Inspection on 15/11/06 for Emsworth House

This inspection was carried out on 15th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Emsworth House 24/06/08

Emsworth House 29/06/07

Emsworth House 27/09/05

Emsworth House 24/05/05

Emsworth House 15/02/05

Emsworth House 26/10/04

Emsworth House 09/03/04

Emsworth House 18/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Emsworth House Emsworth House Close Havant Road Emsworth Hampshire PO10 7JR Lead Inspector Anita Tengnah Unannounced Inspection 15th November 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 Emsworth House DS0000037245.V314712.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. Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Emsworth House Address Emsworth House Close Havant Road Emsworth Hampshire PO10 7JR 01243 373016 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) Hampshire County Council Mrs Melanie Jane Brodison Care Home 48 Category(ies) of Dementia - over 65 years of age (48), Old age, registration, with number not falling within any other category (48) of places Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user, date of birth 13/04/1942, can be admitted to the home. 27/09/06 Date of last inspection Brief Description of the Service: Emsworth House is a care home registered to provide nursing and personal care for up to 48 service users over 65 years of age. The home is registered to provide care for residents with a diagnosis of dementia as well as for the older person. Hampshire County Council owns the service that is situated in a residential area of Emsworth within easy access of local community facilities and local health care facilities. Mrs Brodison is the registered manager. Accommodation is provided over two floors with access via a passenger lift or stairs. The home is separated into small units, each with bedrooms, lounge, dining room with small kitchen area, assisted bathrooms and toilets. All the bedrooms in the new building where all the service users were accommodated are equipped with en suite facilities and part of the service is in the process of renovation. The fees charged ranged from £392-434 per week. Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was undertaken on the 15th of November 2006. The process included a tour of the service where a number of the bedrooms, communal areas, unit kitchen, and bathrooms were viewed. As part of case tracking 6 staff and 7 service users views were sought and care records were looked at. Information gained from the pre inspection questionnaire was also used and included in this report, as was information gathered by the commission since the last inspection to contribute in assessing judgements in this report. The commission has received 14 service users and 4 relatives comment cards that were sent out, as part of gaining the views of people who used the service. All of them indicated that they were satisfied with the overall care provided at the service. What the service does well: What has improved since the last inspection? The home’s manager has been registered with the commission. Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 6 The service users have moved into the new building that is well equipped and meet the needs of the service users. 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. Emsworth House DS0000037245.V314712.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 Emsworth House DS0000037245.V314712.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality outcome in this area is good. The judgement has been made using available evidence including a visit to the service. The pre-admission assessment process is good and ensures that service users’ needs are assessed and the home can meet them. The home does not provide intermediate care. EVIDENCE: The care plans and assessments for three newly admitted service users were looked at as part of case tracking. These indicated that the service users are assessed prior to admission. The assessments were detailed and there was evidence that the service users/ relatives were involved in the assessment process to ensure that all information is gained. Care management assessments are also sought and staff reported that these formed part of the care planning. Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 9 Service users spoken with and information from comment cards received showed that the service users are happy with the information provided. The service users are offered visits to the home prior to admission. Comment from one service user confirmed that she visited the home and was shown around the service. Another service user said that she received all the information and that when she arrived “was welcomed with love and lots of help”. The home does not provide intermediate care as the manager confirmed. Emsworth House DS0000037245.V314712.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality outcome in this area is adequate. The judgement has been made using available evidence including a visit to the service. Some of the care plans were detailed and provided good information, however this did not apply to all the care plans seen. The health care needs of the service users are well met. The medication management was inadequate to the detriment of the service users. The service users are treated with respect and their dignity maintained. EVIDENCE: As part of case tracking the care plans of four service users were examined to assess information on how the home plans to meet the needs of the service users. The care plans for the service users in the nursing wing were detailed and included thorough risk assessments. One service user who was identified Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 11 as risk of falls had a detailed assessment and identified as requiring bed rails. Records showed that this was put in place to ensure the safety of this service user. Other records seen contained assessments for diabetic diet and monitoring, pressure areas risk assessments and care plans were available to show how these