Inspection on 14/11/05 for Heron Hill Care Home

This inspection was carried out on 14th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Heron Hill Care Home 29/09/09

Heron Hill Care Home 23/07/09

Heron Hill Care Home 26/05/09

Heron Hill Care Home 02/06/08

Heron Hill Care Home 13/06/07

Heron Hill Care Home 07/03/07

Heron Hill Care Home 16/05/06

Heron Hill Care Home 22/04/05

Heron Hill Care Home 15/12/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Heron Hill Care Home Esthwaite Avenue Kendal Cumbria LA9 7SE Lead Inspector Marian Whittam Unannounced Inspection 14th November 2005 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Heron Hill Care Home Address Esthwaite Avenue Kendal Cumbria LA9 7SE 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) 01539 738800 Abbey Healthcare Homes Limited Vacant Care Home 86 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (50), Old age, not falling within any other of places category (28), Physical disability (4) Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 86 service users to include: up to 28 service users in the category of OP (old age not falling within any other category) up to 50 service users in the category of DE(E) (Dementia over 65 years of age) up to 4 service users in the category of DE (Dementia under 65 years of age) up to 4 service users in the category of PD (Adults with physical disabilities) Date of last inspection Brief Description of the Service: Heron Hill is a new purpose built home caring for up to 86 residents. it opened to residents in October 2004. It is in a residential area with access to local amenities. There is access to the bus routes and train station and the town centre of Kendal is about 2 miles away. There is a car park at the front of the home. The home is on three floors and there is a passenger lift to all floors. All the bedrooms are single and have en suite bathrooms with showers. There is moving and handling equipment around the home to help residents move around the home. There are 2 communal bathrooms and toilets on each floor and separate communal lounges and dining rooms on each floor. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 14 November 2005 over 5 hours with two inspectors and the pharmacy inspector. The morning was spent talking with residents in the lounges and in their own bedrooms, speaking to the nursing and care staff, cleaning and laundry staff, observing activities and looking at care plans. Ten residents were happy to speak to the inspectors and two visitors to the home. Policies and procedures, personnel and training records were looked at in the afternoon as well as other records required by regulation. Before the inspection some relatives had contacted the inspector about their experiences. What the service does well: What has improved since the last inspection? The numbers of registered nurses on duty during the busy morning shift has been increased to give better nursing cover as the numbers of residents has gone up. The home no longer used large numbers of agency staff and had a more stable staff group. Rotas show that a more equal gender mix on shifts is being achieved which improves resident choice on carers. The home has recognised the need to increase the level of activities on both suites and has advertised for a second activities coordinator to improve opportunities for recreation and stimulation for residents. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 6 The new manager has been reviewing nursing systems and care practices and bringing care planning, assessment and recording systems up to date. Improvements are evident in the provision of mandatory and other appropriate staff training and recording training needs, staff supervision, induction and continuing NVQ training. New policies, procedures and recording systems have been introduced where shortfalls have been identified. Moving and handling training fire training, training on adult protection and dementia has been brought up to date for staff. Recruitment procedures have been improved and are more robust to help safeguard residents. Resident and family meetings have taken place and are planned for the future to improve resident and family feedback and to get opinions and ideas from them. The home now has a permanent manager who has brought a more consistent and systematic approach to planning and is well aware of the improvements the home still needs to make. There is also a manager on the EMI suite, which has improved consistency and care practices. What they could do better: The home has information for prospective residents on the services offered in the statement of purpose and service user guide. However they do not make it clear that there are some limitations on free access to bedrooms for wheelchair users and that bedroom doors are wedged open or staff must open doors and let them in and out. This affects individual choice, privacy, independence and safety, as these are fire doors. The registered person must clearly demonstrate that the needs of independent wheelchair users living in the home can be met. The home is still within timescales to consult with residents on this and make any necessary adaptations to meet physically disabled/ independent wheelchair users needs. The home should consult with the fire officer on this as well. Residents with tube feeds must have clear care plans, procedures in place for nursing and care staff to follow and additional training for staff if needed to make sure that needs are met. The care plan for a resident with a feeding tube did not cover the administration of medication, care of the site and tube and what to do if problems arose. Although improvement was noted in some aspects of medicines handling further improvements were needed. In particular with administration of medicines through feeding tubes (PEGs) and the need to accurately record instructions from GPs relating to medicines changes. Although resident and relative consultation is improving the home should consider, as part of its quality monitoring systems, seeking the views of social and health care professionals on services offered. