Inspection on 13/02/06 for Highfield House

This inspection was carried out on 13th February 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

Highfield House 12/01/09

Highfield House 23/01/07

Highfield House 08/11/05

Highfield House 29/03/05

Highfield House 19/10/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Highfield House High Street Castle Cary Somerset BA7 7AN Lead Inspector Loli Ruiz Unannounced Inspection 12:00 13 February 2006 th 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 Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Highfield House Address High Street Castle Cary Somerset BA7 7AN 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) 01963 350697 01963 350697 highfieldhouse@yahoo.co.uk MR STEPHEN JOHN BIDDLECOMBE MRS PHILIPPA GRACE BIDDLECOMBE MR STEPHEN JOHN BIDDLECOMBE Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 08/11/05 Brief Description of the Service: Highfield House provides residential services for 22 adults under the “older people” category of registration. Mr and Mrs Biddlecombe own, and have managed the home since 1988. The home is located in the main street of Castle Cary, close to all the town’s amenities. Nearby larger towns include the county town of Taunton and Yeovil. There is a rail station on the outskirts of Castle Cary with a main line to London. The home consists of a period main house to which extensions have been built at later dates. Service users accommodation is on two floors. There is a passenger lift and a stair lift. All bedrooms are single and all have washing facilities. Fifteen bedrooms have en-suite toilets. There are five communal toilets, two adapted bathrooms and a walk-in shower for communal use. The home has a number of communal rooms, a conservatory and large, attractive gardens with level access. Food is cooked on the premises by catering staff. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of the planned programme of inspections for the period April 2005 to March 2006. The inspection was carried out over four and a half hours and included contact and discussions with service users, staff, visitors and management, tour of public and private areas in the home and inspection of essential records. Service users, and all spoken with, continue to provide excellent feedback of the home, staff and management. The inspector found that Mr and Mrs Biddlecome have continued to maintain very high standards throughout. What the service does well: What has improved since the last inspection? Two fire-guards have been installed on the doors of the kitchen and the staff’s station so that, if open during the day, these doors will close in the event of fire alarms being activated. Following from a recent meeting with all service users, and with their cooperation, there are plans to extend the conservatory to provide a games area, a larger patio and improved access to the back garden. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 6 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. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3,4,5. NMS 6 is not applicable. Prospective service users are provided with the necessary information, opportunities for visiting and testing out the service prior to deciding about moving in. The assessment documentation is clear and evidences the involvement of the service user, their advocate and any other involved persons. EVIDENCE: The home’s statement of purpose, service users guide, last two inspection reports and an invitation for service users and visitors to forward their views about the home was clearly at hand at the entrance of the home, next to the visitors book. The manager confirmed that all service users continue to be issued with a contract and terms and conditions of residency. Three care records were selected for inspection of service users who had recently come to the home. Records evidenced pre-admission assessments. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 9 A member of the management team visits local prospective service users and ensures that the assessments of health and social care professionals, if involved, are forwarded prior to deciding if the home can meet the needs of the person. Care records included a plan of care and assessments of identified risks and generally evidenced the involvement of service users with their care. The inspector spoke privately with the new service users who confirmed their agreement to their plan of care. They also confirmed to having visited or known about the home prior to admission and to having selected this home in preference of others seen. The majority of staff members have NVQ qualifications and the home has a quality rating accreditation. The home does not offer specialised services but works closely with local health and social care professionals to support the changing needs of service users. Intermediate care is not provided. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 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): 7, 8, 9, 10, Service users benefit from care planning arrangements that are clear and assist staff in meeting their assessed needs. Service users have access to health care services and good links with health care professionals assist with meeting their health care needs. The home has good medication management system and practices, however the medicines fridge and a small cupboard holding aperients had no locks, as they should, to fully ensure the safety of service users. Personal support is offered in a way that maintains the privacy and dignity of service users. EVIDENCE: Care records inspected evidenced satisfactory care plans based on assessed needs and identified risks. Service users were involved with their care planning as their signature or wishes regarding signing care records was documented and confirmed by the service users. Care records included details of health Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 11 care monitoring, contact with health and social care professionals, reviews and also monthly summaries. All plans seen were clear and up-to-date. Care plans are stored in a lockable records trolley. The medication storage, administration, recording and returns system were inspected and found well managed. This included the controlled drugs in use. MAR sheets were well maintained and appropriately signed. The medicines trolley is locked and fixed to the wall and discontinued medicines are promptly returned to the pharmacy. The pharmacist had reviewed all medication recently with the manager, deputy and senior staff in charge of the area. Staff involved with medication receive training and their competencies are regularly reviewed by the manager. The medicines fridge in the staff station had no lock. The temperature was taken daily. A small cupboard nearby holding aperients and other such remedies, also lacked a lock. Mrs Biddlecombe agreed to provide suitable locks and to ensure that medicines of all kinds are always locked away. The home provides single lockable rooms for each service user. Some have ensuite facilities and the majority have telephones installed in their rooms. The inspector observed staff going around their work in appropriate caring and respectful manner. They were observed waiting for permission before entering rooms and service users confirmed that they were treated with respect and staff always sought their views. The inspector received many complimentary comments such as “ home from home” “ better than home” “ they feed us too well” “ very thoughtful staff” “ they are so good” “ happy here” “ so lucky to be in this home” from service users. Complimentary feedback was also received from visitors who came regularly to the home. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Service users are supported to lead the lifestyle that they wish and can participate in leisure activities. Visitors are welcomed and service users are assisted with maintaining contact with relatives and friends, and to cultivate new friendships. Service users benefit from the staff and management in the home who consult and agree with them about all matters affecting their lives. Service users enjoy the meals in the home that offer variety, good quality, good portions and take account of personal preference and dietary needs. EVIDENCE: Service users were observed in all areas of the home freely moving about as they wished. In the living room, service users were able to entertain eachother, chatting, playing the piano or discussing events. They confirmed being able to organise their days as they wished and to staff that worked according to flexible routines. Some service users accessed local facilities next to the home such as shops and pubs. All private areas seen fully reflected the individual tastes of the person living in them and were fully personalised with Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 13 their own furnishings, pictures, paintings, audio-visual equipment and chosen literature. Home activities and paid entertainment had continued in house and, with the warmer months coming, there were plans to organise trips out. A booking had been made to see a local play for a group of service users. The staff had rehearsed and produced a pantomime for Christmas. During the inspection, local friends were visiting a service user. Some of them visited daily. A new service user who liked being read to, because of visual problems, had been introduced to a neighbour who was happy to come in regularly to provide reading sessions. Service users indicated that they had friends within the home and that they maintained contact with relatives and established friends. The inspector had contact with a number of visitors, all of whom provided very positive feedback about the home. There had been a recent meeting with the management team to which all service users had attended and a majority had contributed. Many useful ideas had been received and as a consequence there were plans for extending the conservatory, creating a dedicated games area and extending the patio from the conservatory. The manager indicated that she had followed items in the quality assurance questionnaire for discussion in the meeting, this had been so successful that they were now planning to follow this format again. The inspector observed the lunch meal being served and the tea-time meal choices being offered to service users. Meals were well balanced, appetising and in good portions. The lunch menu was ham and chicken pie, prepared by the cook with a selection of fresh vegetables and potatoes and rice pudding. The home prepared diabetic diets and offered vegetarian and fish if anyone did not want the meat choice. There were alternative sweet options and fresh fruit available. The tea meal choices included soup, sandwiches and fish fingers. Menus were displayed in the dining room and staff also asked service users what they wanted before preparing the meal. Meals were served in the very pleasant dining room. Tables were nicely laid and decorated with fresh flowers. Meals were also served in bedrooms for some service users. All staff, including managers assisted with serving meals achieving a relaxed and unhurried time for service users. Tea, coffee and a selection of cakes was served midafternoon and service users confirmed that beverages are served between meals and as requested. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17,18 Service users are protected by the complaints policy, philosophy of care and practices in the home that ensure a prompt response to meet service users wishes. Service users are protected by the home’s established links with the Age Concern advocacy service and by being able to accessing and maintain formal advocacy services when required. Service users are protected by the arrangements in the home for the protection of vulnerable adults that include rigorous vetting staff procedures. EVIDENCE: The manager informed the inspector that no complaints had been received and indeed no complaints had been received by CSCI. Staff indicated that there were no issues of concern and that it was easy for them to discuss any issue with the management, who often worked with them, and other members of the team to ensure that service user’s wishes were met and minimise the need for complaints. Service users confirmed that and explained that all they needed was to tell any of the staff or management of anything they wanted. They described staff and management as “very caring” and “very thoughtful”. There is a book by the entrance of the home inviting service users and visitors views. Visitors had a high opinion of the home, indicated that there was nothing to complain about and were sure that if there was, staff would deal well with the problem. The home’s complaints policy is included in the information pack at the entrance of the home. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 15 Service users are able to maintain solicitors and access new services if required. The home has established links with Age Concern and would enable service users to access advocacy services. The file of the only new staff since the last inspection evidenced POVA first sought prior to starting work and CRB checks made for new staff. The file also evidence good recruitment procedures, references taken and a good induction given that includes the ethos of the home, non-involvement with service users finances and policy for the protection of vulnerable adults. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Service users benefit from a home that provides a comfortable environment maintained to a very high standard of hygiene and décor and that provides them with attractive and safe indoor and outdoor facilities. Service users are provided with sufficient lavatories, WCs that are equipped to meet their needs and also with other specialist equipment that they require. Service users private space is comfortable, well maintained, attractive and fully personalised. EVIDENCE: Mr and Mrs Biddlecombe consistently maintain the home to an excellent standard throughout with an ongoing programme of refurbishment. All areas seen remain most comfortably furnished, attractively decorated and spotlessly clean. This included the kitchen and public lavatories. Staff appeared proud of the standards achieved and many details were observed that demonstrated this, such as good quality towels, nicely folded, attractive table cloths, and Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 17 attractive decorative items such as mirrors, paintings and flower arrangements. Service users commented on the good quality of their environment and were pleased with it. The home has a large living room