Inspection on 14/12/07 for Hill Ash House

This inspection was carried out on 14th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hill Ash House 04/06/09

Hill Ash House 08/01/09

Hill Ash House 25/09/06

Hill Ash House 21/11/05

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 Hill Ash House Hill Ash House Ledbury Road Dymock Glos GL18 2DB Lead Inspector Mr Adam Parker Key Unannounced Inspection 09:50 14 & 17 December 2007 th 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 Hill Ash House DS0000064284.V347695.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. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hill Ash House Address Hill Ash House Ledbury Road Dymock Glos GL18 2DB 01531 632003 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) European Healthcare Operations Ltd Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th September 2006 Brief Description of the Service: Hill Ash House is an extended Grade 2 building, set in its own extensive grounds. It offers both residential and nursing care to older people. There are ample communal rooms and bedrooms are single with ensuite facilities. A shaft lift offers access to the upper floors. Specialised equipment is provided to meet differing needs and external health care professionals such as the GP, Dentist Chiropodist are contacted as required. The Home has a qualified nurse on duty at all times and care and ancillary staff to meet the needs of those that live at the Home. There are extensive grounds that can be enjoyed by the residents in the milder weather. The local bus stops in the village of Dymock, which on foot is some distance from the home. In some cases and with prior arrangement only, a lift can be organised to and from the bus stop. Current fees for the home range from £360.00 to £700.00. Copies of the homes Statement of Purpose and Service Users Guide are displayed in the main entrance to the home. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was carried out by one inspector over two days in December 2007. The manager of the home was present for the first day of the inspection visit with the regional operations manager present for both days. The inspection consisted of a tour of the premises and examination of residents’ care files. In addition staff recruitment and training was looked at as well as documents relating to the management and safe running of the home. A sample of residents were selected for inspection against a number of outcome areas as a ‘case tracking’ exercise. During the inspection visit three residents were spoken to, to gain their views of the service. Survey forms were received from 12 residents and 18 relatives of residents. An Annual Quality Assurance Assessment (AQAA) form was completed by the home and forwarded to the Commission prior to the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service What the service does well: What has improved since the last inspection? Improvements to meals and mealtimes have been made as a result of a quality assurance exercise. The environment of the home is undergoing a major refurbishment and handrails have been fitted in corridors. Domestic staff have attended infection control training. There have been changes to the arrangements for staff breaks that have improved the availability of staff to meet residents’ needs at certain times of the day. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 6 There have been improvements to the recruitment procedures in operation in the home that are now more robust. Staff supervision sessions have been taking place with records kept. 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. Hill Ash House DS0000064284.V347695.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 Hill Ash House DS0000064284.V347695.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): 1,2 & 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s admission procedure ensures that all prospective residents are given information about the home and admitted on the basis of an assessment of their needs. However additions to the document used for assessment will ensure that residents receive the care that they require. EVIDENCE: Although the documents were not checked in detail at this inspection it was noted that copies of the statement of purpose and the service users’ guide were available in the reception area of the home and in residents’ individual rooms. It was reported that these documents are still in the process of being updated and there are plans to produce them in a number of formats suitable to residents needs. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 9 Following a requirement at a previous inspection the home is now providing a statement for residents who have a nursing contribution paid in relation to how their fees are calculated. The assessment documentation for a number of residents recently admitted to the home was looked at. These had been completed following an assessment of the person’s needs recorded on a pre-admission assessment document. Despite a recommendation at the previous inspection about the areas that this should cover this has not been adopted. Specific areas not covered by the document include religious and cultural needs, foot care and personal safety and risk. Assessments have been carried out by the regional operations manager prior to the arrival of the new manager. Where residents are funded by a local authority the relevant documentation relating to their needs had been obtained. The home does not provide intermediate care and so Standard 6 does not apply. Hill Ash House DS0000064284.V347695.