Inspection on 22/05/06 for Harmony House Care Home

This inspection was carried out on 22nd May 2006.

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 but made no statutory requirements on the home.

Other inspections for this house

Harmony House Care Home 01/07/08

Harmony House Care Home 06/07/07

Harmony House Care Home 22/02/06

Harmony House Care Home 29/09/05

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

CARE HOMES FOR OLDER PEOPLE Harmony House Care Home The Bull Ring Chilvers Coton Nuneaton Warwickshire CV10 7BG Lead Inspector Michelle O`Brien Key Unannounced Inspection 22nd May 2006 08:40 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 Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harmony House Care Home Address The Bull Ring Chilvers Coton Nuneaton Warwickshire CV10 7BG 02476 320532 02476 320632 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) Ashbourne (Eton) Limited Mrs Barbara Moir-Bussy Care Home 57 Category(ies) of Old age, not falling within any other category registration, with number (57) of places Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2006 Brief Description of the Service: Harmony House is situated close to Nuneaton town centre and the George Eliot Hospital. The home is owned by Ashbourne Ltd. Harmony House is a purpose built care home and is registered to provide care for 57 elderly residents. The home is not currently registered for the provision of specialist services. The single room en suite accommodation is situated on two floors. The service provision on the ground floor is for those people who may require assistance with personal care. Whilst the first floor service provision is for those who may require nursing care, qualified nursing staff are available at all times on this unit. Access to the first floor is via passenger lifts/stairs. Garden/patio areas are accessible to all residents including those with limited mobility who require wheelchairs. The current scale of charges is £345 - £580 per week. Additional charges are made for chiropody, hairdressing and newspapers. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced fieldwork visit to this service as part of a key inspection process involving looking at a range of information. This included the service history for the home and inspection activity, notifications made by the home and information shared from other agencies and the general public. This visit took place between 8.40am and 5pm. On the day of the visit 57 service users were accommodated in the home; there were 30 people with high dependency needs receiving nursing care and 27 people receiving personal care. The inspector had the opportunity to meet and chat with many of the service users about their experience of the home and joined them for their midday meal in the ground floor dining room. The people who live on the ground floor are receiving personal care and were able to express their opinions and chat to the inspector. Many of the residents receiving nursing care on the first floor were unable to communicate verbally with the inspector because of their medical conditions; however, some of their relatives spoke on their behalf while others were able to express their feelings using non verbal communication. Five service users were ‘case tracked’. This involves investigating an individual’s experience of living in the care home by meeting with them, talking to them and their families (where possible) about their experiences, looking at their care files and focusing on outcomes. The manager was on sick leave; the deputy manager is running the home in her absence and was present for most of the day. The inspector also talked to four relatives of service users, two of the care staff, one of the nurses, the maintenance man, activities organiser and administrator. Documentation maintained in the home was examined including policies and procedures and records maintaining safe working practices. The inspector would like to thank staff and residents for their co-operation and hospitality during this visit. What the service does well: There is a cheerful and welcoming atmosphere in the home and the staff have a good relationship with residents. Care is provided in lovely surroundings by well trained and competent staff. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 6 Opportunities are provided for people who want to take part in social and recreational activities and residents are supported to maintain links with the local community. What has improved since the last inspection? 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. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 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 Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 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): Standard 3 was assessed. Quality in this outcome area is adequate. Most service users have their needs assessed before they move into the home to ensure their needs can be met by the service. EVIDENCE: Three service users admitted since the last inspection were ‘case tracked’. Records demonstrate that service users are visited by a member of staff to make an assessment of their needs before they are admitted to the home. One resident said that she had been visited in hospital before coming to the home and was able to ask questions, she added, ‘they said if I didn’t like it, I could change – but I’m quite happy here.’ Prospective residents who need nursing care are often dependent on their relatives to make decisions about moving into a home because of their medical conditions. One relative commented that he had chosen the home for his wife because it was easy for him to get to so he could visit frequently; he was happy with his decision to choose this home because he was made to feel welcome and his wife was well looked after. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 9 The home has recently been taken over by a new owner and new, comprehensive pre admission assessment forms are available. However these are not consistently completed with sufficient detail to enable staff to develop care plans. Two of the three files seen contained a complete assessment of the prospective residents’ needs but one file contained an incomplete assessment with very basic information only. There is a risk of the home being unable to meet the needs of a service user if needs are not fully identified during assessment. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 were assessed. Quality in this outcome area is adequate. Care plans are in place to meet most of the identified needs of service users but medicine management must be improved to protect service users from potential harm. EVIDENCE: Two residents receiving personal care and three residents receiving nursing care were involved in ‘case tracking’. All the residents that the inspector met looked well cared for. They were well groomed, comfortable and wore well laundered clothes. Residents spoken to made positive comments about the care they received, saying, ‘it’s very good here, I can have what I want’ and ‘I feel safe here, the staff do every thing I need’. The home is in the process of implementing the care planning paperwork of the new owners and some of the files are in between the old paperwork and the new paperwork. Files contained care plans for most, but not all of the residents’ needs. Care plans are not always updated when there is a change in need. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 11 The care file of one resident did not have a fully completed moving and handling plan and in the care file of another resident is was evident that a hoist was being used to assist the resident in transfers but this was not included in an update of the moving and handling care plan. Some of the care plans were not dated or signed by the staff member who wrote them. One of the residents who was being fed with a tube directly into his stomach (PEG) had been seen by the dietician and his feeding regime had been changed. The care plan had not been updated with sufficient, clear information to give staff clear direction about the type and amount of feed this resident required. There was no evidence in the care files that residents or their relatives are involved in the care planning process although one relative commented, ‘they always tell me about any changes’. There was evidence of good practice in the prevention of pressure sores. Body mapping (diagrams showing areas of residents’ skin that may be at risk or broken) are used; ‘turn charts’ were seen in the bedroom of one very frail resident to record each time this resident was repositioned. Dynamic ‘airwave’ mattresses were in use for residents at risk of developing pressure sores. There was evidence that the home enables residents to have access to other health professionals such as GP, dietician, dentist, optician and chiropodist. Residents have their general health, including their weight, monitored by the home. Risks to the health of residents are monitored using risk assessments including the prevention of pressure sores, nutrition, and falls. The systems for the management of medicines were examined. The temperature of the room where medicines are stored on the ground floor was consistently recorded as 26°C which exceeds the recommended temperature. The manager introduced new organisational medicine policies to staff during training sessions in the week previous to this inspection. The arrangements for the storage of medicines is safe and secure. The home uses a local pharmacy to dispense residents’ prescriptions monthly using a Monitored Dosage (‘blistered’) System. Either trained care staff on the residential unit or nurses on the nursing unit administer medicines. An audit was made of the contents of the controlled drug cupboards and this was found to be correct. Residents’ prescriptions are photocopied and kept with the administration record for each resident. One resident is currently self medicating and a risk assessment is undertaken regularly to ensure this is done safely. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 12 It was of concern that an audit of antibiotics for one resident indicated that one of the doses had been missed although it had been signed for. Another resident had been prescribed furosemide as ‘when required’ medication with no written instructions as to when it should be given. There were a lot of excess medications on the nursing floor and a nurse spoken to appeared confused as to how excess or unused medications were disposed of. She told the inspector the pharmacist picks them up but there was also a special container in the medicines room for the safe disposal of unused or excess medication. These concerns were discussed with the deputy manager. Staff were observed to address service users by their preferred names and were respectful of their rights to privacy and dignity when attending to their care needs. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 14 and 15 were assessed. Quality in this outcome area is good. The home satisfies the social, cultural and recreational needs of people living in the home to enhance the quality of their lives. EVIDENCE: When the inspector joined residents for their midday meal in the ground floor dining room there was a lively discussion about what it was like to live in this home. Residents were very enthusiastic about the social life in the home. Activities include craft groups, exercise to music, sing-a-longs and gardening. There are opportunities to participate in organised group activities and outings; outings include barge trips on the canal, attending the Civic Hall for concerts or shows, visits to the garden centre and occasional shopping trips. People are supported to maintain links with the local community. One resident told the inspector that he uses a scooter to go out to the local pub or club twice a week. All the relatives spoken to said they were made to feel very welcome when they visited and visiting times were not restricted. Residents were seen receiving visitors in the communal lounges and also in the privacy of their own rooms. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 14 People living in the home are supported to make decisions about their everyday lives and given a choice about how they spend their day. One person commented, ‘I get up when I want and go to bed when I want’, another said, ‘there’s always something to do if you want to join in’. One recently admitted resident said she had made some new friends in the home and enjoyed spending time with them during the day. Everyone in the dining room seemed to enjoy their lunch, which was a choice from cottage pie or lamb pasty with sauté potatoes and mixed vegetables. The meal was tasty and nutritious. The tables were beautifully set with linen tablecloths and small vases of flowers. It felt like a restaurant as people chatted over their lunch and enjoyed the social occasion. Staff who assisted offered timely and sensitive service to people who, for example, needed their food cut up. People were complimentary about the food provided in the home and told the inspector that a cooked breakfast was available every day if you wanted it. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18 were assessed. Quality in this outcome area is adequate. The lack of staff awareness of the protection of vulnerable adults leaves service users at risk of harm. EVIDENCE: The home has a complaints policy which is displayed on the notice board in the home. There is a newly implemented complaints log held in the home. No complaints were recorded in this. The Commission has received one complaint about this service since the last inspection. The complaint was from the relative of a resident who was concerned about the quality of care. The complaint was investigated by the provider and upheld. Residents spoken to told the inspector that they would go to the manager or senior staff if they had any concerns. One lady said, ‘I’d tell my son or his wife and they’d go to the head’, another said, ‘I don’t know what I’d do – I’ve never had any call to complain’. One relative spoken to said he felt ‘confident’ that management would take action about any concerns or complaints he had. The home has an adult protection policy and the majority of staff have received training in the protection of vulnerable adults and recognising abuse. Discussions with care staff demonstrated that they were aware of constitutes abuse. The deputy manager was able to discuss local police and social services policies and actions to be taken in response to allegations of abuse. However, during a discussion with a member of the nursing staff it was evident that while she recognised signs of abuse she was unaware of how to respond to suspicion or allegations other than to inform the manager. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 16 It was discussed with the deputy manager that nursing staff deputise in the absence of the manager and should have a working knowledge of how to respond to allegations or suspicions of abuse in order to protect the people in the home. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 17 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): Standards 19 and 26 were assessed. Quality in this outcome area is good. People in the home are provided with safe and comfortable surroundings to live in and enjoy. EVIDENCE: The home provides attractive and comfortable surroundings for people living in the home. The home is purpose built and single, ensuite accommodation is provided for each person. All of the rooms seen by the inspector were clean, odour free and were personalised with the residents’ own belongings. The rooms are all numbered but are also named after desirable personal qualities such as ‘understanding’, ‘faith’ and ‘happiness’. The garden areas outside are well maintained and accessible to residents. One gentleman commented how he enjoyed spending time in the garden during good weather. There are several communal areas in the home that residents can choose to spend time in if they want to be with other people. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 18 All parts of the home that were seen during the inspection were clean. Good practice in the control of infection was observed; staff wore protective clothing when dealing with soiled laundry and different coloured aprons were used during food service. There are sufficient handwashing facilities for staff. Discussions with residents over lunch confirmed that a good laundry service was provided; they expressed their opinion that their clothes were looked after. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 19 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): Standards 27, 28, 29 and 30 were assessed. Quality in this outcome area is good. There are sufficient numbers of competent staff to meet the needs of people living in the home. EVIDENCE: The usual staffing complement for the home is: Ground Floor (Residential Care) 1 senior carer 2 carers 1 senior carer 2 carers 2 Carers First Floor (Nursing Care) 2 Registered Nurses 4 Carers 2 Registered Nurses 3 Carers 1 Registered Nurse 2 Carers 7.30 am – 2pm 2pm – 9pm 9pm – 7.30am In addition the manager is supernumerary and there are sufficient laundry, catering, cleaning, maintenance and administrative staff to ensure that nursing and care staff do not spend time undertaking non-caring tasks. The home uses minimal agency staff with any absence such as sickness or holidays being covered by the home’s own staff. On the day of inspection it became evident that there was a staff member short on the 2pm – 9pm shift and the administrator worked hard to ensure that a replacement was found to ensure there were sufficient staff on duty. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 20 Staff were observed to be aware of the needs of residents and gave prompt attention when it was required. Residents seemed comfortable in asking staff for assistance. Residents were complimentary about staff saying, ‘they’re very good’, ‘helpful’ and ‘very nice’. Out of 30 care staff employed in the home 16 have a National Vocational Qualification in Care (NVQ) at level 2, three staff have an NVQ at level 3, five staff are currently undertaking an NVQ at level 2 and three staff are currently undertaking an NVQ at level 3. The home is to be commended for it’s commitment to ensuring that staff have an NVQ qualification which ensures that residents are being cared for by trained and competent staff. The personnel files of two recently recruited members of staff contained Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (PoVA) checks. One also contained two satisfactory references but one file did not contain any references. Robust pre employment checks must be completed before staff members start working in the home in order to protect the people living in the home. Staff training records demonstrate that staff receive mandatory training in food hygiene, fire safety, Health and Safety, abuse, moving and handling and infection control. Other training undertaken has included tissue viability and the prevention of pressure sores, dementia awareness and care planning. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 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): Standards 31, 33, 35, 36 and 38 were assessed. Quality in this outcome area is adequate. The home has a competent and qualified manager to provide direction and guidance to ensure residents receive consistent quality care but the systems for the management of medicines must be improved to protect service users from harm. EVIDENCE: The home manager is a registered nurse who has been in post for four years and has achieved the Registered Manager’s Award (RMA) NVQ level 4. The deputy manager is deputising during the manager’s sick leave and is working supernumerary to facilitate this. A new audit system for monitoring working practices and the quality of care delivered to residents has been implemented and is completed monthly by the home manager. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 22 A residents survey has recently been undertaken asking the opinion of residents about the service they receive in the home and the results have been published. It was informed that the information collected from the survey has been included in an improvement action plan although this was not seen during the inspection. Residents’ personal monies are kept securely in separate bags and accurate records of income and expenditure are kept. An audit of two of the residents’ personal monies was found to be correct. Evidence was seen in staff files that staff supervision is undertaken with senior staff undertaking the supervision for each of their identified teams. The home has effective systems for maintaining equipment and services to the home to promote the safety of people in the home. A sample of service and maintenance records were examined and found to be up to date; fire alarm tests are carried out weekly and the last fire drill was undertaken on 17th May 2006, hoists were serviced in February 2006, a Gas safety certificate was last issued in May 2005 and Electrical Portable Appliance Testing was completed in October 2005. The programme of mandatory training in fire prevention, infection control, moving and handling and food hygiene along with planned training in Health and Safety further protects the safety of people in the home. However, the poor management of medicines, as detailed in the ‘Health and Personal Care’ section of this report, does not protect service users from the risk of harm. Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 2 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 x 2 Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 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 OP3 Regulation 14 Requirement Timescale for action 30/07/06 2 OP7 3 OP9 4 OP18 5 OP29 The registered manager must ensure that the needs of service users are fully assessed and documented before providing them with accommodation in the home. 15 The registered manager must Schedule ensure that care plans set out in 3 detail the actions needed to ensure all aspects of the health; personal and social care needs of service users are met. 13 The registered manager must make arrangements for the safe recording and administration of medicines in the care home and the issues identified in this report are addressed. (Previous timescale not met) 12, 13, 17 The registered person must ensure that all staff are aware of how to respond to allegations or suspicion of abuse. 19 The registered manager must Schedule ensure that staff files contain 2 evidence of pre employment checks, including satisfactory references. 30/07/06 15/07/06 30/07/06 30/06/06 Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 25 6 OP38 12(1)(a) 13(2) The registered person must make arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. 15/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Harmony House Care Home DS0000065174.V297510.R01.S.doc Version 5.2 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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