Inspection on 23/08/06 for Heath Lodge

This inspection was carried out on 23rd August 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 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

Heath Lodge 06/08/07

Heath Lodge 22/04/05

Heath Lodge 02/11/04

Heath Lodge 27/05/04

Heath Lodge 10/02/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Heath Lodge 6 Pannal Ash Road Harrogate North Yorkshire HG2 9AB Lead Inspector Jean Dobbin Key Unannounced Inspection 23rd August 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Heath Lodge DS0000007801.V309182.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. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heath Lodge Address 6 Pannal Ash Road Harrogate North Yorkshire HG2 9AB 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) 01423 561741 01423 709930 info@harrogateneighbours.co.uk Harrogate Neighbours Housing Association Limited ****Post Vacant**** Care Home 28 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (22) of places Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2005 Brief Description of the Service: Heath Lodge provides residential personal and social care for older people. There are 28 registered places, which include 6 places for people who require dementia care. The service users with dementia are cared for in a separate unit specifically designed for this purpose. The home is a detached property set in its own grounds approximately one mile from Harrogate town centre, where there are good amenities and transport links. There are attractive wellmaintained gardens with level access and seating areas and a car parking area at the front of the building. Heath Lodge has two floors, which are accessed by a vertical passenger lift and bedrooms are on both floors. There are 28 single bedrooms, 6 of which are en-suite. Details provided in July 2006 outline the weekly fees as between £376.25 and £430. This does not include hairdressing, chiropody services and individual items like newspapers and toiletries. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report follows an unannounced site visit to the home on 23rd August 2006. The inspection lasted 8 hours, with additional time for preparation work. The manager was present for most of the day and was provided with feedback at the end of the inspection. A tour of the home including communal, service and private areas was undertaken and staff were observed interacting with residents. Some policy documents were looked at, and care records were examined to see how individual care needs were assessed. Discussions were held with service users, staff and relatives. Prior to the site visit a questionnaire was sent to the home, which was completed and returned, as requested, within the stated deadline. Requests for views, in the form of a written survey, were sent to 10 next of kin chosen at random and 6 were returned. Forms were also sent to 3 health care professionals, and 2 were returned. There was also a telephone discussion held with a health care service. Each of the returned forms gave positive feedback about the home. Surveys were not sent to residents but discussions on the day provided good insight into their service. What the service does well: What has improved since the last inspection? Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 6 All prospective service users are now assessed prior to moving to the home and are given written information so that they can make an informed choice about whether to move to the home. All service users moving to Heath Lodge receive a personalised ‘Welcome Pack’ providing information about what services and facilities they can expect at the home. This also now includes details about the home’s complaint’s policy. There is ongoing refurbishment of private rooms as they become available to provide a more attractive environment for the service users. The present general manager has now applied to be registered and her application is being determined at around the same time as the inspection. There is a newly appointed Responsible Individual who is working closely with the manager. This new management team are implementing changes to improve the service for the users and their families. Staffing levels have now been reviewed and the managers’ hours are now supernumerary, to allow her to develop the service, without having to sometimes work as a care assistant too. 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. Heath Lodge DS0000007801.V309182.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 Heath Lodge DS0000007801.V309182.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): 1, 2, 3 and 6 Quality in this outcome area is good. The pre admission assessment ensures that individual care needs can be met at the home and the prospective resident receives information and help to enable them to choose whether Heath Lodge is the right place for them. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A service user and members of their family were spoken with. They confirmed that the manager had visited them at their own home and discussed what help and support they would need if they were to move to Heath Lodge. They all came to look around the home and were given written information to take away and read. When they moved to the home they were given a contract to sign. The family confirmed that they received a statement of terms and conditions. Similar discussions were held with other service users and their families, who had moved to the home in the last few months. They all described a similar process and said that they received sufficient information to reassure them that moving to the home was the right decision. The assessments, completed by the manager, also confirmed that they would receive appropriate care at the home. Intermediate care is not provided at Heath Lodge. