Inspection on 26/06/07 for Kathryn Court

This inspection was carried out on 26th June 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 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

Kathryn Court 29/09/06

Kathryn Court 17/11/05

Kathryn Court 13/06/05

Kathryn Court 21/01/05

Kathryn Court 13/09/04

Kathryn Court 27/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Kathryn Court 84 Ness Road Shoeburyness Essex SS3 9DG Lead Inspector A Thompson Key Unannounced Inspection 10:15 26th June – 13th July 2007 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 Kathryn Court DS0000015442.V344483.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. Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kathryn Court Address 84 Ness Road Shoeburyness Essex SS3 9DG 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) 01702 292800 01702 292383 www.runwoodhomecare.com Runwood Homes Plc Mrs Susan Loftus Care Home 52 Category(ies) of Dementia - over 65 years of age (52), Old age, registration, with number not falling within any other category (52) of places Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th September 2006 Brief Description of the Service: Kathryn Court is a two-story, fully detached, purpose built property, set in compact grounds in Shoeburyness. The home is registered to accommodate fifty-two older people (over the age of 65), including those who have dementia. Accommodation is provided in forty-eight single and two shared en-suite bedrooms, on both levels of the home. Access between levels is provided by a passenger lift. Communal space available comprises of four day rooms and a conservatory. Visitor car parking is available by the main entrance of the property, where there is also a small enclosed garden for service users to use. Local shops are opposite the home and around the local area. A regular bus route passes the front of the home. Fees for the home range between £400 & £600 a week. CSCI inspection reports are available from the home and the CSCI internet website. Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection commenced on 26th June 2007 with further announced visits on 9th & 13th 2007 July to complete the process. The content of this report reflects the inspector’s findings on the day/s of the inspection, along with information provided by the service and feedback by service users, relatives, staff and other parties. Practice and procedures occurring after this inspection will be reported on in future inspection reports. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. Discussions took place with service users, visitors, the manager, deputy manager and staff. Several service users were unable to express any views on the service owing to their diagnosed dementia. Those spoken to who did have a view confirmed they were satisfied with the care they received and with the quality of the food and accommodation offered. CSCI questionnaires were also sent to service users, relatives and staff, to be completed if they wished. The majority of feedback was positive about staff attitudes, the food and accommodation, although some negative comments were also made on these subjects. It should be noted though, that all written surveys received by CSCI date back to February & early March 2007. At that time the present manager had only been in post for a short period, and evidence at this inspection indicates that from February until July the registered manager had made very good progress on improving the consistency of standards of care provided by staff. Good improvements had also been made regarding support and supervision provided to staff and to the premises environment. These have resulted in positive outcomes for service users and an improvement in the overall quality of service since the previous inspection. Hopefully these improvements will be maintained and built upon in the future. Relatives spoken with on the days of the inspection said they were satisfied with staff attitudes, and with the care and support provided to service users. Feedback from service users and relatives was also very positive about the range of activities offered. Staff spoken with on the days of the inspection confirmed they received good support from the new management team. They also confirmed that they had been offered training appropriate to their role. Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 6 Twenty-seven standards were inspected and the outcomes for service users against twenty-two of these were good, with five adequate. As a result this report includes just one statutory requirement and five good practice recommendations as areas for improvement. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Kathryn Court DS0000015442.V344483.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 Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5 Quality in this outcome area is good. Admission processes ensure that service users can be confident that the home considers they can meet their needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Service user files inspected evidenced that pre-admission assessments are carried out by the deputy manager and a senior carer. Assessment headings included personal and healthcare needs. There was also a separate assessment relating to the needs of people who have dementia. Completed assessments seen had been signed by the service user and the member of staff involved. Residents and their families/representatives are encouraged to visit the home before agreeing to admission, which is initially on a month’s trial. Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. Care plans had been regularly reviewed and provided up to date information on the health, personal and social care needs of service users. Medication prescribed to service users needs to be available for administration at all times. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Five care plan files were inspected. These contained admission information, such as next of kin, with a social history and health history. Care plans are compiled using the homes needs assessment format with daily plans of care and instructions to staff under main headings of memory, communication, mobility, cooperation, manual handling, personal care, dental, diet, hearing, eyesight, social, privacy and independence needs. Since the last inspection senior staff had received training on compiling care plans and this was due to be extended to include carers. Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 10 Care plans seen had been regularly reviewed with written evaluation notes and had been signed by the service user or appropriate relative. Written notes had been kept of multi-disciplinary reviews and of visits to and by health care professionals and advocates. The home also carries out a three monthly review of care, which includes a summary of events since the last review. Relatives are kept informed of these. Individual risk assessments were in place covering manual handling, falls, pressure care and a general risk assessment. There were also separate assessments covering specific needs relating to nutrition (records of regular weight checks seen), mental health, dementia and continence issues. Risk assessments had been reviewed monthly. A separate care plan was kept on all service users covering their night time needs. District nursing services visit the home daily and will provide pressure relieving equipment when needed. The home has access to advice from a community continence nurse. Equipment for the promotion of tissue viability and prevention or treatment of pressure sores is also provided by district nursing services. Chiropody, hearing and optician tests are undertaken at the home by visiting practioners. A dentist also visits and some service users continue to use a community based dentist. GP services are provided by several local practices. The homes policy on the ordering, supply, administering, storage, administration, disposal, PRN, controlled drugs, homely remedies and self medication provided clear instructions and guidance to staff on the required procedures. Dispensing/pharmacy services had just (July 07) been changed to a new pharmacist who had provided training to staff on the new procedures, however evidence that this had been completed for all staff who administer medication was not available. There is a recommendation on this issue in this report. General training on medication was underway, this covered safe handling of medicines. Completion of this programme will be assessed at the next inspection. A random sample of medication stocks and administration records were inspected. Generally these had been acceptably maintained however some instances of service users not receiving their prescribed medication (for supplements and aspirin) at the commencement of the changeover of pharmacist were seen. Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 11 This issue was discussed with the deputy manager and it is understood the problem was caused because some prescriptions had covered three months supply, and the problem should not re-occur. However this is a shortfall and has resulted in a statutory requirement in this report. The deputy manager advised that weekly medication audit checks are carried out in the home, evidence of this was seen. Since the last inspection the medication room had been fitted with an air conditioning unit. There was a payphone in the home for service users to use and the manager advised that several had private telephones in their rooms. Discussions with individual service users indicated that they were treated with respect by staff, as did observation of staff going about their duties and interactions with service users. Staff on duty were seen to be courteous, caring and professional in their dealings with service users, who when spoken with said staff were helpful and considerate. Visitors spoken with also confirmed that they were satisfied with staff attitudes towards services users and themselves. Kathryn Court DS0000015442.V344483.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. The home provides flexible routines and a lifestyle that enables service users to make choices and to engage in their interests. Service users health and welfare is promoted by the provision of a varied and balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service user meetings had to taken place on a monthly basis, minutes were seen, discussion had included activities, complaints, food, cleanliness and accommodation. Meetings had also been held for relatives and a quarterly newsletter is compiled. Service users spoken with confirmed they were fully satisfied with the choices and options made available to them regarding daily routines and leisure interests on offer. They were also complimentary about the care support provided by the staff team. The home employs a full time activities coordinator and activities are offered to service users over the whole week. Records had been kept of the weekly Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 13 programme and of actual events taken part in by service users. These included shopping, bingo, art & craft, coffee mornings, carpet games, sing a longs, visiting entertainers (monthly), move to music, going to church and one to one chats. Local churches have befriended the home and members of the congregation assist service users with transport to services and coffee mornings. A church service is also held in the home regularly for those who do not wish to go out. The activities coordinator has received training on providing meaningful activities to service users, including those who have dementia. Evidence of this was seen. Fund raising events are held to try to raise finances for outings, which tend to be in the local vicinity because of cost implications. The home does not have a