Inspection on 25/01/08 for Flixton Manor

This inspection was carried out on 25th January 2008.

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

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

Flixton Manor 30/10/08

Flixton Manor 31/08/07

Flixton Manor 27/06/06

Flixton Manor 15/02/06

Flixton Manor 28/12/05

Flixton Manor 15/02/05

Flixton Manor 18/08/04

Flixton Manor 29/03/04

Flixton Manor 16/12/03

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 Flixton Manor 2-8 Delamere Road Flixton Manchester M41 5QL Lead Inspector Elizabeth Holt Unannounced Inspection 25th January 2008 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 Flixton Manor DS0000006711.V355761.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. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Flixton Manor Address 2-8 Delamere Road Flixton Manchester M41 5QL 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) 0161 746 7175 0161 748 5583 flixtonmanor@msn.com Dr Jan Al Safar vacant post Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. All service users will fall within the category of old age (60 ). Up to three service users who require personal care may be included within the maximum occupancy. Staffing levels as specified in the Section 25 (3) Notice dated 28th September 2001, shall be maintained. 31st August 2007 Date of last inspection Brief Description of the Service: Flixton Manor is a care home providing nursing care and accommodation for 32 older people. The home had been converted into one residence from two semi-detached houses. Further additions have taken place to enlarge the communal areas and an extension to provide bedroom accommodation. There was a large conservatory at the front elevation of the home that leads into the lounge and dining areas. Access to the home is from the drive and garden. At the end of the drive there is provision for parking. There are concrete steps and a ramp for wheelchair access to the entrance door. The home is situated on the main road between Flixton and Urmston. There was easy access to public transport, local shops and parks. It is convenient for the motorway system. The current scale of charges at the home is £384-£550.00 per week. Costs in addition to the fee are hairdressing £4.50-£16.00, Chiropodist £20.00 per visit, newspapers-varied and toiletries which are charged on an individual needs basis. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This visit was the second key inspection conducted this year and focused on assessing progress made to address concerns identified at the earlier key inspection, which took place in August 2007. This key unannounced inspection, which included a site visit, and a specialist pharmacist inspection took place over two days on Friday 25th January 2008 and Monday 28th January 2008. The manager of the home was not told beforehand of the inspection visit. During the visits we looked at care and medicine records to ensure that the health and care needs of the residents were being met. The time we spent in the home included observing care practices and talking with residents who live at the home, visitors, members of the staff team, the manager and the home owners representative who was present during the inspection. A partial tour of the building was conducted and a sample of care and staff records was looked at, including employment and training records, staff duty rotas and resident’s care plans. The term preferred by the people consulted during the visit was “residents”. This term is, therefore, used throughout the report when referring to those living at the home. Since the last inspection the manager had submitted her application to be registered with the CSCI however she later withdrew this until she gains some further management experience. What the service does well: Before moving to Flixton Manor, residents or relatives are encouraged to visit to look around the home to make sure they are making the right choice. The people living at the home feel that the staff will generally listen to them if they have any worries and that the manager will make attempts to sort these out. The home has flexible visiting arrangements to enable the residents to have regular contact with their friends and families. Staff have close relationships and regular communication with residents and their representatives. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 6 A visitor said she would feel confident in raising a concern with the staff or the manager. One of the relatives replied in the survey that, “The standard of care is very good, the food is very good, and all the staff seem kind and caring”. The manager and the staff were aware of the need to protect vulnerable people and procedures and practices were in place for the staff to respond to incidents and allegations if they occur. A choice of menu is available at each mealtime and residents spoken to were happy about the food they received. What has improved since the last inspection? What they could do better: The service needs to have a registered manager and it is of concern that there are still shortfalls in areas such as medication and care plans. The manager must ensure the care plans and risk assessments accurately reflect the care needs of the residents. Shortfalls in the recording of appropriate detailed information may lead to resident’s needs not being met. The manager needs to make sure there are leisure activities for the residents to provide stimulation for them. Although there were improvements in medication practices since the last inspection some shortfalls in medicine procedures were still present. A requirement was made to make sure the records are clear and accurate and recommendations to have in place a system to audit medication practices. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 7 New staff working in the home must be appropriately mentored, supervised and trained by experienced staff to ensure residents are treated in a dignified manner. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with satisfactory information about the home and have their needs assessed before admission. EVIDENCE: The Statement of Purpose and function had been revised since the last inspection, and included contained the relevant information required by schedule 1 of the Care Homes Regulations 2001. Following a recommendation made at the inspection in August 2007, the Statement of Purpose set out the homes objectives, including how the service provides for the needs of people with dementia and is supported by the resident’s guide that provides good clear information about the home. An information package was given to prospective residents and their families to inform them about Flixton Manor. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 10 The manager had introduced a new pre-admission assessment form, which was filled in before residents are admitted to Flixton Manor. These assessments were carried out by the Registered Nurse employed, by the home who is considered suitably qualified to carry these assessments. Following a requirement made at the last inspection for improvements to these assessments, a review of three of these gave the reader a clear picture of the resident’s care needs at the admission stage. The assessments included personal details, past medical history and the activities of daily living the individual was able to perform or required support with. Where placements were funded from Social Services copies of the Care Management assessments were available, which gave detailed information about the resident’s needs. One resident who had been in the home for six weeks said, “They are all gentle with me, I am doing my best to adjust to living here and the staff are helping me.” The home does not provide intermediate care. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some shortfalls in the systems and practice for monitoring the healthcare needs of residents may lead to the health and welfare needs of residents not being met. EVIDENCE: Care plans are available for each resident in the home. The previous inspection report highlighted that a full audit of the care plans must be undertaken to make sure all aspects of the resident’s health, personal and social care needs are met. This audit needed to include risk assessments for individual residents. Since the last inspection a new care planning system had been put in place and work had been done to transfer the information into the new care planning process. Staff said they were working hard to understand and get used to the new documentation. Three residents care plans were case tracked which varied in the detail of the information provided. One included a resident with diabetes, further detail was needed in this resident’s care plan to show the specific support to be provided Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 12 by the staff and in the risk assessments for what the staff should look for in the event of there being any problems in the management of this resident. It was difficult to look at trail the healthcare needs of the residents by reviewing the care plans as an audit trail was difficult. Some of the daily statements recorded showed a lack of detail. One statement was, “I noticed a slit on the resident’s buttock.” A discussion highlighted the need to record this in more detail so that the staff were aware of the appropriate course of action to take in managing the care of this resident. Following concerns raised at the last inspection where a number of residents were nursed in “Kirton” or “bucket” chairs, which are deep-seated chairs that are difficult to get out of. There was evidence to show the use of these had been reviewed. An alternative chair was being purchased for one resident, and another resident had a risk assessment in place and consent from the resident’s family for use of this chair. Since the previous inspection, the medication policy has been reviewed and although it still needs some work it provides clearer guidance about the way medicines are managed at the home. All medicines are now safely locked away and nurses were careful to make sure they locked the medicines trolley when it was unattended during the medicines round. A second medicines trolley has been purchased and two nurses now administer medicines, so people are not waiting until late morning for their morning medicines. Care is taken to make sure special instructions such as ‘before food’ are followed to make sure medicines work properly. Qualified nurses administer all medicines except some external preparations (e.g. creams) that are applied by care staff. The nurses explained that they were careful to check that creams were applied properly and completed the records to show they had been applied. The nurses remain accountable for making sure the treatment is used properly and should look at developing a formal system for delegating responsibility for applying and recording the use of creams by care staff. A sample of medicines was counted for comparison with the records to check that they were given at the prescribed dose. We saw that the records were mostly up-to-date but they could not always be used to show medicines had been given correctly. For example, we saw records that impossibly showed more liquid medicine had been given than was recorded as received into the home. The records could have been more clearly and fully completed. The administration records were signed before medicines were taken and then changed if someone later refused their medicine, making the records less clear. If ‘one or two’ tablets were prescribed the actual dose given was not shown. Some