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 7 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. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 8 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 Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 9 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, 3 and 4 Assessments of needs are being done before admission and information from other agencies is included. Resident care plans had been developed from this information. The statement of purpose and service user guide does not make clear shortfalls in environmental standards so independent wheelchair users can make an informed choice about coming to live in the home and be sure their needs will be met. EVIDENCE: Individual resident care plans are in place and the improvements in documentation, admission and assessment procedures and record keeping, seen at the last visit, have been maintained. Social and religious needs, hobbies and recreational needs have been assessed and detailed in the care plans. One resident has received a lot of support from specialised nursing support and medical assessments due to depression including increased socialisation activities. Individual assessment records, including individual choices, were done for the residents before coming in and when they were admitted. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 10 Copies of social services assessments and contracts were held on file with the home’s own assessments. Information is available for prospective residents and the latest report is in the foyer. However there is not clear information on shortfalls in the physical environmental standard relating to independent wheelchair access to bedrooms. This must be updated to ensure that prospective residents have all relevant information to make an informed choice about coming to live in the home and so they can be sure that their particular individual needs will be met. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 11 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 and 10 The health and personal care needs of residents are being assessed and planned for within individual care plans. However the care planning for tube feeding lacked detail to ensure all health needs are met. Staff were treating residents with respect and taking appropriate actions to protect their privacy and dignity. Medicines handling is in need of improvement in line with good practice guidelines. EVIDENCE: All residents have an individual plan of care setting out health and personal care needs and with appropriate risk assessments that had been reviewed and updated. This was evident for a resident whose physical condition was deteriorating rapidly and detailed daily records showed good communication with family, medical staff and actions agreed by the family and doctor. Healthcare needs were being identified and met and there was evidence of working with other healthcare agencies to meet individual needs. This was evident for one resident with support from the Macmillan Nurse and the Intermediate support team. However one resident who needed a feeding tube (PEG) to get their food and medication did not have a sufficiently detailed care plan for staff to follow. There were no detailed instructions, or procedures in Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 12 place, about the care of the site and tube, the administration of medication by the tube, checking the position and managing problems including what to do if the tube comes out. Staff should have full information on managing this tube and have training to ensure they can meet the resident’s health needs in this respect. The pharmacist inspector examined medicines handling and found that some aspects of administration of medicines was poor. Improvement was noted in some aspects of medicines handling though further improvements were needed. A more detailed report of medicines administration is available from the CSCI Penrith office. Residents said that they saw personnel from health care services in their own rooms when they needed to. There were records of professional visits to residents and the actions taken. . Staff observed assisting residents using moving and handling equipment did this following explanation and maintained residents personal dignity during the transfers from wheelchairs to easy chairs in the lounge. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 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): 12, 13, 14 and 15 A programme of organised activities is provided that take into account resident’s preferences. Choices about daily life and routines, contacts with family and friends were being maintained according to the residents recorded wishes. The home offered a varied menu and choice of food and catered for special dietary needs. . EVIDENCE: The home has a programme of daily group activities and organised social and musical events. Care plans showed consultation on interests and assessment of this. The home has one activities coordinator and is advertising for a second as resident numbers increase. Some residents would like to be able to go out more, into town or shopping, but the home does not have its own transport. It should consider this or arrangements for providing it to increase residents opportunities for recreation and choice. Those advertised were seen in progress in the lounges during the day. The programme was on display in the foyer and planned Christmas activities advertised. Resident’s hobbies and interests, past and current, are recorded in their care plans and how they liked to spend time. One resident was using their computer on the day of the inspection