Inspection on 11/08/05 for Hillport House

This inspection was carried out on 11th August 2005.

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

The inspector 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

Hillport House 18/11/09

Hillport House 03/08/07

Hillport House 12/09/06

Hillport House 17/01/06

Hillport House 22/02/05

Hillport House 27/06/04

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

CARE HOMES FOR OLDER PEOPLE Hillport House Porthill Bank Newcastle under Lyme Staffordshire ST5 0AE Lead Inspector Irene Wilkes Unannounced 11 August 2005 9:30 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 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. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hillport House Address Porthill Bank Newcastle under Lyme Staffordshire ST5 0AE 01785 277088 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Staffordshire County Council Social Care and Health Directorate Ms Pegi Wilde CRH 28 Category(ies) of DE(E) 28 registration, with number MD (E) 10 of places Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 3 Dementia (DE) - Minimum age 50 years on admission. Date of last inspection 27 July 2004 Brief Description of the Service: Hillport House is a local authority care home, run by Staffordshire County Council. The home specialises in the care of older people who are mentally frail or who have mental health needs. The home is registered for 28 older people. The home is located in Porthill, providing good access to a wide range of local community resources. There are pleasant gardens, particularly an enclosed safe garden courtyard in the centre of the building that can easily be accessed by residents from each of the lounge areas, and which is much used during the summer months. Accommodation is provided on two floors, with access to the upper floor being facilitated by a shaft lift and stairs. There are three separate lounge-dining rooms, along with a small smoke room and quiet room/visitors room. There are three assisted bathrooms and a disabled access shower room, plus ample toilets throughout the building. The home is currently in the middle of a planned refurbishment programme to enable it to meet the national minimum standards for the environment. This commenced on 18 July and will take approximately 35 weeks. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a part day in August 2005, and was undertaken by 1 inspector. The number of residents at the visit had reduced to 16, all female residents. Vacancies in the home had not been filled due to planned refurbishment work that commenced in the middle of July, and will last for approximately 35 weeks. Due to these works, part of the home was securely sectioned off, both upstairs and down stairs, whilst contractors were working at that end of the building. The Care Team Leader (Deputy Home Manager) was in charge of the home at the visit. She is covering the post in a temporary capacity but was very helpful and competent in assisting with the inspection process. The majority of the residents were spoken to, but due to their needs a detailed discussion about their care did not take place. Several staff were spoken to in a general way, with a more structured interview with 1 of them. A District Nurse visited during the morning and her views about the home were also sought. Further evidence was gained from an examination of a sample of care plans; staff training records, maintenance records, complaints log and the staff rota. Particular attention was paid to the environment and the related risk assessments for the building, due to the refurbishment work. Medication procedures were also checked. The limited areas of the core standards that were not looked at will be inspected at the next unannounced visit. What the service does well: The service users at Hillport House have dementia and/or mental health needs, and the inspector could not find out their views about their care at the home. However, the majority of people were spoken to and each appeared content. The way that staff cared for the residents was discreetly observed throughout the visit, and on every occasion the service users were shown the utmost respect by each member of staff. A District Nurse was visiting who had been going into the home for some years, and she said that she and her colleagues considered the care provided to be of a high standard, and that the home addressed the healthcare needs of the service users very promptly, and always put into place the advice that they were given from the nursing service. Procedures for the receipt, storage and administration of medication followed good practice. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 6 Service users were finishing their breakfast on arrival, and had lunch during the visit, and seemed to be enjoying their food. The menu plans showed a good variety of nutritious meals, and the availability of choice was evident. No relatives were seen at this visit, but numerous have spoken to the inspector previously and said that they are made most welcome by the home. Inspection of the ‘Visitors Book’ confirmed that family and friends visit the home at various times of the day and evening. There were no complaints received by the home since the last visit. The home had sufficient staff to meet the needs of the service users at this visit. The training records of staff were seen and these showed that all staff were up to date with mandatory training, and that there was a planned programme of specialist training in place. This provides confidence that care is being provided by a well-trained staff team. Considerable thought had been given to maintaining a safe environment for service users and staff while the refurbishment work is taking place. Risk assessments and the management of the risk for every conceivable hazard were in place. They were well thought out and comprehensive. The home is commended for their attention to this important area. The approach of staff during this difficult time for the home was also excellent. They were aware that the refurbishment could be unsettling for some of the residents and were clearly doing their utmost to support them. It was also apparent that all of the staff, including the ‘none care’ staff work very well together as a team to meet the needs of the service users to as high a standard as possible. What has improved since the last inspection? 