Inspection on 21/09/07 for Garden House

This inspection was carried out on 21st September 2007.

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 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

Garden House 14/06/06

Garden House 18/01/06

Garden House 31/08/05

Garden House 02/03/05

Garden House 18/11/04

Garden House 09/03/04

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

CARE HOMES FOR OLDER PEOPLE Garden House Priestlands Sherborne Dorset DT9 4HN Lead Inspector Gloria Ashwell Key Unannounced Inspection 21 September 2007 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 Garden House DS0000026807.V348300.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. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Garden House Address Priestlands Sherborne Dorset DT9 4HN 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) 01935 813188 NO FAX Garden House Rest Home Limited Mrs Gillian Houghton Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2006 Brief Description of the Service: Garden House is a residential home registered to accommodate 15 older persons. It is situated in a quiet residential area of Sherborne and within walking distance of the town centre. Mr Calder purchased the home in 1992 and continues to take an active role in the management of the home. He lives in private accommodation within the grounds of Garden House. In August 2005 a new registration certificate was issued to reflect the fact that the home is under the ownership of Garden House Ltd (the change to a limited company occurred in 1999). Mr Calder is the responsible individual and Mrs Houghton is the registered manager. The care home is established in the main house and an extension to the property named Trudys Cottage and is set in landscaped grounds. The front garden is set to lawns and herbaceous borders with mature trees and shrubs and a parking area for visitors convenience. A series of steps lead to the front entrance and a large sliding glass door/window at the front of the house allows access to a raised patio area with garden furniture. The back garden has mature fruit trees, lawns and seasonal flower borders. Once inside the home there is level access to residents rooms and communal facilities. The accommodation is furnished and decorated to a high standard. Laundering of clothing and household linen is carried out at the home and arrangements are made for chiropodists, opticians and other health and social care professionals to visit individual residents. On 10 October 2007 the Commission received an undated letter from the registered manager stating that fees “range from £350 to £559 per week depending on different factors”. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection carried out by Regulation Inspectors Debra Jones and Gloria Ashwell, accompanied by an ‘expert by experience’ who focused on speaking to residents and staff to obtain their opinions of the home. The duration of the inspection was 6 hours 30 minutes, being the combined total of hours of the inspection team. Additionally, time was spent in preparation for the visit, looking at previous inspection reports and other relevant documents and preparing a plan for the inspection visit. The care records of four people who live at the home were examined in detail. Between them, the inspectors were able to meet and speak with most of the residents both individually and in small groups in the communal areas. Additional information used to inform the inspection process included the Annual Quality Assurance Assessment (AQAA) and Minimum Data Set completed in advance of the inspection by Mrs Houghton. An inspector arrived at the home during an afternoon in August 2007 with the intention of commencing the unannounced inspection by speaking to residents and thereafter returning to the home at a mutually convenient date and time, to speak to Mrs Houghton and examine documents. Mrs Houghton refused to allow the inspector to enter the home; for this reason the inspection was eventually carried out by two inspectors accompanied by an expert-byexperience. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: Garden House provides a comfortable and homely environment for residents. The management and staff are held in good regard by residents who appreciate the kind, cheerful and professional manner in which they undertake their duties. A good working relationship has been established with the local GP Surgery and primary care team; residents have access to the health care resources that they might need. All staff who administer medication have received formal training. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 6 There is good contact with the local community and residents are encouraged to remain active, independent and retain control over their own lives. Bedrooms are personalised with residents own belongings. All the residents spoken with said that they enjoy their meals, that their likes and dislikes are known and catered for and that they are satisfied with the food provided. Staff have received in house training on adult protection issues. Staff said they felt well supported by the management and could approach any of the management team for advice and guidance. What has improved since the last inspection? What they could do better: This report contains a number of recommendations including for the improvement of the service user guide to provide prospective residents with sufficient advance information upon which to base their decision of whether to live in the home. Aspects of care and medicines related documentation should be improved to ensure staff have enough information readily available to guide their practice and ensure that all residents receive the care they require. The home does not have a suitable system for assuring quality so is unable to adequately demonstrate how it ensures a quality service is provided to residents, and the manager was unable to provide useful information to the Commission in the Annual Quality Assurance Assessment (AQAA). The home should use a systematic quality assurance process to obtain the opinions of service users and reflect them in a development plan, the contents of which can then be notified to the Commission via the AQAA. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 7 On 9 November 2007 the Commission received an undated letter from the registered manager confirming that the recommendations made in this report will be met and that arrangements are already underway to improve the quality assurance system. 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. Garden House DS0000026807.V348300.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 Garden House DS0000026807.V348300.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): 1 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does not provide Intermediate Care so Standard 6 does not apply. Prospective residents (or their representatives) are provided with information about Garden House and are encouraged to visit in advance of admission to establish their impressions of life at the home and the standard of available accommodation, although the format of the information may not be suitable for service users who have specific needs for example those with impaired sight. Prior to admission, the needs of each proposed resident are assessed and the home then writes to prospective residents confirming the ability to properly care for them. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 10 EVIDENCE: The service user guide is made available to all residents and prospective residents. It contains general information about the home but it is recommended that it be amended to include reference to the outcomes of the most recent user satisfaction questionnaire. The Statement of Purpose and service user guide are available in a standard format; it is recommended that this information be made available in alternative formats, appropriate to the needs and capacity of individual prospective residents or their representatives who might find the standard format difficult to read and fully understand. The records of a recently admitted resident included details of pre-admission assessment which had been carried out by the registered manager when she visited the prospective resident at the previous address. In advance of making the decision to enter the home the prospective resident and her closest relative visited Garden House to view the premises and meet residents and staff. The inspector spoke to the resident who confirmed satisfaction with the home and observed that it was “Very comfortable”. Following pre-admission assessment of the persons needs and circumstances the home writes to them confirming agreement and ability to accommodate and care for them; a copy of the ‘letter of offer’ is kept on file. Garden House DS0000026807.V348300.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. Residents care needs are well met but lack of robust risk assessment to underpin care planning means that some aspects of their care may be overlooked. Residents are treated with respect and their rights are upheld. Medicines prescribed by doctors are safely stored and correctly administered by staff trained in this work. EVIDENCE: Residents believe they are properly cared for and some described particular aspects of care they require and receive, confirming their satisfaction with the standard of care. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 12 There is a written plan of care for each resident; the sample examined were sometimes hard to follow because they did not reliably describe the care needs and/or the ways these were to be met. Care records of 4 residents were examined; risk assessments should form the basis for care plans but few had been recorded; as a minimum, for each resident there should be regularly reviewed and up to date assessments for mobility, skin condition and nutrition. To ensure correct identification of residents, records contain a recent photograph of each resident. For each resident the home writes periodic records; the sample examined were of satisfactory standard but most were written infrequently e.g. the latest entry for one resident was written on 2 May 2007. Staff spoken with during the inspection understood the needs of the residents in their care and said that the manager and deputy manager keep them up to date with any changes that arise. In general, care documentation with particular regard to risk assessments and care plans should be improved to ensure that staff have sufficient information upon which to base their care practice. Residents who wish to sign a summary of their care plans to confirm their agreement. Medicines prescribed by doctors are safely stored and carefully administered to residents by staff trained in this work, thereby protecting residents from medicine errors. In general Medication Administration Records (MARs) were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts - those wishing to do so can manage their own medicines in accord with a risk assessment process; some of the currently accommodated residents manage their own medicines. For some residents who are prescribed Warfarin the MARs were unclear regarding changes to prescribed dosage but residents confirmed they receive the correct amounts and an up-to-date and accurate separate Warfarin logbook is maintained. This report contains some recommendations for the further improvement of medicine handling standards. Handwritten instructions should be signed, dated and countersigned by the author; this also applies when a prescribed medication is discontinued by the prescriber. For each resident the MAR should include the allergy status (e.g. “None known” when this is the circumstance). When a medicine is prescribed for ‘as required’ use the reason for administration (e.g. headache) should be stated on the MAR. The home has recorded a list of signatures of all staff involved in medicine handling. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 13 In the presence of staff residents appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and considerate manner and the atmosphere throughout the home was calm and tranquil. Residents are treated with respect and their privacy and dignity is protected at all times. Residents spoken with during the inspection said they get on very well with the staff. Garden House DS0000026807.V348300.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assisted to maintain as much independence as possible. Social and leisure activities are suited to the preference and ability of each resident. Contact with the local community is encouraged and visits by residents’ friends and relatives are welcomed by the home. Meals are appetising and of good quantity and quality. Most residents take meals in the dining area adjoining the main lounge on the ground floor; others receive them in their bedrooms. EVIDENCE: The inspector spoke briefly to a number of residents and at greater length with six including those who were ‘case tracked’; all expressed satisfaction with the home, including the range of activities, meal provision, staff and premises. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 15 A number of residents were in the lounge at the time of the inspection. There were notices on a door with a list of monthly outings and of a luncheon club with trips to various local places. One resident said that the last visit was to Forde Abbey, where they had lunch. The television was on and a resident was playing a game of patience at a table. She said she enjoyed going for walks in the garden to help her mobility and also enjoyed helping the staff and was later seen laying the tables for lunch. Residents freely went in and out of the kitchen where staff were preparing lunch, creating a very homely feel; food is cooked by staff trained in food hygiene. Residents said the food was very good; breakfast can be served to bedrooms and includes a choice of cereal, fruit, toast etc. One resident said she kept fruit in her room. Residents said the lunch always includes at least three vegetables in addition to potatoes, “lovely puddings”, and evening meals are often warm snacks with something on toast etc. One resident regularly organises a quiz or crossword session in the evenings after tea, and two local school children visit the home – a resident observed that it was nice “to bring young people in”. One resident enjoys reading and said the mobile library comes to the home and brings books in for residents to make their own choices. One resident was Catholic and said that there was a new priest who had not yet visited the Home, but that two people from the church bring Holy Communion to her. Visits are also made by a Church of England vicar. One resident enjoys knitting, and displayed a jacket she had knitted for her great, great grandson. Two residents were together reading a newspaper. Other residents sat in the lounge or their bedrooms mostly watching television. Enquiring of residents how they obtained personal items, writing paper, cards etc. it was said that relatives or friends bring in what they need, and if this was not possible staff would buy what they needed on their behalf. Garden House DS0000026807.V348300.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 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints procedure provides information on the procedure to follow to persons wishing to make a complaint; all complaints are recorded and investigated. The home has implemented an adult protection procedure and trained staff to ensure they understand how to protect the people in their care. EVIDENCE: To ensure residents and their representatives have access to the complaints procedure it is displayed in the home, included in the service user guide to the home and a copy is provided to each residents’ relative/representative. Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. The home keeps records of all complaints received and investigated. Since the last inspection no complaints against the home have been received or investigated. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 17 The home has developed and implemented written policies and procedures for the protection of residents from abuse or neglect and provides staff with training in the understanding of abuse and their role in protecting residents from abuse in its many forms, including neglect. Staff spoken with during the inspection confirmed that training in safeguarding adults is provided when they first commence work in the home, and also to staff who have been in the home’s long-term employ. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 18 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Ongoing attention to the daily maintenance of the home ensures the comfortable environment for the residents living there and anyone visiting. The home is kept clean and hygienic and smells fresh, making it a pleasant place to live. EVIDENCE: Service users bedrooms are pleasantly decorated and furnished reflecting their personal tastes. There is a continuous programme of improvement of the premises; since the last inspection the kitchen has been refitted, the utility room redecorated, new Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 19 floorings installed for the kitchen, utility room and a toilet, some new doors have been installed and another hoist to assist the movement of residents has been provided. The home is centrally heated with radiators in all areas used by residents. Radiators do not have covers or low heat surfaces. A risk assessment has been recorded and based on the physical abilities of residents and their understanding and appreciation of risk the home has determined the risk to residents does not merit the covering of radiators or pipework or further limiting of the temperature of the hot water from taps. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 20 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. Recruitment practices ensure the protection of residents from potentially unsuitable staff. The home promotes the achievement of nationally recognised care qualifications and supports staff to access the training they need to be able to properly care for residents. EVIDENCE: Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. Staff are enthusiastic about their work and feel they provide a good standard of care to residents and are properly supported by the management and training provision. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 21 Since the last inspection no new staff have commenced work in Garden House; the records of two staff in the home’s long term employ were examined and found to contain all essential information including two written references, a Criminal Records Bureau disclosure, health details and evidence of identity. At present most of the care staff currently employed by the home hold a National Vocational Qualification in care; the home thereby meets the standard for at least 50 of the care staff to hold an NVQ in care. During recent months a number of staff have attended training on a variety of subjects including fire safety, food hygiene, moving and handling, and safeguarding adults. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 22 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. The standard of day-to-day management is generally acceptable but is weak with regard to quality assurance. The home properly safeguards residents’ financial interests. Policies and practices promote the health, welfare and safety of residents and staff of Garden House. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 23 EVIDENCE: Mrs Houghton, the registered manager, has many years experience of managing a care home. She undertakes day-to-day responsibility for the running of the home, supported by Mr Calder, the Responsible Individual for the Company. Mrs Houghton holds the registered manager’s award at NVQ level 4. The home does not have a suitable system for assuring quality so is unable to adequately demonstrate how it ensures a quality service is provided to residents, and the manager was unable to provide useful information in the Annual Quality Assurance Assessment (AQAA). The AQAA questionnaire provided to Garden House by the Commission had been only minimally completed and thereby provided very little useful information. Guidance on completing the document was given to all service providers by the Commission, to ensure understanding of the task. However, Mrs Houghton submitted a document containing the briefest of replies. For example, in response to an enquiry regarding Value for money, for which the Commission includes the guidance “the relationship between economy, efficiency and effectiveness …tell us what you understand by value for money … how you arrive at the cost and charge for your service… give evidence supporting why you think you are providing value for money” Mrs Houghton simply replied “Ask the residents”. Staff have the opportunity to share their ideas as to how the home might be improved at staff meetings. Minutes are taken of these meetings. A range of policies/procedures underpin practice at the home and were reviewed during the last year to ensure that they are in accordance with guidance and expected practice. The home has no involvement with residents’ finances or money, in accordance with its own stated policy. Residents are given the option of having a lockable facility for the safe keeping of valuables if they so wish. The home has a health and safety policy. All accidents are documented. Accident records are periodically analysed to identify any emerging trends and thereby to introduce measures to reduce risk of similar accidents taking place in the future. There is a rolling programme of staff training for core subjects including health and safety e.g. moving and handling, first aid, food hygiene and infection control and what to do in the event of a fire. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 24 From discussion with staff and examination of records there was evidence that fire safety equipment is checked regularly by the home and by an external contractor. The home has recorded a fire risk assessment. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 25 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 X X 3 Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action 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 OP1 Good Practice Recommendations The service user guide should be made available in alternatives to the standard format and amended to include the current fee range, and to make reference to the outcomes of the most recent user satisfaction questionnaire. Care plans should be based on the findings of reliable assessments and should be clear and comprehensive. Where there are handwritten changes / entries to the medication records these should be countersigned by another competent person to show that the changes accord with the GP’s direction. All medication administration records should record if there are any allergies known or if there are not. 2. OP7 3. OP9 Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 27 4. OP33 5. OP37 When a medicine is prescribed for ‘as required’ use the reason for administration (e.g. headache) should be stated on the MAR. The views of residents’ representatives who have contact with the home should be ascertained through the use of periodic surveys (e.g. once a year) at the home as part of the quality assurance system. The AQAA should be completed in accordance with guidance provided by the Commission, to ensure the provision of accurate and sufficient information, upon which the Commission may reliably assess the service. Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Garden House DS0000026807.V348300.R01.S.doc Version 5.2 Page 29 - 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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