and was on the internet. The resident said they preferred to follow their own interests and was not aware what was on the Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 14 programme except for the video shows. Residents said that they could come and go as they please, have their meals where they wanted and see who ever they wanted to. Residents spoken with made a variety of comments about the food in the home. One said that “the meals are very good” and there is a choice of meals. Another that the food was “very good” and they have started to put weight back on since coming in. The menus provided by the home showed a varied diet with a choice of food with lunch as the main meal. Lunch was attractively presented and as stated on the menu for that day. Residents in the dining room were given assistance if needed. One resident did say that they found the food and portions to be only “adequate” and that they did not always get what they asked for at breakfast. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 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): 16 and 18 The home has a satisfactory complaints procedure and recording system that was displayed in the home. Adult protection procedures were in place and training provided on this to staff to promote resident safety and wellbeing. EVIDENCE: The home has a complaints procedure, logged complaints for investigation and made the procedure available within the home. The complaints procedure was displayed on the home’s notice board and included information on contacting the CSCI. Systems are in place regarding resident’s finances and the care of any money kept in the home for them. Adult protection procedures are in place and local multi agency guidance available to staff on both suites for guidance. Staff are given training on adult protection and responding to suspicions of abuse. This includes the use of videos and questions to answer and is recorded in training files. The manager has not recorded any written complaints since the last inspection. The manager’s office is by the front door and she is available in the home each day to speak with residents or visitors. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 23, 24, 25 and 26 Heron Hill is well maintained and bedrooms and social areas are decorated and furnished to a satisfactory standard to provide a comfortable and homely environment for the people who live there. Aids and adaptations are provided to promote resident’s independence but independent wheelchair users had to be assisted to open their bedroom doors. EVIDENCE: The furniture, fittings and décor are in good condition and routine maintenance was being done. The lounges and dining rooms are well furnished and comfortable with good lighting. All bedrooms have their own en suite toilet, hand basin and shower and there are separate toilets close by and bathrooms. Care assistants were observed using moving and handling equipment to assist residents’ from wheelchairs into easy chairs in the lounge. This was done maintaining resident’s dignity, calmly and with explanation. Several residents showed the inspectors their bedrooms and many had brought in their own possessions and pictures to make the rooms more personal. One Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 17 new resident said that “things were coming together” as they organised their bedroom and had the telephone and television moved where they wanted them. An odour of urine was noted in a bedroom but domestic staff had already been told to clean the carpet by the nursing staff. Domestic staff said that the nurses usually told them when rooms needed the carpet shampooing or needed to be done quickly. Residents who were physically disabled and used wheelchairs as their main source of independent mobility did not have easy access to their bedrooms. Bedroom doors were heavy fire doors and staff had to open them for wheelchair users to go in and come out of the bedrooms so limiting individuals independence and choice. The bedroom doors were wedged open to allow residents to move in and out but this reduces privacy and also safety in the event of a fire. The fire officer should be involved in advising on this and alternatives. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The numbers and skill mix of care staff on the duty rota were adequate to meet resident’s personal and nursing care needs. Procedures for the recruitment of staff are satisfactory offering protection to people living in the home. EVIDENCE: The number of nursing staff on morning shifts has increased as resident numbers have gone up. There are two registered nurses on the rota for each suite during the morning. However on the day of the inspection the manager of Nightingale Suite and a carer had called in sick reducing the numbers. It had not been possible to get cover at short notice so staff levels were low on that suite. The EMI suite was fully staffed with two registered nurses and five carers. One resident said that staff “are helpful” and another that staff had to “put up with a lot” and that “some residents swear at them”. However another resident said “I like it, it’s alright” but that they had some difficulty understanding some of the foreign staff whose English was not good. Another resident said that they thought the foreign staff spoke good English and they had no problem. There had been six new members of staff since the last visit. Satisfactory recruitment and selection procedures and Protection of Vulnerable adult (POVA) and Criminal Record Bureau (CRB) checks had been followed for the staff. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 19 Staff training records indicated that appropriate training was being provided and induction training. A new registered mental nurse (RMN) was on duty and described the application and interview process, references taken and the checks done before she took up her post. Induction to the home had been given and she had been supernumerary at first then second nurse on duty. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 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 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, 32, 33, 35 The manager has a good understanding of the areas in which the home needs to improve, has a clear vision for the home, which she is effectively communicating to staff and residents. The home is reviewing aspects of its performance through self-review, audit and consultations that include seeking the views of residents, staff and relatives to affect the way the home is run. EVIDENCE: There are regular staff meetings and resident/family meetings have begun. The home has a permanent manager who is in the process of registering with the CSCI. There is a new manager on the EMI suite that has had a positive effect on care practices on the unit. The manager has done reviews of procedures and working systems in the home and does weekly audits of care plans. Some shortfalls have been identified and the suite manager must address these within their role. Changes have been made to policies and procedures and new ones started where review has shown shortfalls. If the Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 21 manager is to continue with developing and improving the service resources and support from the provider will have to continue to be forthcoming. Records that are required by the regulations were being kept and these were secure. Policies and procedures are in place to protect financial arrangements. Only small amounts of money were kept on residents behalf and these were recorded and checked for accuracy There was no evidence to show that health and social care professionals like doctors, district nurses and social workers involved with residents in the home are able to have a say in the services offered through quality monitoring systems. The home should develop this aspect of quality monitoring to promote an open and inclusive atmosphere. Many of the residents spoken with made positive comments such as, “ they’re looking after me well” and “they helped me settle in”, but some residents gave examples of poor communication with staff. Records showed that fire training had been given and emergency equipment is checked and appliances serviced. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 2 X 3 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X 3 3 Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 23 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 OP1 Regulation 4 (1) Requirement The statement of purpose and service user guide must make it clear where the home falls short on any environmental standard. This was to have been met by 1/11/05. The home must clearly demonstrate it can meet all the needs of independent wheelchair users coming into the home. The administration procedures of medicines through a PEG must be reviewed and staff must be trained in this form of administration. Care plans must be detailed in the administration of medicines via PEG. The practice of crushing of the longacting medicine must be reviewed urgently. Where medicines are administered through a feeding tube care plans should document discussions with and advice from health care professionals This was to have been met by 01/11/05 Medicine administration records must be in place for all residents DS0000059537.V284745.R01.S.doc Timescale for action 01/11/05 2. OP4 12 (1) 14 (1) 13 (2) 30/01/06 3. OP9 01/12/05 4. OP9 13(2) 01/11/05 5. OP9 13 (2) 01/05/05 Heron Hill Care Home Version 5.0 Page 24 6. OP9 13(2) 7. OP9 13(2) 8. OP9 13(2) 9. 10. 11. 12. OP9 OP9 OP9 OP22 13 (2) 13 (2) 13(2) 23 (1) (2) (a) (n) who are prescribed medicines and must be accurate for date; administration and reasons for non-administration must be documented. This was to have been met by 01/11/05. Medicines must be administered as prescribed This was to have been met by 01/11/05 Medicines must be disposed of appropriately This was to have been met by 01/11/05 Administration procedures must be reviewed and medication must not be pre-prepared in medicines pots prior to the time of administration Medicines must be secure at all times. All changes to medication and dosages must be accurately recorded and implemented Controlled drugs records must be accurately completed The home must consult with residents and make any necessary adaptations to ensure physically disabled residents can get in and out of their bedrooms as they choose and promotes independence and privacy. 01/11/05 01/11/05 01/12/05 01/12/05 01/12/05 01/01/06 30/11/05 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. Refer to Standard OP9 Good Practice Recommendations To request medication reviews for residents. DS0000059537.V284745.R01.S.doc Version 5.0 Page 25 Heron Hill Care Home 2. 3. 4. 5. 6. 7. 8. OP9 OP9 OP12 OP15 OP19 OP27 OP33 Medicines with limited expiry after opening should be marked with the date of opening. It is recommended that the manager request that the pharmacy labels both the outer packs and the inhalers. The home should consider having its own transport or arrangements to provide it for residents. The home should make sure that residents breakfast choices are available as stated on the menus. The fire officer should be consulted for advice and information on the alternatives to wedging open residents bedroom doors. Language skills amongst care staff should be at a level acceptable to all residents to promote good communication. The views of health and social care professionals involved with the care of residents in the home should be sought through quality monitoring systems to affect services offered. Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Heron Hill Care Home DS0000059537.V284745.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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