Inspection on 18/07/05 for Hamiltons Residential Home

This inspection was carried out on 18th July 2005.

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 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

Hamiltons Residential Home 16/10/08

Hamiltons Residential Home 16/10/07

Hamiltons Residential Home 04/01/07

Hamiltons Residential Home 12/12/05

Hamiltons Residential Home 16/11/04

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

CARE HOMES FOR OLDER PEOPLE Hamiltons Residential Home 26 Island Road Upstreet Canterbury Kent, CT3 4DA Lead Inspector Wendy Gabriel Announced 18 July 2005 09:30 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 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. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hamiltons Residential Home Address 26 Island Road, Upstreet, Canterbury, Kent, CT3 4DA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01227 860128 01227 860128 MGL Healthcare Ltd Mrs Kerry Mullens Care Home 17 Category(ies) of Older Persons x 17 registration, with number of places Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16.11.04 Brief Description of the Service: Hamiltons is a large, detached property situated on the main road in the village of Upstreet and is registered to provide care for up to seventeen elderly residents. Currently there are twelve residents living there and the Registered Manager stated that they would not take more than fourteen as the three double bedrooms in the home are occupied as single rooms. All bedrooms have television, telephone, and a call system facility. The Home has an attractive garden to the rear with a wide flat pathway suitable for wheelchair users. There is some parking to the front of the property. Canterbury and the seaside towns of Whitstable and Herne Bay are within 30 minutes drive away. The home does not have its own vehicle but there is public transport from the village. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was clean and tidy and well ventilated. Despite having two longterm sick members of staff the rota was fully covered. Recent concerns highlighted at an adult protection case conference indicated that there had been a breakdown in communications by the staff to the Registered Manager and Health care professionals regarding one incident. The Registered Manager, who was not on duty at the time of the incident and the Inspector, discussed the seriousness of this and the Registered Manager has since made robust changes to the reporting and recording procedures for staff. The Registered Providers visited the home during the inspection and discussed their plans for extending the home to provide further en-suite bedrooms, moving the kitchen to another area of the home, altering and or improving the bathrooms and general redecoration and some refurbishment. The Registered Providers have been in business at the home for approximately a year and are gradually making substantial changes to improve the home. The Inspector was pleased to speak to several of the residents and be invited to see their bedrooms. Two members of staff also spoke to the Inspector. Individual care plans and risk assessments are reviewed monthly. What the service does well: What has improved since the last inspection? The medication system has been improved by the purchase of a suitable, lockable trolley to enable staff to take medication directly to the resident and not have to double decant medication. The trolley is secured in a locked office. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 6 The Registered Manager has also set up a temperature control recording system for the medication storage. Radiator covers have been provided around the home to enhance the health and safety of residents. 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. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 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 standard(s) 1-6 The homes statement of purpose and service users guide are good, providing suitable information for an informed decision to be made about moving into the home. Residents are invited to visit the home and meet staff and other residents prior to moving in. Pre-admission assessments are made for all new residents. EVIDENCE: The home provides a statement of purpose and service users guide and these are given to prospective residents and are also prominently displayed in the reception area for residents and visitors to look at. The Inspector recommended some minor word changes and advised that it include that the bedrooms benefit from having locks. Both documents are informative and along with the statement of terms and conditions given to residents; provide ample information to prospective residents to make an informed choice about moving into the home. The Registered Manager visits prospective residents in their own environment and a suitable pre admission format is completed. Assessments are sought from care managers and any other Health care professional who may be involved with that prospective resident. Evidence of these was seen in the Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 9 care plans viewed. Prospective residents are invited to visit the home and stay for a meal and perhaps overnight to get to know the staff and other residents. A three months trial is followed with a review by the home, care manager and family. The prospective resident is always invited to be involved. Residents also sign any care documents if able. The Registered Manager stated that sometimes respite care is given but that intermediate care is not undertaken. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 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 standard(s) 7-11 Care plans and risk assessments identify individual needs. Medication administration is well managed. Privacy for residents is upheld. Care of the dying is undertaken with support from Health care professionals. EVIDENCE: The standards establish care plans as being central to the effective delivery and evaluation of residential care services, from which they are used to identify and manage potential risks to health welfare and safety. The care plans in the home are clearly written, inclusive of health and social needs and are reviewed monthly. Risk assessments are fulsome and identify staff actions to enable resident independence. Medication has improved since the previous inspection by the purchase of a suitable trolley to store and transport medications directly to the residents. This enables staff to administer medication without double decanting. Suitable recording is undertaken for medication administration. An outside company provides medication training for staff. Competency training is undertaken to manage oxygen for a named resident. Hoist training has recently been obtained for the staff in response to a need identified at a case conference. A respiratory specialist nurse regularly reviews the medication for named residents. The Registered Manager has established a temperature control Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 11 record for the medication storage. A locked box is kept in the fridge in the kitchen if any medication has to be stored at a certain temperature. The Inspector recommended that a suitable lockable fridge be used for this. The Registered Manager stated she was aware of this and that one would be purchased when the new office with medication storage is in place. Bedrooms have locks that can be over-ridden by staff in case of emergency. Dying residents are cared for in the home with support from Health care professionals unless they advise that hospital care is required. The Registered Manager stated that there are good links and support from GP, District Nurse and other Health care professionals. