Inspection on 10/05/06 for Hamilton House

This inspection was carried out on 10th May 2006.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hamilton House 07/11/08

Hamilton House 12/04/07

Hamilton House 26/01/06

Hamilton House 05/07/05

Hamilton House 07/06/05

Hamilton House 24/12/04

Hamilton House 27/07/04

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

CARE HOMES FOR OLDER PEOPLE Hamilton House West Street Buckingham Buckinghamshire MK181HL Lead Inspector Mrs Caroline Roberts Unannounced Inspection 10th May 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 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. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hamilton House Address West Street Buckingham Buckinghamshire MK181HL 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) 01280813414 Acegold Limited (a wholly owned subsidiary of Four Seasons Health Care Ltd) Mrs Elaine Groome Care Home 53 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Maximum 53 Nursing 40 years plus Maximum 8 personal care For one resident with dementia, as identified in variation for registration form dated 27 06 05. That as of the 1st of March 2006, further to a variation application the home is registered to provide care for 1 further service user with Dementia. That this condition applies to a specific service user and should the service user, for whatever reason, leave the home, the home must notify CSCI and this condition will cease to apply. 26th January 2006 Date of last inspection Brief Description of the Service: Hamilton House is situated a short distance from the town centre of Buckingham, a small market town served by local bus networks and possessing a variety of shops and other local amenities. The home is one of the Four Seasons Healthcare Group. The home provides personal care for up to 53 Service Users. Service users are accommodated in one of 39 single or 7 shared rooms, which are found over 3 floors. The home has 4 dayrooms and 1 dining room. These communal areas provide space for receiving visitors, participation in activities, watching television and dining for limited numbers. The front door to the building is accessed by two steps, and is therefore inaccessible to wheelchair users. Side entrances to the home can be used for wheelchair access. The home possesses two through floor lifts, which permit access to all levels of the home. Grab rails are found in toilets, bathrooms and bedrooms. The home possesses hoisting equipment to facilitate safe moving and handling practice, and the home has a nurse call system in place. The staff team consists of trained nurses, care staff, domestic, catering and laundry staff. The home has a manager who has been registered under the Care Standards Act 2000. The fees for this service range from £352.03 to £1167.00. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the unannounced inspection carried out at Hamilton House on the 11th of April 2006. The majority of all inspections conducted by The Commission for Social Care Inspection will be unannounced. The lead inspector was Mrs Caroline Roberts who was accompanied by Mrs Gill Wooldridge. The inspection commenced at 7.15am and consisted of meeting with residents, staff and visitors, viewing records and documents pertaining to the provision of care and the running of the home. Evidence gained from this has formed the judgements for this report. A tour of the building took place, gaining permission from a number of residents to enter their bedrooms and viewing a further number from the doorway. Staff were polite, helpful and welcoming, and the inspector would like to thank them for their co-operation and assistance throughout the course of the inspection. The inspector would especially like to thank the residents for their time and for allowing the inspector into their home. What the service does well: What has improved since the last inspection? A deputy manager has been appointed. Four seasons have commenced a refurbishment of the home. POVA training has commenced for staff. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 6 Ongoing training and staff development. 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. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 7 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 Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 8 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): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All of the assessments evidenced were completed fully and clearly and demonstrated that the home was able to meet the identified needs of the individual prior to admission to the home. Intermediate care is not provided at this service. EVIDENCE: The home have an organisation generated pre admission checklist which is used for all admissions to ensure the home can meet the needs of potential residents prior to admission. Only senior staff and nurses undertake preadmission assessments and have received training in this area. The preadmission assessment tool has been reviewed by the senior management team of Four Seasons and implemented in this home in March 06. During this inspection three completed assessments were examined, all had been completed fully and highlighted the potential residents health and social needs. Due to the new assessment tool only recently being introduced only one has so far been used by the home, this was seen and covered all the areas as required in standard 3.3 National Mininum Standards. Intermediate care is not provided in this home. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 9 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): 7,8,9,10 Quality in this outcome area is poor. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. There are care plans in place for each resident, which cover a broad range of personal care needs, in addition to health care and cultural/social preferences. Shortfalls were noted regarding frequency of reviews and management of information. Residents are registered with a GP and have access to health and specialist services in accordance with assessed needs. Medication in the home is stored appropriately with no excess stock; staff need to ensure that policies with regards to administration of medication are followed fully to ensure the safety of residents. EVIDENCE: There is a care planning process in place, which includes procedures for ongoing assessment and reviews of needs. The frequency of reviews varied between the care plan, which were read. For example, the last recorded monthly care plan review for one care plan was February 2006 (3 months out of date) another plan had been reviewed in March 2006. Due to the large Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 10 amount of information on file, the care plans were difficult to follow. Daily report sheets in some instances had been filed out of date sequence and there appeared to be duplication of assessment records. This makes it difficult to access information quickly and accurately. Photocopies of care plan paperwork within care plans was unreadable due to the poor copy quality in many cases. There was evidence in care plans that residents are registered with a G.P and have access to specialist health services, as recorded on their medical record sheets. The home reported to receive a good support service from the local GP’s. Health intervention is recorded within the daily reporting sheets however, from case tracking care it became apparent that not all GP visits are being fully recorded and followed up on, it was discussed with the deputy manager the use of different coloured pens to record within the daily reports so that it is easily tracked. Medication in the home is stored in a locked room and dispensed by staff that have had training in the administration of medication. Medication administration sheets (MAR) identified that not all staff are signing for medications administered, unexplained gaps were noted. When required medications (PRN) are also not consistently signed for, the home need to decide what method they are going to use for recording the refusal of PRN medications and ensure this is used. Residents with type 1 diabetes have their blood sugars monitored prior to the administration of insulin, the case tracking of one resident identified that blood sugars are not always taken/recorded, for example one resident had no blood sugars recorded for 3 days. The home is reminded that handwritten entries on the medication administration sheets must be backed up by a copy of the prescription or hospital discharge sheet. The home needs to develop protocols on the following areas to ensure staff are all working in the same manner: Diabetes care (Blood sugar monitoring and recording) Catheter care (Specific advice for individual residents) This information then needs to be incorporated within the residents individual care plans. Observation and comments made provide evidence that residents are afforded with privacy, dignity and respect. The home are reminded that using commode chairs to transport residents from the bathrooms is not a safe method of moving and handling. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 11 Throughout the course of the inspection 12 residents were noted as not having access to their call bell, 2 residents spoken with confirmed that this is usual practice and that the staff forget to give them the call bell when they get them up in the morning. Night staff were observed giving out the morning cup of tea. All of the cups used were plastic beakers and no thought appeared given with regards to how residents like their tea; for example, one resident was left with a luke warm cup of milky tea with no sugar, she confirmed that she prefers stronger tea and takes sugar, a member of staff was approached and asked to get the resident some sugar. These details were not noted within the care plan nor was the need for a plastic beaker. The evidence seen and comments received, indicate that this service meets the diverse needs (religious, racial, cultural and disability) of individuals within the limits of its statement of purpose. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 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): 12,13,14,15 This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Residents interests and previous lifestyle are taken into consideration when developing care packages and contact with family and friends is encouraged. The food is well presented and appeared appetising and nutritious. Quality in this outcome area is good. EVIDENCE: The home employs a dedicated activities organiser for 30 hours per week. A structured programme of activites is being formulated by the activities organiser and manager, meetings are being arranged to include the views and wishes of the residents. Church services are aranged via the local church. Routines in the home are arranged around residents needs as much as possible. The home do not have restrictions on visiting hours, except visiting during the night would need to be pre-arranged and under exceptional circumstances. Family and friends can meet in residents own bedrooms or one of the lounges, family can stay for meals with prior arrangement. Residents and families are encouraged to manage their own finances, although the home do offer residents access to the residents saving scheme for small Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 13 amounts of personal finance, for which procedures are followed including clear documentation and receipts for all expenditure. Most of the bedrooms in the home show that residents are able to bring items of their own furniture to personalise their rooms. Residents are involved in the care planning process. The home has 1 dining room that can seat up to 16 residents, this room has recently been pleasantly decorated and allows the residents to enjoy their meal in a congenial setting. Due to the frailty of many of the residents a lot of meals are taken in the residents own bedroom with the assistance of staff. 