medicines had been crossed off the pre-printed administration records; it was not always possible to tell when these medicines had been Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 13 ‘stopped’ or who by. Medicines record keeping needs to improve to clearly and accurately show that medicines are given as prescribed. Thorough recorded checks (audits) by staff are planned. This should help to ensure that both medicines records and stock are accurate. Thorough audit is needed to assess and improve the quality of the medication service offered. From observations made during the inspection and conversations with staff members, residents and visitors, it appeared the care staff and nurses were respectful and supportive to the residents in the way they spoke to them. Resident’s fingernails looked clean and had been attended to and residents spoken to were happy with the care and attention they received. One care worker who was relatively new to the home was observed putting a plastic apron over a resident and tying the plastic ties at the back of the chair, not around the resident. This was raised immediately with the individual and the manager and the staff member explained this was “because the resident would not lean forward”. New staff must be guided and supported by experienced staff members and practices, which could be seen as a method of restricting someone’s movement, must not be used. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents are given some opportunity to exercise control and choice over their lives but shortfalls in activities and stimulation may put hamper the resident’s opportunities to fulfil their lifestyles. EVIDENCE: As raised at the last inspection the residents would benefit from a person dedicated to provide activities and social stimulation and a requirement was made. The manager had recruited a person for this role however they left after one day and the manager was making further attempts to find a suitable person for this position. Four resident survey forms were returned to the Commission and one stated that improvements could be made, “by arranging for entertainment and activities occasionally to occupy the residents.” One resident expressed concern in relation to laundry going missing for her relative and commented that there could be more activities provided. Staff members spoken to said they did continue to try to encourage residents to be involved in activities like singing, bingo and crosswords. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 15 Mealtimes were generally seen to be sociable occasions in the dining area of the main lounge/conservatory and staff were seen supporting residents in an appropriate way. The tables were pleasantly laid. Residents who could express a view said they were satisfied with the food provided and they felt they got enough to eat. The main meal on the day of this visit was fish pie, and peas and a choice of deserts. Two residents were seen having a salad, which was their choice. The residents were encouraged to bring in personal items into the home such as photographs, pictures and ornaments. The staff were seen to speak to residents in a friendly way and knew the residents well. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear complaints procedure that ensures concerns are appropriately dealt with and procedures were in place to protect residents from harm. EVIDENCE: The home had a complaints procedure and a record of concern/complaints was held by the home. One complaint had been made since the last inspection directly to the home and this had been appropriately dealt with within timescales. The Commission for Social Care Inspection had not been in receipt of any complaints about the home since the last inspection. The four responses to the service user and relative’s surveys showed that they were aware of how to make a complaint and whom they would approach in the home. Staff had received awareness training through Trafford’s training consortium in adult safeguarding procedures. The home has a copy of the local inter-agency adult protection policy and procedure. Staff spoken to during this visit showed awareness of what they would do if they suspected someone was being abused. Flixton Manor DS0000006711.V355761.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, well-maintained home that was generally comfortable and odour free. EVIDENCE: A partial tour of the home was carried out, which showed that a programme of redecoration of a number of bedrooms had been carried out since the last inspection and others were planned for. This included some rooms having new adjustable beds, new furniture and bedding. Two residents said they liked their rooms and felt they were homely. The shower room has been refurbished including new non-slip flooring and a sluicing disinfector has been installed. The manager said the bathroom on the first floor was not used much at all, as residents preferred the shower room. Consideration should be given to upgrading this room to make it comfortable if residents did prefer a bath. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 18 Bedrooms had been personalised with photographs and ornaments. Flixton Manor DS0000006711.V355761.