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. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 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 standard(s) 3 All service users receive a full assessment of their needs prior to moving into the home. This provides an assurance that the needs of the service user are understood, allowing an early confidence that the home will be able to meet the person’s needs. EVIDENCE: There have been no new admissions to the home since the last inspection, as the home has been preparing for some upgrading work to take place to bring the environment in line with national minimum standards. Care files seen at this inspection, and also at previous inspections show that a care plan is received from the local authority prior to admission. This home is for people with dementia, and a full assessment of needs covering all aspects of physical and mental health, as well as social needs and background information about the person’s life and history is undertaken prior to the service user moving into the home, with the involvement of relatives where possible. 3 care plans were inspected at this visit and each had all of the appropriate information in place. Standard 6 does not apply to this home. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 The home sets out clearly the needs of each service user in their care plan, and does its utmost to meet these needs in practice. Any health concerns are responded to quickly, and medication procedures are sound. This means that the welfare of the service users is at the heart of the service, and relatives can be confident in the care that is provided. EVIDENCE: The care plans of 3 service users were examined at this visit. Each had a detailed plan of care in place clearly showing the health, personal and social care needs of each person and how these are to be met on an individual basis. The health records showed good recording of the action taken when any health problems were experienced, i.e. full involvement of the GP and District Nurse and recording of hospital appointments, dental, ophthalmic etc. During the visit a District Nurse came to the home to attend to some of the residents and she was asked for her views on the care provided in the home and the level of co-operation that she received from the manager and care staff. The District Nurse was full of praise for the home and told the inspector that every aspect of care that she and her colleagues had observed over the long period of time visiting the home was positive, with the full co-operation of staff always being apparent. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 10 Each service user plan evidenced that appropriate risk assessments were in place for each person, and there was clear evidence to see that every attempt is made to gain an insight into the past interests and activities of each person, to help with current care. The home has appropriate policies and procedures in place related to medication. Medication receipt, handling, storage and return are appropriate. There are sound stock control systems in evidence. Medication is provided in individual dosette boxes. The medication round was not observed on this occasion, but a sample of MAR (Medication Administration Record) charts were looked at and compared to the medication in the dosettes and each record and the number of tablets available tallied. A photograph of the service user was slotted into the side of the dosette box. In addition to the MAR charts, there was a Medication Profile in place for each service user setting out clearly their current prescribed medication. A separate coloured sheet showed when antibiotics were being taken, which was considered by the inspector to be good practice. A discussion was held with the Care Team Leader (Deputy Home Manager) about the recommendation from the pharmacist for the use of a Controlled Drugs Register in addition to double signatures on the MAR chart whenever controlled drugs were prescribed. This action was recommended by the inspector at a previous visit, but she had also agreed that she would seek further clarification from the pharmacist, which had now been received. This report therefore formally recommends that a Controlled Drugs Register is used by the home. Due to people in this home having dementia, it was not possible to gain the views of the service users about the way in which they are treated by staff. However, the staff were discreetly observed throughout the visit as they provided care, and the inspector was impressed, as at previous visits, with the approach of staff who talked to the residents in a very patient, reassuring and friendly way, but which was never patronising. Staff were also overheard asking the deputy about aspects of individual service user’s care, and it was clear that they were thoughtful about how to meet each person’s needs. A member of staff was questioned about care practices and her knowledge of people with dementia and she was clear and confident about how people should be treated, and about her responsibilities. Staff were also observed assisting a couple of service users to eat their lunch, and this was done in a discreet and caring manner. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 The home endeavours to try to find out what interests the service users and to provide stimulation to enrich their lives. Friends and relatives are encouraged to visit, and to provide information about the service users earlier lives to gain more insight into the sort of activities that they may enjoy. Mealtimes are positive occasions with a variety of choices being offered via a changing menu. By these means the home does its utmost to have a positive impact on the daily lives of the service users. EVIDENCE: The service users at Hillport House have dementia. The home makes every attempt to provide stimulation for the service users and employs an Activities Organiser for 3 sessions per week towards this. The Activities Organiser was present at this inspection, and she was seen working in the lounge and involving individual service users in various activities. Several of the staff team were also observed throughout the visit interacting with the service users and playing music and singing and dancing with those that wished. There were no relatives visiting the home at this inspection visit. However, several have been spoken to at previous inspections and confirmed that they are made very welcome by the home. The ‘Visitors Book’ was looked at, however, and showed that relatives had visited at numerous different times Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 12 throughout the days and evenings of the previous weeks, confirming that visiting is encouraged at all reasonable times. The service users generally require support in decision-making. However, there was evidence to show that relatives are kept informed and are involved in all issues about their relation. Information is provided about advocacy services. Service users are encouraged to take personal possessions into the home with them, and there was evidence that bedrooms had been personalised to reflect the interests of the residents. The service users had lunch towards the latter part of this visit. The meal consisted of fish fingers or sausage, chips and mushy peas, followed by fruit tart or sago. 2 ladies spoken to said that they had enjoyed their lunch. The menu plans follow a 5 week rolling programme and these were examined and showed that there was a varied selection of nutritious food. Drinks were also observed as being provided at regular intervals throughout the visit. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has the appropriate policies and procedures and staff training in place to respond appropriately should any complaints be made, and towards protecting the service users from abusive practice. This means that staff have a sound baseline from which to work, that provides confidence that service users will be adequately protected. EVIDENCE: The home has an appropriate Complaints Procedure in place. A Complaints Log is maintained, but no complaints had been received. The service users needs are such that they would not be able to voice any complaint to the inspector, but several relatives have been spoken with in the past, and all had only sincere praise for the home and all of the staff. Staff at the home undertake a rolling programme of training relating to vulnerable adult procedures, that includes the prevention of abuse, and also violence and aggression training. There is no restraint used at the home. The Home Manager is particularly experienced in dementia care, and had just prior to the inspection provided the staff team with an updated training session about dementia awareness and the needs of the residents. A staff member was questioned about her understanding of what constitutes abusive practice and about the care needs of people with dementia. She had a sound awareness of the service users’ needs, and her own responsibilities should she ever suspect any abusive practice. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 14 The home has appropriate policies and procedures in place regarding abusive practice and reporting responsibilities. A copy of the local authority multiagency procedures was in place, and the home also has a copy of the Department of health guidelines entitled ‘No Secrets.’ Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 Necessary attention has been made to securing as little disruption as possible for the service users during the extensive refurbishment work that is taking place. The good practice by the home of considering and recording every possible risk that may present, and the management of such risks whilst the work is in progress is commended. The approach by the home means that the safety of the service users and the staff is assured. EVIDENCE: The Commission had some concerns earlier in the year that some planned improvements to the environment had been postponed. It is pleasing to record that this upgrading work commenced on 18 July, and will take approximately 35 weeks to complete. The home will keep the inspector fully informed of progress. Because of the works to be completed, at this visit part of the building was blocked to access, both upstairs and down. This was obviously done to allow Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 16 works to proceed and for the safety of the service users. Once this end of the building work is completed, different arrangements will then apply. The inspector was impressed with the thought that had been put into effecting the building works with as little disruption as possible for the residents. The risk assessments that have been undertaken relating to the works are worthy of particular note, as they comprehensively cover all areas of risk and possible hazards. The home is commended for this work. The home is operating under difficult conditions at the moment, but everywhere was clean and hygienic. Arrangements have been made for the home to use the laundry at another local authority home from the week after the visit, as the laundry will by then also be out of action. The arrangements made for transporting the laundry were appropriate. The home has suitable hand washing facilities in place throughout, and there are appropriate policies and procedures in place for the control of infection. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The home ensures that sufficient numbers of appropriately trained staff are on duty at all times with someone in a senior position always being available. The staff team are well trained and competent. This ensures that the needs of the service users are met in a timely and efficient manner, by staff who are able to understand the individual needs of the service users and provide care in a safe manner. EVIDENCE: The home is registered for 28 places. Because of the awaited refurbishment places have not been filled when they have become available, and the home currently has 16 residents. The staff team has not been reduced although there are 2 care workers currently on maternity leave, and 1 person on long term sick leave. On the morning of the inspection the staff team was as follows: 1 4 1 1 Care Team Leader (Deputy Manager) Care Workers Activity Organiser Hotel Services Officer 1 4 1 1 Handyman Domestic Assistants Cook Kitchen Domestic The rotas for the previous week were inspected, and these showed at least 2 care staff with 1 senior on duty at all times, and 2 waking night staff and 1 sleep in. The inspector considered that the level of staffing was sufficient to meet the needs of the service users. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 18 Training records were examined, and these evidenced that all mandatory training for staff is up to date, and other specialist training such as violence and aggression, dementia awareness, health emergencies, blood born transmissible diseases has been or is in the process of being addressed. Medication training has been completed by all senior staff. The inspector was advised that a training matrix was currently being drawn up to cover all areas of staff training and to show when training needs to be updated. A member of staff was questioned about staff training, and she advised that all of her mandatory training was up to date, and that she had completed other areas of specialist training. She also possessed her NVQ2 and was studying for her NVQ3. The staff member was clearly interested in training and finding out all that she could to improve her ability to care for the residents. She identified that a training session from the District Nursing Service about the various typed of bandages and dressings that were used by them in the home would be a useful addition to the training list. The home is recommended to consider this very sensible proposal. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 From the records sampled at the visit, and observation throughout the day, it is considered that suitable procedures and systems were in place to promote and protect the health, safety and welfare of service users and staff. EVIDENCE: Records relating to the health, safety and welfare of the service users and staff were sampled. The home’s fire records were seen relating to weekly and monthly checks of the fire alarm, automatic door release systems, emergency lighting etc. These were all in order. Staff fire drills had taken place at regular intervals and names were recorded. An engineer visited the home during the inspection to undertake a routine 6 month check of the nurse call system, which was in order. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 20 COSHH (Control of Substances Hazardous to Health) data sheets were seen in place and temporary arrangements for the storage of COSHH products were seen and found in order. Fridge, freezer and food temperature records from the kitchen were examined on a sampling basis and raised no concerns. Moving and handling aids had been timely serviced. Environmental risk assessments have been put in place for the period of the refurbishment, as mentioned earlier. Individual risk assessments were also in place for the service users, both those normally in situ for each person, and any additional ones needed during the building work. Further good practice was evidenced in the list of information available for contractors regarding their interactions with the service users whilst at the home. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 3 Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 22 N/A 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. 1. 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. 2. Refer to Standard 9 30 Good Practice Recommendations Mainain records of any controlled drugsused in the home in a controlled drugs register, in addition to recording double signatures on the MAR chart Consult with staff regarding any additional specialist training that they would like to see introduced at the home. Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Hillport House E51-E09 s.33345 Hillport House v 238242 120705 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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