Inspection on 01/11/05 for Esther House

This inspection was carried out on 1st November 2005.

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

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

Other inspections for this house

Esther House 21/11/07

Esther House 14/08/06

Esther House 28/06/05

Esther House 14/12/04

Esther House 30/06/04

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 Esther House 34 Mauldeth Road Heaton Mersey Stockport Cheshire SK4 3ND Lead Inspector Kath Oldham & Jennie Robson Unannounced Inspection 1st November 2005 08:20 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 Esther House DS0000008554.V261492.R01.S.doc Version 5.0 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. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Esther House Address 34 Mauldeth Road Heaton Mersey Stockport Cheshire SK4 3ND 0161-432 0826 0161 947 9439 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. Paul James Kelly Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 15 OP. Date of last inspection 28th June 2005 Brief Description of the Service: Esther House is a small home situated in the Heaton Mersey area of Stockport, close to local shops and amenities. It is a large detached house set in its own grounds. Esther House is registered to take people whose primary need for care is due to old age. At any one time, a minority of service users may suffer from short-term memory loss. The majority of service users have care needs which are relatively uncomplicated, i.e., help with washing, dressing/ undressing, assistance with toilet, administration of medication, acquisition of medical treatment, as and when necessary. A member of staff is employed to co-ordinate an activities programme for service users. Eight bedrooms have en-suite toilets. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on 1st November 2005, commencing just before 8:30am. Time was spent in conversation with residents, observing staff practice and routines and examining a sample of records. Comment cards were left with the home to distribute to residents and their visitors; their comments are included in this report. A partial inspection of the building was also undertaken. The pharmacy inspector spent time at the home evaluating the administration, storage and record keeping in relation to medication. What the service does well: A number of residents who have been at the home for some time have formed friendships with one another and genuinely care about other residents and welcome them into the home. Residents are able and are assisted to make their feelings and views known to staff and take part in the inspection process through conversation. In the main, residents said that the home is comfortable and that staff at the home are dedicated and pleasant. Residents are able to make day-to-day decisions and choices for themselves and, as far as possible, live as they wish to. Staff said they worked well as a team; most of them had worked at the home for some time and were flexible, helping out in other areas of the home for the benefit of residents. Meals and mealtimes are a pleasant experience, with a choice of meals available. Residents have ample choice of fresh produce, including fish, meat and vegetables. Residents and relatives said they were more than happy with the care and support that they receive from the home and were complimentary about the staff and the manner in which they assist them. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Staff must receive moving and handling updates annually and fire drill training and practice at least twice a year. The acting manager said that moving and handling training was scheduled for all staff later in the month and that all staff would attend fire drill training on their next duty at the home. The home continues to strive to improve and develop the service they provide at the home. All comments received were favourable and complimentary. The home could have a better-designed care plan, which records all the service user’s needs clearly and demonstrates how their needs are met. Staff were aware of the care needs of service users and appeared to provide for these needs at the appropriate frequency, however the care plans did them an injustice as a lot of the support and the specifics of the support were not recorded. Some areas of medication administration, storage and record keeping needs to be further developed to ensure safeguards are in place and in keeping with regulations. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 7 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. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 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 Esther House DS0000008554.V261492.R01.S.doc Version 5.0 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): 1, 2, 3 & 5 Residents are provided with the information they need prior to moving into the home. EVIDENCE: A service user guide is available to residents to give them information about the home and the service it provides. A resident said the information was helpful when you have to come into a care home and it had information in you just wouldn’t know to ask, if it wasn’t in the booklet. The service user guide is in large type so it is easier to read. One new resident was reported to have taken a copy of the guide when they came to look around the home with their family. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 10 Examination of the contracts identified that they needed to provide more information about which room the resident is to occupy and how much care costs when residents were in hospital. This was reported to be going to be addressed by the registered person. Some of the care files examined did not contain a terms and conditions of residency. A resident said that staff from the home came to visit them in their previous residency before they went to look at the home. The family of the resident looked round initially, then the resident came on a couple of occasions to see if they liked the home. The resident said when they first came to the home they knew it was the place for them and were admitted earlier than initially planned, as they wanted to come into the home. The resident, although only at the home for a relatively short period of time, said they were settling in very well and everything was “perfect”. Examination of a sample of care files identified the home’s assessment had been undertaken by the acting manager. For one recently admitted resident the local authority assessment had not been provided. The acting manager said that she had asked for the assessment and the placing authority was having difficulty faxing it to them. It was expected that this essential information would be forwarded to the home in the days after the inspection. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 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 & 10 Residents’ health, personal and social care needs are provided for at Esther House. The lack of detail recorded in the care plan has the potential for care needs not to be addressed. EVIDENCE: All residents’ comment cards stated that they felt well cared for. Staff expressed confidence that good support was available from the district nursing service and that doctors were contacted when necessary. Visiting professionals said the home works with them in promoting residents’ healthcare needs. Residents’ weights are recorded to ensure they are not losing weight. One service user said that some residents are weighed more regularly and this was due to the home needing to keep an extra check on them. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 12 All residents’ files inspected contained a care plan that identified their health, personal and social care needs. Previous inspections have reported the need to develop the recording within the care plans. This development is ongoing. A record is maintained of visits or appointments made to health care professionals, the detail of which can be researched to inform of treatments or plans that are put in place. Residents said they saw the doctor when they were unwell. Staff stated how they promote residents’ privacy and dignity when carrying out personal care and when speaking about personal matters. Staff practice was observed on the inspection and time was taken discreetly by staff when undertaking personal care tasks. One resident said they were “well-looked after” and “nothing was too much trouble for staff.” It was found that some prescribed medication was not recorded and dosage information had been amended which was not signed or dated. It was not possible to determine the actual dosage of medication administered to the resident. One of the items of medication dosage had been amended by a spare label and was being administered twice a day but incorrectly signed as administered daily. Where a variable dose of medication was prescribed the actual dose administered was not always recorded. The home is therefore not maintaining accurate records of medication administration. Medication prescribed to be administered “as directed” is not sufficient; as it does not provide staff with adequate dosing information to ensure that medication is administered correctly. Medication administration details had been handwritten which had not been signed or dated or validated by an additional member of staff. Examination of medication storage areas and medication records identified a number of duplicate dispensing labels, which were either loose or attached to the medication records. This must not be continued as labels may be placed over previously printed directions, thus obliterating the record of the medicine or they may be removed at a later date. Examinations of the monitored dosage system identified items of medication that had been signed as having being administered and were still in the blister pack. It was not possible to determine on which day the tablets had not been administered as prescribed. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 13 Appropriated risk assessments had not been completed for residents who selfadminister medication. Non-prescribed items of medication are administered to a resident, which had been chosen by the resident and purchased by family. The home had not consulted the resident’s pharmacist or GP to confirm that these items are safe to be administered alongside prescribed medication. Some excess stock was found, staff members are failing to check the current stock, to ensure that items are ordered only when they are needed. A small number of tablets were not labelled with prescribed directions. Items of prescribed medication were not always labelled sufficiently with the doctors’ instructions. The containers of eye drops or eye ointment had not been labelled with the date of opening. Staff who have received basic training in the handling and administration of medication give out medication. This training had been updated recently. Not all staff had undertaken this essential training. The training is not followed-up with a formal assessment of carer competency. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 15 Activities, stimulation and menus are discussed with service users, and visitors and families are included and involved if this is their choice. Service users have a flexible lifestyle in the home and maintain contact with their families and friends. EVIDENCE: An activities co-ordinator is employed at the home for three days each week. A number of service users spend their time knitting and have just been in the local newspaper for their efforts in sending parcels of their handiwork to people in need. One resident said she liked to be doing something and knitting kept her mind and her fingers occupied. Some of the residents are going to a garden centre to purchase additional plants for the garden. One service user has shown an interest in the garden and doing some planting out. One service user said they had been to the local shops to purchase a newspaper and to get their bearings, which they said helped them to orientate themselves to where they were. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 15 Other activities take place at the home, which include darts, quizzes, bingo, craft sessions and manicures. Residents said they chose what they want to do and that they watched specific television programmes. One resident was looking at the programmes in the paper to decide what they were watching that day. Residents, staff and some visitors are collecting items to make a Christmas hamper. The proceeds from such things are spent on activities and entertainment for the residents. Staff said that they had a garden party in the summer and the proceeds are to be put towards the cost of decking being installed in the garden. One resident said that in the warmer weather they plan to sit out on the decking area. A further resident said they like to spend the day in their room listening to music and watching television and come to the dining room for meals. Visitors are able to visit the home at a time that is convenient to themselves and their cared for relative. Some residents said they receive their visitors in the lounge, in the small quiet lounge or in their bedrooms. Drinks were observed to be offered to visitors. Some service users have visitors at particular times during the week, while other visitors come at differing times. A four-week lunch menu is in place. Residents said they had no complaints about the meals. The meal on the inspection was hot and attractively presented. Residents said they enjoyed the meal. The records did not detail individual diets, as they need to do in line with regulations. The meals on the menu were traditional meals, residents said they were asked what they liked and the menus were designed from what they tell staff they like. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The complaints procedure ensured that all interested parties were aware of how to complain and the process that would be undertaken. Systems are in place to protect and safeguard service users from abuse. EVIDENCE: Residents spoken with said they were aware of what to do if they weren’t happy. One resident said they had nothing to complain about and everything to be thankful for being in a home like Esther House. A record is made of complaints and comments and how the complaint has been addressed. Relatives and representatives said they were more than happy about the care their cared for relative received at the home. The acting manger and staff team have attended adult protection training, which has assisted their development and understanding of what constitutes abuse and how this should be handled. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 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): These standards were not assessed at this inspection. EVIDENCE: Esther House DS0000008554.V261492.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 The procedures for the recruitment and training of staff provide protection to service users living at the home. The deployment and number of staff on duty are sufficient to meet the needs of service users. EVIDENCE: Examination of the staff duty roster identified that there were sufficient care staff on duty to meet the needs of service users. Cooking staff are employed at the home for five days each week with care staff undertaking cooking on the other two days. The home continues to try to recruit another cook to work the remaining two days. The staff who cook at the home have all completed intermediate food hygiene training, other staff have the basic food hygiene training. Periodic staff meetings are arranged where a variety of topics are discussed, records are maintained of these meetings. This arrangement provides an opportunity for staff to come together as a group and influence the way the home is run and should be used more by the acting manager to get ideas and develop the home. Currently, the meeting is predominantly used for management to tell staff what should and shouldn’t be done. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 19 Three staff have recently concluded NVQ level 2 training and enquiries are being made into the possibility of a staff member undertaking NVQ level 3. Arrangements have been now made for all staff to receive updates in moving and handling which must be undertaken annually. Health and safety training is scheduled to take place in November 2005. Examination of a sample of staff files identified that all staff had completed a job application form and Criminal Record Bureau checks had been undertaken. Two written references were also on file. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35, 36 & 38 There is an open and approachable management style that focuses on meeting the needs of service users. Heath and safety issues had not been fully addressed. EVIDENCE: The acting manager has been employed at the home for approximately ten years and has worked in a variety of roles during her employ. The registered person has nominated the acting manager for registration to the Commission for Social Care Inspection and an application is being processed. The acting manager has commenced her studies to obtain NVQ level 4 in management and care, as is required. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 21 Examination of the safety records identified that the chair lift had been regularly serviced; the last recorded service being in May 2005. A record is maintained of all accidents, incidents and occurrences experienced by service users; the record was completed in keeping with regulations. An accident analysis is not yet undertaken to see if there are any patterns to the accidents. Risk assessments are in place and are reviewed in line with residents’ changing needs and abilities. A record is made of the maintenance jobs within the home. Staff detail all jobs that need attention and when the job is completed, it is signed as such. The home appeared well maintained. Examination of residents’ money sheets identified that receipts were not with these records. The acting manager stated that these records are kept separately and are seen by the accountant on a weekly basis. The owners visit the home regularly and spend time in conversation with service users to see if the care that they receive is what they need. Formal supervision was not being