Inspection on 09/11/05 for The Firs Residential Home

This inspection was carried out on 9th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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

The Firs Residential Home 11/09/07

The Firs Residential Home 22/08/06

The Firs Residential Home 13/07/05

The Firs Residential Home 08/12/04

The Firs Residential Home 24/05/04

The Firs Residential Home 04/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Firs Residential Home, The 186 Grange Road Felixstowe Suffolk IP118QF Lead Inspector Jane Higham Unannounced Inspection 9th November 2005 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 Firs Residential Home, The DS0000024387.V264501.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. Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Firs Residential Home, The Address 186 Grange Road Felixstowe Suffolk IP118QF 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) 01394 283278 01394 284504 patricia.houston@anchor.org.uk Anchor Trust Mrs Ann Patricia Houston Care Home 40 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 1 The home may accommodate up to 20 people over the age of 65 years, of either sex, who require care by reason of old age. 2 The home may accommodate up to 20 people over the age of 65 years, of either sex, who require care by reason of dementia. 3 The maximum number accommodated must not exceed 40 persons. 13th July 2005 Date of last inspection Brief Description of the Service: The Firs Residential Home for Older People was built in 1991 on the land adjacent to a former local authority home. The home offers accommodation and care for up to forty service users, within four individual living units, each accommodating ten people. The two living units situated on the first floor of the home are allocated for older people with a diagnosis of dementia, therefore presenting more complex individual needs. The home is owned and administered by Anchor Homes Trust, a non profit making organisation which provides housing and residential care throughout the country. Twelve of the forty beds are offered on a private basis and the remaining twenty-eight beds are block purchased by Suffolk Social Care Services. The home is situated in a quiet road in a residential area of Felixstowe. There are several local shops close by and a superstore a short distance away which includes a pharmacy, a post office and local GP practice. The home is purpose built and offers a high standard of accommodation on two floors. The home has one room, which is allocated for respite care. Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced Inspection of The Firs Residential Home, a forty bedded home for older people situated in a residential area of the coastal town of Felixstowe. The home is administered by The Anchor Trust and the building leased from Suffolk County Council. The home is registered to accommodate forty residents. Twenty people are accommodated in the special needs unit on the first floor of the building and the remaining twenty on the ground floor. Twelve beds are allocated for privately funded residents and the remaining twenty eight are block purchased by Suffolk Social Care Services. This was the second scheduled inspection in the inspection year 2005/2006. The inspection took place on 09 November 2005 over a period of five and a half hours. This report should be read in conjunction with the report of the Unannounced Inspection of 13 July 2005. The home was inspected against the National Minimum Standards: Care Homes for Older People and the Care Standards Act 2000. The National Minimum Standards and Care Homes Regulations 2001 are referred to throughout this report and any non compliance identified. All core standards have been assessed over the two inspections. On the day of the inspection both the Manager and Deputy Manager were present and assisted with the inspection process. During the inspection feedback was gained from staff, residents and relatives who were visiting on that day. Records, policies, procedures and resident care plans were examined and an environmental tour was undertaken. Standards not assessed as part of the previous inspection were examined. The inspection of the medication standard was undertaken simultaneously by the pharmacist inspector, Mr. M. Andrews following the receipt of Regulation 37 reports relating to erroneous medicine administration incidents arising at the home in recent months. A full pharmacy inspection report has been sent to the providers alongside this report and is available subject to request. What the service does well: The home provides residents with a good standard of accommodation which is spacious but gives them the opportunity to live in small homely living units. Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 6 Residents are supported by staff who are competent, knowledgeable and well trained. Staff have formed good working relationships with care staff and a mutual respect exists between both parties. In addition to meeting the personal and physical care needs of residents the home ensures that they are offered a range of appropriate activities and are also enabled to use community resources. Staff are dedicated and work well as a team offering support to one another and are pro-active at organising functions for the benefit of residents. The home has a warm and relaxed atmosphere and the smaller living units enable residents to get to know each other as well as enabling staff to gain a good understanding of the needs and preferences of residents. What has improved since the last inspection? What they could do better: The home must ensure that prior to any prospective staff member commencing duties, two satisfactory written references are obtained and that both these references are available for inspection. This measure is paramount in ensuring that residents are as far as possible protected from abuse. The pharmacist inspector has made requirements in relation to the home’s system for the administration and safe keeping of service user medication and these have been issued under a separate report. Whilst in general the home provides a safe environment for both service users and staff several minor issues in relation to health and safety have been identified and require addressing. Firs Residential Home, The DS0000024387.V264501.