Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 02/08/05 for Laurels Retirement Home

Also see our care home review for Laurels Retirement Home for more information

This inspection was carried out on 2nd August 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Mrs Price aims to provide an informal homely environment for residents, and it is clear from talking to the residents that she achieves this. One person said `Trina is marvellous`. There is a core of committed long-standing staff who know the service users well and provide a caring and sensitive environment. All the residents spoken to expressed satisfaction with the care provided and made comments like `Staff excellent` `Look after you wonderfully` `Staff all friendly and kind`, this person also commenting especially about a male member of staff who he/she said was `very obliging`. Residents felt that staff were not rushed and had sufficient time to provide them with the care they need. The home ensures that residents have a choice of GP. It was apparent from the records seen during the inspection and from talking with Mrs Price that she works closely with the primary healthcare teams to ensure residents medical needs are met. Residents rooms are clean and comfortable with considerable redecoration and refurbishment being undertaken over the last year. Rooms are personalised to suit residents needs and they are able to see their visitors in private or the communal areas as they wish There have been no complaints since the last inspection. Residents seen had total confidence in the manager and if there were any complaints would choose to speak with her and commented `Trina would act` and `Trina would put in right`

What has improved since the last inspection?

Mrs Price who was Head of Care has now become the registered manager. As she is well supported by Mr and Mrs Kitchen, the owners of the home, she is able to get on and make day-to-day decisions herself. As stated earlier the home is now registered to take residents with mild to moderate dementia. All care staff have received a course of training from a retired Community Psychiatric Nurse to increase their confidence and knowledge when dealing with this group of service users. There has been a sluice room installed which has made disposal of waste materials easier for staff. An additional bathroom has been fitted and this will improve bathing facilities even further when suitable aids and equipment are supplied as planned. Mrs Price became a recognised manual handling trainer in April 2005 and this enables staff to receive training promptly and keep updated. The home has a quality assurance system in place and the views of residents and their families as well as staff are sought. Mrs Price was able to show that where comments had been made action was taken to further improve services. The garden at the rear of the property is now enclosed to ensure the privacy and security of residents is maintained. All residents bedrooms are being fitted with door locks, this was in process during the inspection.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Laurels Retirement Home 195 Barrack Road Christchurch Dorset BH23 2AR Lead Inspector Gill Kennedy Unannounced 02 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Laurels Retirement Home Address 195 Barrack Road, Christchurch, Dorset, BH23 2AR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01202 470179 01202 485200 info@laurels.uk.net Mr Richard Kitchen Mrs Elizabeth Kitchen Mrs Tarina Ruth Price PC Care Home only 20 Category(ies) of OP - 20 registration, with number DE(E) - 20 of places Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service users should only be admitted to the home who have low to medium dependency needs, i.e. have mild to moderate dementia and intermittently need interventions that require reassessment, there is some likelihood of specialist referral. Physical or mental health is sometimes fluctuating, erratic or unstable, sometimes requiring intensive or unpredictable interventions. Service users must not be admitted to the home who present aggressive, violent or wandering behaviour. Date of last inspection 14 March 2005 Brief Description of the Service: Laurels Retirement Home is a residential care home registered for twenty places under the category of OP (Old Age) and DE(E). It is an older style property, with a more recent extension, situated on one of the main roads into Christchurch town centre. Mr and Mrs Kitchen took over as proprietors of the home in September 2004. Mrs Price who was formally employed as Head of Care by the previous owners became the registered manager in June 2005 and has worked in the home for many years. The majority of rooms are single with two of these being en-suite and one of the four double rooms is also en-suite. The home has a lounge and a dining room which also has a small seating area that looks out onto the patio. There are stair lifts to the upper floors. To the rear of the property is a secure, private patio area with seating where service users can entertain visitors. