CARE HOMES FOR OLDER PEOPLE
George Basterfield House Risedale Road Barrow in Furness Cumbria LA13 9BZ Lead Inspector
Marian Whittam Unannounced Inspection 12th June 2006 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 George Basterfield House DS0000035198.V291294.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. George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service George Basterfield House Address Risedale Road Barrow in Furness Cumbria LA13 9BZ 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) 01229 894549 www.cumbriacare.org.uk Cumbria Care Mrs Julie Bernadette Lowery Care Home 35 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (35) of places George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 35 service users to include: - up to 35 service users in the category of OP (old age not falling within any other category) - up to 16 service users in the category of DE(E) (Dementia over 65 years of age) The staffing levels in the home must meet the Residential Forum Care Staffing Formula for Older Adults. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 9th January 2006 3. 4. Date of last inspection Brief Description of the Service: George Basterfield House is a care home registered to provide care for 35 residents, including 16 with dementia. The home is in a residential area of Barrow in Furness, close to the local park, leisure centre, shops, post office, public houses and other amenities. The home is on a bus route and is about half a mile from the town centre. The home is on two floors and has a passenger lift for residents .All the bedrooms in the home are single occupancy and 3 have en suite facilities. The home is divided into individual units, Linden and Elmview are EMI units and Ashlea and Oakdale are for physically frail residents. Each unit has its own non smoking lounge, kitchen and dining area in addition to the large communal lounge on the ground floor and the ground floor lounge used by service users who wanted to smoke. The home has secure garden areas that residents may use. Information is available to prospective residents in the combined Statement of purpose and service users guide; this is available and displayed in the home. A copy of the last inspection report is included. The fees charged by the home range from £385.00 to £423.00 per week as at the date of the inspection and an additional charge is made for personal toiletries, newspapers, magazines, also hairdressing and chiropody services and any personal travel expenses, according to information provided by the home.
George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced site visit took place on 12/06/06 with the regulation inspector spending seven hours in the home. Pre inspection information on residents, fees, staffing and services provided requested in advance of inspection by CSCI was not returned by the providers before the inspection. However 7 resident surveys were returned before the inspection. Therefore before the site visit information was gathered on the service from records of previous visits, notifications, regulatory activities and complaints, concerns and allegations received. Comments made by residents using surveys have been included in the inspection planning. The morning was spent examining policies and procedures, menus, systems for recording complaints and quality assurance, activities programmes, medication practices and records, financial, personnel and training records as well as other records required by regulation. The afternoon was spent looking around the home talking with residents in the lounges and in their own bedrooms. Speaking with the manager, with care and supervisory staff, observing activities on the units and work practices, and looking at care plans. Thirteen residents were happy to speak to the inspectors about their experiences of living in the home. Two visiting relatives also spoke with the inspector. What the service does well:
Residents and visitors spoken with praised the staff and generally liked the staff team and one resident said they felt that staff are, “ like friends”. Staff have a good rapport with residents and their approaches to residents friendly and informal. Throughout the day the inspector saw that staff and residents got on well together and that residents individuality is respected. The home provides a comfortable and homely atmosphere. With only one exception all residents spoken with felt staff worked hard for them and gave them time and listened to what they had to say. Staff show an interest in the residents and in supporting them in daily life and in small details such as getting small items of shopping for them. The service has worked hard and shown commitment to improving areas of the service where requirements have been made and to try and improve the service for residents from this. George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better:
Although the home provides information on the services provided it should make this available in different formats such as large print or audio and this good practice point also applies to the complaints information and procedure. This could improve access to both sources of information for residents with visual impairments. Residents should also be made aware of their right to see records kept about them. There is an experienced registered manager in the home working part time job sharing with another manager. The application for registration for the other manager in post should be done promptly if that person intends to work as and have the responsibilities of that role. Some residents were unaware who the manager was and they should know who is running the home they live in The home has worked hard at reviewing and improving medication practices but some areas must be improved to ensure sustained improvements for resident’s safety with medication. The registered manager must ensure that