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. Firs Residential Home, The DS0000024387.V264501.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 Firs Residential Home, The DS0000024387.V264501.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): 3 and 5 Prospective residents can expect to have their needs assessed prior to the home making a decision about whether the individual’s needs can be met by the service. Prospective residents can also expect to be given every opportunity to visit the service prior to making a decision about whether they wish to live there. EVIDENCE: On the day of the inspection, the pre-admission documentation for two service users who had come to live at the home within the last six months were examined. In both cases the home was able to evidence that a detailed individual assessment of need had been carried out and the prospective resident had been visited by the home’s manager in their current care setting for that purpose. Whilst both residents had been placed via the local authority, the home had only been provided with a Community Care Assessment in the case of one. It is the responsibility of the named assessor to ensure that the home is provided with a Community Care Assessment before any placement is agreed. The home should not accept any placement via this agency without being in receipt of this documentation. Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 10 The Manager advised that in the majority of cases relatives of a prospective resident will come and visit the home before a placement is agreed. Prospective residents who are going to live on the residential unit, often carry out several visits before moving in permanently, although for those residents with special needs this practice is not always thought to be beneficial. Firs Residential Home, The DS0000024387.V264501.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, 9 and 11 Residents living at the home can expect to be provided with a plan of care which correctly reflects their health, personal and social care needs. At the time of the inspection the home was unable to ensure that policies and procedures in relation to the administration and safe keeping of medication fully protected residents. Personal wishes in relation to death and dying were not necessarily reflected as part of the care planning process. EVIDENCE: As part of the inspection, the Independent Living Agreement (Care Plans) for two service users who had come to live at the home within the last six months were examined. The quality of the care plans had significantly improved since the previous inspection and in each case provided a clear picture of the assessed needs of each person and the interventions and support required to ensure that those needs are met. It was identified however that some of the Independent Lifestyle Agreement templates provided were not used to their full potential and required completion. Records available at the home evidenced that care plans were reviewed at a minimum frequency of once a month. Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 12 It was noted that whilst the Individual Lifestyle Agreement templates provided the opportunity for agreed funeral arrangements to be entered on the personal details sheet, this information had not been included in the two care plans seen at the time of the inspection. During the inspection, the pharmacist inspector identified several areas of concern in relation the systems in place for the storage, handling and administration of medicines that could have contributed to medication incidents reported. It was evident, however, that the home had taken action to implement a new system of medicine administration due to commence on 11 November 2005. Members of care staff had already received training on the new system. The Inspector discussed with both the registered manager and deputy manager the new system of medicine administration and means by which arrangements for the storage and management of medicines could be improved. On conducting an audit, the pharmacy inspector also identified inadequacies relating to the home’s medication record keeping practices and also some situations that had arisen because of the non availability of prescribed medicines for varying period of time. The Inspector considered that the home’s procedure for assessing the safety of service users self administering medicines required further remedial action. Several recommendations were also made to enhance medication practices at the home. Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 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, 14 and 15 Residents can expect to be enabled to state their preferences and to make choices around their daily lives. Residents can also expect to have their dietary needs met and to be provided with meals which are acceptable to them. Residents can expect to be offered the opportunity to take part in a range of activities which are appropriate to their needs and abilities. EVIDENCE: Resident care plans seen at the time of the inspection evidenced that service users are consulted about their preferred daily routines. This may include choices around what time a person gets up and how they wish to spend their day. The home was also able to evidence that residents make choices around meal provision. The environmental tour of the home carried out on the day of the inspection evidenced that residents were encouraged to make their own rooms as homely as possible with the addition of personal belongings. Whilst the standard of meal provision was assessed as part of the previous inspection, residents again made positive comments about the quality of food provided. One resident commented that the food was “beautiful” and that you could “always have what you want”. Staff monitor the diet of service users to ensure that they receive appropriate nutrition. Daily notes seen at the time of the inspection evidenced that one recently admitted resident had a poor Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 