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 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although there has been an improvement in care planning, some further work still needs to be done around medication administration in the resident’s interests. However residents’ health needs are being met and their privacy and dignity is promoted. EVIDENCE: Care plans described specific needs and how these would be met through interventions. The care plans looked at were recent enough not to have received reviews. It was reported that care plans were completed in conjunction with the resident and their relatives where appropriate and evidence was seen of this with one resident signing their assessment and their daughter signing the care plan. A daily record is maintained for each resident as well as a record of personal care given such as baths. Risk assessments had been completed for pressure areas, moving and handling, nutrition and falls as well as specific areas in the interests of Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 11 residents’ safety such as pouring hot beverages and use of a heater in the resident’s room. A monthly record of residents’ weight is kept in line with nutritional assessments. It was clear that where a need was identified through assessment and in one case an assessment by the funding authority a care plan was written to manage this. There was recorded evidence of residents receiving input for health needs from visiting professionals such as chiropodists, GPs and dentists. One resident was receiving input from a Community Psychiatric Nurse (CPN). The home should check if arrangements are in place under the care programme approach and if so request a copy of related documents and request involvement in any future review meetings. Arrangements for medication administration and storage were looked at. There were no gaps in the recording of administration on the Medication Administration Records (MAR) although some hand written directions had not been signed or dated by the staff member making the entry such as where one resident’s course of medication had been stopped. With another resident the hand written directions for the administration of one medicine differed from the printed directions although there was no indication of who had made the handwritten alteration. One resident had been prescribed Lactulose with a variable dose; although administration had been recorded there was no indication of the dose given. At the previous inspection similar shortfalls had been noted. Storage was secure and the clinical room was cool so should be at a correct temperature for storing medication. However temperatures should be monitored and recorded in case there are any seasonal variations. The medication stored in a refrigerator was being monitored although a record of this should also be kept. It was noted that medication containers had been dated on opening. It was reported that medication audits had been completed on a monthly basis although the most recent document relating to these was dated September 2007. Examination of the medication policy for the home showed that it did not give reference to the Special Waste Regulations 1996 and how these apply to the disposal of medicines from a care home with nursing. Residents confirmed that staff knocked on doors before entering and were polite to them. In the AQAA document supplied by the home, knocking on doors before entering was described as the policy of the home. It was noted that one female resident had their preference for not being cared for by male carers recorded. The home has recently obtained information from the Department of Health’s Dignity in Care campaign. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from an activities programme, social contact and a variety of meals served in attractive surroundings. EVIDENCE: Around the time of the inspection visit a number of seasonal activities were taking place such as a carol concert by a local school (which one resident described as the “highlight” of the Christmas celebrations), a Christmas Party and a concert by hand bell ringers. At other times activities provided consist of musical entertainment in the home and trips out such as a boat trip and the local garden centre for tea and cake. On a survey from one resident commented, “The musical afternoons are very entertaining.” A monthly newsletter is produced and distributed to the residents. The latest edition contained news about the home, information about activities and contributions from residents. Once a month a party is held to celebrate all the birthdays of residents for that month. The latest edition contained news about the home, information about Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 13 activities and contributions from residents. A mobile library visits the home and library books were seen in the room of one resident spoken to. Holy communion is held in the home once a month for all Christian denominations. It was reported that one resident was receiving visits from a Roman Catholic Priest although this had not been recorded. The home’s AQAA document stated “All service users are able to receive visitors in privacy and they are able to see whom they choose, there is no restriction on visits or on times of visits.” Despite the rural location of the home, residents are able to access to transport through the use of ‘dial a ride’ and the home has the use of a minibus and a wheelchair car. A recommendation was made at the previous inspection about information on advocacy services being located where residents and visitors could read it. Although it was reported that such information was available in the home this could not be located during the inspection visit. Residents are able to personalise their individual rooms with a number of items including The home has a four weekly menu. At lunch a vegetarian option for the main course is always given and soup is served as a starter. There is also a diabetic option for dessert on the menu. A record is kept of any alternative meals provided to residents that are not part of the menu. Tea consists of a choice of soup and bread or a cooked snack as well as cakes or a dessert. It was noted that the dining area was attractively presented with the main course of lunch serve from a hot trolley and vegetable dishes on the tables for residents to help themselves. Sherry is served for lunch and this was taken to residents who took their meals in their rooms as well as those using the dining room. Information about the availability of snacks and refreshments was on display in the home and had been distributed to individual residents. One resident spoken to said there had been an improvement in the variety of meals “especially in the last 18 months.” Another resident said about the meals “some days were better than others.” Another stated that the food was “very good.” On a survey form one resident commented “I love the meals as there is always something different.” The home has produced a booklet for staff entitled ‘Nutrition in Care of the Elderly’ which gives information about the nutritional value of food as an aid to preparing menus. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information is available if any resident or their representative should wish to make a complaint. An improvement in the number of staff trained in protecting vulnerable adults should ensure that residents are protected. EVIDENCE: The home keeps a record of complaints received and the responses to these. Three complaints received during 2007 were looked at. Information about how to make a complaint is available on several noticeboards around the home It was reported that there are plans to produce a large print format of the complaints procedure. The majority of both residents and relatives who returned survey forms indicated that they knew how to make a complaint. The home has a policy for protecting residents from abuse that was on display as well as a ‘whistle blowing’ policy. The home’s AQAA document stated “Staff undergo POVA training during induction and as annual updates” The training record received from the provider indicated that although 26 staff had received training in protecting vulnerable adults there was 16 staff that had not received this training. It was reported that such training is planned for February 2008. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 15 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): 19,24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have the benefit of living in a generally well-maintained and clean, environment with personalised individual rooms. EVIDENCE: A tour of the premises was undertaken. All areas of the home inspected were found to be clean and generally well maintained, although there was a hole in the ceiling in a bathroom on the second floor where a spot light had been installed. The home smelt fresh throughout and some redecoration work was in progress during the inspection visit as part of a major refurbishment of the whole home. The entrance hall contained information about the home and about planned activities. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 16 There are well kept gardens around the home with car parking at the front of the home. A small courtyard provided with seating is available for use by residents when the weather allows. Residents’ rooms were comfortable and contained various degrees of personalisation with some enjoying views of the countryside surrounding the rear of the home. Some rooms on the ground floor at the rear of the home had their own individual access to the garden. One resident described her room as “just right” Another had identified a problem with a draft from a window. Attention to this was promptly given by the maintenance man. It was noted that handrails had been installed in corridors. The laundry had washable floor surfaces although the walls were in need of some attention to flaking paint to ensure a washable surface. However it was reported that an upgrade to the laundry is planned as part of the refurbishment. Arrangements for hand washing were in place. Following a recommendation at the previous inspection, Domestic staff in the home attended infection control training in September 2007 that included hand washing. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 17 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 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements have been made to staff deployment in the home as well as recruitment although more training would be of benefit to residents. EVIDENCE: In addition to the manager the home is staffed with a registered nurse on duty at all times with five carers in the morning and three in the afternoon and two at night. At various times of the day there is a housekeeper, two domestic staff, a laundry worker, a chef, a kitchen assistant, a ‘tea girl’ and an administrator. The regional operations manager reported how changes to how staff breaks are organised has improved the availability of staff for residents at certain times of the day. However there is still an issue with the lack of a staff member to wash up at teatime although it was reported that recruitment was planned for this role. Based on information supplied on the AQAA document the home currently has under 50 of staff trained to NVQ level 2 or above although one staff member was working towards the qualification. Records for recently recruited members of staff were examined. All the required information and documentation had been obtained including an employment history against which any gaps in employment could be explored. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 18 Checks against the Protection of Vulnerable Adults list were being made as well as with the Criminal Records Bureau. The home has a document for induction training that covers the common induction standards for social care in England. This has recently been introduced at the home. Evidence was given of training and updates carried out by registered nurse in the home this included such areas as dementia training, catheter care and first aid research. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 19 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): 31,33,35,36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The use of a quality audit has been successful in identifying and improving part of the service provided for residents, and although there are good safety procedures in place staff training needs must be checked to ensure that the home is run in the interests of residents. EVIDENCE: Since the retirement of the previous registered manager the home has been managed by an acting manager who is a registered general nurse. A new manager has now been appointed and was present on the first day of the inspection visit. She is a registered mental nurse with previous experience as a deputy manager in a care home setting and is currently undergoing the Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 20 registered managers award. It was reported that her application to be registered with the Commission was ‘in hand’. The home has carried out client satisfaction questionnaires in relation to meals and mealtimes. Changes have been made in relation to comments received back from residents including sherry served with the meals, improvements to the temperature of meals served, a change in how staff are deployed at mealtimes and more choice and availability of certain foods. Other quality surveys have been received from residents and relatives and although a good response was reported the information had not yet been looked at with an action plan formed. The arrangements for looking after residents’ money was looked at and satisfactory arrangements were in place with records kept. A check on the money held for one person showed this to be accurate in relation to the records kept. Secure storage is available in the home. Staff supervision is underway in the home with appropriate records kept although the frequency of the sessions should be improved. Although the vast majority of staff had attended training in fire safety, areas such as infection control, moving and handling and health and safety had not been attended by all staff. There was no evidence on the training chart supplied that any staff had attended food hygiene or first aid training. The homes AQAA document stated that training in first aid and food hygiene had taken place. However it was reported that information about staff training under the previous registered manager had not been found. The home must ascertain the training needs of staff in relation to food hygiene, infection control, first aid, health and safety and moving and handling and ensure that these are or have been met. Regular monthly checks are made on hot water temperatures with records kept. It was reported Central heating boilers were due to be serviced soon having last been done in December 2006. The electrical wiring in the home has been checked as well as portable electrical appliances. The maintenance man has undergone training and has achieved a qualification in water hygiene. Work is carried out in the home on reducing the risk of Legionella with checks in relation to controlling and reducing the risk well documented. The home has completed a fire risk assessment and has had a recent inspection from the fire safety officer, following this some changes to the risk assessment were being carried out. A record of fire drills was being carried out with the responses of the staff team recorded. Window restrictors are fitted to upper floor windows and regular checks were reported although not recorded. A record of checks should be made. Although there have been no security problems with the home and security measures are in place it is recommended that a security risk assessment should be completed for the premises as an extra safeguard. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 21 Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 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 3 2 X X N/A 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 2 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X 3 X 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 2 X 3 X 3 2 X 2 Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 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 OP9 Regulation 13(2) Requirement Timescale for action 29/02/08 2 OP18 13 (6) 3 OP38 18 (1) (c) (i) The Registered Manager must make arrangements for the recording and safe administration of medications. (This is with reference to the identified shortfalls within this report). This requirement has been repeated from the previous inspection. In order to provide safeguards 30/04/08 for residents, all staff in the home must receive training on protecting vulnerable adults from abuse. Staff training needs in relation to 31/03/08 safe working practices must be identified and recorded in order to plan for providing training to promote residents’ safety and welfare. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 24 No. 1 2 Refer to Standard OP3 OP7 Good Practice Recommendations Each pre admission assessment should follow a set format, which meets all the criteria within standard 3.3. The home should check if Care Programme Approach arrangements are in place for one resident and if so request any relevant documentation and involvement in any future review meetings The temperature in the medication storage room should be monitored and recorded to check that residents’ medication is being kept at the correct temperature. The homes medication policy should make reference to Special Waste Regulations 1996 and how these apply to the disposal of medicines from a care home with nursing. Guidance regarding advocacy and advocacy agencies should be located where residents and visitors can read it. Attention should be given to the hole in the ceiling around a light fitting in the second floor bathroom. More care staff should undertake an NVQ. Staff should receive a minimum of six supervision sessions per year. Complete a risk assessment exercise for the security of the premises. 3 4 5 6 7 8 9 OP9 OP9 OP14 OP19 OP28 OP36 OP38 Hill Ash House DS0000064284.V347695.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Regional Office 4th Floor Colston 33 33 Colston Avenue Bristol BS1 4UA 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. 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