Inspection on 12/12/05 for Greenhill

This inspection was carried out on 12th December 2005.

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

Greenhill 06/06/08

Greenhill 12/06/07

Greenhill 16/06/06

Greenhill 27/06/05

Greenhill 08/03/05

Greenhill 10/12/04

Greenhill 26/01/04

Greenhill 16/09/02

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOMES FOR OLDER PEOPLE Greenhill Wagon Road Potters Bar Hertfordshire EN4 OPH Lead Inspector Hazel Wynn Unannounced Inspection 12th December 2005 18:30 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 Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Greenhill Address Wagon Road Potters Bar Hertfordshire EN4 OPH 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) 0208 449 8849 0208 449 6343 B & M Investments Limited (Trading as B & M Care) Care Home 67 Category(ies) of Dementia - over 65 years of age (16), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (67), Physical disability over 65 years of age (3) Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: Greenhill is a care home providing personal care and accommodation for 67 people aged over 65 years and who may have a physical disability and/or dementia. No other categories apply and, therefore, the home cannot provide nursing care nor a service to people who have mental health problems other than dementia. Set in extensive, and well-kept grounds, Greenhill is a very attractive old detached manor style house, which has had various extensions and an annexe has been added. The property has been sensitively adapted, whilst maintaining its numerous and attractive features, which include a bar and large hall with seating for several people. There is a passenger lift. The majority of the homes rooms provide single occupancy, two offer shared accommodation. Most of the rooms have an en suite. There are four communal bathrooms in use. The upper rooms and gardens provide wonderful views as far a-field as London Wharf, and are easily accessible. There is ample parking space within the grounds and Potters Bar Town Centre is a short car journey of approximately two miles. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 12th December 2005. The home was able to evidence that most of the National Minimum Standards had been met and that the overall quality of care provided was good. The CSCI spoke to 8 of the service users and one relative who stated that they were satisfied/very happy with the service provision and especially with the care staff team and the quality of food served; she felt that staff were kept very busy with 5 care staff at night providing for up to 67 service users. There are also two senior care staff on duty at night but they are less hands on mainly supervising, delegating and doing medication and administration work. The same relative also felt that not all of the activities provided suited her father’s preference. There is a satisfactory programme of activities on the notice board in the hall but the service user does not avail himself of many of them. On the night of this inspection there were 58 service users at home with some in hospital. Three requirements and six recommendations were made. The requirements related to management of medication and the need to appoint a manager and apply for registration of the manager appointed. The inspector looked at records, systems in place and made general observations. The inspector interviewed staff and met with the acting manager during the inspection process. One requirement regarding the dating of medication on opening has been brought forward this time; other requirements and recommendations from the last inspection had been met. Service users were, overall, very happy with their care and participated valuably in this inspection, as did the care staff and acting manager. The service users stated that they receive a very good service and have good relationships with the staff. The findings published in this report are a snapshot of the evidence gained on the day of the inspection. What the service does well: The service provides a friendly atmosphere and the home is attractively maintained, clean and comfortable. There is a large conservatory overlooking beautifully maintained gardens and an additional large lounge on the ground floor with alternative communal areas on the upper floor. Fresh, seasonal and local produce and good quality meat products are used to provide meals. The home has a warm and inviting atmosphere. Advocacy is provided when needed by referral to age concern who will provide advice where required. Policies, procedures and protocols are in place to safeguard and offer protection to service users. A satisfactory training programme is in place with ongoing training and updates (although some additional training is needed, see the section ‘What they could do better’). Progress is being made with care staff undertaking NVQ level 2 and the acting manager plans to enrol for level 4. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Currently, an acting manager, who appeared very committed, enthusiastic and knowledgeable about the management of care, manages the home. A manager must be appointed and an application made for the registration of that manager. Care plans were examined and it was found that improvements were needed; the lack of training in care plan training was obvious. All care staff writing care plans need to be trained so that there is a consistent approach on how care needs are met. The medication storage room was too warm and medication could deteriorate rapidly at the temperature the medication was stored at (26°C). Lactulose should be stored at a temperature no higher than 20°C. The acting manager stated that a new storage provision is already in the pipeline as the storage room is far too small for effective and efficient management of the system, but in the meantime interim measures must be taken to cool the present storage arrangement immediately. The acting manager stated that she would be able to purchase a cooling unit the day after this inspection; as long as this would cool the area to a satisfactory temperature this action would suffice until the new area is ready. The temperature of the room must be recorded daily. In sampling medication stored it was evidenced that not all medication was dated on opening and a requirement was made. The acting manager has started providing formal supervision but not all staff were receiving this with sufficient frequency of at least 6 times per year. The acting manager would not be able to manage the formal supervision workload and it was recommended that training in supervision is provided to sufficient numbers of senior staff to meet this task (i.e. two more to be trained on the day shift and two more on the night shift). It would also be best practice to provide a supervisee course for the care staff. When providing a trainer for supervision training it is found to work best if the same trainer provides the care plan training. If the requirements and recommendations are met the already good standards (in most areas) will be pushed to a much higher level within quite a short time frame. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 5. Standard 6 is not applicable to this home. Full and comprehensive assessments are carried out and placement is only offered if the needs of the individual can be met. Service users are provided with the information and opportunity to satisfy them that needs can be met. Visits prior to moving in are encouraged so that service users and their representatives are happy with what the home has to offer. EVIDENCE: One care plan was fully tracked at this inspection; the original assessment had been reviewed in light of changing needs and the care plan had been updated (although see the summary of this report regarding what they could do better) The service user and/or their representative is fully involved in the assessment process. A relative stated that they were advised and invited to visit the home and had found this reassuring and they had also been given a welcome pack/service user guide. Both parties signed an agreement in respect of the service to be provided and a copy was on the file sampled. Service users stated that their needs were well met by a friendly and caring team. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 10 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 The individual care plans include the service users’ health, social and personal care needs; assessed needs are met. Service users would be supported to selfadminister medication where appropriate; improvements are needed regarding the storage and management of medication. Service users are treated with dignity and respect in this home, and their right to privacy is upheld. EVIDENCE: One care plan was thoroughly tracked; the care plan were up to date but it was difficult to evidence in the recording that needs are being met, reviews are regularly but because the care plan was poorly written it did not provide evidence of reliability. Service users stated that they felt that their needs were well met. The entries in the progress notes did not always relate to the care plan formed from the assessment. A recommendation for care plan training has been made. The service users spoken with during this inspection praised the home and staff for the provision of good care, a comfortable environment, and a warm, friendly and professional approach to meeting their needs. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 11 The service users verified that they felt they were treated with dignity and respect and that their rights to privacy were upheld. Protocols are in place for service users who would be able to self-administer medication. The storage of medication was not satisfactorily as the storage area was far too warm. A requirement was made for medication to be stored in accordance with the pharmaceutical company’s guidance (Lactulose must not be stored at a temperature above 20°C and the room was 26°C). The acting manager stated that a new storage was in the pipeline for medication storage as the area was extremely cramped. In the interim period an immediate action was required to cool the temperature to the storage room and the acting manager stated that she would purchase a cooling unit the following day; this would satisfy the requirement, during the interim period, if the correct temperature can be achieved by such unit. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 12 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 - 15 The lifestyle experienced by service users in the home is generally in keeping with expectations, preferences satisfying social, cultural, religious and recreational interests and needs (although there was one possible exception). Contact with family/friends/representatives and the local community is maintained and supported. Service users are helped to exercise choice and control over their lives (but see recommendations re the writing of care plans). Service users receive a wholesome, appealing and well balanced diet in pleasing surroundings and mealtimes are flexible to meet needs. EVIDENCE: There is a satisfactory activities and entertainment programme and the activities and entertainments programme is posted on the communal notice board. Staff stated that they remind service users about activities and entertainments as they come close to starting. One service users daughter stated that perhaps there could be more activities available but staff are kept very busy; her father did not choose to attend all of the activities arranged, as they were not all to his preference. Other service users spoken with by the inspector were happy with the programme of activities and entertainment. Some of the service users enjoy getting out to the local community facilities and resources and do so with family and sometimes with staff (the latter is more likely in fairer weather and when staffing levels permit this). Service users and one relative stated that visitors are always made very welcome and Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 13 there are no restrictions on visitors who the service users are happy to see. Local clergy provide religious services in the home for those who wish to attend and service users who are able to do so or who can be supported to attend the local church if they wish. Service users stated that they felt that they had control and choice over their lives (with the exception of being impeded by frailty) but the care plans could add to evidence if they were better recorded. The menus provided good evidence of a wholesome and varied diet and service users were complimentary regarding the chef’s efforts to provide enjoyable meals. Some of the service users said the chef is very nice and comes to talk to them about the food and makes lovely cakes. The dining areas are comfortable and flexibility regarding meal times is provided either on request or if staff are aware that a service user needs a meal beyond the set mealtimes. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 14 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 Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: The home has a complaints procedure in place and service users and their representatives are provided with a copy prior to their admission. A copy of the complaints procedure is also posted on the notice board in the main corridor. In the last report the CSCI recorded that the registered manager (in post at that time) had taken full and proper action to protect service users regarding an issue and had followed through with POVA procedures. Service users spoken to stated that they were aware of how to make a complaint and that the staff would sort out any problem for them and would make sure everything was ok for them. Abuse awareness training is in place for staff right from the induction stage and staff stated that they attend updates to keep them reminded of the whistle blowing policy and how to spot signs of possible abuse and what they must do if they suspect abuse. The training programme also provided evidence that abuse training is well scheduled. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 15 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 and 26 The home is well maintained with safety measures in place. The service users have access to safe and comfortable indoor and outdoor communal facilities and there are sufficient and suitable lavatories and washing facilities (with refurbishments underway). The service users own bedrooms are comfortable and well furnished and they have there own personal possessions around them. The home is comfortable, pleasant, clean and hygienic. EVIDENCE: During this inspection, the home was seen to be well maintained. It was clean and fresh with no mal odours detected. The extensive and beautiful grounds are also very well maintained and are of special interest and pleasure to most of the service users. Infection Control systems are in place. The general layout and location of the home are suitable for the service user group. One bathroom and a toilet had been refurbished. There is provision of a specialist bath to support service users who require full assistance. Further refurbishment of bathroom and toilet facilities has been scheduled. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 16 The CSCI inspector noted that specialist equipment was in use to aid independence and that service contracts are in place to ensure equipment is kept serviced. Manual handling training for care staff was evidenced on the training programme; by certificates on staff files and staff also stated that they had attended their updates in mandatory training. A fire safety contractor maintains fire safety equipment and regular drills and safety checks were recorded. Health and safety policies and procedures are in place and staff attend health and safety induction training and training updates on a rolling programme. Service users own rooms are comfortably furnished and meet their needs and they are encouraged to bring in personal possessions to create ownership and additional comforts. The home was seen to be clean, pleasant and hygienic during this inspection and policies, procedures and protocols were in place for the control of the spread of infection. Evidence was obtained from discussions with staff, from certificates and the training programme that staff are provided with food hygiene training. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 17 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 - 30 Staff are kept very busy in order to meet service users needs and some skills (supervision training and care plan writing skills) are lacking. Service users are in safe hands at all times and they are supported and protected by the home’s recruitment policy and practices. Some additional training is required to support staff to be trained and better equipped to be competent in some areas of their work. EVIDENCE: A relative and some of the service users stated that staff are kept extremely busy to meet their needs and that sometimes they have to be patient when waiting for a need to be met; the inspector also observed at this inspection that staff were too busy to pause for long with the service users they were supporting although they provided gently and patiently for their needs with proper handling. There were 58 service users at home during this inspection and the home has the capacity to meet the needs of 67 service users a proportion of who have high needs. There were five care staff on duty and two senior carers who mainly supervise, delegate and manage medication duties and administration duties; they will help out where they can. The staffing levels need to be kept under review as service users’ needs change and the likelihood of a greater proportion of service users with higher needs increases. It is recommended that this should be reviewed as part of the proprietors visit and outcomes then recorded as part of the proprietors visit report under regulation 26 to the CSCI each month. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 18 The home does adhere to its robust recruitment policies and procedures and a recent recruit was being closely shadowed and did not have access to service users in a lone situation whilst her CRB application was being processed. A POVA check had been satisfactory for this recruit and good references had been received, her curriculum vitae revealed no gaps in employment and one of her references was from her last employer where she had been employed as a carer. The carer’s recruitment file was scrutinised closely at this inspection by the CSCI. Staff are provided with training to provide a safe service (generally but see requirements and recommendations) to the service users and policies, procedures and protocols are in place to safeguard and protect service users and staff (supervision training and care plan writing skills training is a need). Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 19 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 Standard 31 is not met although an acting manager is working hard to cover the duties of a registered manager and presented as having a good ethos, ability to lead and ability to manage appropriately. In most areas the home is run in the best interests of the service users and their financial interests are safeguarded. Although great efforts are made by the acting manager not all staff were appropriately supervised. The rights and best interests are safeguarded in the main by the home’s record keeping, policies and procedures but there is room for improvement in the requirements and recommendations made in the relevant sections of this report. The health, safety and welfare of service users and staff is in the main promoted and protected but again, there is room for improvement in the requirements and recommendations made in the relevant sections of this report. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 20 EVIDENCE: The inspector discussed the outcomes of this inspection with the acting manager and during this discussion, the acting manager presented as having a good ethos and staff had stated that she is approachable and monitors the service enthusiastically. During this inspection it was evidenced that in some areas she is not provided with the tools to meet the tasks demanded of her more effectively and efficiently. Not all staff had received regular formal supervision; the supervision schedule was seen and it was evident that the acting manager had made a brave attempt to provide formal supervision for as many staff as was possible but it is an impossible task for her to provide reliable supervision for the whole staff team. A recommendation was made for supervision training to be provided to at least two more senior staff on the night shift and two more staff on the day shift. It would also be best practice to provide supervision training to supervisees. A sampling of the care plans provided evidence that care plan training is a need and care staff should be provided with training in order to be able to produce a reliable care plan that not only reflects the assessed need but provides clear information on how the needs are to be met for consistency of approach. Throughout this report there is evidence that the home is generally being run in the best interests of the service users and if the requirements and recommendations are met the standards in this home will no doubt be raised to a much higher level. The care team and acting manager demonstrated good ethos, commitment and enthusiasm regarding their role and service users and a relative were very complimentary about their approach and input. Service users are provided with safeguards in connection with their financial interests. Only small amounts of cash are held for some of the service users and this is transparently accounted for. For the majority of costs the head office invoices service users and those service users who no longer manage their own finances have an appointee/relative with power of attorney who arrange to settle their accounts. There is a policy and procedure in place in respect of service users finances and also to protect service users from any financial abuse; staff are prohibited from accepting gifts above a very small token. The records, other than the care plans are generally well maintained and policies and procedures are in place to promote and protect the health, safety and welfare of service users and staff; procedures regarding medication were not entirely satisfactory and requirements were made (see earlier in this report). Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 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 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 2 2 X 3 1 2 2 Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 Requirement Medication must be dated on opening (It will not be possible to date medication already opened and partly used but all medication in future must be dated on opening. Medication must be stored at a maintained temperature suitable to prevent deterioration. A suitable individual must be appointed to manage the care home. A suitable individual will have all of the skills required in OP36 Timescale for action 13/12/05 2. 3. OP9 OP31OP36 13 8(1) 13/12/05 31/01/06 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 OP7OP8 Good Practice Recommendations Provide care plan training to staff to enable them to write care plan actions that provide consistent guidance to meet service users’ needs and ensures that reviews and tracking of the meeting of care needs is reliable. Consider using the DS0000019415.V270889.R01.S.doc Version 5.0 Page 23 Greenhill 2. OP27 3. OP30 4 5 OP32 OP33 6 OP37OP38 same training provider for training in care plan skills as for the provision of care plan training. Continue to review staffing levels to ensure changing needs can be adequately met. Include the service users feedback in gathering evidence of the meeting of needs and include this information in the proprietors visit reports. Equip sufficient staff with supervision training to provide them with the skills needed to formally supervise staff. Best practice would also see the provision of supervision training to all supervisees. Equip the acting manager with the tools to enable her to manage the team more effectively (by equipping staff with training needs mentioned above. Collate and provide evidence that service users views have been obtained and acted on as part of the proprietors audit at monthly visits and provide this in turn by way of regulation 26 reports to the CSCI. Ensure that care plans are written in a manner that protects and safeguards the service users rights and best interests in relation to the provision of their care according to their needs and preferences and in a manner that provides assurance that their health, welfare and safety is promoted and protected. Guidance on care plans should also provide for the health safety and welfare of care staff when carrying out care provision. Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greenhill DS0000019415.V270889.R01.S.doc Version 5.0 Page 25 - 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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