CARE HOMES FOR OLDER PEOPLE
Dovehaven House 58 Moss Road Birkdale Southport Lancashire PR8 4JG Lead Inspector
Val Turley Unannounced Inspection 16th August 2006 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 Dovehaven House DS0000005973.V298323.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. Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Dovehaven House Address 58 Moss Road Birkdale Southport Lancashire PR8 4JG 01704 564259 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) Mr Mark Jonathan Gilbert Mrs Wendy Josephine Gilbert Mr Peter Andrew Brookfield Care Home 40 Category(ies) of Dementia (40) registration, with number of places Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The service is registered for a maximum of 40 service users in the category of DE (Dementia) 21st March 2006 Date of last inspection Brief Description of the Service: Dovehaven house is situated in the village of Birkdale near Southport town centre with all its amenities being a short drive away. The home provides 24hour personal care for up to 40 older people who have a dementia related condition. The home has been designed to provide care on two separate units, each of which has its own lounge and dining areas. The home has a passenger lift to the first floor. Single room accommodation is provided for all service users. Of the forty rooms, ten have en-suite facilities. Security is a prime concern at the home. There is a secure internal courtyard with a lawned area, flowerbeds and seating and a garden area to the rear of the home. Fees at the home range from £415 - £440 per week. Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The key inspection of a service takes place over a period of time and involves gathering and analysing written information. A site visit was also made to the home as part of the inspection process and this involved discussion with service users, discussion staff, observation of the staff working there, an examination of records, policies and procedures and a tour of the premises. A questionnaire was completed by the manager prior to the site visit. Comment cards were received from 7 relatives. These provided information that was included in the report. As part of the inspection, the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allowed the inspector to focus on four of the service users living at the home. Records relating to those individual were inspected, discussion took place with them were possible, staff were observed providing individual support to the service users and discussion with the support staff took place. During the course of the site visit, discussion took place with other service users were this was possible. What the service does well:
The home provides a clean, comfortable and well-maintained environment for both the service users living there and the support staff. The home had a thorough approach to admission. The pre-admission assessment enabled staff to gain a good overview of the service users support needs and information about their preferences and dislikes, hobbies and interest and links with family and friends. The care plans in place for each of the service users were detailed and in conjunction with the information regarding the service users individual preferences, likes and dislikes, provided staff with detailed information regarding the personal support needs of the service users. The health needs of the service users were met appropriately with a number of health professionals being involved in the home. Medication in the home was generally well managed. Staff were well motivated and had a good knowledge of the service users needs. They spoke to service users in a respectful manner, respected their privacy and dignity and gave them information to help them to make decisions and choices. The home had an activities programme in place although this was flexible to allow it to meet the needs and wishes of the service users. The home employed staff to co-ordinate activities. The religious needs of the service
Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 6 users were observed and ministers invited to the home were service users wished this. Visitors were welcome to the home at any reasonable time and could meet with service user in the privacy of their own home. Service users were provided with information about independent advocacy services. The cook had a good knowledge of the individual service users likes and dislikes and dietary needs. Alternatives were always available and meals were well presented. Assistance was discretely provided for service users at meal times. The policies and procedures in relation to the protection of service users were examined. These contained all the expected information and guidance. The homes training record indicated that training had been provided for most staff in the protection of vulnerable adults. The laundry at the home was clean, well equipped and appeared to be well organised. The staff team were provided with a range of training opportunities and almost 50 of the staff team had achieved a nationally recognised qualification in care. The staff team felt well supported by the manager and felt that they could approach him at any time for support, advice or guidance. The home was generally well managed and the registered manager had the skills and experience to run the home well. The home was well maintained with equipment and services being appropriately serviced. Policies and procedures were updated as required. Accident records were maintained. Staff had received health and safety training and infection control training. What has improved since the last inspection? What they could do better:
There were a number of areas that the home needed to improve its practice. The manager should ensure that any routine risk assessments that should be undertaken on a monthly basis are completed by support staff to ensure that the changing health and personal care needs of the service users are attended to. A record should be kept of the activities each of the service users
Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 7 participates in to ensure that activities are appropriate and everyone is given the opportunity to participate. Storage arrangements for prepared food should be reviewed to ensure that the health of the service users is protected. All staff who administer medication must have received accredited training and MAR sheets should be countersigned where handwritten entries have been made. A review of the number of staff that the home needs to have on duty at night must be undertaken, based on the dependency needs of the service users and taking into account the layout of the building. Recruitment procedures in the home must be improved to ensure that the necessary checks and references are in place before a member of staff commences work. The manager must also ensure as far as possible that references for prospective employees are authentic. These procedures should be adopted to safeguard the service users. Formal supervision of staff should take place six times a year. Handrails should be installed in the corridors and an area of rust in one of the baths should be attended to. A system should also be introduced for analysing accident reports. Some additional work needs to be undertaken to ensure that service users monies are managed more effectively and protocols need to be introduced to ensure service users valuables are further protected. 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. Dovehaven House DS0000005973.V298323.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 Dovehaven House DS0000005973.V298323.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. National Minimum Standard 6 was not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a good and thorough approach when admitting new service users ensuring as far as possible that the choice of home was suitable. EVIDENCE: The files of four service users were examined in detail. These indicated that the home had a thorough and detailed approach to admission. A pre-admission process had been followed for all of these service users, apart from one who had been admitted as on an emergency basis. The pre-admission assessment enabled staff to gain a good overview of the service users support needs and information about their preferences and dislikes and links with family and friends. Assessments from care managers were also obtained where this was appropriate. The information obtained through the pre-admission process had been developed into a care plan for each of the service users. Of the 7 comment cards, which had been completed by relatives on behalf of the service users, 6 felt that they had received enough information to enable them to make an informed choice of home. As well as providing a Statement of Purpose and Service User guide to prospective residents and their families, the
Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 10 home also made a copy of the homes inspection report available within the entrance area of the home. Dovehaven House DS0000005973.V298323.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 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 good. This judgement has been made using available evidence including a visit to this service. The service users individual health and personal care needs were met by the support staff. EVIDENCE: The care plans in place for each of the service users was detailed and in conjunction with the information regarding the service users individual preferences, likes and dislikes, provided staff with detailed information regarding the personal support needs of the service users. Discussion with the key workers of two of the service users indicated that they had a good knowledge of the service users needs and were keen to improve their quality of life as far as possible. The home had undertaken a number of risk assessments in respect of all but one of the service users whose files were examined, enabling staff to provide any additional care and support and so maintain the health and well being of the service users. It was recommended that the registered manager introduce measures to ensure that these assessments are always completed. Service users families were given the opportunity to become involved in the development of service users care plans. Care plans had been reviewed monthly to help ensure that service users changing needs were addressed.
Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 12 Information on the service users files, information provided in discussion with support staff and other records within the home indicated that the health needs of the service users were met appropriately. A number of health professionals were involved in the home including the District Nurse, a chiropodist, an optician, a physiotherapist and a psychologist. There was also evidence in place to indicate that service users were supported to attend any hospital appointments. The majority of the comment cards received from service users relatives stated that their relative always received the medical support that they needed, while the rest felt that medical support was usually provided. The medication at the home was generally well managed. All but one of the staff members who administered medication had received appropriate training. The home must ensure that medication is only administered by staff who have received appropriate training. Records in relation to the management of medication were all accurately maintained and the home conducted medication audits. It was recommended that the home ensure that any hand written entries on the Medication Administration Records (MAR sheets) are countersigned by a second member of staff to help ensure accuracy. Policies and procedures in respect of the management of medication were in place and had been reviewed annually. Observation of staff supporting service users indicated that they spoke to them in a respectful manner. Staff were observed to knock on service users doors before entering the room and included them in conversations, ensuring that they were given information and opportunities to make choices and decisions. Policies and procedures were in place in respect of service users rights to privacy and dignity. Induction training for staff included information regarding privacy and dignity and information was also included within the Statement of Purpose and Service Users Guide. Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to this service. Service users were supported to make choices and have control over their daily lives. EVIDENCE: The home had an activities programme in place and this was displayed in the entrance area. The activities organised were varied and included group activities and 1-1 activities and trips out. Activities were generally arranged for the afternoon and activities co-ordinator worked on two afternoons a week. Those service users who were able to verbalise confirmed that they could join in activities if they wished. Although an activities programme was in place, staff stated that often activities had to be organised in accordance with the needs and wishes of the service users. There was good information on service users files about heir individual interests and information was included within care plans were service users preferred 1-1 support to follow their interests. Information regarding service users religious needs was recorded within their file and arrangements were made for a visit from a minister where this was requested. This was confirmed by one of the service users. It was recommended that a record be maintained of the activities each of the service
Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 14 users participated in. Service users were seen to be offered choices, for example, a choice of drink or where to sit at lunchtime. Service users were able to receive visitors at any reasonable time and information regarding this was available within the Service Users Guide. Visitors were able to visit service users in the privacy of their own room. Care plans included specific information where there was a need for specific support for service users to receive visitors. Information regarding independent advocacy services was available within the reception area and the pre-inspection questionnaire indicated that 3 people living at the home received support from advocates. The kitchen at the home was clean, tidy and well organised. There was a four weekly menu in place and although this did not show any alternatives available the cook stated that alternatives were always available. A record was maintained of any alternatives served. The cook was well aware of the individual likes and dislikes and dietary needs of the service users. Independence was encouraged at meal times although assistance was provided discretely as required. All meals, including those which were liquidised were well presented to aid nutrition and appetite. One of the service users stated that the food is always really good. I enjoy every meal.’ Of the comment cards completed by family members, all but one said that they were satisfied or usually happy with the meals provided. The home had given a lot of thought as to what meals should be served throughout the day and a decision had been made to serve finger foods at tea time as this is the time of day service users are most restless and find it difficult to settle. Only one concern was raised in connection with the kitchen and this was the early preparation and storage of the evening meal in a warm area. The meal had been prepared early as the cook was to attend a training course in the afternoon. This arrangement should be reviewed to ensure as far as possible that the health and wellbeing of the service users is protected. Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to this service. The home had good policies and procedures in place to protect service users. EVIDENCE: The policies and procedures in relation to the protection of service users were examined. These contained all the expected information and guidance. The homes training record indicated that training had been provided for most staff in the protection of vulnerable adults. A member of staff confirmed that she had had the training. Comment cards completed by relatives on behalf of service users indicated that they were aware of how to make a complaint. Information about making a complaint was included in the Service Users Guide. Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 16 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided a clean, well-maintained and comfortable environment for both the service users living at the home and the staff who worked there. EVIDENCE: The home was clean, tidy, odour free, well decorated and maintained. Bedrooms were furnished to a satisfactory standard with a lockable facility for valuables in each. The service users had access to an attractive courtyard area that provided seating. It was recommended that handrails be installed in the corridor areas and that an area of rust in one of the baths be attended to. The laundry appeared to be well organised and the member of staff working there stated that it was sufficiently well equipped to meet the needs of the service users. The area was well ventilated and equipped with protective clothing, and hand washing facilities. Infection control policies were in place and 26 members of staff had completed infection control training this year. Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 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 poor. This judgement has been made using available evidence including a visit to this service. The homes approach to recruitment did not fully protect the service users. EVIDENCE: The home’s staffing rota indicated how many staff were on duty and in what capacity they were working. The training records indicated that the staff team had a range of skills and knowledge enabling the support needs of the service users to be met. The home used few agency staff helping to ensure consistency of care for service users. The staffing hours were not calculated in accordance with the dependency needs of the service users and although there appeared to be sufficient numbers of staff on duty during the day, it was questionable as to whether there were enough staff on duty during the night, even though the number of staff hours had been increased since the last inspection. It was required that the registered manager must calculate how many staff should be working at night based on the dependency needs of the service users and taking the layout of the building into account. The staff had been provided with a range of training opportunities during the last 12 months including first aid, infection control and abuse awareness. Dementia training was planned for the near future. Almost 50 of the staff had achieved a nationally recognised qualification in care. Staff received at least 3 paid days for training each year. All training was provided in house by a training organisation. The files of two recently employed members of staff were examined. Although the manager had an awareness of the recruitment processes that needed to be followed to ensure that service users were safeguarded, these files indicated
Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 18 that staff had commenced work at the home prior to all the necessary checks and references having been received. An Immediate Requirement Notice was issued in respect of this. It was also required that homes obtain references directly from referees to guarantee, as far as possible, their authenticity. Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 19 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well managed in the best interests of the service users. EVIDENCE: The registered manager at the home had been in post for a number of years and had achieved an NVQ in care and management. There was evidence available to indicate that he had undertaken and planned to undertake additional training to update his skills. There were clear lines of accountability in the home and staff felt well supported by the manager The home had a number of quality assurance and quality monitoring systems in place. It had achieved the Residential and Domiciliary Benchmark Award, which is a quality assurance award accredited by an outside body. A survey of relative’s views had been undertaken and the results made available to all visitors to the home. A survey of involved health and social care professionals views had also been undertaken. The staff at the home conducted care plan, medication and cleaning audits. Staff meetings were held giving staff an
Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 20 opportunity to raise any concerns. All the staff spoken said they felt able to raise any concerns with the manager. Policies and procedures were reviewed and updated when required. The registered provider made monthly visits to the home and submitted a report of his findings to the Commission for Social Care Inspection. The home kept only a minimum amount of money on behalf of service users that was used mainly to pay for chiropody and hairdressing. Receipts were kept for all transactions. Individual records showed the balance of money each service user should have. Unfortunately the balance of money held for each service user did not always correspond with the monies held. These discrepancies occurred as a result of the homes practice of ‘borrowing change’ from the individual purses. It was recommended that the service users monies be managed more effectively to ensure that the individual balances can be reconciled. The home did not keep valuables on behalf of service users, although occasionally items, especially jewellery and watches, were found in the home. The home had experienced problems trying to return these items to their owners, as it was not always possible to identify who they belonged to. It was recommended that the home look at the options open to them that would enable them to identify the owners of any items found in the home. The staff at the home received supervision and support from the management team in a variety of ways. Staff were able to ask for advice and guidance at any time, and 1-1 formal supervision had been introduced. It was recommended that 1-1 supervision be provided six times a year. From observation on the day of the site visit and from information provided by the manager in the pre-inspection questionnaire, the environment was seen to be safe for service users. Policies and procedures in respect of health and safety were in place and staff had received appropriate training including in first aid. Equipment and systems were serviced appropriately. The manager had maintained accident records although these weren’t being stored in accordance with data protection. This was resolved on the day of the visit to the service. It was recommended that the manager analyse any accident reports on a monthly basis to enable any emerging patterns to be identified. The homes fire procedures were displayed in the home and the manager stated that issues identified in the last fire officer’s report had been addressed. Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 21 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 2 X 3 Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 22 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 2 Standard OP9 OP27 Regulation 13(2) 18(a) Requirement All members of staff responsible for administering medication must receive accredited training. The registered person must ensure that there are sufficient numbers of suitably qualified staff on duty during the night (Timescale of 30/05/06 not met.) The registered person must not employ a person to work at the home unless the necessary checks have been made. The registered manager must ensure as far as possible that references for prospective employees are authentic. (Timescale of 30/06/06 not met.) Timescale for action 31/08/06 30/09/06 3 OP29 19 31/08/06 4 OP29 19(4)(c) 31/08/06 Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 23 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 6 7 8 9 10 11 Refer to Standard OP8 OP9 OP12 OP15 OP19 OP19 OP28 OP35 OP35 OP36 OP38 Good Practice Recommendations The manager should ensure that risk assessments should be undertaken for all service users and reviewed at least monthly A second member of staff must countersign handwritten entries on the MAR sheets. A record should be maintained of the activities each of the service users participates in. Storage arrangements for prepared foods should be reviewed. Handrails should be installed in the corridors. The area of rust in one of the baths should be attended to. The home should continue working towards 50 of its staff achieve a relevant qualification in care. Service users monies should be managed more effectively to ensure that individual balances are reconciled. The home develop a protocol for identifying the owners of valuables belonging to service users that have been lost in the home and disposing of those which are not claimed. Formal supervision of staff should take place six times a year. A system should be introduced for analysing accident reports. Dovehaven House DS0000005973.V298323.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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