Inspection on 18/01/06 for James Page House

This inspection was carried out on 18th January 2006.

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 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

James Page House 31/10/07

James Page House 16/08/06

James Page House 28/09/05

James Page House 19/10/04

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

CARE HOMES FOR OLDER PEOPLE James Page House Deyes Lane Maghull Liverpool Merseyside L31 6DJ Lead Inspector Ms Lorraine Farrar Unannounced Inspection 18th January 2006 01.05p 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 James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service James Page House Address Deyes Lane Maghull Liverpool Merseyside L31 6DJ 0151 526 4133 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) Parkhaven Trust Mrs Sheila Francis Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (3) of places James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users to include up to 30 OP. Maximum no. registered - 33, of which up to a maximum of 30 (OP) (N) and up to a maximum of 3 (YA) (PD). The service has two (2) named service users under pensionable age. The service should, at all times, employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. That Mrs Francis receives training with regard to the specific needs of YA, PD, this should include person centred planning training, challenging behaviour training and the Learning Disabilities Award Framework (IDAF) training. 28th September 2005 5. Date of last inspection Brief Description of the Service: James Page House is owned and run by Parkhaven Trust, an organisation who have several care homes in the Maghull area of Liverpool. The home is on a large site on Deyes Lane in Maghull and there is another registered home sharing the site called the Kyffin Taylor. The grounds are large and there is plenty of room for residents to sit out or go for a walk. Although in its own grounds the home is in the middle of a residential area and there is a public transport service nearby, car parking is provided and local shops and facilities are not far away. The building is single story and has been adapted to a high standard, there are 30 single bedrooms each of which has an en-suite with toilet and sink. The home has three wings and a main dining / sitting area. Each wing has bedrooms, sitting and dining areas and bathrooms. In addition there is a main laundry, kitchen, offices and a reception area. The home is registered to provide care with nursing for 30 people over retirement age. Registered Nurses and carers are available 24 hours a day and there are domestic and kitchen staff during the day. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection of the home was carried out in September 2005 and a pharmacy inspection was carried out a couple of weeks later. The Inspection was carried out by two Inspectors, Lorraine Farrar and Joanne Revie. During this inspection discussions were held with three residents and several staff. Parts of the building including communal areas, the kitchen and medication room were looked at and records including medication records, care plans and financial records were read. What the service does well: What has improved since the last inspection? James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 6 Since the last inspection the home has worked very hard to meet requirements relating to medication and improve the way they manage these. They have increased the management hours within the home by use of a part time manager and part time clinical supervisor. The home are in the process of reviewing a number of their practices, these include, staff training and updates for Nurses, care planning ad the way they record pressure areas. The kitchen area was cleaner than at the last inspection. The manager and clinical supervisor are clear as to the improvements they want to make within the home and are in the process of planning and implementing these, this includes ensuring staff attend appropriate training. What they could do better: As identified at the previous inspection the home needs to make sure that care plans are reviewed regularly and that residents or their representatives are offered the opportunity to read and sign their agreement with the plan, they also need to have a clear policy stating the timescales for writing a care plan for new residents. The home need to continue with the improvements made to managing medication and, as identified at the last inspection put formal auditing systems into place for this. The organisation need to record on residents files the reasons why they act as appointee for some residents and how this money is managed and the home need to put a system into place to record any valuables that they hold for residents, this will prevent items not being returned to their owner or not being labelled. The home should also look at providing a training plan, which covers general care courses and also training applicable to the needs of the people currently living in the home. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Staff from the home meet with future residents and carry out an assessment to make sure that the home can meet their needs before they offer a placement. EVIDENCE: Two residents spoken with said that they had an assessment carried out before they moved to the home and one confirmed that they had received written information about the home. One also confirmed that they had visited the home prior to admission and had chosen their bedroom. Both care plans contained information, which showed that an assessment had taken place by a qualified nurse, which gave an overview of the residents needs. One was particularly detailed regarding the residents likes and dislikes. Both residents confirmed that staff had been supportive to them about their admission to the home. The manager was aware of the need to obtain a copy of the local authority assessment, if the resident was funded via them and not privately. The James Page does not provide an intermediate care service. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8, 9,10 There are individual plans of care in place for each resident which cover their basic support needs. Not all of these had been updated as often as required and residents or their representative had not been offered the opportunity to sign them. Staff in the home identify residents health care needs and act appropriately in providing support with these. Medication is generally well managed within the home with recent systems put into place to make sure that medication is stored, given out and recorded correctly, although the methods of auditing medication are not recorded. Staff have a good understanding of residents and respect their privacy and dignity. EVIDENCE: The home has individual care plan files for each resident, which follow a standard format. These identify through assessment the persons needs and brief plans are written stating how the home are supporting the person to meet these needs. Not all plans had been reviewed within the past month with one plan last reviewed on 5/10/05. It was identified at the last inspection that the home must ensure all relevant sections of care plans are reviewed monthly, this will enable staff to quickly identify changes in the residents needs and plan how they can be met. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 11 There is space in the plans for the resident or their representative to sign to say that they agree with the plan and it was identified at the last inspection that they should be offered this opportunity, however this has not yet been done. The Manager explained that the home are looking at the format currently in use and considering changing this so that information can be more easily recorded. Both an RGN and the clinical supervisor explained that following a meeting they are in the process of reviewing the way they document and plan for dealing with any pressure sores arising. The current format is adequate but they intend to improve on this. A resident had been residing in the home for thirteen days. No written instructions were available on the plan of care regarding this residents needs. The two other care plans viewed contained pressure sore risk assessments, nutritional risk assessments, and manual handling assessments. Observations of vital signs and weight had also been carried out and undertaken. Discussions were held with three residents and three care plans were viewed. One resident stated, “ The staff are marvellous here, much better than the last place- yes I’m well cared for”. Another said “ staff are very good, very kind, very caring”. One resident explained that staff had identified that different lifting equipment was needed due to a change in their needs. Reading the care plan confirmed this and showed that staff had taken steps to obtain this equipment. Another resident was being supported to stabilise their diabetes. They explained that “ the home meets my needs at this time of my life” and that they were “satisfied” with the care they received. Viewing the care plan confirmed that staff undertake daily blood sugar recordings and act appropriately to any changes. During discussion with the resident and later with the clinical supervisor it became evident that some residents were following outdated guidelines of how their diabetes should be managed and expecting a diet to be provided that was not required or necessarily best practice. One resident stated that they were unhappy with the service provided by their G.P. and that staff were supporting them to find another. Viewing records confirmed this to be true. A resident who has recently recovered from surgery stated that “ the staff were marvellous” and “ looked after me well” following the operation. A pre assessment for one resident identified that they needed to see a chiropodist on admission and records showed that staff in the home had arranged this within a short time span. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 12 Staff have worked hard to address the requirements issued following the pharmacy inspection. The clinical supervisor is monitoring levels of medication, maintenance of medication records, and receipt and disposal of medication. Night staff are carrying out weekly stock balances on homely remedies and are ensuring that each resident takes their own medication rather than several residents sharing a stock bottle. The medication room was clean, tidy and well organised. The controlled drugs register was viewed and appeared to be in order. A sample of medication administration records was viewed on each wing and in the medicine room, which showed that there had been an improvement in staffs recording of administration. One gap was evidenced regarding the administration of Temazepam. The clinical supervisor stated that any gaps in recording are identified and this is discussed with the member of staff concerned. No formal recording system is in place for auditing medications, this was a requirement of the last inspection and will help the home to quickly identify any recurring difficulties that arise. One service user stated that staff administered medication promptly whenever they complained of pain. A box of dressings was viewed in a resident’s bedroom. The clinical supervisor stated that each resident keeps their own cream/ dressings in their room. This was implemented to address a requirement made by the pharmacy inspector. Three staff were observed without their knowledge talking to residents and attending to their needs. Each instance evidenced that staff have a good understanding of how to promote dignity and are respectful towards the residents. Three residents confirmed that they believed this to be true. One agreed that they always received their post unopened. Another stated that staff “always knock” and “treat the things in my room as if they were in someone’s home.” James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 