George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 7 when hand-written the Medication Administration Records (MARs) are always signed, dated and double checked for accuracy and audit. Resident’s MARs must always include all current medication they are receiving where that gives a record of medication prescribed and administered by the home. Residents taking medication requiring specific instructions to be followed by staff for a period of time after administration need to have the time of administration recorded on the chart. Staff following on will then have information to ensure the specific instructions are followed for the required time for proper use and resident safety. Although staffing levels are more stable now the home must make sure that rotas are done in a way that does not allow periods of time in the day when staff levels drop. There must always be enough staff available to provide prompt assistance to meet residents needs. 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. George Basterfield House DS0000035198.V291294.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 George Basterfield House DS0000035198.V291294.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose, Service User Guide and terms and conditions of residency provide information for prospective residents to make informed choices about living in the home. An assessment process, care planning system and information from other agencies is in place to provide the information staff need to meet resident’s needs when they come in. EVIDENCE: The home has an up to date statement of purpose and service user guide, including resident views and the most recent inspection report on display in the entrance hall. It is also available in the office. Information on where it can be obtained from is displayed on unit notice boards. These are not available in alternate formats, such as audio or large print for those with sight problems. Individual care plans show that the residents have their personal health and social needs assessed before and following admission to the home and their individual care plans have been developed from this. The home manager or senior staff do an individual assessment of needs in addition to social services care management plans to try to ensure that the home will be able meet those
George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 10 needs before residents come to live there. The home has an eight week introductory period followed by a review to make sure needs are being met and the home suits the resident. Residents are provided with terms and conditions of residency so they are aware of their rights and responsibilities. George Basterfield House DS0000035198.V291294.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A care planning and review system is in place and the personal, social and health needs of residents are being met and privacy respected. Despite significant improvements the recording of some aspects of medicine administration needs further improvement to fully safeguard residents. EVIDENCE: All residents have an individual care plan, based on initial assessments and risk assessments, setting out assessed health, social and personal care needs and these are being reviewed and updated. Specific healthcare needs are being identified at assessment and residents said they are asked about their care by staff and care staff answer their questions. Staff spoken with are aware of residents care needs and their preferences. One resident explained how the staff had helped her “get going again” with mobility when admitted. The home has been reviewing its medication practices and made significant improvements in practices. There are protocols in medication records for staff detailing requirements for using ‘as required’ medicines and a system for following up medication queries. This improves meeting some resident’s health care needs in regard to specific medical conditions. However a resident with a
George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 12 monthly injection, given by the district nurse, did not have this included on the medicine chart, to provide an up to date record of medication for that person. The supervisor contacted the pharmacy and was able to put this in place during the visit and this needs to be consistent. Most medicine charts are printed by the pharmacy but a handwritten one did not make it clear who the author was or if it had been checked by a second person for accuracy. One resident on medication, administered by night staff, requiring specific actions for a period of time after administration did not have the time of administration recorded on the chart. Staff following on will not know the timescale since administration unless it is recorded on the chart. The records for medicines administration, receipt and disposal are clear, storage and stock levels are satisfactory and the handling of controlled drugs is satisfactory. Observing staff indicated they are polite and respect individual’s wishes and privacy. Residents confirmed that staff explained what they were doing when helping them and “are helpful” and one resident said they had “never been so well treated in my life”. Residents