with smaller sitting areas by the entrance and landing. There is an attractive dinning room and a conservatory. With a small garden area. A path leads to the large back garden. The garden is well used in the warmer months where some service users can tend their own vegetables, aided by staff, have tea parties or just sit and enjoy nature. There are plans to extend the conservatory and near patio to provide easier closer access to a larger outdoor area. The home has a passenger lift as well as a stair lift over a few steps on the first floor. It has an attractive stairway by the entrance hall. All equipment and systems inspected had been serviced and maintained as required. Mrs Biddlecombe confirmed that the home has service contracts to ensure that all requirements are complied with, i.e. LOLER and fire regulations, and that the home is safe. Fifteen bedrooms have en-suite facilities. The remaining seven rooms have washing facilities. Rooms without en-suite have WCs and bathrooms nearby. There are also well equipped WCs near the communal areas. There are two adapted bathrooms and a walk-in shower. A bedroom had a radiator that would not regulate and was either too hot or too cold and another room also was observed with a radiator supplementing the central heating. The manager had risk assessed the use of these heaters and discussed with the inspector maintaining these reviewed. It seems that the heating system needs emptying and Mr Biddlecombe plans to do it after winter so not to disrupt the heating for the rest of the home during the cold months. The inspector did not visit every private room in this occasion but those seen were beautifully maintained. Private rooms had items of furniture, paintings, books, pictures and equipment belonging to the person. The excellent standard of hygiene in all areas, including the kitchen, bathrooms and WCs is commended. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29,30 Service users benefit from a home that has good staffing levels, a stable team and by competent and qualified staff. Service users benefit from the recruitment practices in the home. EVIDENCE: On the day of the inspection there were twenty service users at home. One was in hospital and a vacant room had been taken and the new admission was due the next week. The staff team has remained stable with only one staff leaving to manage own business and a new staff recruited. In addition to Mr and Mrs Biddlecombe, there were a senior carer in charge of the shift, a care assistant and the deputy manager covering a sick absence. There were also a cook and kitchen and domestic assistants in the home. In the afternoon the care and support staff would leave and two others would take over plus a kitchen staff come until the evening. Care staff worked until the night staff came on duty. There was time allocated for passing on information between shifts. Members of the management team worked until the evening and are all close at hand in an emergency. Rotas showed that this is a daily pattern with a member of the management team either working at week-end or at hand on call. Absences were always covered and this was accomplished either with existing staff or by either the manager or deputy covering the absence. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 19 Good training opportunities continue to be provided for staff who can nominate themselves for any specialist training they feel they would benefit from. The deputy manager has compiled excellent training and supervision records and a three years training plan that ensure that top-up mandatory training is booked in advance and provided in time. The record provides good evidence of both mandatory training and additional training provided for staff. The home now exceeds the 50 VNQ trained at level II and has 6 of 26 staff, nominated or doing NVQ III. The new staff file evidenced that sound recruitment practices have been maintained and that a good induction package is used. The staff member was doing NVQ II. Mrs Biddlecombe ensures that the home benefits from training bursaries and government assistance when available. She engages a range of training providers and distance learning packages. Work in connection with ensuring a well trained and competent staff team and the good records that evidence work in this area is commended. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 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): 31,32,33,36, 37, 38. Standards 34 and 35 were not inspected. Service users benefit from experienced registered providers who ensure that the service is effectively run for the benefit of service users. Service users best interests are safeguarded by the ethos and leadership qualities of the providers. Service users benefit from a well trained and supervised staff team. Service users benefit from the recording and health and safety arrangements in the home. EVIDENCE: Mr and Mrs Biddlecombe have owned and managed the home for many years. They are both open and frank in their style of management and always contribute positively to the inspection process. Mrs Biddlecombe has completed Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 21 NVQ IV and the Registered Managers Award. She has NVQ assessors qualifications. The staff continue to indicate that the owners are most approachable and flexible and also appreciate their hands on assistance when necessary. They confirm that the pace is good in the home and have time to spend with service users. Service users describe Mr and Mrs Biddlecombe as “ most kind”. Mrs Biddlecombe maintains herself up to date with developments in the care industry and provides staff with good training opportunities. Her deputy has compiled clear and complete training records and a three year training plan. In addition to planning for meeting identified training needs, staff are encouraged to nominate themselves for training and they have all attended mandatory training and updates, as required. There are group and general staff meetings and records evidenced annual appraisals and regular supervision, at two monthly intervals for care staff. Records inspected and found well maintained and up to date included * Care documentation * Staff files * Staff rotas * Fire testing and inspection records * Records of servicing of mobile equipment * Training charts * Medicine records. * Records of electrical PAT testing and wiring certificate * Accidents record The inspector also noted H&S notices, menus, the quality accreditation, registration certificate and other such information displayed in the home. The home has appropriate safe storage space and the environment is maintained free from clutter. Locking of over the counter remedies and the medicine fridge has been recommended under NMS 9. Good practices with regards to infection control were noted as were the availability and good use of protective equipment and materials. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Good Practice Recommendations The manager should ensure that all medicines are always locked and to this end install locks in the medicines fridge and small cupboard holding aperients and other such remedies, as agreed during the inspection. Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Highfield House DS0000016098.V279740.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!