3 cooked meals a day are offered with drinks readily made available. Menus are varied and reflective of the season. On the day of the inspection lunch consisted of roast turkey, potatoes, vegetables followed by fruit flan and cream, a second choice is always available and is detailed on the menu choice records. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 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): 16,18 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The home has clear complaints and adult protection policies in place and staff have a good understanding of these. Information about how to make a complaint is made available to residents and relatives. EVIDENCE: The home has a complaints policy in place which advises complainants of the process to follow, and the time this will take, this information is available to residents and relatives via the home’s notice board and service user guide. The complaints log was examined, this showed that 6 complaints have been received and investigated in the last 12 months. Any complaint received by the home is discussed with the regional manager as part of the company policy. The home has adult protection and whistle blowing policies in place and also has a copy of the policy for Buckinghamshire county council. Records showed that some staff have had training in adult protection from Buckinghamshire county council and further training was planned in house on the 17th May 2006, a requirement was served during the last inspection that all staff are to have received POVA training by September 2006 this requirement is re-served. The home has had 5 POVA investigations in the last 12 months, all of which have been investigated in line with Buckinghamshire county council protection of vulnerable adults policy. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 15 Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 16 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): 19,26 This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Residents live in a safe and homely environment. Qulaity in this outcome area is adequate. EVIDENCE: Hamilton House is constructed over three storeys and service users live on one of the floors, depending on their specific needs. Most service users benefit from single room accommodation and some are fitted with en-suite facilities. . Four seasons have invested considerable money into the home and commenced a refurbishment programme earlier this year. At the time of the inspection the communal areas had been redecorated with new soft furnishings, carpets and lighting provided all of which look very tasteful. The manager informed the inspector that 10 of the bedrooms are to be refurbished this year, this is good news as many of the rooms are starting to show signs of wear and tear and would benefit from refurbishment. This will be monitored at the next inspection Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 17 The managers office has also been redecorated and new office furniture provided. It was extremly disapointing to note that the shared bedroom on the ground floor identified to the manager was not one of the bedrooms planned to be refurbished, this room was found to be dirty with a ripped privacy curtain the inspector was sticking to the lino floor when walking across and the furniture is in desperate need of replacement. The inspector would question the need for lino floor in this room and a requirement is served that the manager demonstrate the need for such including the views of the residents and family members of the residents in this room. A requirement is also served that this room be refurbished to include – redecoration, new soft furnishings, bedroom furniture and flooring suitable for the needs of the residents in this room. The laundry is integral to the building and provides adequate facilities for the laundry provision in the home. The home has an infection control policy and training records evidenced that all staff receive training in personal care and infection control. The home uses the red bag system for segregating soiled and infected laundry. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is poor. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Based on evidence taken from the rota, staff and resident discussions and observation during the inspection the level and deployment of staff on the day of inspection is not adequate to meet the needs of the very frail resident group at the home, reduction in the agreed staffing levels puts residents at risk. The home operates a thorough recruitment process to ensure staff are suitable to work with vulnerable people. Staff receive training in a variety of subjects related to meeting residents needs. EVIDENCE: Based on dependency levels and geographical location of the groups the agreed staffing levels are 11 staff in the morning, 9 staff in the afternoon and 4 staff at night. On arrival to the home at 7am it took 15 minutes to gain entry to the home, eventually the cook arriving for duty opened the door for the inspectors, 3 night staff were on duty, all of which were extremely busy and residents were needing assistance. Many did not have their call bells to hand and the inspectors called the staff for them, based over three floors with many residents requiring 2 members of staff for all care, going down to 3 staff during Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 19 the night time period puts residents at risk. The manager stated she was unaware of the shortage of staff throughout the nighttime period. On the day of the inspection visit 9 staff were on