confirmed they saw relatives, other visitors and doctors and nurses in private. George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides some social activities within the home and outside, the staff support residents to maintain their own affairs, outside contacts and interests. There is variety and choice in the food on offer and special dietary needs are catered for. EVIDENCE: Regular organised activities, musical events and religious services are provided and the month’s activities advertised on the notice boards within the home. Religious preferences are recorded and there is a multi denominational service held monthly although some people see their own ministers. Care plans contain some information on resident’s hobbies, interests and individual religious preferences. Residents said that they could come and go as they pleased, take their meals where they preferred and staff assisted them as they wanted. Information is available on advocacy services and dealing with pension problems. When asked residents spoken with did not know that they could see records kept about them. The supervisor and a carer have responsibility for coordinating the activities and are actively developing this aspect of the service. Staff on the different units do individual and group activities and chat with residents as their work
George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 14 allows. One resident said how much they had enjoyed the Easter activities and comments from a relative showed they had felt included in that social occasion. This relative praised the hard work of the staff in organising such events and a recent plant sale. The minutes of residents meetings show the subject of trips out has been discussed and menus. Residents spoken with confirm this. Trips out locally are now taking place on a more regular basis. One resident spoke of looking forward to celebrations for the Queen’s birthday. Menus have been discussed at the residents meetings and residents confirmed the quality of food provided. One resident said that they have started to put weight on now because they are getting regular meals and confirmed they are offered drinks throughout the day. More than one resident said the food was “ good” and that they enjoyed it and always had a choice. The lunchtime meal offered a choice, was well presented and unhurried. Residents did not make any complaint about the lunch when asked. One resident had a late lunch, as they had wanted a “lie in”. The menus provided showed a nutritious and varied diet that residents had been able to comment on. The home has developed a “Friends of George Basterfield” group of relatives and friends to support the home and residents in putting on events and participate in the life of the home. George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure available within the home and a system in place for logging and responding to complaints. There are satisfactory adult protection processes in place to help protect vulnerable adults and these and appropriate training are available for staff in the home. EVIDENCE: Since the last inspection the home has completed one adult protection investigation following an allegation of abuse. The correct procedure was followed using multi agency guidance and it has been addressed by the home with other relevant agencies. The home has a complaints procedure and a system for logging complaints for investigation and the procedure is available to residents on the units and in the service user guide. However it is not available in alternative formats such as large print or audio. Residents spoken to said that they knew who to speak to if they were not happy, usually their key worker, carers or the supervisor. Those spoken with felt confident staff would listen and “do something” if they were unhappy. Two residents commented they did not know who the manager was. Advocacy services are available to residents if they want someone to act on their behalf and information on this is displayed. Staff records show they are given training and information on adult protection, on dealing with suspicions of abuse and on dealing with aggression to promote resident’s safety and well being. Multi agency guidance is in use with adult protection procedures. Staff spoken with confirmed they had received training
George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 16 and were clear on what they would do, in the first instance, if they thought someone was being abused in the home. The home did not deal with any resident’s personal finances only small amounts of spending money for safekeeping and practices and procedures are in place to protect resident’s financial interests. George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, tidy, homely and adequately maintained for residents and has the equipment they need to promote mobility and independence. EVIDENCE: There is a programme of maintenance and improvement for the home planned and agreed annually within the organisation. Contracts were in place for care of the gardens. The dining and lounge areas on the units are clean, homely and well decorated and used for daily activities, and some residents were sitting in them reading their papers, knitting and watching television. There are telephone facilities available for residents to use. Resident’s bedrooms seen by the inspector had locks for privacy, satisfactory decoration and suitable lighting, ventilation and furnishings. Many residents had brought in their own personal possessions and this made their rooms more personal and homely.
