Inspection on 22/10/07 for Highgrove

This inspection was carried out on 22nd October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Highgrove 18/03/08

Highgrove 05/05/06

Highgrove 06/10/05

Highgrove 07/04/05

Highgrove 10/09/04

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 Highgrove Stapehill Road Stapehill Wimborne Dorset BH21 7NF Lead Inspector Jo Palmer Key Unannounced Inspection 22nd October 2007 10:30 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 Highgrove DS0000061344.V353167.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. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highgrove Address Stapehill Road Stapehill Wimborne Dorset BH21 7NF 01202 875614 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) Samily Care Ltd Post Vacant Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th May 2006 Brief Description of the Service: Highgrove has been operational as a care home since 1991, the present owners Mr & Mrs Bleach have been registered since June 2004 under the company name of Samily Care Ltd. The registered manager post is currently vacant. The home is registered to accommodate 21 older persons for personal care only. The property is a large Victorian house that has been extended and is set in large, well-maintained gardens. The front of the home provides off road parking for several cars. Highgrove is in Stapehill between the towns of Ferndown and Wimborne and is a short walk from the local bus route and post office. Accommodation is provided on ground and first floor levels, the first floor is accessible by a central stairway, there is no lift. Catering and laundry services are provided. The current level of fees for personal care and services and accommodation at Highgrove is between £420 and £520. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 22nd October 2007 between 10.30 and 15.30. There is currently no registered manager for Highgrove, the previous registered manager having left post earlier this year. A senior carer was responsible for the day to day running of the home on the day of inspection although was in telephone contact with the owners who were on holiday. The main purpose of this key inspection was to check that the residents living in the home were safe and properly cared for and to review progress in meeting requirements and recommendations made at the previous inspection. The inspector was made to feel welcome in the home throughout the visit. Seven service users and two members of staff were spoken with, the inspector took a tour of the premises and examined relevant records. The Commission for Social Care Inspection sent questionnaires to service users, their relatives, staff and visiting professionals in order to obtain feedback about the services provided, no questionnaires were returned limiting information available for this inspection. What the service does well: What has improved since the last inspection? A requirement was made at the last inspection involving cleaning schedules in the home and the elimination of unpleasant odours; during this visit, the home was clean and well maintained and no odours were noticeable. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Highgrove DS0000061344.V353167.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 Highgrove DS0000061344.V353167.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 is not applicable to Highgrove) Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home’s admission procedure is not used to its best advantage, residents move into Highgrove without a proper assessment to ensure that their needs can be met. EVIDENCE: Care files for two residents who have recently moved to Highgrove were examined. A pre-printed format is used to take out to see prospective residents and complete with essential information prior to their admission to the home; in both instances these had not been sufficiently completed. For one resident the assessment had been left blank in areas relating to their personal safety, history of falling and mobility and the sections of the form used to assess the person’s personal health and hygiene needs gave minimal information: for example, the section headed ‘Mental Health’ stated ‘yes’, the Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 9 section relating to their communication said ‘yes’ and the section asking whether a hoist was needed stated ‘yes’ without any further assessment of the person’s moving and handling needs. There was no assessment of the person’s dietary requirements and their weight had not been recorded. Social assessment questions were left blank apart form a statement that the person was ‘very sociable’ and it had been added that this person liked to take her meals in company. Since admission, daily records indicated that the resident had taken her meals alone in her room. The second resident’s file examined had been completed in slightly more detail but still did not provide sufficient information in order that the home could establish a baseline of need prior to admission: for example, this person was, under the heading Mobility, assessed as requiring some assistance and it stated that a Moving and Handling Assessment would be required, there was no such assessment. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care plans give limited information in respect of some aspects of care needs and in one instance, a resident did not have a systemised plan of care to give staff instruction on how to meet the person’s needs. Medication systems need improving to ensure the safety of residents in the home. Residents spoken with confirmed they are treated with respect and their dignity is upheld by staff practices. EVIDENCE: One resident who had recently moved to the care home did not have any form of care plan and a very limited assessment of need. A care file examined for another resident had some completed care plans that had been reviewed Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 11 monthly and which gave adequate information regarding some personal care needs, independence and choice. This resident had a care plan for catheter care, however that did not provide staff with sufficient instruction on how to care for the catheter. There was no information held on the frequency of review of the catheter, the district nursing service’s intervention required to change, wash-out and monitor the catheter and instruction for care staff regarding care and hygiene of the catheter site. For this resident a moving and handling care plan gave no instruction to staff regarding the outcome of the perceived need, this care plan was not dated. The resident had a care plan in place produced by the local authority responsible for the placement, which stated that the resident’s weight was to be monitored by the home; there was no record of the resident’s weight held for monitoring purposes. One resident with a care plan specifically relating to diabetes stated that glucose levels should be tested 6 monthly, the record held identified one recording in January 2007 at 12.00 where the reading was 2.8; there was no record of the normal parameters of this persons levels or what action staff should take if it falls outside these parameters. One record relating to urinalysis was held dated March 2007, the next test was marked as being needed in June 2007, this had not been done. Medicines are held in a locked cabinet and a trolley. The home uses a monitored dosage system for administering medicines to residents. The system allows for a 28 day delivery of medicines from the pharmacist in day marked blister packs; pre-printed record sheets (MAR) are supplied to support the system and staff are to sign and date the form on delivery of the medicines and sign after each administration. Examination of these records highlighted some anomalies in the home’s management of medication. None of the MAR sheets had been signed to indicate receipt of the medicines although most had been signed indicating correct administration. However, one resident who had been in hospital during the 28 day period to which the MAR related, had unexplained gaps in recording for some medicines, and for others had been signed through, for example, a prescription for paracetamol to be taken 4 x daily was signed as given once on the MAR although the blister pack had 16 tablets missing from the morning dose and 13 missing from the lunch time dose. This resident also had some medicines that had been dispensed in their original containers rather than in blister packs. There was no audit trail to support that the right amount of medicines had been given. Some medicines are held in the locked cabinet that are no longer required by the resident they were prescribed for, and need to be returned to the pharmacy. Some medicines were held in unmarked containers with no indication of who the medicine had been prescribed for or what it was. Residents spoken with confirmed that they are treated respectfully by a caring staff group and that their dignity is upheld during personal care routines. However, a requirement of the inspection dated May 2006 is repeated regarding photographs of a resident used to direct her care. The resident’s care file holds photographs to indicate how to use equipment in relation to Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 12 moving and handling; the photographs had not been taken in a manner that protected the resident’s dignity. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The absence of up to date care planning documentation for service users leaves staff without formalised action plans to follow in order that each service user’s assessed needs in relation to social, cultural, religious and recreational activities are met. This also limits evidence that residents are able to exercise choice and control over their lives. Family and friends are able to visit at any time. Meals in the home are generally well accepted by residents who confirmed their dietary needs are met. EVIDENCE: There was no evidence of an organised programme of activities for residents; care planning documentation did not address individual residents personal preferences for chosen activities. Seven residents were spoken with during this inspection, five in their rooms and two in the lounge area of the home. When Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 14 asked how they spend their day, six responded by stating that there was nothing to do, one was unable to comment. Residents stated that they spent the day either in their room or the lounge, sometimes with the television on. Care files did not evidence that the resident and/or their family had been involved in providing information about the person’s social history. Residents spoken with were able to confirm that friends and family are able to visit. Meals are provided from a central kitchen, the kitchen, food supplies and records of food provided were not examined. Care plans associated with nutritional assessments were not available for staff reference in order that individual nutritional requirements could be met. Residents spoken with stated that the food was good and they enjoyed their meals although none knew what they were having for a meal until it was served; there was no evidence of choice. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management of complaints needs reviewing to ensure that any issues raised are thoroughly addressed to the satisfaction of the complainant. Adult Protection procedures are in place in accordance with Department of Health Guidance and local authority procedures meaning that any allegations of abuse can be managed effectively. EVIDENCE: A complaints file is held where any complaints received are documented along with the response from the home. A letter of complaint had been received which had been responded to well and aspects of the complaint had been addressed accordingly, although the letter of response to the complainant was not dated. A second letter of complaint was received concerning an increase in fee levels and a decrease in activities. The response to the complaint addressed the home’s activities with an explanation of what was available to residents; the letter did not address the part of the complaint relating to the home’s fee increase. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 16 Adult protection procedures are in place detailing for staff what action must be taken should any suspicions or allegations of abuse be reported, staff training files indicated that all staff have attended training in adult protection. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in comfortable, clean surroundings which are well maintained although their safety is compromised by exposure to hot water and surfaces. EVIDENCE: The last inspection reported strong, unpleasant odours in the home, this was not the case during this inspection. The lounge, dining area, some resident bedrooms and bathrooms were visited, all of which were clean, comfortably equipped and furnished and homely. Residents spoken with reported that their rooms are kept clean and their laundry, including personal clothing, bedding and towels was done accordingly. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 18 Of two bathrooms visited, one did not have a thermometer to test hot water temperatures; the hot water in this bathroom was very hot to the hand. The other bathroom had a non-calibrated thermometer, which registered off the scale (over 50 degrees) when testing the hot water from the bath. One resident’s bedroom visited did not have a radiator guard and the exposed radiator was very hot to touch. The resident was seated in an arm chair next to the radiator separated only by a broken wheelchair that the resident stated was not for their use. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of staff are on duty in order to meet residents needs. Training is provided to staff in order that they have the skills and are competent to do their jobs. Staff recruitment practice needs reviewing. EVIDENCE: Rotas examined evidenced that there are three care staff on duty each morning, three each afternoon and two each night. Residents spoken with confirmed that there are sufficient staff on duty to meet their needs. Nine staff employed have attained NVQ level 2 in care, one is currently doing level 3 and two have attained this level. Staff recruitment files examined evidenced some irregularities. One file did not have a CRB (Criminal Records Bureau) check, three showed gaps in employment history, two had references that had not been verified and three did not have signed contracts indicating their role in the home or start date. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 20 Staff training files examined evidenced that all staff had attended statutory training events including health and safety, fire training, abuse, medication, moving and handling and food hygiene, only one however had attended first aid training. Other courses attended by staff included pressure area care, dementia awareness and palliative care. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Management of the home needs reviewing to ensure it is run in the best interests of residents. EVIDENCE: Since the resignation of the registered manager, a person was appointed to assume this role although was not registered with the Commission; this person has also left employment at Highgrove due to personal circumstances. It is acknowledged however that this was not a matter that Samily Care Ltd could have foreseen, although they are now urged to consider a strong recruitment Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 22 campaign in order to fill this vacancy and provide the home with effective leadership. Staff spoken with reported that Mrs Bleach, owner of Samily Care Ltd comes to the home regularly to oversee its operation. This inspection has however highlighted many areas that require attention, some of which are repeated from previous inspections when a registered manager was in post. It is now critical that Samily Care Ltd appoint and register a suitable person to manage the home in order that regulations are not breached and standards are maintained. Standard 33, although a key standard, was not inspected during this visit as there was no manager available to discuss the home’s quality monitoring processes. Highgrove takes responsibility for some residents personal money, for others, the home operates a monthly billing system for newspapers, hairdressing, chiropody and miscellaneous expenses. Records examined were unwieldy and not easy to audit, and there is no record of where any income comes from. Expenses are recorded and often a negative balance is recorded; in these instances, the resident is funded from petty cash and the next amount of unspecified income, goes toward payment. Of records seen, they were not accurately calculated. Residents’ health and safety in the home is compromised by exposure to hot water and surfaces, there are no risk assessments in place for the residents affected. The home’s fire exits were not obstructed and fire fighting appliances were in place and evidenced regular servicing, staff have received training. The home’s fire risk assessment was not examined, the registered persons are reminded that since a change in the legislation in October 2006, it is their responsibility to ensure that a reviewed fire risk assessment is available for inspection by the local fire authority. Infection control procedures are in place in the home and it was evident that staff are provided with appropriate hand washing facilities including anti-bacterial soaps, alcohol hand rub and disposable towels, waste bines are appropriately placed and covered. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 3 3 2 3 1 X X 1 3 STAFFING Standard No Score 27 3 28 3 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 x X 1 X X 2 Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 Requirement Timescale for action 31/12/07 1. OP7 14 & 15 All service users must have a full and comprehensive assessment of need prior to entering the home. All service uses must have a full 31/12/07 and comprehensive assessment on which to base an individualised plan of care that must be followed in order that care needs can be met and risks reduced or eliminated. Service users must be consulted with regard to the decision-making processes of assessment and care planning. This requirement was first made at the inspection dated 07.04.05 and was repeated at the inspection of 05.05.06 The timescale for action was 23/03/07 This matter may now be referred to the Regional Enforcement team for action. A record must be held indicating the amounts of all medicines received into the home including the date and signature of the staff member responsible. DS0000061344.V353167.R01.S.doc 2. OP9 13 31/12/07 Highgrove Version 5.2 Page 25 Medicine records and audit trails must be regularly monitored, the outcome and action taken recorded to ensure that medicines are given as prescribed and accurately recorded. The medication policy must be updated so that staff have clear procedures to follow on all aspects of handling medication. This requirement was first made at the inspection dated 23/03/07 and is repeated for the second time. Where photographic materials are used to direct caregivers in the use of equipment, photographs must be taken in a manner that respects the dignity of the service user. This standard was not assessed at this inspection. This requirement was first made at the inspection dated 05.05.06 and is repeated for the second time. Any complaints received must be responded to in full within the given time-scale of 28 days. Adequate storage space must be provided for mobility aids. Hot water temperatures must be kept at or below 43 degrees centigrade where full body submersion occurs. Hot surfaces must be guarded to prevent accidental scalding. The registered persons must not appoint any staff member to work in the home until all the conditions of regulation 19, schedule 4 have been met including obtaining verification of the applicants claimed qualifications. DS0000061344.V353167.R01.S.doc 3. OP10 12 31/12/07 4. 5. 6. OP16 OP22 OP25 22 23 13 31/12/07 31/12/07 31/12/07 7. OP29 19 31/12/07 Highgrove Version 5.2 Page 26 8. OP30 18 9. OP33 24 This requirement was first made at the inspection dated 05.05.06 and is repeated for the second time. The registered persons must 31/12/07 ensure that there is one appointed person on duty in the home at all times to manage any issues in relation to first aid. The registered persons must 31/12/07 establish and maintain a system for reviewing and improving the quality of care in the home, a report of any such review must be provided to the Commission and be available to service users. This requirement was first made at the inspection-dated 05.05.06 and is repeated for the second time. The registered persons must ensure effective recording systems are in place for the safety and protection of residents finances. The Registered Person must make arrangements for the recording, handling, safekeeping and safe administration of medicines received in the care home including: Ensuring that medicines are prepared, administered and recorded one resident at a time to limit the risk of medication errors. This requirement was not inspected at this inspection. 10 OP35 17 31/12/07 11 OP9 13(2) 31/12/07 Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 27 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 OP3 Good Practice Recommendations It is recommended that where residents are asked to sign their pre-admission assessment information that this is done following their participation in the process and that they have a full understanding of the implications of the assessment. This recommendation is repeated from the last inspection. It is recommended that social care plans are formulated for residents that identify, following assessment, how their individual social, recreational, cultural and religious needs can be met. This recommendation is repeated from the last inspection. It is recommended that residents are reminded of choices available from the daily menu. It is recommended that access to the rear garden through the patio doors is assessed and advice sought on control measures that could be used to reduce risks associated with the two steps into the garden. This recommendation is repeated from the last inspection as it was not assessed during this visit It is strongly recommended that the registered persons considered the legal requirement of the Employment Rights Act 1996 that states that a statement of the particulars of employment shall be given not later than two months after the beginning of employment. This recommendation is repeated from the last inspection. It is recommended that the Responsible Individual ensures that she addresses the homes compliance with the Care Homes Regulations and the expected standards as part of her monthly visits to report on the conduct of the home. This recommendation is repeated from the last inspection. The record of fire drills and evacuation should be extended to include detail of who took part and how long the process took. DS0000061344.V353167.R01.S.doc Version 5.2 Page 28 2. OP12 3. 4. OP15 OP20 5. OP29 6. OP33 7. OP38 Highgrove 8. OP9 This recommendation is repeated from the last inspection. The home should follow guidance from the Royal Pharmaceutical Society including: Countersigning medicine details that are handwritten on the MAR chart to show that a second carer has checked for them accuracy. Copies of confirmation of medication should be kept on residents’ files. This recommendation is repeated from the last inspection. Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Highgrove DS0000061344.V353167.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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