duty for the morning shift, plus an additional carer performing one to one care, when the manager was questioned as to why the home were 2 staff short she again stated she was unaware this was the case, on viewing the rotas it became apparent that staff shortages are not always covered this was confirmed by the staff spoken with. This was discussed with the manager who stated that a senior carer is responsible for planning and maintaining the rotas and that she does not always keep her updated. The manager is reminded that as the registered manager it is her responsibility to “ensure that at all times suitably qualified, competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of service users”. On further examination of the rotas it became apparent that most of the senior carers work together on the same shifts and quite often it is only the morning shifts, the inspector would question whether the rota is being devised around staff need as opposed to resident need. The deputy manager stated that she had offered to take responsibility of the rota, but that the manager had declined, it is recommended that the deputy and manager oversee the rotas as they both have supernumery time to enable them to undertake this task fully as opposed to the senior carer who quite clearly is not covering the rota in the best interests of the residents. Residents spoken with stated that staff are always busy and quite often say they are short of staff, when answering bells staff tell residents I will be back in a minute and that can mean anything up to half an hour, throughout the course of the inspection 12 residents were noted as not having access to their bells. A requirement is served regarding the number of staff required on duty at all times. Three staff files were looked at, all contained evidence that the home had obtained a Criminal Records Bureau (CRB) check, references and proof of identification for staff. They had also supplied copies of the homes terms and conditions and a declaration of health from the person. Five members of staff were interviewed as part of the inspection process, four members of staff said that they considered the training provided in the home to be sufficient to meet their job specification and needs of residents. Training certificates for four members of staff were inspected and showed that updates in mandatory training are ongoing. Staff spoken with stated that they had received training in the following areas: Moving and Handling Infection Control First Aid POVA Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 20 NVQ Diabetes Staff files examined showed evidence of new staff undertaking induction training. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The registed manager is experienced in the management and care of older people. The home has a clear quality assurance system in place, which involves obtaining residents views. Policies and practice for managing resident’s monies are clear and well managed by the home. The home carry out the required health and safety checks to ensure residents live in a safe environment. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The manager has 3 more units to achieve on her registered manager award (RMA) of which she is hoping to achieve by the summer of this year. The manager is experienced in care services for older people, the manager through Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 22 inspections has been able to demonstrate her knowledge of the client group. An organisational quality assurance tool is used in the home, this is conducted by the director of care services within four seasons, results are made available to residents and families. The home provides a facility for the managing of small amounts of money, this system is computerised with manual records maintained. The home retains all records of expenditure including reconciliation accounts. Service agreements are in place for safety testing, records are maintained by the manager these include periodic internal Health & Safety checks. All Health & Safety checks have been completed within timeframes from evidence submitted in the provider data set. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 1 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP18 Regulation 13(6) Requirement All staff are to receive Protection of Vulnerable Adults training by September 2006. The manager is required to ensure that all staff follow correct moving and handling guidelines. Previous Timescales of 26/1/06 Not Met. The manager is required to ensure that staff follow policies and procedures with regards to the administration of medications. The manager must ensure that any handwritten medication administration sheet is backed by a copy of the prescription or hospital discharge sheet. The manager must ensure that residents have access to the nurse call bell at all times. Staffing levels are to be maintained at the agreed level of 11 staff in the morning, 9 staff in the afternoon and 4 staff at night. DS0000019227.V289526.R01.S.doc Timescale for action 01/09/06 2. OP38 13(5) 31/05/06 3 OP9 13(2) 31/05/06 4 OP9 13(2) 31/05/06 5 6 OP8 OP27 13(4) 18(1)a 31/05/06 31/05/06 Hamilton House Version 5.1 Page 25 7 8 OP19 OP7 23(2) 15(2) The shared room on the ground floor identified to the manager is to be re-furbished fully. The manager is required to ensure that care plans are kept under review. 01/08/06 31/05/06 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 OP2727 Good Practice Recommendations It is recommended that the manager and deputy manager take on the responsibility for the overview of the rotas. Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Hamilton House DS0000019227.V289526.R01.S.doc Version 5.1 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. 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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