line with the change of ownership. Both documents must include the name and address of the registered provider. Where risks of pressure sores are identified management strategies must be devised in order to minimise or eliminate the risks. Nutritional risk assessments must be carried out as necessary. The medication administration record must be signed immediately after the administration of medication to avoid omissions in the record. (Previous timescale of 31/01/06 - not met). The controlled drugs register must be accurate and kept up to date at all times. The medication administration record must include specific instructions for the application of creams. (Previous timescale of 31/01/06 – not met). DS0000065155.V292021.R01.S.doc Timescale for action 15/07/06 2. OP8 15 30/07/06 3. OP9 13 (2) 06/06/06 4. 5. OP9 OP9 13(2) 13 (2) 06/06/06 06/06/06 Dercliffe Care Home Version 5.1 Page 22 6. OP9 13 (2) 7. OP19 23 8 9. OP22 OP33 23 (2) (n) 24 A system must be established for the return of “loose” tablets back to the pharmacist, so as to facilitate a full audit trail of medication. The responsible Individual must produce a programme for the future renewal of fabric and decoration of the premises. A call point must be installed in the conservatory. An annual development plan must be devised based on a systematic cycle of planning, action and review, reflecting the aims reflecting the aims and outcomes for service users. There must also be continuous monitoring, using an objective, consistently obtained and reviewed and verifiable method (preferably a professionally recognised quality assurance system) and involves the service users and an internal audit takes place at least annually. 15/07/06 01/08/06 01/08/06 01/10/06 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. 2. 3. 4. 5. Refer to Standard OP9 OP9 OP12 OP18 OP25 Good Practice Recommendations A risk assessment should be carried out for all those residents who self medicate. A written protocol should be devised for all medication prescribed “as necessary”. Residents meetings should be held on a more frequent basis. Staff should receive specific training in relation to the vulnerable adults procedure. Preset valves of the type unaffected by changes in water pressure and which have fail safe devices should be fitted to hand wash basins to provide water at 43°C. DS0000065155.V292021.R01.S.doc Version 5.1 Page 23 Dercliffe Care Home 6. OP29 7. 8. 9. 10. OP29 OP31 OP31 OP33 A written recruitment and selection procedure should be devised, which takes into account the amendments to the Care Homes Regulations 2001 and the introduction of POVA. Staff should be given copies of the Code of Conduct set by the General Social Care Council. The registered manager should complete NVQ 4 in management and care. The registered provider should provide the registered manager with a job description. The registered manager should distribute satisfaction questionnaires to the residents and their representative. The results of satisfaction surveys should be collated, published and made available to all interested parties. Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 24 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 Dercliffe Care Home DS0000065155.V292021.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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