needs would be met. The care plans also recorded the type of assistance needed and detailed daily records were available. The home has introduced the malnutrition universal screening tool (MUST) to assess the nutritional needs of the service users. Staff reported that this was working well and ensured that the service users nutritional needs are monitored constantly and included monitoring their weight and swallowing difficulty. However the care plans for the service users receiving personal care on the first floor lacked details about the type of assistance that was needed. Care plans for two service users indicated that help was needed with bathing and personal care. Staff spoken with said that the service user would need assistance with the assisted bath. The daily records for these service users were also poor. This was brought to the attention of the manager who confirmed that these would be rectified. All the service users are registered with a GP and access to healthcare is available to them as required. The manager stated that they have developed good relationships with the local healthcare professionals and are supported. The home had one service user who required treatment for a pressure ulcer. Records showed that there was a detailed care plan in place to inform practice and the manager reported that district nurses input is sought as needed. There were records maintained in care plans of multi professionals visits to the home that provided up to date information to the staff. The home has a medication policy in place and training in the administration of medication was available to staff. A sample of Medication Administration Record (MAR) sheets seen on the first floor showed that not all medication administered was recorded accurately. In two service users records there were gaps on the MAR sheets and in another instance medication prescribed to be given twice a day were administered only once on four occasions, none on one day and four times on two separate occasions. Staff spoken with could not account for the extra dosages or the missed ones. Staff must ensure that prescribed medications are administered and recorded accurately in order to safeguard the welfare of the service users. Staff reported that they did not see the repeat prescriptions as these were sent from the surgery directly to the chemist. It was also noted that two inhalers did not contain the name of the service user that these were prescribed for. The registered person must ensure that all medication prescribed are labelled with the service users’ names to minimize risks of the service users receiving the wrong medication. This is a repeated requirement from the last two previous visits that remains outstanding. All of the above findings were Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 12 brought to the attention of the manager who confirmed that these needed to be rectified. A group of service users spoken with were all very complimentary of the care provided by the home. They stated that staff were very helpful and were treated with respect. Comments included ”the staff are wonderful” and “the girls do their best and I am happy”. A number of service users were spoken with and information form comment cards indicated that the service users were satisfied with the care that they were receiving. Comments included “this is the best home around”, “staff are second to none”. Another service user said, “The staff are brilliant”. They also said that the staff are always respectful and kind and their privacy and dignity are respected. Comments received and observation on the day showed that the staff had developed good relationships with the service users and treated them with respect. Staff were observed to knock prior to entering the service users’ bedrooms. Emsworth House DS0000037245.V314712.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): 12,13,14,15 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The social and recreational needs of the service users meet their needs. Contacts with family are encouraged and supported. Meals appeared balanced and choices are available to meet with the satisfaction of the service users. The service users are supported in exercising control over their daily living. EVIDENCE: Staff and the service users spoken with said that there are various activities such as bingo, arts and crafts, games and cake making available for the service users. One service user talked about the art and craft that took place the previous day that she enjoyed. Daily newspapers were available. Comment cards indicated that 12 service users found that they usually took part in the activities and 5 stated that they always participated. Three service users said that the activity programme had diminished since the refurbishment and hoped that this would improve when they return to the residential part of the service. Staff stated that they were aware of less organised activities due to staffing availability at the current time. Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 14 Holy communion is available on a monthly basis; staff reported that some of the service users attend. The service users also benefit from link with the local school, external entertainers fortnightly, twice yearly visits from a clothing company and special events arranged by age concern. Discussion with residents indicated that they are able to retain control over their daily activities, such as being able to make the choice whether to join in with activities or not, where to take their meals. Three service users spoken with said that there were no restrictions about the time they went to bed or woke up. The home has an open visiting policy and record of visitors as maintained by the home evidenced this. Service users commented that they have choice and can see their visitors in the privacy of their rooms and other areas in the home. The home has a menu that is rotated on a monthly basis. Lunchtime meal was observed and service users said that meals are usually good. A choice of meals was always