budget to pay for outings and the registered provider does not supply a mini bus for the home to use. Discussions with service users confirmed that some go out with staff to church and local shops. The main meal of the day is lunch with two choices available. Services users are asked their preference the day before. Some choose to eat in their rooms the remaining eat in the home’s dining areas. Staff provide assistance and support at mealtimes to service users who need help with eating. Nutrition records (including size of portion eaten) and menus evidenced that a range of choices is available with appropriate nutritional content. Service users spoken with said the food was good and that there was always a choice at lunch. Discussion with staff and observation confirmed that food stocks were kept at a good level. Information on access to independent advocacy services was seen displayed in the home. A local service had visited to speak with service users and had left leaflets, these were also seen. Kathryn Court DS0000015442.V344483.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 good. Practices in the home safeguard service users, and ensure that concerns are listened to and addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy included information to the prospective complainant on whom to complaint too with response timescales. There were also contact details of the registration authority. A copy of the policy is included in the information provided to new service users. Service users spoken with said they knew who to speak to in the home if they any concerns, and that in the past management had responded positively to any queries/issues they had raised. Records were seen of complaints received with details of the investigation findings and the outcome. One file seen did not include all copies of correspondence between the home and the complainant, however this evidence held at the company office and a copy was sent to the home during the day. However as this evidence was not initially kept at home there is a good practice recommendation on this point in this report. Staff had been trained on adult protection procedures and the recognition of abuse. Certificates of evidence were seen but these did not include details of Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 15 the syllabus content covered. There is a good practice recommendation on this issue in this report. The home had guidelines and procedures relating to adult protection and actions expected from staff under this subject. These included a quick action flowchart guide at various office locations around the home. Included were recording and reporting guidelines and procedures along with definitions of the various recognised types of abuse. Discussion with staff confirmed that staff had received POVA training and knew what to do if abuse was suspected. The home’s ‘whistleblowing’ statement/policy was seen and also provided appropriate guidance to staff on reporting concerns. Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,25,26 Quality in this outcome area is good. Furnishings in the home looked comfortable and the home appeared safe and was well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Kathryn Court is a large detached property set in small well maintained private grounds. Following inspection of the premises the inspector considered that the home is accessible and is now maintained to acceptable standards. The needs of individual service users are provided for and accommodation was regarded to be comfortable and clean. Since the last inspection broken drawers in bedrooms have been repaired or replaced, bed covers have been renewed, extended call bell cords had been provided for service users with restricted mobility, curtains had been professionally cleaned, the staff room had been cleaned and was not used to Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 17 prepare drinks for service users, new carpets had been fitted in some bedrooms and new chairs had been provided in the lounges. The main office had been refurbished and in between the inspection dates the lounges were redecorated and a new assisted bath was fitted in the rear groundfloor bathroom. Accommodation is provided in forty-eight single and two shared en-suite bedrooms, on both levels of the home. Access between levels is provided by a passenger lift. Communal space available comprises of four day rooms(two on the groundfloor and two on the first floor) and a conservatory with access to the small garden. There was also a separate room designated for use as a visitors room, this had a small kitchen area. Furnishings in communal and private rooms were considered to be domestic in character and of good quality. There were six bathrooms five of which offered assisted bathing facilities. All bathrooms had wc’s, and there were separate wcs around the home. There were also two shower rooms. Rooms inspected were personalised to individual tastes, naturally ventilated with windows and were centrally heated. During discussion with service users all said their rooms were comfortable and that they were able to bring in personal items when they moved to Kathryn Court. The homes laundry room was fitted with appropriate washing machines and tumble dryer. The laundry floor finishes were considered impermeable and readily cleanable. Policies and procedures were in place for the control of infection and include safe handling and disposal of clinical waste. Throughout the inspection the premises were considered clean and free from any offensive odours. Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Staffing levels appeared to meet the needs of service users, staff had been trained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes staffing rota was inspected and evidence staffing levels are being provided at one senior and seven carers on morning shifts with one senior and six carers on afternoon shifts. Night staffing was one senior and three carers on waking duties. The manager hours were supernumery and the deputy manager was supernumery two days a week. Staffing rotas also evidenced that separate and additional staff are employed for administration, catering, domestic and maintenance duties. Training records confirmed that eleven staff had the NVQ 2. The manager advised that all remaining eligible staff were due to receive this training, including, administrative, catering and domestic staff. Staff spoken with on the day confirmed this. Staff recruitment procedures were inspected. Two written references, proof of ID, photo, application forms and CRB checks were obtained on new staff. Also on files were training records and contracts of terms & conditions of Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 19 employment. Staff spoken with confirmed that they had interviews and CRB checks. The home’s induction and foundation training process was now based on an in house package completed within four weeks of starting work (evidence seen) and then onto the Skills for Care Common Induction Standards. This was based on a workbook modular format with headings of principles of care, role of the worker, safety, communicating, abuse and neglect and developing as a worker. One completed workbook was seen and discussions with staff and inspection of training records and certificates confirmed that they received induction training and that short course training was provided which included: Dementia, POVA & abuse, health & safety, loss & bereavement, manual handling, first aid, pressure care, fire safety, sensory impairment, food hygiene and medication. Update training for staff is planned for by the manager completing a monthly training needs review form which goes to head office for action. Evidence of this process was seen. Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 Quality in this outcome area is good. The home had been run and managed efficiently. Procedures for gaining the views of service users and relatives were in place to ensure their views were listened too. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new registered manager is experienced, qualified and holds the Registered Managers Award. She has managed similar services for over 12 years and had kept updated on the needs of service users. The home’s quality assurance system had last been fully implemented in 2006. Questionnaires had been provided to service users, relatives and other Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 21 appropriate persons/agencies. Responses were summarised in an annual audit report. The registered provider also carries out an annual quality check on the service and produces an internal report showing any required outcomes. Some service users chose to entrust their personal allowance monies to the home for safe keeping. Records of balances held and of transactions undertaken were presented for inspection and a random sample checked was considered appropriately maintained. 1-1 formal staff supervision meetings had commenced since the new manager had joined the home. Records were seen to confirm that regular meetings had taken place with senior staff but not with all carers. It is understood that senior carers (Care Team Managers) will in future be responsible for ensuring that regular meetings take place with all care staff, however until this is evidenced there is a recommendation on this point in this report. Random samples of records required to be kept were inspected. These included care plans, assessments, fire procedures, fire drills, regulation 37 notices, accident records, staff rotas, complaints, cash held for safekeeping, staff recruitment, visitors, photograph of service users, nutrition & medication. Discussions with staff, management and inspection of records confirmed that training is provided to staff in moving and handling training, fire safety, food hygiene, first aid and basic training in infection control. Records seen confirmed that fixed and portable hoists, fire alarms, fire fighting equipment, staff call bells and shaft passenger lift, gas and electrical installation supply, had all been tested/serviced at appropriate intervals. Hot water supply to baths is regulated and tested manually by the home’s staff. The home had a general premises risk assessment in place, this was comprehensive but should have been reviewed. There is a recommendation on this point (it should be noted that review had taken place by the time of the last site visit on 13/7/07). Kathryn Court DS0000015442.V344483.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 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 3 3 X 3 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 3 2 Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 The supply of medicines must ensure that service users receive all their medicines as prescribed. Timescale for action 30/09/07 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 3 4 5 Refer to Standard OP9 OP16 OP18 OP36 OP38 Good Practice Recommendations Evidence should be available that staff update training on the safe handling of medication has been completed with written competency assessments available for inspection. Copies of all responses to complaints should be available for inspection to evidence what action and outcomes had resulted from complaints received. The content syllabus of staff training on adult protection should be made available for inspection to evidence that that relevant headings had been included. Formal staff 1-1 supervision should be offered to staff at least six times annually so that they have the opportunity to discuss their role and workload. The home’s written assessment on safe working topics should be reviewed and updated if necessary. Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kathryn Court DS0000015442.V344483.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!