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The recruitment policies and procedures did not fully protect the safety and wellbeing of residents. EVIDENCE: At the time of the visit the home had 21 residents in receipt of nursing care and 3 residents in receipt of personal care only. From observations made during the visit and a review of the duty rotas there appeared to be sufficient staff on duty to meet the care needs of the residents. Since the last inspection the staff files were now be stored in a lockable facility. Three staff files were looked at, which showed two of the three had completed application forms. Although written references for two of the staff members were held on file one of the application forms did not name the referees. The third staff file did not have a completed application form. The manager stated this was with the homeowner. None of the three files included a recent photograph of the employee. There was evidence of Criminal Records Bureau checks carried out prior to employment. A discussion with the manager highlighted that proof of the registered nurses personal identification numbers with the Nursing and Midwifery Council were not currently being carried out. A requirement was made for appropriate recruitment procedures to be followed. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 20 Training and supervision arrangements are in place and staff spoken to said this happened. In light of the practice observed in standards 7-11 the new staff must be appropriately mentored and supervised to make sure their care practices are in line with the policies and procedures of the home. Visitors and residents said the staff and management are very approachable and it was clear that staff had friendly relationships with the relatives visiting the home. Flixton Manor DS0000006711.V355761.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Further work is needed to ensure the standards and practices in the home promote and safeguard the health, safety and welfare of the residents living there. EVIDENCE: Since the last inspection the manager’s application to be the registered manager with the Commission was withdrawn due to the lack of experience in a managerial position. Mrs Simcock plans to resubmit this when she has completed the registered managers award and has gained more managerial experience. The provider has put in a new clinical lead nurse who had been in post for only a couple of weeks at the time of this visit and was still getting to know the residents and the policies and procedures of the home. Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 22 A review of the accident records showed there was no audit of these records to show if any strategies could be put in place to minimise the risk to the residents. It was evident the manager continued to make improvements in the home for the benefit of the residents since the last inspection, however the shortfalls in the care plans, risk assessments, in the monitoring arrangements for the medication administration systems and the staff recruitment procedures does not safeguard the health, safety and welfare of the residents living there. Mrs Simcock showed a good knowledge of the residents and it was pleasing to see that an experienced nurse has been appointed to lead on the clinical needs of the residents. The residents personal pocket money accounts were not looked at during this visit, however the manager has policies and procedures in place to manage these. Relatives spoken to said the manager was approachable and they felt she would listen to any comments or suggestions made. A review of two of the maintenance records showed these were up to date. Flixton Manor DS0000006711.V355761.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X X 1 Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 24 YES Are there any outstanding requirements from the last inspection? 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 Records regarding medication must be clear and accurate at all times in order to ensure that residents are administered the correct doses of medication. [Previous timescale 14/10/07 not met.] Staff must be appropriately trained in order to appropriately meet the needs of the residents accommodated. Therefore ensuring that residents who use this service are not at risk of not having their needs met. Appropriate recruitment procedures must be followed to demonstrate that appropriate action has been taken to minimise the risk to residents. This must include appropriate referees and completed application forms. Care workers must be appropriately supervised and mentored to make sure they are clear of the homes policies and procedures to deliver care appropriately. The home must put forward an DS0000006711.V355761.R01.S.doc Timescale for action 28/03/08 2. OP28 13(4) c 28/03/08 3. OP29 19(1)b Schedule 2 25/03/08 4. OP30 18(2) 25/04/08 5. OP31 18(1) 30/04/08 Page 25 Flixton Manor Version 5.2 appropriately experienced person to manage the care home to ensure the health and welfare of the residents are promoted and protected. (Previous timescale of 19/10/07 not met). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP8 OP9 Good Practice Recommendations Daily entries must be clear and linked to the care planned. These documents must be reviewed on a regular basis. An system to audit medication and to assess the quality of medication handling should be established and maintained by the manager, to ensure that the quality of medication handling is assured and residents’ health is not at risk. A formal system to delegate responsibility for applying and recording the use of creams by care staff should be considered. Staff should ensure the needs of the residents are met in a way that respects the dignity of the residents. It is strongly recommended that residents should not be attached by their pinafore strings to their dining chair. The day’s menu should be readily available to all residents each day. A system to audit the frequency of accidents in order to minimise the risks to residents should be carried out on a monthly basis at least. 3. 3. OP9 OP10 4. 5. OP16 OP38 Flixton Manor DS0000006711.V355761.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Flixton Manor DS0000006711.V355761.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. 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. 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