available. Comments included “ food excellent”. One service user had commented that he would like more fish and the manager reported that he had raised this with her and will be looked into. Two service users stated that meals were often cold. It was noted that the hot trolley was brought up to the unit kitchen, however hot meals were left on the side as the trolley moved on to the other areas in the home. Staff were observed heating some meals in the unit’s kitchen. This was brought to the attention of the manager as cooked meals should be maintained at correct temperatures for the safety of the service users and she stated that this would be rectified. Records of meals taken were maintained and the chef stated that she was aware of the service users likes and dislikes and that they preferred wholesome old-fashioned meals. The chef reported that pureed meals and diabetic diets were available. The service users said that hot and cold drinks were available at all times and one comment was “you only have to ask”. Emsworth House DS0000037245.V314712.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): 16,18 Quality in this outcome area is adequate. The judgement has been made using available evidence including a visit to the service. The procedure for complaints is detailed and available to the service users. The lack of evidence of complaint investigation and outcome was inadequate. Staff have clear understanding of adult protection and ongoing training ensures that the service users are protected EVIDENCE: The home has a complaint procedure that is available to the service users. Three of the service users spoken with said that they have no complaints and they would be happy and confident in approaching the manager with any concerns. A copy of the complaint procedure was available in the entrance hall together with other information. The manager stated that the procedure is available in other formats such as large prints if required. Service users spoken with and comments received indicated that they were confident in approaching the manager and felt that they would be listened to. Fifteen of the comment cards received said” no complaints” The home has received one complaint since the last inspection and the manager has referred this to her service manager. There was no record of the response to the complainant to demonstrate whether the complaint was investigated and its outcome. This was brought to the attention of the manager and she will be discussing with the provider. The complaint log should Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 16 contain details of all complaints made and action taken by the registered person in respect of any such complaint. The home has Hampshire County Council’s procedures to be followed should abuse be suspected. There is an ongoing training programme for staff in abuse awareness and the registered manager and assistant unit managers have also attended more detailed training courses. Staff spoken with had clear understanding in reporting any allegations of abuse. Service users spoken with said that they felt safe. Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The home provides the service users with a comfortable, homely and well maintained environment that meets their needs. The infection control procedures and practices observed ensure that the service users are protected. EVIDENCE: A tour of the service was undertaken as part of the visit. Accommodation is provided in a spacious and well maintained environment. Adaptation and equipment were available to maintain and support the service users in maintaining their independence. All the service users bedrooms seen were highly personalised with evidence that they are supported to bring into the home items of personal belongings. The bedrooms were decorated with Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 18 pictures and family photographs. Service users comment included” top class home” and “ my bedroom has everything I need”. Call bells were in place and all the bedrooms were for single occupancy with en suite facilities. All parts of the home seen were clean and no adverse odours were present in the home on the day of the visit. The laundry room was being renovated at the time of the visit as part of the refurbishment programme. An area in the home was used as a laundry room and this contained washing machines with sluicing facility and driers. The temporary laundry room was well maintained despite the difficult situation that staff faced with restricted area to work in. The home has infection procedures in place and practices observed on the day indicated that staff were following the procedures. Equipment such as gloves and aprons were available and soiled linen was handled appropriately. Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The home has system in place to ensure that staff have the skills to deliver care safely. The staffing on day duty was good, however the number of trained staff on night duty should be looked at. There is a robust recruitment process in place that safeguards the welfare of the service users. There is a good training programme in place to ensure that staff are competent in their work. EVIDENCE: The home has a duty roster for carers and a separate roster for domestic and kitchen staff. The home was managed with the nursing unit on the ground floor and the residential unit on the first floor at the time of this visit. The nursing unit had 1 trained nurse and 4 carers on the morning shift, 1 trained nurse and 3 carers in the afternoon and 1 trained and 2 carers on night duty. The unit providing personal care had an assistant unit manager (AUM) and 4 carers. Afternoon shift had an AUM and 3 carers and night duty had 2 carers. Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 20 The trained nurse was overseeing both areas on night duty. The manager discussed that the nursing unit had the majority of service users with high care needs. The manager is aware that staffing on night duty should be reviewed, as one trained nurse is at present responsible to administer medication for up to 48 service users on nights. The dependency and layout of the building would also need to be considered. The manager reported that dependency in the nursing wing was high and that this was managed satisfactorily at present with assistance from staff from the first floor. The service users spoken with and comments received indicated that there are “usually” adequate staff provided the home was not “short staffed.” A relative and two service users raised concerns about service users with dementia invading their privacy such as entering their rooms and switching off lights in various parts of the home. The manager was aware of these issues and was addressing them. The home has an ongoing National Vocational Training (NVQ) for the carers employed. Information received indicated that 23 carers had completed the NVQ level 2 and three carers were undertaking this at present. This showed that 72 of carers have achieved NVQ. Some staff have also achieved NVQ 3 and 4. The manager reported that all new recruits undertook an induction programme including a three days company induction. One staff record did not contain the induction record; this was brought to the attention of the manager and will be rectified. A sample of three staff records was seen as part of the visit. This indicated that the home has a thorough recruitment procedure in place to ensure that all necessary checks are completed prior to employment. All three files contained application forms, references and criminal record bureau checks including POVA first and identification. Staff files seen contained evidence of their registration with the Nursing and Midwifery Council as part of their eligibility to practice. However record shows that the home did not have the required PIN numbers for two nurses employed and must be rectified. The home has an ongoing training programme for staff. Information received indicated that staff had completed training in care planning/ record keeping, infection control, medication training, first- aid and adult protection. The manager and two AUMS have completed training in managing services with dementia and they would be cascading this to the staff. Staff confirmed that training was good and helped them in their practices. The manager reported that three days training in dementia care support is planned for staff that would enhance care planning for service users with dementia. Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 21 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): 31,33,35,38 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The home has a registered manager who was responsible for the day- to- day management and discharges her responsibilities fully. There is a good process in place to ensure that the service users financial interests are safeguarded. The manager has process in place to ensure the health and safety of the service users are protected. EVIDENCE: Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 22 The service has a registered manager who is responsible for the day- to day management of the home. Service users spoken with and comments received indicated that the manager has clear lines of responsibility for the home. The manager has completed the Registered Manager’s Award (RMA) and has a degree in ageing care. She undertakes regular training to update her skills and maintain her registration as a nurse. A sample of the personal allowance as managed by the service was looked at. There is a robust procedure in place to ensure that the service users’ financial affairs are safeguarded and the home has two designated persons to deal with this. The home’s administrator and the manager were the people designated for the management of the service users’ personal allowances. Records of all transactions including receipts were maintained and a random check of balance as recorded showed that these were accurate. The manager reported that regular service users’ meetings were held and two service users spoken with confirmed this. The home is planning to start an audit of the service users’ views shortly as the manager discussed that the home has acquired a large number of new service users recently. Information received and staff practices observed on the day of the visit indicated that staff followed procedures in infection control. There is an ongoing programme for the servicing of equipment at regular intervals to ensure the safety of the service users. Records of weekly fire alarm testing and fire drills were maintained. The service is provided in a new building and the environmental health officer visited in August 06, electrical wiring certificate was issued in May o6 and gas installation engineer visited in August 06. The bath hoists and mobile hoists were serviced in June and September 06. All substances that are hazardous to health were stored safely as required. Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 23 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 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 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13(2) Requirement The registered person must ensure that medication is labelled with the service user’s name. This is a repeated requirement from 24th May 05 and 14th October 05. The registered person must ensure that a record of all medication administered is maintained. Medication dosages must be given as prescribed. Timescale for action 30/12/06 2 OP9 13(2) 17(1) (a) Schedule 3 (k) 30/12/06 3 OP16 17(2) Schedule 4. The registered person must 30/12/06 ensure that records of complaints made and any action taken by the registered person in respect of this is maintained. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000037245.V314712.R01.S.doc Version 5.2 Page 25 Emsworth House Standard Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Emsworth House DS0000037245.V314712.R01.S.doc Version 5.2 Page 27 - 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. 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