Residents are satisfied that the home supports them to make choices and have control over their decisions, this is supported by the home providing advocacy information and regular residents meetings. The home should continue to expand on the choices offered, including offering residents the opportunity to agree their care plan and to chair their own meetings. EVIDENCE: Three residents confirmed that they offered choices. One explained that there is a choice of three light meals at lunchtime and a choice of two dinners in the evening. All confirmed that they choose their own clothing. One resident stated,” I can do what I want when I want” another stated that they had been supported to move from a small bedroom to a larger bedroom as was their choice. Another resident stated that usually they spend the afternoon sitting in their armchair but staff had supported them to return to bed, as today they had felt uncomfortable. Two of the three resident’s spoken with confirmed that they knew that staff kept records but had never viewed them or been involved in their development. The care plans for these residents were viewed and no input from them or their representative could be found. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 14 Residents meetings had been held monthly up until last summer, then they became more infrequent, however meetings occurred in December and again in January. Issues raised in December were discussed and outcomes and progress of these issues were discussed at the next meeting. The minutes showed that a large number of staff attended these meetings A discussion with a resident revealed that they had been attending regularly but had stopped as they felt that the meeting had not been chaired properly. This was later discussed during feedback with the manager and the clinical supervisor. The home should offer residents the opportunity to chair their own meeting with minimal staff present, this will had control back to residents and may offer them the opportunity to raise issues that they have not felt comfortable raising with large numbers of staff present. Information about advocacy services is available on the notice boards within the home and the organisation encourage residents or their relatives to act as appointee for their benefits where possible. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home has copies of adult protection polices and the manager has a good understanding of how to work within these. Training for staff is provided and there is an appropriate policy in place for managing residents’ monies. EVIDENCE: The home has a copy of the organisations adult protection policy and that of Sefton local authority. It is recommended that the home obtain copies of adult protection procedures from any other local authorities residents are from. This will ensure staff are following the correct procedures for that person. Staff training records show that some staff have received training in this area and further training in planned for February and March. The home manager has a good understanding of the adult protection polices and the home have implemented these when needed. The organisation have an appropriate policy in place for managing residents monies when needed. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The home is clean, tidy and well maintained with sufficient space for residents, staff and visitors. EVIDENCE: The building and grounds were generally well maintained at the time of inspection. There is enough space within the home and the grounds for residents, staff and visitors to feel comfortable and spend time alone or socialising as they chose. The building is single-storey and divided into three wings with sufficient office and storage space. There is a lounge / dining area on each wing, and a larger central lounge/ dining area. Outside there are large gardens and a small patio and seating area, which residents can use. All communal areas were viewed and all were nicely decorated with good quality furnishings and had a homely atmosphere. Generally the home was very clean and tidy, it was identified that an unpleasant smell in one of the lounges related to an easy chair, the manager stated that she would deal with this immediately. It was also identified that the pink carpet in C wing was in need of cleaning as it was stained and marked in places. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 17 Several bedrooms were looked at, each appeared, warm and comfortable and was personalised for the resident. Several bathrooms and shower rooms were also looked at, each was clean and tidy, the water was tested by hand and was at a comfortable temperature. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 30 There are sufficient staff available within the home to meet residents needs. The organisation have an induction programme in place, which is followed by new staff, and provide basic training courses. However there is no clear training plan in place for the home, which covers general training needs and those, specific to residents needs. EVIDENCE: The rotas showed that the home is staffed with a minimum of six care staff in the morning plus two qualified `staff. In the afternoon this decreases to five care staff and one qualified nurse. Viewing the rota showed that this is the minimum number of staff provided. Staffing levels fluctuate above this level at times and the manager stated this would be due to resident’s needs or staff attending training courses. The home has waking staff at nighttime, with one qualified nurse and three care staff available. The home has a number of regular bank staff available with the aim of filling vacancies quickly rather than using agency staff who may be unfamiliar with residents. The organisation provide a planed induction programme for staff and discussions with one member of staff confirmed that they had followed a set induction to the home. There is a training department within the organisation who provide and arrange training for staff. The clinical supervisor explained that training from outside agencies is also used and that the home plan to update all Nurses on their clinical skills within the next year. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 19 Training had recently taken place on use of syringe drivers and training was booked for ‘protected meal times’ and inoculations. Staff training records were not up to date and there was no clear plan of the training required within the home. The manager explained that she intends to update training records with the training department. The home should put together a training plan which covers basic care courses and those that are specific to the home, this will help them to ensure staff are up to date on aspect of care relevant to residents. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 There are clear lines of accountability within the home, the manager is experienced and qualified in management and is supported by qualified Nurses. There is a quality assurance system in place within the home, which involves obtaining residents and relatives opinions. Money held in the home for residents is well managed, however it is not clear why the organisation act as appointee for some residents of how they manage this money. Records are not kept of valuables held for residents and there are several items held which cannot be identified. EVIDENCE: The home does not currently have a registered manager in post. Mrs Maggie O’Reilly has been appointed by the organisation to manage the home with support from Mrs Anne Keogh as clinical Supervisor. Both will work 25 hours in the home and not be counted within the numbers of staff providing care. The manager holds a management qualification and has significant experience of management within care and working with older people. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 21 Lines of accountability within the home are clear and staff spoken with said that they are satisfied with the management structure. The manager is in the process of applying to the Commission for Social care Inspection to become the registered manager. The organisation had an external quality audit carried out in May 05 and achieved a 4 star rating, the manager advised that this is booked to take place again in May 06 and they are currently working with the auditor to improve standards and their star rating this year. The organisation carried out surveys to obtain staff views in September 05 and to obtain residents views on May 05 and the results of these are available. Residents were given time and privacy to talk with the Inspectors during the inspection. The organisation regularly review and update their policies and procedures and the home have worked hard to meet the majority of requirements from their last inspection. The home provides a safe and recording system for storing small amounts of residents’ money. Records and storage of three of these were checked and were correct. The organisation acts as appointee for some residents’ benefits, with other managed by the person themselves or a relative. Where the home act as appointee there should be an explanation on file as to why they do so. There must also be an explanation on each residents file stating how the organisation manage the money, this must include the day the organisation receive the benefits and when they pay the resident their personal allowance. This will ensure that money belonging to the resident is not held in a company account. The manager has found several items of jewellery in the safe that are not labelled. The home must make reasonable effort to return these to their owners. They must also keep records of any items held in the safe for residents and the date they are returned. James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X X 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 2 X 3 X 2 X X X James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(2)(b) Requirement The Home must make sure all relevant sections of care plans are reviewed monthly. This is a previous inspection requirement 2. OP7 15(1) The home must offer residents or their representatives the opportunity to discuss and sign their care plan This is a previous inspection requirement The home must put a system into place for internally auditing their medication. This is a previous inspection requirement. 5 OP7 15(1) A policy must be developed and implemented detailing when care plans for new residents will be in place by. 31/03/06 31/03/06 Timescale for action 31/03/06 4. OP10 13(2) 28/02/06 James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 24 6 OP35 20(3) 7 OP35 13(6) 8 OP35 17(2) schedule 4(9) Where the organisation acts as appointee for residents, care plans must contain; - An explanation and assessment as to why the organisation is appointee An explanation of how this money is managed The home must make a reasonable effort to return unidentified items in the safe to their owner. The home must maintain a record of all items held in the safe for residents. 31/03/06 30/04/06 20/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations The clinical supervisor should continue to remind staff of the importance of signing for all medication omitted/ administered. Residents who suffer from diabetes should be provided with up to date information about the management of the disorder. Residents should be encouraged to chair their own meetings and be given privacy to discuss any concerns as a group. The home should obtain copies of all relevant local authority adult protection policy for residents. The home should clean the dining and hall carpet in wing C The home should compile a training plan for the staff team, which identifies training required to meet residents’ needs. 2 OP8 3 OP14 4 5 6 OP18 OP19 OP30 James Page House DS0000017244.V279169.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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. 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