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 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 standard(s) 12-15 Residents special dietary needs are assessed and catered for. Residents’ favoured choices are recorded but recreational activities are limited by lack of interest and motivation from the residents. Families are welcomed to the home. Religious preferences are recorded and enabled. EVIDENCE: Several residents spoke to the Inspector and said that they were quite happy sitting quietly in their rooms and that they did not really want to undertake any activities. Staff confirmed that it was difficult to motivate residents to join in with any activity offered. There are only two care staff on duty in the afternoons and whilst this is normally practicable when residents are well, it means that there is little time for activities or one to one interaction when staff are otherwise engaged including preparing and serving tea. A recommendation was made that time be allocated for either an activity organiser to try to motivate and encourage residents to participate or to allow dedicated time for staff to arrange activities. However, the Inspector recognises that the residents have freedom of choice to decline to join any activity offered. Catholic nuns and/or Priest visit the home weekly and a Church group visits the home every month. Although the home does not have transport, the Registered Manager said that a vehicle could be hired to take residents on trips out. The Registered Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 13 Manager also confirmed that it was difficult to motivate residents to go out and occasionally if a trip had been arranged, residents would change their minds at the last minute. In house activities have included Old time sing a longs, Christmas visits from a school to sing carols, themed food nights and celebrations such as birthdays and Christmas. There are plans for the kitchen to be re-sited in another area of the home and this would include new facilities. As previously noted, some cleaning was required to the fridge door and in some awkward areas of sliding cupboard doors. The menu is on a four-week rota and residents may ask for a different choice if they do not like what is offered. The Inspector suggested that the current menu indicated a number of meals more suitable for cold weather but the Registered Manager said that residents preferred them to salads, although salad was available as an alternative. Changes to the menu are recorded. A dietician has responded to a request to visit to advise on a particular resident and the home was given suitable written information to enhance the dietary needs of that resident. A referral may be made at any time for this service. Meals may be taken in the dining area of the home or in residents’ bedrooms. Breakfasts are mostly taken in bed by choice, although may also be taken in the dining area. The Inspector was very pleased to observe and to be informed by staff that hot and cold drinks are encouraged throughout the day, not just at set times. Jugs of squash are kept in rooms also. Sherry is given to residents before lunch. The Registered Manager was very clearly aware of the importance of residents receiving adequate fluids throughout the day. A resident confirmed that drinks are available at any time during the night or day. Staff and the Registered Manager indicated that the friends and families of residents are warmly welcomed into the home at any reasonable time. Care plans indicate residents’ likes and dislikes and risk assessments enhance the empowerment of residents. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 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 standard(s) 16-18 The complaints process in the home is clear and accessible. Adult abuse awareness is promoted and the whistle blowing policy is sensitive and clearly identifies staff responsibilities. Residents’ legal rights are maintained. EVIDENCE: There is a suitable complaints policy on display in the home and the statement of purpose also indicates the procedure to visitors and residents. A complaints book is in the reception area with an invitation to write in any concerns, anonymously if preferred and if the complainant does not wish to speak in person. There were no entries at the time of the inspection. The Registered Manager would record complaints and action taken. The Registered Manager has been seeking suitable recording formats for the home to use that would be simple and informative. Residents are encouraged to vote and the majority now do so by postal vote. The home promotes an advocacy service that is independent from the home and that would source suitable legal advice and support as required. All staff undertake adult protection training and this includes the induction level through the TOPSS accredited training. Two members of staff were awaiting their course at the time of the inspection. Some residents said that staff were very helpful and kind and would immediately come whenever the call bell was rung. A member of staff confirmed that the abuse awareness course she had undertaken had informed her of signs of abuse she had not previously considered. The home has a very good and clearly written whistle blowing policy that supports the Registered Providers commitment to good practice. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 15 Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 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 standard(s) 19-26 The environment is well maintained and provides residents with a cosy and attractive place to live. Redecoration and refurbishment is planned once the proposed development is complete. The Registered Providers and the Registered Manager has a good and clear understanding of how they wish to improve resident welfare and planning and investment is in place to manage this. EVIDENCE: Some areas around the home are in need of revamping, but at the time of the inspection did not pose a health and safety problem and it is reasonable to wait until the development is complete before undertaking redecoration and refurbishment. However, if the development does not take place this must be viewed as a requirement to provide a homely and pleasant environment for residents. The Registered Manager agreed and has already earmarked areas and items to be renewed and redecorated. The Registered Providers discussed their business plans with the Inspector and it was clear that they have progressive ideas to improve and develop the home. The Registered Providers also stated, and the Registered Manager Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 17 confirmed, that they wanted to support the Registered Managers ideas for improving the welfare of the residents. The home provides a comfortable and cosy environment for the residents. The home was clean and tidy and where there was a urine odour in one bedroom, the Registered Manager confirmed that the