George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 18 The home has policies and procedures for infection control in place supported by staff training. One resident commented that they would “highly recommend the cleaners”. The laundry facilities are clean and tidy and systems in place to minimise risks from Legionella and test water temperatures are being done to minimise risks from scalds. A schedule of shower -head cleaning is also in place. Sluices were tidy and kept locked as cleaning substances are stored there There is a range of mobility equipment and adaptations in the home to help residents make the most of their independence and to get about the home. One relative commented that their relative’s bedroom is always clean and the bedding changed regularly. George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing deployment is not always good as there are times of the day when staff levels are low in regard to meeting residents assessed needs. There are satisfactory recruitment procedures being followed to safeguard resident and appropriately trained staff offering care to residents. EVIDENCE: After a period of staff shortages the rotas suggest the home now has more stable staff levels. Rotas on the day of the inspection showed adequate supervisor cover using relief staff being maintained despite being one down. There were periods of time on the day of the visit, on an EMI unit, when there is one carer rostered on duty on the unit. This is half hour period in the morning and a period of 1 hour before night staff come on duty when there is only 1 carer based on that unit. The staff member on duty confirmed that help was available from staff on other units if they needed this to deliver assessed care. A resident spoken with who needed the assistance of 2 carers for aspects of personal care said that they often had to wait for 2 people to attend to them and that often that was “too late”. Assessments in place indicated 2 staff are needed for some personal aspects of this and other resident’s care to meet their needs. The home must make sure that staff are deployed in a way that does not allow periods of time when staff levels are low and that there are always enough staff available to provide prompt assistance. Residents spoke well of staff approaches and how hard they work. One resident said that staff “are marvellous and have really helped me”, referring to her improved mobility whilst in the home. However some resident surveys
George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 20 and comments indicate that there are times when staff are not available or busy with other tasks when they need them. The number of staff with NVQ Level 2 in care meets the 50 level required and staff spoken with felt supported in achieving this and are well motivated to take on training and to progress in their NVQ qualifications. The homes recruitment practices are in good order and appropriate procedures and checks are being carried out. The training and staff development files indicate forward planning for training needs and updates and satisfactory recording of training undertaken including induction. George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has quality systems to see if it is meeting its aims and promoting residents best interests and maintains satisfactory records required for their protection. There is a part time registered manager in post and the management approach to staff is supportive. There are procedures and systems in place to safeguard resident’s welfare. EVIDENCE: There are quality monitoring systems and procedures in place in the home. Regular staff meetings allow staff feedback, there are internal reviews of policies and procedures and staff appraisals are being done. Residents said that they see the supervisor every day and could raise issues with her or their key worker. Two residents did not know who the manager was by sight. There are records of residents meetings taking place in the home, the topics residents wish to discuss and minutes of the meetings. The home is doing
George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 22 satisfaction surveys for residents, families and health care professionals. These are collated and issues raised are acted upon. Staff spoken with felt that the manager was approachable and supported them. There is a development plan for the home within the overall organisational plan for 2006-7, setting targets and objectives and a strategic action plan. Policies and procedures are produced and reviewed centrally across the organisation. Formal staff supervision is being done and records kept, the long term absence of a supervisor has meant some staff have fallen behind but the home has acted to remedy this. The standard of record keeping and organisation of information is satisfactory. Policies and procedures are in place to protect resident’s financial interests and to safeguard spending money given to the homes for safekeeping. There are health and safety procedures in place to promote the interests and safety of residents and records of fire and other mandatory training, fire drills, equipment testing and the servicing of equipment and appliances. The home has a job share for its registered manager post. The home does have a part time experienced registered manager but the other manager, who has been working in a management post for 6 months, should apply for registration promptly if it is their intention to work in the role of a registered manager in the home. George Basterfield House DS0000035198.V291294.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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 3 X 3 3 3 3 George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Requirement The registered manager must ensure that • Hand-written Medication Administration Records are signed, dated and double checked. • Resident’s medication administration records include all current medication. This was to have been met by 01/03/06. Timescale for action 17/07/06 2. OP9 13 (2) 3. OP27 18 (1) The time of administration for 17/07/06 medication that must be given before food and other medicines and with specific instructions following administration must always be recorded. At all times there must be staff 17/07/06 available and deployed in sufficient numbers appropriate to meet the assessed health and welfare of residents. George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP1 OP14 OP16 OP31 Good Practice Recommendations The home should consider making its statement of purpose/service user guide available in different formats. Residents should be made aware of their right to see records kept about them. The complaints procedure should be available in different formats. Applications for registration for the job share management post in operation should be done promptly if they wish to work in that role. All residents should be aware of who manages the home they live in and identify them. 5. OP32 George Basterfield House DS0000035198.V291294.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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