provided for staff. The acting manager said that she planned to implement a system of formal supervision in the months following the last inspection. One supervision has been undertaken in this time. The fire safety records examined identified that all the fire safety checks were recorded as having been undertaken at the regularity recommended by the fire authority. Two staff were not recorded as having received fire drill training or practice in the previous six months, this needs to be addressed by the home to ensure that all staff are aware of what to do in an emergency situation. Esther House DS0000008554.V261492.R01.S.doc Version 5.0 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 3 2 3 X 3 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 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 2 X 2 Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 23 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) 17(1) Requirement Timescale for action 07/11/05 2 OP9 13(2) 17(1) 3 OP9 13(2) 4 OP9 13(2) 13(4)(c) The registered person must ensure that all items of medication, whether administered by staff or selfadministered by the resident, are recorded as such on the appropriate medication administration record chart. The registered person must 07/11/05 ensure that if the dosage of medication is amended by the prescriber, the current record is discontinued and a new record is commenced. The registered person must 07/11/05 ensure that all medication is administered as prescribed and that staff members administer blistered medication from the specific blister labelled for that day. The registered person must 05/12/05 ensure that residents who wish to manage their own medication are assessed as to their ability to do so, before medication is provided to them. Assessments must then be repeated on a regular basis. DS0000008554.V261492.R01.S.doc Version 5.0 Esther House Page 24 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. 5 Standard OP9 Regulation 13(2) 13(4)(c) Requirement The registered person must ensure that medical advice is obtained and recorded regarding the administration of any nonprescribed medication by care staff. The registered person must develop a record of food served to detail meals for individual service users to enable anyone inspecting the record to judge whether the diet is satisfactory in terms of nutrition and otherwise. (Previous timescales of 31/07/04 and 31/01/05 not met). The registered person must ensure that all staff receive updates to the moving and handling training annually. The registered person must ensure that all staff receive fire drill training and practice at a minimum of twice yearly. Timescale for action 05/12/05 6 OP15 17(2) Sch 4 30/09/05 7 OP30 13(5) 28/06/05 8 OP38 23(4) 28/06/05 Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP2 Good Practice Recommendations The registered person should amend the present contract to contain information regarding which room is to be occupied and charges applicable should a resident be admitted to hospital. The registered person should continue to develop the care staff team to facilitate their completion of the care plans and the daily reports. The registered person should ensure that on occasions where a variable dose of medication is prescribed, for example, one or two tablets to be taken, an accurate record is made of the actual dosage of each medication administered. The registered person should ensure that the directions of medication prescribed as ‘as directed’ are clarified with the resident’s General Practitioner and the prescriptions altered accordingly. The registered person should ensure that handwritten medication details on the medication administration records are signed and dated and the details are validated by an additional member of staff. The registered person should ensure that duplicate labels are not requested from the supplying pharmacy for the purpose of affixing to the medication administration record chart. The registered person should ensure that stocks of medication are rotated regularly and that stock is checked each month prior to medication ordering to prevent the build up of excess medication. The registered person should ensure that any items of medication, which are not labelled with prescribed directions, are returned to the supplying pharmacy. In no instance should prescribed medication be kept as “stock” or reused for a resident for whom it was not prescribed. 2 3 OP7 OP9 4 OP9 5 OP9 6 OP9 7 OP9 8 OP9 Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 9 Refer to Standard OP9 Good Practice Recommendations The registered person should liaise with the supplying pharmacist to ensure that all medication received by the home is labelled on both the inner container and the outer box. The registered person should ensure that all eye drops and eye ointments are labelled with the date of opening of the container, and discarded 28 days after this date. The registered person should ensure that all carers with responsibility for medication administration receive appropriate updated training and that their competence is assessed regularly on a formal basis. The registered person should enable the staff to bring items to staff meetings to assist in the development of the home and the care and services provided. The registered person should provide, in all service users bedrooms, lockable storage space for medication, money and valuables and provide a key, which can be retained by the service user. The registered person should produce a staff training and development programme. The registered person should obtain for the acting manager regular, formal supervision to assist in the development of her role and abilities. The registered person should arrange for service user meetings at the home to discuss areas of interest at intervals appropriate to their needs. The registered person should record the notes/minutes of the meeting. 10 11 OP9 OP9 12 13 OP27 OP24 14 15 16 OP30 OP31 OP32 Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Esther House DS0000008554.V261492.R01.S.doc Version 5.0 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!