Inspection on 03/03/08 for Elmhurst

This inspection was carried out on 3rd March 2008.

CSCI found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Elmhurst 27/09/07

Elmhurst 17/08/06

Elmhurst 09/03/06

Elmhurst 17/11/05

Elmhurst 10/02/05

Elmhurst 17/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Elmhurst Priory Road Ulverston Cumbria LA12 9HU Lead Inspector Jenny Donnelly Additional Inspection 3rd March 2008 09:00 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 Elmhurst DS0000036576.V358791.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. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elmhurst Address Priory Road Ulverston Cumbria LA12 9HU 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) 01229 894115 www.cumbriacare.org.uk Cumbria Care Mrs Jayne Allonby Care Home 40 Category(ies) of Dementia (40), Old age, not falling within any registration, with number other category (40) of places Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 40) Dementia – Code DE (maximum number of places: 40) The maximum number of service users who can be accommodated is: 40 Date of last inspection 27th September 2007 Brief Description of the Service: Elmhurst is a purpose built locally authority care home. Cumbria County Council own the home, which is operated by Cumbria Care. Mrs Jayne Allonby is the registered manager. Elmhurst is a single storey building situated 15 minutes walk from the centre of Ulverston town. It is divided into four units of 10 bedrooms. Each unit has its’ own dining lounge, two bathrooms and a toilet. There are four bedrooms with an en-suite bathroom, and two with adjoining doors for married couples or siblings. Three of the units cater for people with dementia, and the other unit is for the physically frail. The three-dementia care units have open access within the home, but no free external access. Elmhurst has a small smoking room, and a pleasant secure garden. The weekly fees ranged from £363.00 to £422.00 according to residents’ dependency needs. The home had information for prospective residents and their families in the form of a statement of purpose and service users guide. A copy of the latest inspection report was also available from the home. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was the second main or “key” inspection of Elmhurst within this inspection year. The homes’ last inspection took place in September 2007, and the purpose of this visit was to monitor progress with requirements made at that time. This inspection comprised of an unannounced visit by Jenny Donnelly and Ray Mowat, regulatory inspectors, on 3rd March 2008. We spent from 9am until 3.30pm in the care home. During this time we toured the building, reviewed care, staffing and general records, and spoke with staff and visitors. We also spent some time observing what goes on in the home, seeing how people with dementia spent their day and how well staff worked with them. Prior to our last inspection in September 2007 we collected written information from the manager, and sent out some postal surveys to residents, relatives and staff. This information gathering exercise was not repeated for this inspection. What the service does well: The service has thorough admission procedures, which include a detailed assessment of people’s personal, health and social care needs. This enables staff to be fully prepared to receive new people into the home. The care records were nicely detailed and included information specific to each individual about what was important to them. The service was working towards developing ‘person centred planning’ which would further enhance this. People were treated with dignity and respect, and were enabled to make choices in their daily lives. There was a good variety of activities and entertainment on offer and people were happy with the provision of meals. The home was clean and odour free throughout the day and the communal areas and bedrooms were warm, comfortable and homely. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 6 The staff group were competent and caring and some had received specialised training in specific areas of care such as dementia. Over 50 of the care staff had a National Vocational Qualification at level 2 or above in care. The service operated sound recruitment procedures. The service was well managed, and people felt they were listened to and their views acted on. What has improved since the last inspection? 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. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 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 Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Peoples care needs were assessed in detail before they are offered a place in the home, to ensure staff could meet their needs. But, not everyone had a signed contract of terms of conditions for their stay. EVIDENCE: During the inspection we examined several people’s personal files and in particular people who were new to the home. There was evidence of the home completing their own detailed needs assessments in addition to either Social Work or other health professional’s assessments. These were informative and enabled the home to decide if they had the resources and expertise to meet individual’s needs. This is particularly important for people with dementia and complex or challenging behaviours. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 9 Some people had a personal history or pen picture in place, which is good practice and gives staff a better understanding about the person, what is important to them in their lives, and how it would be best to support them. It is recommended all the people in the home have a personal history developed as part of a person centred care plan. The staff work closely with the psycho geriatrician, Community Psychiatric Nurse (CPN) and the mental health assessment unit to ensure they have the skills and knowledge to provide a service to people whose behaviour is challenging and unpredictable. Multi agency strategies to guide and support staff are agreed with other agencies to ensure people are receiving appropriate support. Some staff have completed advanced dementia training, which also guides and supports good practice. From the files we examined it was evident that not all the people had been issued with and agreed and signed a contract of terms and conditions. A contract of terms and conditions must be agreed and signed by the person or their representative when they move into the home. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People were receiving a good standard of personal and health care, but some care records were inconsistent and there were areas of medicines management which need improving. EVIDENCE: The home is in the process of introducing Person Centred Care plans that will improve the type of information recorded and empower and support people to lead a more independent lifestyle. Choice and respect are core values that will be promoted in all aspects of people’s lives. On the whole the care plans we examined contained relevant information enabling staff to provide a personalised service. Personal and health care needs were documented including specific strategies to deal with difficult or challenging behaviour, including what may trigger behaviour and how to respond. This supports staff in ensuring a consistent approach is maintained. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 11 Nutritional assessments are completed on admission to the home and ongoing monitoring takes place including weight gain or loss and any other special dietary requirements. Stock phrases are used to describe some of the care plan goals, which do not support a person centred approach, however this should be improved with the introduction of the new person centred care plans. Risk assessments were in place that promoted an independent lifestyle whilst safeguarding people, with detailed manual handling assessments and risk assessments for falls having been completed. Daily diary recordings were inconsistent and did not record what activities people had been involved in each day, and some lacked detail about the personal care provided. Staff were respectful and had a good understanding of individual needs and habits. They responded sensitively to people’s demands, enabling them and encouraging independence. The community psychiatric nurse (CPN) visits the home at least every two weeks, but will come sooner when specific issues arise and additional support is needed. This has proved effective in supporting some people and improving their quality of life. We looked at the management of medicines on each of the four units, as well as looking at the controlled medicines register. Medicines were supplied in a monthly pre-packed system along with printed administration charts. Where people start a new medicine mid month, a handwritten administration chart was added. Where medicines were prescribed on an, ‘as required’ basis, there were charts in place describing what the medicine was for and advising staff when it was to be given. On the whole the management of medicines was satisfactory, but there were some areas in need of improvement. Changes to medication were not always dated on the administration chart. This made it difficult to audit the medicines stock, as it was not clear when dosages had been increased or decreased. This made it difficult for staff to know if they had sufficient medicines in stock to last the month. One person had a handwritten and a printed medicines chart showing the same medicines. This could lead to the person being accidentally overdosed if staff did not realise the same medicine had already been given and signed on the other chart. Daily records did not always support the use of ‘as required’ sedating medication, in that the daily record showed the person to be ‘fine’. A further example of this was one person’s plan described two specific actions for staff to take to help settle the person when agitated, but there was no evidence these actions were tried prior to sedation being given. The controlled medicines register needed replacing as the index page was full making the book difficult for staff to navigate. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 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. 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. People received appropriate support to make choices in their lives and lead a fulfilling lifestyle. The provision of meals was good and suited people needs. EVIDENCE: A two-week schedule of activities is displayed in each unit, and this included a good variety of both sedentary and active activities. The types of activities provided were discussed at a ‘resident’s meeting’ and suggestions to be included into the programme, were a film night, card games and more bus trips. A fee was payable for the bus trips and fish and chip suppers. Special occasions and significant festivals relevant to the religion of the people living in the home were celebrated and activities arranged. Easter activities included card making and an Easter Bonnet parade with buffet tea. A coffee morning was also being planned to raise funds for the home. There was evidence that people were consulted about how any money raised from such events should be spent in the home, which is good practice. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 13 People enjoy and look forward to these occasions, which provide them with an opportunity to socialise and meet other people. We met with visitors to the home who confirmed that people are “well looked after” and that staff are “attentive and make sure people have everything they want”. The grounds and gardens are accessible and provide secure space for people to enjoy the gardens or a short walk. People told us they were happy with the choice and variety of meals on offer. There was a four-week rotating menu in operation, and this was on display for people to look at. There was a choice of two main options at each meal and people were asked to make their choice in advance. We observed lunchtime in two of the units, and saw that staff were flexible in offering people the alternative if they did not want the dish they had ordered. Staff assisted and prompted people discreetly and sensitively, and were observant as to whether people had eaten or not. Specialist dietary needs were well catered for. Drinks were freely available throughout the day, and people were encouraged to help with table setting and making drinks if they wished. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 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. 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 this service. Awareness of safeguarding procedures among the management team had improved, and recent incidents had been appropriately referred and dealt with. However, care staff would benefit from some training in this area. EVIDENCE: The home had received one formal complaint since the last inspection, which relates to the handling of an Adult Protection referral. This has been ongoing for some time and has been referred to the Adult Social Care department. Since the last inspection the organisation has reviewed their practice and agreed that the operations manager will attend all Adult Protection referral meetings. All the senior team have attended adult protection training, which has increased their awareness of the procedures and the reporting of issues of concern. Care staff receive some training at induction and through their NVQ training. The manager should ensure all staff receive some form of awareness training to inform their practice and give them a clear understanding of their roles and responsibilities. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 15 There had been no further protection incidents involving staff, but referrals had been made relating to incidents between people living in the home. These had been appropriately referred to Adult Social Care and safeguards put in place to prevent a reoccurrence. This involved the home liaising with other health professionals to review strategies and care plans, and identifying trigger points to prevent further occurrences. The organisations health and safety department were also monitoring incidents to review and improve practice. The manager had completed a days training relating to the Mental Capacity Act and supervisors had also received training, with courses also planned for care staff. This should improve staff awareness and practice in what is a complex area. If the home continues to follow procedures and good practice in this way, ensuring staff are well trained and understand their role and responsibilities, people in their care will be adequately safeguarded. Elmhurst DS0000036576.V358791.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some areas of the home were in need of attention to ensure a safe and comfortable living environment is maintained. EVIDENCE: On the whole the home was maintained and decorated to a good standard, however there were some areas that need to be addressed. The carpets in two lounges and a number of bedrooms were stained and worn and should be replaced as soon as possible. The manager was aware of these and was liaising with the organisations ‘accommodation manager’. There was a damp area under a window in the kitchen and the wallpaper was beginning to peel, and also needs attention. Some of the paths in the gardens were covered in moss, which is a slip hazard particularly when wet, and must be cleaned as soon as possible to enable people to safely access the gardens. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 17 Two fire exits although not blocked were restricted due to wheelchairs and broken furniture being stored there. These must be removed and the exits kept clear to ensure the safety of the people living and working in the home. Toilets and bathrooms were clean and hygienic and suitably equipped to enable access to people with physical disabilities. Other aids and adaptations were in place around the home such as manual handling equipment and grab rails to support independence and maintain people’s safety. Each unit had a well-equipped kitchen/dining area where meals were served, which provided a comfortable space for people to enjoy their meals. Bedrooms were clean and suitably decorated and furnished to individual taste. Some people had chosen to bring their own furniture and belongings into the home, giving their rooms a homely feel. The use of signs, photographs and symbols to make the home more accessible to people with dementia and to promote their independence should be considered in line with good practice guidelines. The home was free from offensive odours and suitable arrangements were in place with dedicated domestic staff to maintain a clean and hygienic environment. The laundry was well ordered and fitted with suitable industrial quality appliances to meet the demands of the home. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of suitably trained and knowledgeable staff to meet the needs of the people living in the home. EVIDENCE: The home was adequately staffed at the time of our inspection with the manager, a supervisor and eight care staff on duty. There were also sufficient domestic and catering staff on duty. At night there are 3 staff on duty. In discussion, staff demonstrated a good awareness of their role and responsibilities, and were suitably skilled and experienced. They had a good knowledge of the people they were supporting and their individual needs and circumstances. They said they were receiving good levels of training including core subjects and some specialist areas. Each person living in the home had a link worker identified who takes a lead role in liaison with the supervisory team in ensuring people’s needs are recorded and responded to. We examined a selection of staff files, which were well ordered and contained all relevant information as required by the National Minimum Standards. All relevant safety checks and references for new staff were in place. Each member of staff had a Continuous Professional Development file in place that recorded all of their training and development needs and activity. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 19 This included copies of certificates and qualifications and a training record. Not all of the training records were up to date. Over 50 of the care staff had achieved an NVQ in care at level 2 or above, which is good. Some staff had attended specialist training in dementia care, but it was not easy for the manager to check how many staff had completed this. The training matrix records the hours of training each staff has attended, but does record the subject. This information is held in the individual files, which were not all up to date. It is recommended that training records be organised to provide an easier overview of who has completed what training. All staff complete a six-day induction programme with a three yearly re-fresher course. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 20 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, 32, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff ensure the safety and welfare of people living in the home. People are involved in all aspects of home life and their views are listened to and respected. EVIDENCE: The manager is suitably trained and experienced and provides clear leadership to the staff team. She works closely with a team of supervisors to ensure the home is operating efficiently and effectively and in the best interests of the people living there. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 21 A formal quality assurance questionnaire is issued annually to all the people living in the home and their relatives. Feedback regarding the outcome of the consultation is given to people through a newsletter, which is issued four times a year. It is also included in the Statement of Purpose. Results from the most recent survey had not yet been collated, but we saw the individual survey responses, which were mostly positive. Areas of concern highlighted included the state of some carpets and laundry arrangements. Regular ‘resident’s meetings’ take place which ensures people are consulted about and involved in the running of the home. Minutes we looked at covered menu planning, trips and suggestions for activities. We looked at how the service manages any money held in safe keeping on behalf of some people. Each person, for whom the service held money, had an individual money book showing all income and spending, with receipts. The money was held in individual wallets stored in the safe. Since the last inspection one person’s money had gone missing, the police had been involved, and the company replaced the missing money. Since then the service has tightened up their security arrangements and liaised with the pensions agency to reduce the amount of cash held in the home. Routine maintenance and servicing of equipment had taken place with suitable records maintained. Appropriate insurance was also in place. Routine safety checks had been completed and the fire log was up to date with drills and training taking place. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 22 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 2 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 2 2 3 2 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP2 Regulation 5 Requirement Each person must be issued with, and sign agreement to, the terms and conditions relating to their stay in the care home. The external paths must be cleared of moss so they are safe for people to walk on without slipping. The fire exits must be kept clear at all times to allow people an easy exit from the building in an emergency. Timescale for action 01/05/08 2. OP19 13(4) 01/04/08 3. OP19 13(4) 01/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP3 OP7 OP9 Good Practice Recommendations A personal history should be developed as part of everyone’s person centred care plan. Daily care records should be accurate and reflect the actual personal, health and social care provided. Changes to medication should be dated on the administration chart. DS0000036576.V358791.R01.S.doc Version 5.2 Page 24 Elmhurst 4. 5. 6. 7. 8. OP9 OP9 OP19 OP19 OP22 9. 10 OP30 OP30 The documented strategies in place for the use of sedating ‘as required’ medicines should be adhered to, and evidenced in the daily records. A new ‘controlled drug’ record book should be purchased. An assessment relating to the condition of carpets within the home should be completed, with badly stained or worn carpets replaced. The damp areas in the kitchen should be repaired. The use of signs, photographs and symbols to make the home more accessible to people with dementia and to promote their independence should be considered in line with good practice guidelines. All staff should complete training in relation to the policies and guidance for the protection of vulnerable adults. Staff training records should be organised to provide an easier overview of who has completed what training. Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Elmhurst DS0000036576.V358791.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!