carpet is being replaced. The Registered Manager confirmed that advice was being sought from the District Nurse to meet the continence needs of that named resident. Several residents were sitting or walking in the gardens to the rear of the property. The garden is flat and enclosed and a wheelchair friendly pathway meanders through the grounds. One resident walking from table and chairs in the garden to the house said that he enjoyed his morning drink outside in the fine weather. The laundry has equipment suitable for maintaining high washing temperatures for soiled linen and the Registered Manager confirmed that alginate sacks are used as an infection control measure. COSHHE items are stored in a locked cupboard and COSHHE records kept. Staff have yet to complete infection control training and the Registered Manager is currently seeking suitable training as previously indicated. Bedrooms are individual and contain items personal to each resident. All bedroom doors are lockable and may be over ridden by staff in case of emergency. Several residents were in their rooms and confirmed that this was their preferred choice during the day. The home provides a television and a telephone in every bedroom. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27-30 Suitable recruitment practices are followed and will be improved by a more robust job reference format. Training is promoted but has not yet included all mandatory training for safe working practices. Staff induction is TOPSS accredited. EVIDENCE: The staff rota was fully covered despite two members of staff on long-term sick leave. It was recommended that further staffing be considered for the afternoon shift if a resident is sick, as the pm staff have to prepare tea as well as undertake care duties. There is one domestic cleaner employed in the home and the Registered Manager said that night staff have cleaning duties. The Registered Manager said that further domestic hours would be provided when the planned extension is built. Staff induction is TOPSS accredited. The home has not yet obtained the 50 ratio of NVQ trained staff. Two staff have obtained NVQ2, three are currently undertaking NVQ and three are waiting to commence NVQ. The Registered Manager stated that it is difficult to access places with training providers but is actively seeking places for staff. Recruitment procedures include conditions of employment and CRB checks. Two references are required but the current format is very basic with little opportunity for the referee to comment on the applicant. The Registered Manager agreed that this was not suitable and had already commenced a new format to be more comprehensive. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 19 Supervision and annual appraisals are undertaken with recorded evidence of this in place. There was evidence of training courses being undertaken with the exception of infection control, which is mandatory. A requirement was made for this to be arranged. The Registered Manager agreed to this and said that courses were difficult to access. The Inspector discussed various routes to seek suitable training. The Registered Manager verbally indicated her commitment to training for the staff and said she had the full support of the Registered Providers in this. Staff and residents communicated in a friendly manner. The Inspector observed staff being aware of residents’ requests before they were voiced, for example, assisting a resident to carry personal items from one area to another. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-38 The Registered Manager has a clear development plan for the home that is supported by the Registered Providers. The Registered Manager has a robust grasp of health and safety issues and has demonstrated management of staff responsibilities. Regular reviews of policies and procedures are in evidence. Staff mandatory training is not yet complete, although is being sourced. EVIDENCE: The Registered Manager has almost completed her NVQ4, and has completed the registered managers award. The Registered Manager has been in post for approximately a year and has been systematically reviewing policies and procedures. There is a clear line of accountability in the home between the Registered Manager and the Registered Providers. Staff and residents who spoke to the Inspector confirmed that the Registered Manager is approachable and ‘hands on’. The Registered Manager has devised a quality assurance questionnaire for residents, families, and for Health care Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 21 professionals. A summary of findings and action to be taken is recorded. The Registered Manager said she is seeking a better format to engage residents in making comments about the care they receive. Residents told the Inspector that they felt the staff and the Registered Manager were kind and caring and would help them as much as possible. The Inspector gave the Registered Manager some information regarding accessing suitable financial procedures for residents’ monies. At the moment the Registered Manager holds monies given to her by families on behalf of residents. Receipts and records are kept of any transactions. The home has an up to date insurance certificate. The Registered Manager stated that to the best of her knowledge the Registered Providers have a business plan that is available to the Inspector upon request. Staff are supervised and receive annual appraisals. Care plans and risk assessments are regularly reviewed. Confidential information is held in a secure facility. The home maintains current maintenance certificates. The fire book was in order and accident book now maintained. A recent adult protection issue was to do with lack of communication to appropriate persons about an accident and since then the Registered Manager has instigated a more robust recording policy for staff and has informed staff that failure to comply would result in a disciplinary procedure. Despite this one incident there was evidence of recording in accident book, day reports, care plans and risk assessments. COSHHE items are stored safely in a locked cupboard and COSHHE information sheets retained. There are environmental risk assessments for the premises. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 23 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. 2. 3. 4. Standard 30 37 26 37 Regulation 18 17 16 17 Requirement Staff to complete mandatory training. Confidential information is not to be held in the handover book. Thorough cleaning to be undetaken in the kitchen as identified. staff to record and communicate issues to appropriate persons as identified. Timescale for action 18.09.05 18.07.05 18.07.05 18.07.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 9 12. 27 Good Practice Recommendations A lockable fridge to be provided for when medication has to be stored at a certain temperature. More staff hours to be provided for afternoon shift when a resident is unwell, and to enable further activities for residents to be undertaken. Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent, TN23 1HU 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 Hamiltons Residential Home H56-H05 S61038 Hamiltons Residential Home V229302 180705 Stage 4.doc Version 1.30 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. 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