14 dietary intake. A member of care staff working with the resident confirmed that this was the case and reported that a diet record had been maintained until the appetite of the service user returned to normal. As in the previous inspection, the home was able to evidence that it offers residents the opportunity to participate in a range of activities which are appropriate to their need and abilities. On the day of the inspection, one relative confirmed that staff try to offer activity to residents on a daily basis. In the ten months that their relative had been at the home they had enjoyed several trips out and also attended the weekly lunch club held on the premises. The home employs an activities co-ordinator on a sixteen hour a week basis whose responsibility it is to offer activity to residents. It was confirmed that this member of staff had recently been on a one day seminar provided by the Alzheimers Disease Society. This is in response to the extended service for older people with dementia provided at the home. Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 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): 18 Residents living at the home can expect to be protected from abuse by the homes policies and procedures and the level of training provided to staff. EVIDENCE: The home was able to evidence that it maintains and adheres to appropriate procedures relating to the protection of vulnerable adults from abuse. Training on the recognition and reporting of abuse is provided to all staff members as part of the mandatory core training package provided by Orbit and is entitled Rights and Responsibilities. The home was able to evidence that more senior staff have also completed protection of vulnerable adults training provided by the local authority. Since the previous inspection the Commission has received one written complaint in relation to the service. At the time of writing this complaint is being investigated and a separate report will be produced detailing the outcome. Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 Residents accommodated at the home can expect to be provided with a homely environment that is both spacious and appropriate to meet their individual needs. Residents can also expect that accommodation is maintained to a good standard of decorative order, repair and cleanliness. EVIDENCE: The Firs consists of a fit-for-purpose building which provides accommodation which is appropriate for the care of older people and people suffering from dementia. Accommodation is provided on two floors, each consisting of two units. Each unit has ten bedrooms, all of which have ensuite toilet and shower facilities. Additionally, each unit has its own small lounge, with a dining, sitting and kitchen area where light snacks and drinks can be prepared. In addition to the ensuite bathroom facilities each unit is provided with a communal bathroom, with assisted bathing and WC. There is a large communal lounge on each floor where residents can meet together and where larger functions can be held. The home is sited in pleasant grounds, including a secure garden where residents with dementia can wander unassisted. Some major work on Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 17 the grounds is planned during the winter months. Whilst accommodation is on two floors both can be accessed via a stairway or passenger lift. On the day of the inspection an environmental tour of the premises was carried out. A selection of resident bedrooms were seen. These were spacious, attractively decorated with good use of co-ordinating soft furnishings. Residents had obviously been encouraged to bring personal possessions with them and the majority of rooms seen had been made to look very homely with the addition of photographs and paintings. All bedrooms have large ensuite facilities which include a walk in shower. The communal living units in the home are domestic in style and provide a warm and comfortable environment where residents can relax. On the day of the inspection several residents were sitting listening to music on one of the units. All areas of the home were maintained to a good standard of cleanliness and there were no unpleasant odours. Appropriate aids and adaptations were provided in private and communal areas where appropriate. Firs Residential Home, The DS0000024387.V264501.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, 28 and 29 Residents living at the home can expect to be supported by a level of staffing which is appropriate to meet their individual needs and ensure their safety. At the time of the inspection, residents could not necessarily be assured that recruitment procedures were strictly followed and therefore offered maximum protection. Residents could expect to be supported by staff who had attained sufficient competence levels to do their jobs. EVIDENCE: On the day of the inspection, the home was being staffed by the registered manager, deputy manager, two senior care staff and seven care staff. During the afternoon period this level decreases to six care staff. The level of staffing provided to the special needs unit has recently increased to four care staff as a response to an increased level of need. Feedback gained both from service users and visitors to the home in relation to staffing was very positive. One relative described staff as being very supportive to both residents and family members. A resident also commented on how hard staff members worked and how well everyone is looked after. The resident also felt that at times staff members were overstretched and it was confirmed by management that at the present time there were 294 vacant care hours. Staff members were observed interacting well with residents in a warm yet professional manner and carrying out their roles and responsibilities with confidence. As part of the inspection, personnel files for two recently employed members of care staff were examined. The home was able to evidence that all newly Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 19 employed staff are subject to a POVA check and Enhanced Disclosure via the Criminal Records Bureau. However it was noted that in the case of one staff member, only one satisfactory written reference had been obtained prior to the prospective staff member commencing duties. The home was able to evidence that 7 staff members have achieved NVQ qualifications (Level 2 or above) and a further 18 were undertaking these qualifications at the present time. The home has its own NVQ Assessors and holds an NVQ workshop for staff on a monthly basis. Firs Residential Home, The DS0000024387.V264501.