CARE HOMES FOR OLDER PEOPLE
Lambton House Lambton House New Lambton Fencehouses Durham DH4 6DE Lead Inspector
Lesley-Anne Moore Unannounced Inspection 5th February 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lambton House DS0000007484.V328173.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. Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Lambton House Address Lambton House New Lambton Fencehouses Durham DH4 6DE 0191 3855768 0191 3852169 No e-mail 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) Mr Jason James Thompson Mr Richard Coltman Mr Jason James Thompson Care Home 38 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (23) of places Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: Lambton House is a registered care home providing personal care and accommodation for up to 23 older people and 15 people with dementia over the age of 65 years. It is not registered to accommodate persons who require nursing care. The home was opened in April 1999 and is owned by Mr R Coltman and Mr J J Thompson, the later also being the Registered Manager. Lambton House is located on the outskirts of Fencehouses. The home is a 2storey building situated in its own private, well-maintained ground, with personal accommodation being provided over 2 floors. The home is currently undergoing extensive refurbishment of both communal and individual accommodation with a planned completion date for the end of summer 2007. Local amenities are accessible by public transport. The home also provides a day-care service for up to 12 older persons per day. Separate facilities and staff are provided for this service. There is a committed team of care and support staff. The current weekly fees charged range from £365 - £398.80 for the category Older Persons, and £398 - £413 for the category Dementia over 65 years. There are additional charges for hairdressing, chiropody, and transport with escort if required for hospital visits. Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 7 February and lasted for approximately 7.5 hours. The Registered Manager supplied some information on the pre-inspection questionnaire and 4 service user surveys and 10 relatives/visitors comment cards were completed and returned. The inspection focussed on key standard outcomes for service users. No requirements or recommendations had been made at the previous inspection visit. During the inspection time was taken talking to service users and staff; the home’s policies and procedures and a number of individual records were looked at, and the Inspector was given a tour of the home. On entering the home there was a relaxed and homely atmosphere. Service users appeared happy, well cared for, were carrying out their normal daily activities and were interacting well with staff. What the service does well:
The home has a long-standing team of staff who promote service user choice and support service users to achieve their optimum independence within a safe homely environment. The Manager said that he was ‘very proud of the service. The staff don’t just know the service users but they know the families as well.’ Service users and their relatives were in support of these comments, ‘You couldn’t wish for nicer staff, tip top’, ‘Nothing’s a bother to any of them’, ‘The laundry worker is lovely’, ‘The cook is spot on’, ‘Four seniors lovely, absolutely wonderful’, ‘a home rather than a place to stay’, ‘Like a 5 star hotel’, and ‘Lambton House excels in all aspects of care, even when confined to bed’. There is a strong commitment to staff training and development that is supported by a comprehensive training programme. 87 of care staff hold the National Vocational Qualification (NVQ) Level 2 in care, all senior care workers hold NVQ Level 3 with 2 having completed Level 4. 2 members of staff hold the Registered Managers Award. The refurbished areas in the home have been completed to a high standard, individual service users rooms are well-presented and personalised with own furnishings and possessions. Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better:
The Statement of Purpose must be amended to include details of the dimensions of individual rooms in the home. Although the home has invested time and effort in providing all service users with an individual contract, detailed information showing the breakdown of fees and who has responsibility for meeting those fees is absent. The service should ensure that each service user is provided with a contract that provides this information. The home has in place formal documents upon which a full assessment of the service users health, personal and social care is recorded on admission. However, examination of the file of 1 service user showed that this information had not been documented onto the record used for this purpose. A 2nd file showed this information to have only been partially completed. The Manager should ensure that the care staff are carrying out a full assessment of needs on admission and that this information is recorded in the correct place in the service users file. Two errors relating to the administration of medicines have been reported to the Commission in the past 6 months. Whilst it is acknowledged that the home has taken immediate action to improve its policies and procedures in the safe administration of medicines it is an area that should be kept under constant review to safeguard service users. Access to the garden may be restricted in certain areas to wheelchair users. The Manager should review the access arrangements for wheelchair users and ensure that as far as possible these service users have a reasonable safe access to areas where they may wish to sit and enjoy the garden. Comments received from relatives suggest that the home should keep under review its staffing levels particularly at busy periods. The Manager should satisfy himself that staffing levels are adequate to meet the needs of service users at all times. Inspection of staff records showed that 1 staff member had commenced employment prior to the service receiving confirmation of their fitness to work
Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 7 in relation to any criminal convictions. The Manager must ensure that the mandatory checks are completed prior to the commencement of employment of all staff and that evidence of this is held within the staff files. 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. Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 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 Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives receive adequate information about the home and are encouraged to visit prior to admission to the home. The home does not provide intermediate care and therefore assessment of this standard is not required. EVIDENCE: The Statement of Purpose and Service User Guide have both been updated recently to reflect changes in the service. However, within section 11 of the Statement of Purpose it was noted that information relating to the size of individual rooms has not been included. This information must be added to provide service users with full details of the services and facilities provided by the care home.
Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 10 The Manager reported that copies of the contracts given to service users are kept in individual care files and detail the fees to be paid for the provision of service. Of the 5 records examined 2 files did not contain a contract. Of the 3 remaining records where placement had been arranged through the care management process it was noted that the contracts did not provide detail of the individual contributions to be made on the part of Social Services and service user where there is a ‘top up’ element. Each service user should be provided with a contract that clearly sets out the total fees payable and clearly details any contribution for which the service user is responsible. The home’s admission policies and procedures are in place and generally seen to be satisfactory. Service users are encouraged to visit the home in advance of placement where possible. No service user is admitted through care management arrangements until the service has received a copy of their care needs and care plan upon which the service users suitability for the home can be assessed. Staff carry out a pre-admission assessment on all prospective service users to include health, personal and social care needs to ensure that the home can meet individual care needs. Of the 5 service user records looked at the admission assessment was not available for 1 service user, and the assessment was only partially completed for a 2nd service user. The Manager should review the admission procedures with the care staff and stress the importance of documenting the initial assessment upon which future care can be planned. Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care that each service user receives is based upon individual assessed needs. EVIDENCE: Each service user has a care plan, agreed with them where possible, which is easy to understand and considers the health, personal and social care needs of that individual. The care plan includes comprehensive risk assessments with evidence of regular reviews that take into account the needs of the service user balanced against their rights to choice and independence. The care plan is reviewed regularly and the necessary action taken to respond to any changes in consultation with the service user. 3 service users commented on the pre-inspection survey that they ‘always receive the care and support they need’ whilst 1 commented that ‘he/she usually receives the care and support that he/she needs.’ 1 relative commented on the relatives/visitors comment
Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 12 card ‘I think the staff of the care home do a very good job in looking after my mothers needs’. The home has a medication policy in place and medicines are generally received, administered and disposed of safely. However, 2 Regulation 37 notifications were reported to CSCI over the past 5 months relating to an error with service users medicines. In one instance the medicine had been given to the wrong service user in error. Discussion with the Manager at the time of the incidents identified a possible training need in respect of the safe administration of medicines. It was noted during the inspection that this area has already been addressed during staff supervision and that training was currently underway to ensure that the policies and procedures in relation to administration of medicines are adhered to at all times However, this is an area that should be kept under close review at all times. The aims and objectives of the home reinforce the importance of treating service users with respect and dignity in all aspects of their life. Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social, cultural and recreational activities meet service users expectations. Service users receive a balanced, wholesome diet according to their individual assessed needs and choice. EVIDENCE: Service users are helped in making choices about their daily activities and are given the opportunity to engage in social activity where possible. 6 relatives/visitors comment cards record that the service always supports the service users to lead the life they chose. The home runs a weekly activities programme that includes in-house activities, such as sing along sessions, listening to music from the past with external performers and outings to local shopping centres, pubs and the theatre where possible. The Manager and 4 senior care workers spoke enthusiastically of the holidays that they have enjoyed with small groups of service users, most recently to Blackpool. The home also organises a summer fete in the rear
Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 14 garden to which friends and relatives are invited and the proceeds are generally put towards funding future holidays and activities. The service has 2 mini buses that are used for transporting service users on outings and hospital visits. 3 members of staff have received training in the driving of these vehicles. A small room within the home has been equipped as a hairdressing salon with a local hairdresser being employed on a full time basis. Relatives and friends are warmly welcomed into the home and are kept up to date with service user progress and developments within the home. The service employs 3 cooks and 2 kitchen assistants who provide a varied and well-balanced menu. Staff have recently received training in the new guidelines issued from the Food Standards Agency Safer Food, Better Business on the safe handling and preparation of food. Meals are served in the dining room and meal times are considered a social occasion. Service users also have the option to have meals in the privacy of their own room if they wish. Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected. EVIDENCE: There is a clear and accessible complaints procedure within the home which is available to service users and their relatives. This enables anyone associated with the service to make a complaint or make suggestions for improvement. Any complaint received by the home is fully investigated and an accurate record is kept of the nature of the complaint and the action taken. The manager reports that there have been no recorded complaints over the past 12 months. 3 out of the 4 service users completing pre-inspection surveys confirm that they always know how to make a complaint, with the remaining service user saying that they usually know how to make a complaint. The policies and procedures regarding protection of service users are of a high standard and are reviewed and updated on a regular basis. Staff receive training on the protection of vulnerable adults. The service is clear when incidents require external input and which agency to refer the incident to. Lambton House DS0000007484.V328173.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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe and homely environment. EVIDENCE: The home is currently undergoing an extensive refurbishment programme. The purpose of this is to update the accommodation, provide all service user rooms with ensuite facilities and install a new passenger lift by the end of summer 2007. Despite extensive building works the Manager has worked hard to ensure that there is minimal disruption to service users daily lives and that the environment remains safe and as free from hazards as possible. 1 relative commented on the relatives/visitors comment card ‘The care home improvements seem to be on-going and all for the best’. The areas that have been completed are finished to an exceptionally high standard providing individual accommodation that can be personalised with own furnishings,
Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 17 choice of décor and carpet. 3 rooms on the ground floor have been adapted to allow adequate space for wheelchair users. Each of these rooms has a door to allow access into the garden and the Manager reports that ramps and handrails are to be installed shortly for this purpose. There is a pleasant conservatory overlooking the garden where service users can sit. This is also available as a smoking area for those service users who wish to smoke. There are gardens to the rear and front of the building that provide pleasant areas for service users and their relatives to relax in. However, a relative suggested on a CSCI comment card that access to the garden for wheelchair users may be limited to certain areas owing to the restricted width of paving stones around the outside of the building. At the time of the inspection the Manager spoke of service users using the garden freely. However, the Manager should satisfy himself that wheel chair users have reasonable access to those areas that are considered safe and that restrictions are reduced as far as is practically possible. The Inspector was able to see evidence that all mandatory health and safety checks have been conducted and are up to date. The home appeared to be clean in all areas despite the building works that are currently in progress. Lambton House DS0000007484.V328173.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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service ensures that all staff receive relevant training that is targeted and focused on improving outcomes for service users. EVIDENCE: Discussion with the Manager, examination of the duty roster and observation during the inspection demonstrates that appropriate number of staff and skill mix are generally on duty to meet the needs of the service users. However, comments received from relatives suggest that at times staffing levels may appear to be on the low side although this has not generated any formal complaints, e.g. ‘Think that staffing levels are inadequate sometimes’, ‘As with all homes, staff levels are minimal to requirements’ and ‘I think the only way things could improve would be to have more staff’. However, of the 4 surveys completed from the service users themselves 2 reported that the staff are always available when they need them with 2 reporting that the staff are usually available when they need them. The Manager should ensure that staff are able to respond to service user needs during busy periods and keep staffing levels under constant review to accommodate the varying needs of the service.
Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 19 The service ensures that all staff receive relevant training that is targeted and focused on improving outcomes for service users. Documentation within the home gives evidence of the training that staff members are currently receiving e.g. fire training, first aid, medication, moving and handling, infection control, dementia, Protection of Vulnerable Adults, death and dying, and kitchen safety. The Manager explained that the service is also involved with and has received training from the Durham Employers Care and Health Alliance. 87 of care staff currently employed hold NVQ Level 2 in care. The records of 5 staff were looked at during the inspection. 4 staff were noted as being in post prior to the mandatory Criminal Records Bureau checks were required of employers. However, the remaining staff member was seen to have commenced employment prior to the CRB check having been received by the service and without any evidence of a Protection of Vulnerable Adults 1st check having been obtained. As part of the recruitment process the Manager must ensure that he has carried out all the mandatory checks on new members of staff prior to their commencing employment. Lambton House DS0000007484.V328173.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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager has the required qualifications and experience to effectively manage the home. He provides sound leadership in supporting the staff to deliver a high quality of care for the service users. EVIDENCE: The Manager provides an environment in which staff are supported and developed to achieve a high standard of care for the service users. The leadership style is that of a democratic manager who listens to, respects and supports his staff whilst encouraging an open and friendly culture between staff, service users, their relatives and visiting support staff. The service holds
Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 21 regular meetings for staff in which staff have the opportunity to discuss any current issues or developments in the home. The service obtains the views of service users and their relatives on the quality of care through periodic surveys through questionnaires. Small amounts of personal monies are held on behalf of service users that require 2 signatories and receipts retained for any transaction on the part of the service user. The service has a supervision and appraisal system in place in which staff receive regular support either on a one to one basis or as part of a small group. The Care Consultant employed by the home generally carries out the staff reviews. Supervision topics were seen to include current issues arising in the home, e.g. administration of medicines, CSCI’s Inspecting for Better Lives programme, or areas of interest relating to the service, e.g. challenging behaviour, communicating with the deaf and the Mental Capacity Act 2005. Detailed health and safety policies safeguard the interests of service users, staff and visitors to the home. These were available for inspection and included evidence of regular servicing of fire equipment and gas and electrical appliances. There is evidence to confirm that accident records are duly completed and reviewed to detect any trends emerging in relation to individual service users. If necessary risk assessments can be put in place so that the health, welfare and safety of service users can be maintained at all times. Lambton House DS0000007484.V328173.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 3 2 2 X 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Lambton House DS0000007484.V328173.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 OP1 Regulation 4(1)(c) Requirement Timescale for action 30/04/07 2. OP2 5 3. OP3 14(1)(a) 4. OP29 19 (1)(a) and (b), and Schedule 2 The Statement of Purpose must be amended to include details of the dimensions of individual rooms. The Manager must ensure that 31/07/07 each service user’s contract clearly sets out the fees including a breakdown of those fees and who has responsibility for meeting the various elements in the event that the service user is funded through continuing care arrangements. The Manager must ensure that 31/03/07 staff are carrying out a full assessment of a service users needs on admission and that this is documented using the correct recording system in the care file. The Manager must not employ a 31/03/07 person to work at the care home unless he has completed all the necessary checks to confirm that the person is fit to work at the care home and that evidence of this is documented in the staff members file. Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 24 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. Refer to Standard OP9 OP19 OP27 Good Practice Recommendations The Manager should keep under constant review the policies and procedures for the safe receipt, storage, administration and disposal of medicines. The Manager should ensure that wheel chair users have access as far as possible to the communal areas of the garden for recreation purposes. The Manager should ensure that suitably qualified, competent and experienced staff are on duty at all times in appropriate numbers for the health and welfare of service users. Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Lambton House DS0000007484.V328173.R01.S.doc Version 5.2 Page 26 - 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!
