Inspection on 28/08/07 for Girtrell Court

This inspection was carried out on 28th August 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Girtrell Court 30/06/06

Girtrell Court 06/03/06

Girtrell Court 06/12/05

Girtrell Court 14/01/05

Girtrell Court 06/08/04

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

CARE HOME ADULTS 18-65 Girtrell Court 5 Woodpecker Close Saughall Massie Wirral CH49 4QW Lead Inspector Peter Cresswell Unannounced Inspection 28th August 2007 09:10 Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 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 Girtrell Court DS0000035848.V343836.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 Adults 18-65. 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. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Girtrell Court Address 5 Woodpecker Close Saughall Massie Wirral CH49 4QW 0151 605 1806 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) Metropolitan Borough of Wirral Application pending Care Home 20 Category(ies) of Physical disability (20) registration, with number of places Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named adult over 65 years. Date of last inspection 30th June 2006 Brief Description of the Service: Girtrell Court is a care home for twenty people who have a physical disability. Some of the people who live in the home also have a learning difficulty. It provides permanent accommodation for fourteen people and there are also bedrooms which can be used to provide respite care. Girtrell Court is all on the ground floor and there is plenty of car parking space at the front of the home. There is a large garden – mainly grass – at the rear and side of the building. Everyone who lives in the home has a single bedroom. There is also a spacious dining room and a number of lounges. Everywhere in the home is easily accessible to wheelchair users and there are many aids and adaptations to meet the needs of the people who live there. The home is generally well maintained, and there is a continuing programme of redecoration. Girtrell Court admits people for short term respite care but there are not usually more than two in the home at any one time. Fees for Girtrell Court are £737.50 a week. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced site visit which lasted about eight hours. Before the visit the manager completed an Annual Quality Assurance Assessment (AQAA) which is required by the Commission for Social Care Inspection. The AQAA includes the manager’s own detailed assessment as to how the home is performing. During the site visit the inspector toured the whole building, including a number of bedrooms and spoke to the manager, several members of staff, six people who live in the home, a visiting relative and – very briefly – the responsible individual from Wirral Borough Council. He also observed a staff meeting. A number of the residents completed survey forms. What the service does well: What has improved since the last inspection? What they could do better: Although individual files contain a lot of detail they are not kept in a forma that is easily accessible. The manager has plans to change the format to one which is more useable on a day to day basis. There is scope to organise more activities, especially if the home were to have its own transport. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 6 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. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Quality in this outcome area is good. The assessment process ensures that the needs of people considering moving into the home can be met. Enough information is provided to help people make a choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Girtrell Court has an easy to read service user guide which includes illustrations to help the reader. The guide is kept in the reception area so it is readily available to anyone living in or visiting the home. Before anyone is admitted to the home the manager carries out her own assessment in addition to the assessments received from Wirral Social Services care managers. This includes people who stay in the home for a respite break. During the site visit a family visited the home to see if it would be suitable for a respite break and were made very welcome by the manager and the staff. Contracts were in place on all of the files seen during the inspection. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10. Quality in this outcome area is good. Care plans set out service users’ needs – though they could be made more accessible - and are, on the whole, regularly reviewed, ensuring that care is based on their current needs. The people who live in the home play a full part in making decisions about matters that affect them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Everyone who lives in the home has a care plan based on the assessments made at the time of their admission. The care plans are reviewed every six months and the reviews are comprehensive, involving the service user, relatives, staff and other professionals where appropriate. Key workers organise the reviews but in one of the cases examined there had been no review since March 2006. The manager said that she had become aware of this and was now organising the review herself. A schedule of review dates would allow the manager to ensure that reviews are held regularly. In this instance, it was evident that the individual’s changing needs were, in any event, still being met. The care plans cover areas such as personal care, communication skills, culture and religion and other areas of care. The individual plans for each element were, however ,scattered throughout the files and could not readily be used as a guide to practical everyday action. Nor was it apparent that they had been updated following reviews, though the reviews themselves were well documented and followed up with an action plan where Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 10 necessary. The files were full of useful information, but clearer, more easily updated care plans which contain a summary would be of more practical use on a day to day basis. Daily reports are made up to three times a day in a loose leaf file, but there are no care plan summaries attached to the review sheets. This can help to focus staff on the elements of the care plan when they are making their daily notes. The shift handover/communications book contained some personal details which should have been restricted to the individual file or other confidential document. The communications book can then be used as a ‘signpost’ to where the (in this case very important) information can be found. The people who live at Girtrell Court play a full part in decisions about their own lives and the running of the home. Regular meetings are held, where they can discuss activities, meals and other subjects of interest. Recently the residents voted for a large screen television in the main lounge and one was subsequently purchased. During the site visit two people were meeting an officer from a housing association about their plans to move into their own home in the community, where they will receive appropriate support. Staff at Girtrell Court are fully involved in the proposed move and helping the people in question to prepare for the change. People are encouraged to take appropriate risks, according to their abilities, and full risk assessments are on file. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17. Quality in this outcome area is good. Service users are able to take part in activities that they enjoy. There is a healthy diet at the home and people who live there enjoy their food. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Everyone who lives at Girtrell Court is encouraged to develop their interests and personal life. For instance, as described in the last section, at least two people are currently being supported in moving into their own home in the community. Most people attend a social services day centre two days a week. Service users take part in a range of other activities including some trips out, parties, games and ‘film evenings’ with the widescreen TV. The home does not have a dedicated activities organiser and no volunteers visit the home. The advantage of an activities organiser is that they cannot be distracted from their task by other duties and can focus on the considerable task of supporting people in taking part in leisure pursuits of their choice and organising people to help with them. The home does not have any form of transport to take its service users out on trips and would no doubt benefit from the use of a minibus which could accommodate wheelchairs. Merseytravel’s ‘Mersey Link’ service is sometimes used but has not proved to be completely satisfactory, especially as it appears, curiously, unwilling to travel across to Liverpool. This Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 12 restricts, for instance, people’s ability to go to football matches unless they support Tranmere Rovers. The owners – Wirral Borough Council - should address this issue, either by sorting out its own transport or speaking to Merseytravel. Activities are not well recorded and there was no record of any activities since 24 July. This does not of course reflect the real situation and it is important to record activities and who took part in them, partly to enable staff to plan future activities on the basis of evidence of who enjoys which particular activity. The home recently had a party to celebrate the fact that two people have lived at Girtrell Court for 25 years – when it opened. Everyone said that they had a wonderful time at the party, which was attended by friends, relatives and the Mayor of Wirral. People go out into the local community; several service users for instance, go o the local pub. The home is set apart from local housing but the manager said that on the whole they have good relations with local people. Minor issues with local youths have been addressed by speaking to them. Families and friends are welcome in Girtrell Court and several visited during the site visit. In a survey form one service user said that ‘my mum comes (to Girtrell Court) and is welcomed’. No volunteers do any work at Girtrell Court. The main meal of the day is served at tea time (early evening) and there is always a choice available. The inspector joined some of the service users for lunch, when there was a choice of beans on toast, sandwiches and salad. Staff often eat with the residents in the bright, spacious dining room and this helps to create a real sense of community. When anyone needed help with their food this was done discreetly and with care. There is also a choice of meals at tea time and the menu occasionally includes meals such as curry or chilli, at the request of some of the residents. On the day of the site visit one of the cooks was making home made fairy cakes for dessert. The manager and a member of catering staff recently went on a course on ‘Healthy Eating’. As a result of some of the information they got on the course, and after discussion with the residents, the home has introduced healthy eating principles into the menu. This includes decaffeinated drinks, grilling food rather than frying it, more fruit rather than stodgy puddings etc. The manager feels that the new diet has had a beneficial effect of many people’s health and mood. Everyone who spoke to the inspector said that they enjoyed the food in the home. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21. Quality in this outcome area is good. Personal support is provided as service users prefer. Medication procedures protect service users’ safety and welfare. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People’s personal needs are set out in the care plans and care is given in the privacy of their own rooms or in the well equipped bathrooms. Service users have access to all community and specialist health services. Details of medical appointments and specialist reports were on all of the files examined during the site visit. One person looks after his own medication. A risk assessment was on file and the medication is kept securely in his room. There is a spacious medication room and support workers, who have been appropriately trained, administer medication. The home uses a monitored dosage system in which most tablets are supplied by the pharmacist in dedicated blister packs. Medication for three people was checked during the site visit and were found to be in order apart from one tablet which was still in the blister pack although it had been recorded as having been administered. Some Warfarin tablets not included in the monitored system were difficult to check and the support worker in charge of the medication at the time has applied for it to be included in the monitored dosage system which will clarify matters. Where medication is to be administered ‘as required’ (PRN) there should always be information available Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 14 as to the precise circumstances in which it is to be given. There is a controlled drugs cabinet and some medication is kept in there for additional security but there were no controlled drugs in use at the time of the site visit. The manager and her staff are reviewing the information kept on issues around death and dying and this was discussed at the staff meeting on the day of the site visit. People who live at Girtrell Court will be allowed to stay there for as long as the home is able to meet their needs and they want to live there, no matter what their age. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. Service users are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users said that they know who to complain to should the need arise. Girtrell Court uses Wirral Borough Council’s complaints procedure. No formal complaints have been received during the past twelve months. Staff are trained in Safeguarding Adults and there are appropriate procedures in the home. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. Quality in this outcome area is good. Service users enjoy a spacious, accessible and clean environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Girtrell Court was purpose built for people with disabilities and is very well equipped. Every part of the building is accessible to wheelchair users and specialist equipment such as Parker baths is available. Every room has ceiling mounted electric lifting equipment and bedrooms and bathrooms have electronic locks which are accessible to everyone. Everyone living in the home has a spacious single bedroom; some of them are particularly large. All have specialist beds. There is a number of communal spaces and the main lounge has a large flat screen television which is wall mounted to make sure that everyone can see it. Many individuals have their own large televisions and other leisure equipment in their rooms. A handyman is employed to carry out routine maintenance and the home is generally well cared for, though there is evidence of wear and tear caused by wheelchair use. Individual rooms are decorated in accordance with the individual’s wishes and communal areas are in the process of being redecorated. The garden is huge, mainly consisting of a lawn which might be used more if it was slightly better maintained. Barbecues are held in the back garden when the weather allows Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 17 – not too often this summer. Residents who want to smoke can do so in the conservatory. There is a small residents’ kitchen which can be used for people preparing for more independent living. The home employs domestic staff and the building is clean and free from offensive odours. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36. Quality in this outcome area is good. The people who live in the home are supported by well motivated and trained staff. The Council’s recruitment policies and procedures guard against the employment of unsuitable staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Sufficient staff are employed to meet the needs of the residents, though staff numbers have been stretched over the holiday period. The manager can occasionally employ agency staff if required though she prefers to avoid this where possible. Wirral Borough Council is developing its own bank of staff to cover shortfalls. During the daytime there are four or five care and support staff on duty in addition to the management team. At night there are three waking staff. In addition to two deputy assistant managers there are 24 care staff (divided into ‘care staff’ and ‘support workers’). For three people there are particular packages in place to provide one to one support and this is done via agency staff who complement the home’s own staff. The agency staff appeared to be well integrated with the Council staff and knew other residents as well. There is a training programme in place and recent courses have included Safeguarding Adults, Risk Assessment, Managing Challenging Behaviour and Recruitment. All staff either have an NVQ or are studying for one, with the exception of two staff who are later in their careers. The home does not yet meet the target of 50 of care staff with NVQ or better. The course on healthy eating has led to the changes described in an earlier section, evidence of the benefits of good, imaginative training. The manager said that Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 19 all staff receive regular updates in Moving and Handling (‘Load Management Theory and Client Handling Techniques’). The manager said that the home seeks to promote inclusion and equality and staff discuss issues around cultural diversity in a manner appropriate to the understanding of the resident.’ Wirral Social Services has a range of policies and initiatives to promote equality and diversity. Staff are not allowed to start work until Criminal Records Bureau (CRB) clearance is received. This information is kept by the Borough Council’s Human Resources section. Recruitment files were checked and all contained references and applications. It would be useful to keep a checklist of when clearance is given by the Council for staff to be employed, together with the number of the CRB certificate. If the CRB reveals a criminal record the applicant is interviewed by the Human Resources section and any relevant information is shared with the manager. The people who live in the home are not involved in the recruitment process and this is under consideration. The manager might find it helpful to speak to other services that have already introduced such a system. All staff receive regular one to one supervision. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42. Quality in this outcome area is good. Service users are protected by effective health and safety policies and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager has left since the last inspection and a new manager has been appointed. She has been working in the home for several months now and was previously registered to manage another Wirral Borough Council home. She is in the process of applying to be registered by the Commission for Social Care Inspection and this should be submitted without delay. Staff are committed to the welfare of the people who live in the home and work as a team. There was a positive and friendly atmosphere in the home and staff said how much they enjoyed working at Girtrell Court. Although service users’ views are obtained from meetings there is no formal quality assurance procedure in place, using, for instance, surveys of residents and relatives. However, the responsible individual visits the home regularly and completes reports in accordance with Regulation 26 of the Care Homes Regulations. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 21 One person’s bed has a ‘bedleaver’ bar which is designed to help someone get out of bed. There was no risk assessment in place of this piece of equipment. A risk assessment based on advice from the Medicines and Healthcare products Regulatory Agency must be put in place as these products can cause accidents if not used properly. Safety checks are carried out regularly and fire safety checks were up to date. There had recently been a ‘Legislative Compliance Audit Report’ by an external body on the home’s whole heath and safety procedures. The kitchen was clean and well organised though one or two flavourings were out of date. Dry stores should be routinely checked to make sure that nothing is kept beyond its use by date. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 4 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 x x x 2 Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA42 Regulation 13(4) Requirement The registered person must ensure that unnecessary risks to the health and safety of service users are avoided and must therefore carry out a risk assessment on the use of the ‘Bedleaver’ bar in the identified service user’s room. Timescale for action 01/10/07 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. Refer to Standard YA6 YA10 YA14 Good Practice Recommendations Care plans should be regularly reviewed and updated and should be kept in a form which is readily useable and understandable by staff caring for her person concerned. Confidential information should not be kept in the handover/communications book. A record should be kept of activities in which service users take part. The appointment of a dedicated activities organiser would help to extend the range of activities that service users take part in. Where prescribed medication is to be taken ‘as required’ (PRN) there should be clear instructions as to the DS0000035848.V343836.R01.S.doc Version 5.2 Page 24 4. YA20 Girtrell Court 5. 6. YA32 YA34 7. 8. YA39 YA42 circumstances in which the medication should be administered. The programme of training to ensure that over 50 of care staff have NVQ should continue. Evidence of when CRB certificates are received should be kept in the home as well as centrally. The home’s recruitment process would be improved by the involvement of the service users. Girtrell Court’s quality assurance procedures would be improved by the use of service user and relatives surveys. Dry food stores should be checked regularly to make sure that no ‘out of date’ items are used. Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Girtrell Court DS0000035848.V343836.R01.S.doc Version 5.2 Page 26 - 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. 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