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 and 38 Residents accommodated at the home can expect that procedures adopted protect them from financial abuse . They may also expect to be supported by staff who are appropriately supervised. On the day of the inspection, residents could not be totally assured that their health and safety was protected. EVIDENCE: During the inspection, the procedures used for the safe storage and administration of resident finances were examined. The home is currently introducing a new system where individual bank accounts will be held for all residents who are unable to manage their own finances or who do not have a financial advocate or appointee. The current systems used were found to be secure and all transactions carried out on behalf of service used were recorded, signed for and receipts issued. Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 21 Whilst the home was able to evidence through records that staff are provided with one to one formal supervision the frequency had lapsed in some cases and did not adhere to the recommended six times a year. Whilst in general the home was able to evidence that it provided a safe environment for both service users and staff some issues in relation to health and safety were identified. * In the case of one resident whose care plans were examined, a mobility assessment and risk assessment had not been provided. * Wardrobes provided in some residents bedrooms had not been secured to the wall and were unstable, thus presenting a risk to the health and safety of both residents and staff. * A disposable razor had been left on the bedside table in an unlocked bedroom on the special needs unit and posed a health and safety risk to residents. Firs Residential Home, The DS0000024387.V264501.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 x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 3 x 2 Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 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 OP9 Regulation 13(2)& 13(4) Requirement The Registered Persons must take steps to ensure the administration (or non administration) of medicines is fully and accurately recorded and therefore that medicines are safely administered at all times The Registered Persons must take steps to ensure records for the receipt of medicines are administered at all times. The Registered Persons must take steps to ensure prescribed medicines are available for administration at all times. The Registered Persons must take steps to ensure full recorded assessments are undertaken and reviewed on a regular basis for service users wishing to self administer medicines. The Registered Persons must ensure that two satisfactory written references are gained prior to any prospective staff member commencing employment. The Registered Persons must DS0000024387.V264501.R01.S.doc Timescale for action 25/11/05 2 OP9 13(2) & 13(4) 12(1), 13(2)& 13(4) 13(2), 13(4) & 14 25/11/05 3 OP9 25/11/05 4 OP9 25/11/05 5 OP29 19(1)(b) 09/11/05 6 OP38 13(4)&(5) 04/01/06 Page 24 Firs Residential Home, The Version 5.0 7 OP38 13(4)(a) 8 OP38 13(4)(a) ensure that a written assessment is produced for each resident in relation to mobility and any risk involved in their care. The Registered Persons must 01/02/06 ensure that all wardrobes provided in resident bedrooms are stable and can not be pulled away from the wall. The Registered Persons must 09/11/05 ensure that disposable razors are not left in bedrooms, which are accessible, by other residents. 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 OP3 Good Practice Recommendations The Registered Persons should ensure that prospective residents seeking placement via local authority funding are not admitted to the home until a Community Care Assessment has been received from the social care services named assessor. It is recommended that service user identifying photographs are held alongside MAR charts to assist in the safe administration of medicines. It is recommended that arrangements for the storage of medicines are reviewed and rationalised to achieve central storage of all medicines including medicine trolleys and that consideration is given to obtaining proper metal cabinets for the storage of medicines. It is recommended that steps are taken to ensure medicines requiring refrigeration are clearly and separately identified at the time of delivery. It is recommended that a final check of hand-written entries by a second member of care staff is made prior to the use of new MAR charts each 28 day period and on each new entry. It is recommended that consideration is given to improving security for keys to the storage of controlled drugs. It is recommended that a copy of the RPSGB guidelines DS0000024387.V264501.R01.S.doc Version 5.0 Page 25 2 3 OP9 OP9 4 5 OP9 OP9 6 7 OP9 OP9 Firs Residential Home, The 8 OP9 9 OP11 10 OP36 “The Administration and Control of Medicines in Care Homes and Children’s Homes June 2003” is obtained for reference. It is recommended that further training is provided for all authorised members of care staff on medication in line with National Minimum Standard 9.7 and that in addition , the competence of staff members is assessed regularly via supervision. The Registered Persons should consult newly admitted service users on any wishes they may have with regard to funeral arrangements and these should be documented as part of the care plan. The Registered Persons should ensure that staff receive formal one to one supervision at a frequency of six times per year. Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Firs Residential Home, The DS0000024387.V264501.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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