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection had been conducted as part of the normal inspection process legally required. Mrs Price, the manager, was available throughout the inspection to provide information and answer questions and she was helpful and co-operative. Since the last inspection the home has become registered to accept residents with mild to moderate dementia. These changes took place after full consultation with long-term residents and their relatives. A section of two residents files were read during this inspection with particular concentration being upon risk assessments. Seven residents were spoken to during the inspection. Two were seen privately in their rooms and four in the small communal lounge to discuss their views about life in the home and the services provided. One resident was angry about being asked his/ her views so this discussion was terminated. A selection of residents rooms were seen and the communal areas. The time taken on this inspection was 6.5 hours and 12 standards were inspected. The terms resident and service user used in this report are interchangeable. What the service does well: Mrs Price aims to provide an informal homely environment for residents, and it is clear from talking to the residents that she achieves this. One person said ‘Trina is marvellous’. There is a core of committed long-standing staff who know the service users well and provide a caring and sensitive environment. All the residents spoken to expressed satisfaction with the care provided and made comments like ‘Staff excellent’ ‘Look after you wonderfully’ ‘Staff all friendly and kind’, this person also commenting especially about a male member of staff who he/she said was ‘very obliging’. Residents felt that staff were not rushed and had sufficient time to provide them with the care they need. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 6 The home ensures that residents have a choice of GP. It was apparent from the records seen during the inspection and from talking with Mrs Price that she works closely with the primary healthcare teams to ensure residents medical needs are met. Residents rooms are clean and comfortable with considerable redecoration and refurbishment being undertaken over the last year. Rooms are personalised to suit residents needs and they are able to see their visitors in private or the communal areas as they wish There have been no complaints since the last inspection. Residents seen had total confidence in the manager and if there were any complaints would choose to speak with her and commented ‘Trina would act’ and ‘Trina would put in right’ What has improved since the last inspection? Mrs Price who was Head of Care has now become the registered manager. As she is well supported by Mr and Mrs Kitchen, the owners of the home, she is able to get on and make day-to-day decisions herself. As stated earlier the home is now registered to take residents with mild to moderate dementia. All care staff have received a course of training from a retired Community Psychiatric Nurse to increase their confidence and knowledge when dealing with this group of service users. There has been a sluice room installed which has made disposal of waste materials easier for staff. An additional bathroom has been fitted and this will improve bathing facilities even further when suitable aids and equipment are supplied as planned. Mrs Price became a recognised manual handling trainer in April 2005 and this enables staff to receive training promptly and keep updated. The home has a quality assurance system in place and the views of residents and their families as well as staff are sought. Mrs Price was able to show that where comments had been made action was taken to further improve services. The garden at the rear of the property is now enclosed to ensure the privacy and security of residents is maintained. All residents bedrooms are being fitted with door locks, this was in process during the inspection. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 7 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. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 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 standard(s) None of these standards were inspected on this occasion. EVIDENCE: Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 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 standard(s) 8,9 The home relates to a number of GP practices that ensure residents are able to exercise choice and the home strives to ensure that residents’ health care needs are met. Systems in the home for the management of medication are generally sound, but some minor improvements are needed for the standard to be fully met. EVIDENCE: The home relates to six primary care teams and Mrs Price says she has a good rapport with them all. It was noted on the care plans seen that there are separate sections for GP and District Nurse visits as well as other ancillary services such as chiropody and opticians. Three residents have visits from the District Nursing services to attend to pressure sores and are provided with specialist equipment as necessary. Where there was concern about a resident’s health it was clear from records and talking with Mrs Price that action was promptly taken to seek specialist advice. There is also close liaison with the psycho geriatric services. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 11 There had been twenty-two accidents since the last inspection. Twelve related to one resident, who had subsequently been admitted to hospital. A risk assessment was in place, but this could benefit from being more detailed and information was supplied about recommended professional guidelines for this. Following the last inspection on 14 March 2005 it was arranged that Christine Main, CSCI pharmacist, would visit and assess Standard 9. As a result of that visit on 21st April 2005 two requirements and four recommendations were made. How these have been progressed were judged on this inspection. The home currently has no residents who are self medicating. There is a medicines policy that has been updated as recommended to include actions taken in the event of a medication error. However, there were still areas of the policy that required further work and Mrs Price said she would liaise with the CSCI pharmacist for additional clarification. Evidence was seen that the home now keeps a record of all medicines received. There are still storage issues regarding the medication as the medicines refrigerator is not locked, but it is kept in a secure room. The home does not have a controlled drugs cupboard that complies with the Misuse of Drugs regulations, although the manager has a method of storing controlled drugs. MAR charts still do not indicate in all cases if residents have any allergies. Mrs Price said she had taken this up with the pharmacist supplying the home. On the records seen the MAR charts were either blank in this section or allergies were noted. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14,15 The home is committed to providing a welcoming environment for visitors that enables residents to retain family and community contacts. Residents are encouraged to be as independent as possible and have control over their lives. There is more work required on menu planning to increase some service users’ satisfaction with the meals provided. EVIDENCE: There is open visiting in the home and this is highlighted in written information supplied to residents. All the residents spoken to confirmed that their visitors were made welcome and offered refreshments. Some residents go out to local clubs and one lady continues to visit her regular hairdresser. Another resident told me he enjoyed visits from the vicar of the former church he attended. Residents are able to bring their own possessions into the home and it was noted that bedrooms were personalised to suit their own needs. Residents confirmed that they felt able to do as they wished in their everyday lives. The menus supplied to residents are recorded in a book, it was noted that a high proportion of the main meals were red meats. Breakfast is delivered to Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 13 residents’ rooms and there was general satisfaction with this meal, although one service user said he/she would enjoy a cooked breakfast, but it was ‘not the custom of the house’ whilst another resident was confident a cooked breakfast would be supplied if requested. Views about the main meal of the day, which is served between 12.00 and 13.00 hours were variable. They ranged from ‘Lunches poor’ to ‘Food good, but sometimes spoilt in cooking’, and other comments about the food in general were ’Pretty good, you can’t expect miracles’, ‘OK’ and ‘Quiet good – tea is best’. Whilst a choice of main meal is not supplied, residents likes and dislikes are well known and an alternative meal would be provided. There was a variety of options at teatime including sandwiches, pork pies and soup followed by homemade cakes and fresh or tinned fruit. Mrs Price said she tries to take into account residents preferences, but finds it difficult to please everyone. In view of the comments made she intends to offer two choices at lunchtime. This will be discussed with the cook who is very experienced and worked for many years in another residential home before coming to the Laurels Care Home. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 There are systems in place, which ensure residents are confident that any complaints are dealt with speedily, and necessary action taken. EVIDENCE: There have been no formal complaints made since the last inspection. The home has a complaints book where they would be recorded. The home has a complaints procedure that meets the NMS standards. In practice all residents spoken to said they would see Mrs Price and were confident she would sort any concerns out. One person said they had ‘Nothing to complain about’. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 21,24 Bathing facilities could be further enhanced to improve the number of assisted bathrooms available to meet the needs of service users. Bedrooms are homely and comfortable enabling residents to live in a pleasant and well-maintained environment. EVIDENCE: At the last inspection in March, Mr Kitchen, one of the owners of the home had planned over the following three months to install a Parker Bath in one bathroom and an assisted walk in shower in another bathroom. Work has been done to improve bathing facilities at the home and a standard bathroom had been installed. Mrs Price says that a bath seat will be fitted to provide easier access for some residents and she is considering which type will be the most appropriate. A selection of bedrooms were seen during the inspection, they were found to be clean and comfortable. One resident was pleased about the redecoration of his room and the new curtains that had been supplied. All bedroom doors were Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 16 currently being fitted with locks and Mrs Price would undertake risk assessments to ascertain who would want to have a key and how this would be managed. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 The home has sufficient staff with the necessary skills to meet residents assessed needs. Due to a shortfall in the recruitment procedure residents are not fully protected from risk. EVIDENCE: A copy of the staffing roster was supplied to CSCI, which indicated that sufficient care and ancillary staff are on duty to meet residents needs. Additional care staff are employed at busy times and there are two waking night staff between the hours of 20.00-08.00 hours who also take responsibility for the laundry. Residents were all very positive about the staff, with comments - ‘excellent’, ‘Plenty of staff – very kind’, ‘All friendly and kind’ and ‘Somebody here for very need.’ There are no agency staff employed, as staff in post would work additional hours in times of sickness and holidays, this was clearly indicated on the staffing roster. Evidence was seen that enhanced CRB checks have been sought for all staff and are currently being processed. One new member of staff has been employed since the last inspection and the file indicated that appropriate references had been sought and a contract issued. However, CRB clearance Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 18 had not been obtained prior to employment and as a minimum to safeguard residents *‘POVA first’ check had not been sought. There was also insufficient documentation as proof of identity as required in Schedule 2 of NMS. *Protection of Vulnerable Adults register. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,38 The views of residents and other interested parties are sought and the home is run with their best interests in mind. Whilst generally robust systems were in place to ensure the health and safety of residents there were some omissions that could place them at risk. EVIDENCE: Mrs Price seeks the views of residents and relatives via questionnaires as well as face-to-face contact about the services provided in the home. It is clear from talking with her and the residents as well as general observation that she is keen to make the home as comfortable and friendly as possible. To date she has not included in her quality monitoring an annual development plan, but discussions took place during the inspection on how this could be achieved. The home ensures the safety of residents by having the required maintenance and servicing undertaken including regular Legionella testing. Mrs Price states Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 20 that the majority of staff have completed an infection control course and all staff have had current Moving and Handling training. There is a current fire risk assessment in place and the records indicated that staff were up to date with fire training. However, full and partial fire evacuations had not been carried out as required and are considerably out of date. The emergency lights and extinguishers had not been checked monthly as required to ensure they were working efficiently, although they had recently been checked by a qualified professional on 1st July 05 as part of a regular maintenance contract with the home. Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 2 COMPLAINTS AND PROTECTION x x x 2 x 3 x x STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 2 x x x x 2 Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 22 YES 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 OP9 Regulation 13(2) Requirement Arrangements must be made for locking the medicines refrigerator. (Timescale 31.05.05 not met.) The home must be able to demonstrate that food served to all residents is varied and properly prepared. Care staff must not be employed until an enhanced CRB check is obtained. As a minimum a POVA first check must be sought if a staff member needs to be appointed for operational reasons. Two forms of identification e.g birth certificate and passport must be on staff files as proof of identity. Procedures must be in place for the registered manager to audit all aspects of the home’s care practice, occupancy, housekeeping, staff training, staff turnover, accidents and incidents, medication usage and accounts to ensure the home is achieving it’s stated aims and objectives. An annual development plan must be produced as a result of the audit. Timescale for action 31.10.05 2. OP15 16 30.09.05 3. OP29 19 Schedule 2 30.09.05 4. OP29 19 30.09.05 5. OP33 24 31.10.05 Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 23 (Timescale 14.06.05 not met.) 6. OP38 23 Fire drills must be undertaken twice yearly, one being a full drill to include residents and where they have not taken part the reasons for this fully recorded. Evidence must be available to demonstrate that fire extinguishers and emergency lights are tested monthly to ensure they are working correctly. 30.09.05 7. OP38 23 30.09.05 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 OP9 OP9 Good Practice Recommendations The medicines policy should be updated to include all the recommended actions in the guidance provided by the CSCI pharmacist. Details of any medicine sensitivity or none known should be included on or with the MAR chart. The home should have a cupboard that complies with the Misuse of Drugs (Safe Custody) regulations 1973 for storing Controlled Drugs (CSs) and a CD record book. (Information already supplied.) Work should continue to ensure that additional bathing facilities installed have the necessary aids and adaptations to suit residents assessed needs. 4. OP21 Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Laurels Retirement Home D55 S61915 Laurels Retirement Home V236366 020805 Stage 4.doc Version 1.40 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!