Inspection on 02/11/05 for 2 & 10 Grove Road

This inspection was carried out on 2nd November 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2 & 10 Grove Road 21/05/08

2 & 10 Grove Road 04/05/07

2 & 10 Grove Road 26/04/06

2 & 10 Grove Road 16/06/05

2 & 10 Grove Road 26/07/04

2 & 10 Grove Road 12/03/04

2 & 10 Grove Road 05/09/03

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

CARE HOME ADULTS 18-65 Grove Road, 2 & 10 Kings Heath Birmingham West Midlands B14 6ST Lead Inspector Kerry Coulter Unannounced Inspection 2nd November 2005 10:50 Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 Grove Road, 2 & 10 DS0000016795.V263783.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 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. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grove Road, 2 & 10 Address Kings Heath Birmingham West Midlands B14 6ST 0121 441 3221 0121 441 3541 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) Sense West Vacant Care Home 8 Category(ies) of Learning disability (8), Sensory impairment (8) registration, with number of places Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Residents must be aged under 65 years The home may provide care for up to 8 service users requiring personal care by reason of combined learning disability & sensory impairments 16/6/05 Date of last inspection Brief Description of the Service: Grove Road is located in a small cul-de-sac in a residential area of Kings Heath. The Home comprises of two purpose built properties each accommodating up to four service users with learning disability and sensory impairment. Grove Road is within reasonable walking distance of the main shopping area of Kings Heath, where there are numerous shops, public houses, restaurants, churches and recreational amenities. There is a large park close by and public transport is easily accessible. 2 & 10 Grove Road is on opposite sides of the cul-de-sac. Each house has a lounge and a separate dining room, a modern fitted kitchen and a small laundry room. The administrative office is located at number 2 and the staff sleeping in room at number 10. Number 2 also benefits from a conservatory, which gives additional space. All service users’ bedrooms are of single occupancy and are decorated and furnished to reflect individual interests and personalities. There are bath and shower facilities in the upstairs bathroom plus separate toilets on the landing and on the ground floor. Both homes are comfortable and well furnished and there are many aids and adaptations related to sensory and other disabilities. There are three male service users living at number 2 whilst at number 10 there is a mixed gender group. The service users have diverse cultural backgrounds, which are reflected in the choice of decoration and furnishings. Both properties have rear gardens. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was conducted by one inspector over four hours. This was the second of the statutory inspections for this home for 2005/2006 and not all of the National Minimum Standards were assessed. To get a full picture of the home it is advised to read this report in conjunction with the report from June 2005. Conversations with some of the service users were limited due to their complex needs and limited verbal communication abilities. However, the Inspector met with most of the service users and time was spent observing care practices, interactions and support from staff. A tour of the buildings was made. Service users care plans, risk assessments and a number of Health and Safety records were inspected. The Inspector had the opportunity to talk with the Manager and several care staff. During this visit the Inspector did not have opportunity to speak with relatives and other professionals. What the service does well: What has improved since the last inspection? House 10 had undergone some recent redecoration making it a more pleasant place to live. A new large television with ‘Freeview’ has been purchased for house 10, this gives the service users a greater choice of channels. Progress has been made on recruiting additional staff to ensure that service users are supported by a team of staff who know them well. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 6 The managers have commenced a reorganisation of the administration systems within the home, ensuring that relevant information is available in each house. What they could do better: 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. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5 Individual contracts need to be updated to provide clear and current information. EVIDENCE: The written contract for one service user who moved into the home in March 2005 was sampled. The contract was observed to relate to the home where they previously lived. An up to date contract is required showing clearly the current cost of the service and indicating specifically service user and other parties’ contributions and charges. Ideally, contracts should be signed by the individual concerned, where possible. In cases where individuals are unable to sign, the opportunity for the contract to be countersigned by a relative, friend or independent third party should be seen as standard good practice. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 Not all care plans have been kept under review, this has the potential to cause inconsistencies in the care given to the service user. Service users are supported to take responsible risks, but some work needs to be done on the ways in which risks are assessed and to ensure the assessment is up to date. EVIDENCE: The care files of two service users were sampled. One plan sampled was up to date with evidence of recent review and clearly identified the support required from staff. This included mobility, social and leisure, behaviour, daily living skills, family contact, communication, choice, privacy, dignity, rights, independence, fulfilment, health and self-care. Plans include information about individual’s likes and dislikes, things that are important to them and are in a format that includes pictures and photographs. Evidence was available that other professionals are involved in the care of people who live at the home, for example the Speech and Language Therapist has completed assessments for eating and drinking. It was disappointing that one of the care plans sampled was not up to date. The last two inspections of this home have also identified that some care plans Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 10 required review. Care plans need to be reviewed at least six monthly to ensure that service users are receiving the support they need from staff in a consistent manner. Risk assessment summaries have been completed to give the reader a quick reference to the assessments in place for each individual. Risk assessments were observed to require review for the service user new to the home. This was identified at the last inspection but there was no evidence provided that this had been done. Work also needs to be undertaken to ensure each risk assessment includes the level of risk, ie low, medium or high. Each risk assessment should be directly cross-referenced to the element(s) of the care plan to which it relates, and vice versa, so that the reader is naturally directed from one to the other. One of the outcomes for completing risk assessments and care plans should be that the finished article is a simple and effective working document, in which essential information can be easily found. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 13 A range of activities is offered to ensure service users experience a meaningful lifestyle. EVIDENCE: The care plans contained a “Schedule of activity”. People who live at the home take part in a variety of daytime activities including swimming, music, art, rock climbing, gym, canoeing, horse riding and rambling. This was also evidenced through daily records and photographs displayed in the home. On the day of the inspection most service users were out at community activities. Service users participate in a variety of activities in the local community including shopping, walks, restaurants and pubs. Discussion with the Manager on house 10 indicates that a holiday abroad for two service users is being planned for early in 2006. Sampled daily records indicate that only a small percentage of scheduled activities are cancelled. One service user enjoys using a small trampoline, usually on a daily basis. It is positive that when the trampoline broke a new one was quickly purchased to ensure his usual routine was not disrupted for Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 12 too long. Discussion with the Manager on house 10 indicates that a holiday abroad for two service users is being planned for early in 2006. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Personal support is delivered in accordance with service users preferences and requirements. Health needs are appropriately met. The systems for the administration of medication require improvement to ensure service users medication needs are met. EVIDENCE: Support is given by staff in a warm and friendly manner, and staff were seen to be polite, considerate, patient and respectful, as appropriate. Care plans include detailed information on the support required for personal care, this includes information on gender specific care. After a meal, staff were observed to support service users to go and change dirty clothing, where needed. Sampled service users files showed information relating to healthcare appointments including visits to clinics and specialist consultants. All individuals are registered with a local GP and detailed records are kept of all health appointments by the staff. Records sampled and discussion with the Manager (House 10) evidenced that one individual who has diabetes receives satisfactory support from staff and the Community Nurse to manage the condition. The Manager will however need to ensure that the care plan re blood testing is updated to reflect that tests need to be done three times daily as it currently records four. Records included regular visits to the dentist and Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 14 optician and visits from the community nurse as appropriate. It is good practice that when one service user had to spend time in hospital 1:1 support was provided by staff from Grove Road at the hospital. The medication administration system was sampled. None of the people who live at the home are able to manage their own medication. Medicines were seen to be stored appropriately in a secure location. Topical ointments and eye drops were observed to have been dated on opening to ensure they can be disposed 28 days after opening. Written guidance was available on the administration of ‘as required’ medication but some guidelines were not dated and others had not been kept under review. A random audit of stocks revealed no discrepancies, and there were no gaps on the administration record. However the administration records were stored in folders with lots of other information and were difficult to access. It is recommended that medication folders are better organised. Paracetamol was stored that had been dispensed in 2004. This needs to be returned to the pharmacist and new stocks ordered. Such supplies should be held for a maximum of six months. Discussion with the Manager indicates that two staff are yet to complete a medication training course. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): N/A EVIDENCE: These standards were not assessed at this inspection. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 29 and 30 The standard of the environment is variable with some matters requiring attention in house 2. In general, house 10 provides individuals with an attractive and homely place to live. EVIDENCE: The two houses are in keeping with the local community. House 10 was observed to be more homely in style than house 2. House 2 had an unpleasant odour and some attention was required to cleaning of items such as a radiator and a fan that were both observed to be quite grubby. The Manager explained that house 10 had undergone some recent redecoration and it was hoped that house 2 would be redecorated in 2006. It was identified at the last inspection that attention was required to the garden at house 2. The Manager stated that the previous gardening contractors were no longer used and new contractors were in place. He said that it is hoped that the garden will now be maintained on a regular basis. The kitchen in house 10 is becoming worn and tatty in appearance. Plans will need to be put in place for its refurbishment in the near future. Recently a new large television with ‘Freeview’ has been purchased for house 10. One service user was observed to be happy with the new purchase from Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 17 her facial expressions whilst watching the new music channels she now had access to. Bedrooms sampled were observed to be personalised according to individual needs and preferences. Some bedrooms have areas that are not fully accessible due to a sloping roof, this is not ideal where the individual has a visual impairment. It was observed that in house 2 there was no window covering in the bathroom, and therefore the privacy of service users when bathing is not ensured. The Manager said that the window blind had been pulled down by a service user the previous week. This will require replacement. Suitable adaptations have been made to the home to ensure it meets the needs of individuals with a sensory impairment. This includes objects of reference attached to doors so individuals know where they are in the home and bedrooms have appropriate systems installed to alert individuals to someone entering their room. Recently one service user in house 2 has been reluctant to use the bath. This usually follows visits to stay with parents who have had an adapted bath installed. Discussion has taken place with the GP to refer the service user to an Occupational Therapist to assess if the current bath is suitable. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 35 and 36 Progress has been made on recruiting additional staff to ensure that service users are supported by a team of staff who know them well. The procedures for recruitment are robust and provide satisfactory safeguards to offer protection to service users. EVIDENCE: Each house provides a minimum of two care staff per day shift not including the Manager and Practice Development Worker. At the last inspection the home had four staff vacancies. Discussion with the Manager indicates that all but one of these vacancies have been recruited to, with staff due to start when all the appropriate recruitment checks have been completed. At the last inspection staff were unable to locate evidence that Criminal Record Bureau checks have been completed for staff. These was available at this inspection. The recruitment records for one recently employed member of staff were sampled and were found to be satisfactory. Staff training records were not fully assessed at this visit. However a previous requirement that additional training in supporting people with diabetes should form part of the core programme for this house has yet to be actioned. The Manager of house 10 stated that she hoped to secure the services of the Community Nurse to provide this training. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 19 The supervision records for two members of staff were sampled. Both staff had received regular supervision from their manager. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 42 The home has not had a registered manager in post for some time, the home has therefore not benefited from a clear sense of direction. Systems are in place to promote the health and safety of service users but some updating of risk assessments had not been done. EVIDENCE: Since the last inspection in June 2005 the home has undergone management changes. A manager is based in both houses, but it is intended that the Manager in house 2 will apply to become the registered manager for both homes with overall responsibility. Grove Road has undergone several changes of Manager in recent years and a period of stability is required to ensure that the home has a clear sense of direction. Both of the new managers have been at the home for only a short time but now need to ensure that areas identified for improvement are actioned. In the short time they have been at the home they have commenced a reorganisation of the administration systems within the home, ensuring that relevant information is available in each house. Previously most of the records were held in house 10. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 21 The fire safety records were examined and all tests, checks, servicing of equipment, drills had been completed or scheduled as appropriate. The West Midlands Fire Officer conducted a recent visit of the home. It was recommended that the fire alarms for the houses a separated. This needs to be seriously considered as the alarms sound in both houses if activated, even though the houses are on opposite sides of the close. Staff spoken with said it is not always clear for which area the alarms are sounding. Staff test the fridge and freezer temperatures regularly to make sure that food is being stored at the correct temperature. Staff test water temperatures weekly. Records of these showed that these are safe. As earlier stated in standard 9, the risk assessments for one service user were not up to date. Risk assessments require regular review to ensure service user health and safety is promoted. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X 2 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 3 2 X 3 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Grove Road, 2 & 10 Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 2 X X X X 2 X DS0000016795.V263783.R01.S.doc Version 5.0 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA5 Regulation 5(1) Requirement A copy of a written contract / statement of terms and conditions, detailing the required information needs to be available in the home. In needs to specify the room to be occupied, fees, term and conditions, facilities and support. Service user or their representative and manager should sign it. Outstanding requirement from 31/10/04.(Current contract was not available for one service user) Individual care plans must be reviewed at least every six months or as needs dictate. Outstanding requirement from 30/9/04. The risk assessments for the service user new to the home require review to reflect their new environment. Outstanding requirement from 30/6/05. Ensure risk assessments record the level of risk and cross reference to/ from the relevant care plan(s). Outstanding from 30/8/05. Medication stocks should be DS0000016795.V263783.R01.S.doc Timescale for action 30/12/05 2 YA6 15 30/11/05 3 YA9 12(1) & 13(4) 17/11/05 4 YA9 12(1) & 13(4) 30/12/05 5 YA20 13(2) 30/11/05 Page 24 Grove Road, 2 & 10 Version 5.0 6 YA20 13(2) 7 YA24 23(2) 8 YA27 12(4) & 23(2) 9 YA30 23(2) 10 YA35 18(1)(c) 11 12 YA37 YA42 10 13(4) & 23 reatained for no longer than six months after the date of dispensing. Ensure all protocols for ‘as required’ medication are dated and kept under regular review. Some staff require training in medication. Training for care staff must must include basic knowledge of how medicines are used and how to deal with problems in use and the principles behind all aspects of the home’s policy on medicines handling and records. (Two staff still to do). Outstanding requirement from 30/11/04. Attention is required to the general maintenance of the garden at house 2 to ensure it is a pleasant and safe area. Outstanding from 15/8/05. Ensure that suitable window coverings are provided in bathrooms to ensure the privacy and dignity of service users is protected. Ensure the premises are kept free from offensive odours. Radiators and fans must be kept free of dust and dirt. Training in supporting people with diabetes should form part of the core programme for this house. An application is required to register a manager. Serious consideration must be given to separating the fire alarms for house 2 and 10 as recommended by the West Midlands Fire Officer. 30/01/06 30/12/05 30/11/05 30/11/05 30/12/05 30/11/05 30/12/05 Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 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 Refer to Standard YA20 Good Practice Recommendations Medication administration records were stored in folders with lots of other information and were difficult to access. It is recommended that medication folders are better organised. Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Grove Road, 2 & 10 DS0000016795.V263783.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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