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 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 and10 Quality in this outcome area is good. The residents have a comprehensive assessment plan in place and their personal, social and health care needs are well met. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Three service user files containing care records were examined. These were presented in a consistent format, so were easy to read. They contained comprehensive assessments of the service users’ needs, which were reviewed monthly by their key worker. Service users had a ‘pen picture’ at the front of their records. This emphasised their individuality and personality, as well as their care needs. There were risk assessments in place with review dates documented. One service user, following an accident, had formally had all their assessments reviewed and there was clear documentation highlighting which assessments had changed, and why. Care required during the night was also documented, with comments such as the ‘service user requires regular checks through the night as they are unable to use the call bell’. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 10 There was evidence in the records of visits from the optician, the chiropodist as well as the local GP. A doctor visited a service user on the day of the visit and they were seen in their own room. A survey returned from a GP raised no concerns and a telephone discussion with a member of the RRICE team (Rapid Response Intermediate Care for the Elderly) who visit the home following referrals from the GP also said that advice was followed appropriately. The medication systems were looked at. The home uses an MDS system, (drugs dispensed from blister packs). The drugs for the main part of the home are kept in a mobile trolley, and for Alison wing, (the small separate unit) they are stored in a cupboard, both within a locked room. The manager demonstrated good understanding of why the drugs were being given and nine staff members have completed training in medication practice, to ensure they understand the checks necessary to prevent errors. The administration charts and Controlled Drug record book however, each highlighted two occasions in the previous week where signatures were missing, and this poor practice needs addressing. There is a pay phone in the home and there are telephone points in all the private rooms with several service users having their own phone. Service users spoken with said that staff always treated them with kindness and respect. Staff were observed interacting in a respectful and courteous manner. One service user said that although she had a lock on her door she never used it because people always knocked. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 11 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 and 15 Quality in this outcome area is good. The service user’s day-to-day life is what they would expect, and the meals are nutritious and varied. This judgement has been made using available evidence including a visit to the service. EVIDENCE: There are visitors in and out throughout the day and volunteers also work at the home. There is a weekly timetable of activities, generally organised by carers. On the day of the inspection two service users were doing a newspaper crossword in the conservatory and others were enjoying a glass of sherry whilst playing bingo. One person said that they were always asked whether they wished to participate and service users from the separate unit are also invited to attend these activities as they choose. Service users recalled the garden party, held a month earlier and photographs of the event are displayed in the reception area. When moving to Heath Lodge service users receive a personalised ‘Welcome Pack’, which gives details about all aspects of the home, including social activities. The library visits and changes books and talking books each month, and the home has bought two talking book machines for service users, who have a visual disability. The attractive gardens have level access and service users were observed sitting outside with their visitors. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 12 The main dining room is a large bright room, with several square tables, with table linen and cloth napkins. Roast pork, with stuffing and applesauce, was on the menu, and when asked earlier that day, most service users had chosen this rather than the pasta alternative. The vegetables were presented in serving dishes so that people could help themselves. Several service users provided positive comments of the meal afterwards. The carers wear tabards when helping at mealtimes and they were present in an unobtrusive manner over lunchtime. The medication was dispensed during the meal, although the drug trolley is not taken into the dining room. This is a somewhat institutional practice and consideration should be given to dispensing the drugs when service users have finished their meal. On Alison wing (the unit for those service users with dementia), the meals are taken on a trolley and served individually in the small dining room. There is a hot cabinet on the unit, however on the day of the visit this wasn’t used, with the plated desserts being left in the small kitchen. As a result all the desserts had to be re-heated prior to serving. In the main dining room, following the main course, ice cream was offered to service users as an alternative to the hot dessert. This didn’t happen in the unit where the carer said “the service users never like ice cream”. The management need to ensure the same choices are available to all service users. The menu is not currently displayed however plans are in place to remedy this. The experienced cook is responsible for ensuring all kitchen staff complete food hygiene training and meets regularly with the manager to discuss catering issues. She talks with the service users and attends their meetings so that she can hear their views about the food. Service users’ comments about the meals were generally complementary, stating that the portions were large enough, with plenty of fresh vegetables. Some service users said they would like more fresh fruit and this provision was discussed with both the cook and the manager, who felt this was a very reasonable comment that she would follow up. There were written details of service users’ likes and dislikes in the kitchen and health and safety records, to protect service users from risk of food poisoning, were all in order. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Residents and their families can be sure that complaints will be taken seriously and staff are alert to any signs of abuse. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The complaints policy is displayed in the entrance to the home. There have been two complaints since the last inspection, which have been investigated and addressed appropriately. One service user said if they were concerned about a carer’s behaviour, then they would speak to the individual initially, and then with the manager if it happened again. Another service user however, would not want to tell anyone. The manager should promote a culture in the home where complaints are seen as a way of improving the service and not just “making a fuss”. Staff spoken with would feel able to speak with the manager if they had concerns. Recruitment processes are robust. Staff have received abuse awareness training this year. They were very clear about their responsibilities should they see something they were concerned about. The manager was also able to explain her role should an allegation of abuse be made. Volunteers at the home are requested to watch several videos, including one on ‘abuse’ so that they have some understanding of the process. There are booklets displayed in the reception area about the provision of advocacy services in Harrogate and the social services policy on managing allegations of abuse. Service users can be reassured that the home will treat complaints seriously and protect them from harm. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 14 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, 23, 24 and 26 Quality in this outcome area is good. The service users live in a clean, wellmaintained and comfortable home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A tour of the home was carried out at the start of the inspection. The general appearance and impression is that Heath Lodge is a clean and comfortable place to live, with no malodours evident. The home has a small separate unit for service users with dementia. Although access to this unit, through the home, is via a door with a keypad, the door is often open. This unit includes a large walk in shower and an assisted bath, a lounge with television, dining room with French windows and a small kitchen where drinks can be made and service users can carry out small domestic duties if they wish. There are videos and CD’s of older music in the lounge, however on the day of the visit there was daytime television on the box. There is access from this unit to a well-maintained, fenced garden and work was in progress to provide a safer ramped access to the outside through the French windows. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 15 The main part of the house has a large dining room, quiet sitting room with no television, conservatory and a largish seating area in the reception, where there is a television. There are books, newspapers and magazines evident and the environment is homely with lots of pictures and ornaments. There was juice available in the lounge and service users were sat talking or reading. The private rooms are large and individually furnished with many personal possessions evident. Many of the rooms were more like bed-sitting rooms with a settee, or two chairs, standard lamp, coffee table and bureau. The gardens are well tended and mature with seating areas and tubs of bedding plants. One service user had a well-stocked bird table erected just outside their window. There are adequate toilet facilities and these are situated near to the communal areas as well as the private rooms. There are several bathrooms, but only one assisted bath and one walk in shower. The rooms can be locked when inside and from the outside too, however none of the service users spoken with chose to lock their doors as they said they felt very safe. One person said that if they had anything of value then they would ask the manager to lock it in the safe. Water temperature monitoring records are kept and in order. However random checks of four sinks showed one hot tap in the bathroom on Alison wing recorded only 37°C, which is too cold. The manager was informed of this. There is also a file with maintenance requests recorded, which showed that maintenance requests are attended to promptly. The laundry area was satisfactory and staff were able to explain how their practice safeguards the spread of infection within the home. There are gloves and plastic aprons available and disinfectant hand wash in all the rooms. All commodes are removed from service users’ rooms during the day and cleaned and stored in sluice areas. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome area is good. Service users are supported and cared for by well-trained staff and a robust recruitment policy ensures that they are in safe hands. This judgement has been made using available evidence including a visit to the service. EVIDENCE: There are four carers on the morning shift and the manager who is supernumerary, three on the afternoon and evening and three through the night. There is one senior housekeeper, with two members of staff, and a cook and kitchen assistant. The maintenance person is full time. There is no activities person, nor laundry person. Although the number of carers has increased since the last inspection, most service users spoken with felt that the staff were still very busy for much of the time. The management need to ensure that there is always enough staff on duty to meet the needs of the service users. There have been a number of staff vacancies this year and recently the management have needed to use agency staff most weeks. However prospective employees have been interviewed and police checks are awaited. Management hope that the staffing complement will be complete within a few weeks. More than half the carers at Heath Lodge have completed their Level 2 National Vocational Qualification in Care, with almost all the remaining carers working towards the award. Several are working towards, or have completed, Level 3. Service users are likely to receive better quality care from staff, who have knowledge and understanding about their role. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 17 Two staff recruitment files were examined. Both had started work at Heath Lodge earlier this year. The recruitment process had been followed correctly and neither had started work until the CRB clearance was obtained. This Criminal Records Bureau check is to ensure that a prospective employee is not barred from working with vulnerable adults because of a previous offence. A recently employed member of staff described a supernumerary period when they started at the home and how they were given an induction programme to aid their learning and understanding in their new role. There is a training plan in place and records of attendance are kept in staff files. Recent training has included abuse awareness, food hygiene, fire training, safe handling of medicines, moving and handling and COSHH, (Control of Substances Hazardous to Health). Well-trained staff are more likely to provide safe and consistent care. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 18 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 and 38 Quality in this outcome area is good. Service users and their families are central to the development of the service and management recognises safe working practices as paramount to protecting service users and staff. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The manager has been in post for several months and has recently applied to be the registered manager. She is very experienced, having worked in the care sector for a number of years, and has completed her registered manager’s award and Level 4 National Vocational Qualification in Care. Staff, service users and visitors describe her as approachable, with an open door policy, enabling her to be available for others to talk with. The providers have appointed a new Responsible Individual since the last inspection and she has brought fresh ideas for the home as well as supporting the manager in her new role. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 19 There are plans in place to develop quality assurance systems to show that the home is monitoring itself, and staff and service user meetings, are already being held regularly. The home is not an appointee for any service users. The home holds pocket monies for some service users and one staff member is responsible for checking the monies each week. Each service user has a record book and ‘purse’. Receipts are not routinely issued and this would be good practice. Personal supervision takes place with records in individual staff files. All annual health and safety records are in date with the home looking into purchasing their own kit for checking the risk of legionella. The manager will forward the legionella check when the equipment is delivered and used. There was a letter to evidence that enquiries had been made about the cost of the kit. Staff are attending fire training annually, however North Yorkshire Fire Authority recommend that day staff should attend training every six months and night staff every three months. The management team are determining the best way to provide this training. Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 20 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 3 Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement The manager needs to ensure that all staff take responsibility for monitoring drug charts to check that there are no omissions, and drugs are signed for appropriately. The manager is required to ensure that all service users are given the same opportunity to choose, and carers do not make choices on their behalf. The manager is required to ensure that meal delivery in the dementia unit is to the same standard as meals in the main dining room. Timescale for action 30/09/06 2. OP14 12(2) 30/09/06 3. OP15 16(2) 30/09/06 Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 22 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 3 Refer to Standard OP9 OP33 OP35 OP38 Good Practice Recommendations Staff should consider regularly counting the non-blister packed tablets weekly, as a way of checking that the actual number of tablets tallies with the expected number. It would be good practice to provide receipts for all monies that change hands to evidence that the transactions take place. As part of the fire risk assessment consideration should be given to providing staff training in line with the recommended intervals suggested by North Yorkshire Fire Authority Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Heath Lodge DS0000007801.V309182.R01.S.doc Version 5.2 Page 24 - 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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