Inspection on 24/06/08 for Leeming Garth

This inspection was carried out on 24th June 2008.

CSCI found this care home to be providing an Adequate service.

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

Leeming Garth 02/07/07

Leeming Garth 04/07/06

Leeming Garth 22/11/05

Leeming Garth 08/06/05

Leeming Garth 30/12/04

Leeming Garth 01/07/04

Leeming Garth 02/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Leeming Garth Leeming Bar Northallerton North Yorkshire DL7 9RT Lead Inspector Jane Bassett Key Unannounced Inspection 24th June 2008 09:00 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 Leeming Garth DS0000028033.V366171.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. Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Leeming Garth Address Leeming Bar Northallerton North Yorkshire DL7 9RT 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) 01677 424014 01677 425121 leeminggarth@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Home Properties Limited Angela Fellows Care Home 55 Category(ies) of Old age, not falling within any other category registration, with number (53), Physical disability (2) of places Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 53 2. Physical disability - Code PD, maximum number of places: 2 The maximum number of service users who can be accommodated is: 55 2nd July 2007 Date of last inspection Brief Description of the Service: Leeming Garth Care Centre provides general nursing care for up to 53 older people and for two people with physical disabilities. The home is situated in the village of Leeming Bar with close access to the A1. The accommodation is spread over two floors and there is stair lift and a passenger lift, giving access to the upper floor, there are two areas of the home, the manor and the court. The home is set in extensive grounds and there is ample car parking facilities for visitors and staff. Southern Cross Home Properties Limited owns the home. Fees range - between £341.04 and £698.50 per week. Information is available regarding the service through inspection reports, statement of purpose and service user’s guide. Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. During the inspection the inspector carried out an unannounced visit to the home. The inspection visit lasted seven hours. During this time the inspector looked at a range of documentation including, service user and staff files. The inspector spoke to five service users, five staff members and the manager. Nine service users, thirteen relatives and four staff returned questionnaires to CSCI. The agency completed an Annual Quality Assurance Assessment (AQAA). At the time of the inspection the home was providing services to forty two service users. What the service does well: What has improved since the last inspection? What they could do better: To promote the health, safety and wellbeing of service users work should continue to develop assessments and plans of care in relation to acute health care issues. These must be reviewed on a regular basis to ensure they reflect Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 6 the service users current circumstances. Risk assessments should also be reviewed on a more regular basis. To promote the safety of service users staff who administer medication should receive further training with regard to safe practice and current guidelines. The manager must ensure that satisfactory recruitment checks have been carried out for both permanent and agency staff employed at the home. Consideration should be given to increasing the resources in relation to activities provision to enhance the lifestyles of individuals who do not participate in group activities. Refurbishment work should continue to enhance the environment and comfort of service users. 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. Leeming Garth DS0000028033.V366171.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 Leeming Garth DS0000028033.V366171.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): Outcomes for standards 3 & 6 were looked at. People who use the service experience Good quality outcomes in this area. Admissions are not made to the home until a full needs assessment has been undertaken. People who may use the service and their representatives have the information needed to choose a home that will meet their needs. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: During the inspection the file of one service user recently admitted to the home was examined. This was found to contain an assessment of need carried out by the persons funding authority and a further assessment carried out by the manager prior to the service user’s admission to the home. Service users and families have access to a service user guide containing information about the services offered by the home. Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 9 Information contained in surveys returned by service users and relatives confirmed people had received information. At the time of the inspection the home was not offering care to anyone requiring intermediate care. Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 7, 8, 9, & 10 were looked at. People who use the service experience adequate quality outcomes in this area. Individuals are involved in decisions about their lives. People have access to health care services both within the home and in the local community. There is evidence in the care plan of health care treatment and intervention, however there are some gaps in recording information. Medication systems do not always follow good practice or safe practice guidelines. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: During the inspection three service users files were examined. These were found to contain assessment of need and risk assessments. Assessments in relation to nutrition, moving and handling, prevention of pressure sores, continence, and dependency were seen to be reviewed on a monthly basis. However the risk assessments seen had not been reviewed for a number of months. One file contained a risk assessment dated 15/05/07, there was no evidence of a review. Another file contained a risk assessment in relation to Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 11 the use of bed rails dated 22/01/07, there was no evidence of review but other documentation seen indicated bedrails were no longer in use. Two files were found to contain assessments in relation to wound care, neither of which had been reviewed for some time. One assessment was dated 16/02/08, the other 15/04/08. There was no evidence of plans of care with regard to these specific needs. Recent daily records did not contain any reference to these issues. It was therefore not possible to establish if the individual’s health care needs were fully met. Files contained plans of care for areas of general care needs identified during assessment. These were seen to be reviewed and agreed with either the service user or their representative. Documentation included service user reviews which recorded the individual service user or their representative’s views. Files contained daily records and a weekly diary entry by the individuals named carer. Evidence was seen that indicated people had access to other health professionals including GP’s, District Nurse, Chiropodist, and a Tissue Viability Nurse. Information contained in surveys returned to CSCI indicated people were satisfied with the care they receive. For example ‘do you receive the care you need?’, 7 people commented always, and 2 commented usually. Comments received included ‘ I have always felt welcome and cared for and my individual needs are always met’, and ‘ staff look after me well’. Comments in surveys completed by relatives included ‘ Staff are responsive to the residents needs’ , and ‘Leeming Garth employs caring, friendly staff who respect my mothers needs, feelings and wishes’. However one person commented that ‘mouth care seems to be a problem’. Service users who spoke to the inspector confirmed they were satisfied with the care they receive, the staff treat them with respect and they are given choice in daily activities. Staff who spent time with the inspector spoke of treating people as individuals. The inspector was told the home no longer has a ‘bath list’, the bathing facilities have been refurbished and people are now offered a choice. Staff were observed to address people in a friendly but respectful manner, knocking on doors prior to entering rooms. Information in the AQAA indicated the home has a policy and procedure in relation to safe handling of medication. Medication is administered by the qualified nursing staff. People generally have their medication administered, Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 12 stored and disposed of correctly. Stock balances take place on a weekly basis and controlled drugs are recorded and stored in line with the home’s medication procedure. Staff are aware of how to dispose of controlled drugs and strict records are kept to ensure there is a clear audit trail. Eye drops and ointments were dated with the date they were opened, and were to be used within 28 days, however two of these were seen to be in use 4 days after the 28 day period. A sample audit of four medication administration records (MAR) indicated administration is recorded correctly. Three of these records contained hand written entries of details of how medication is to be administered. Only one of these entries contained the signature of the person making the entry and the signature of a person confirming the accuracy. The other two were not signed. Other entries for PRN (as required) medication contained little information as to the circumstances when and how the medication should be administered. During the lunchtime medications the inspector and the manager observed a medication trolley had been left open and unattended. During feedback later in the day the manager told the inspector that further training and supervision for staff with regard to safe practice in medication had been arranged. Leeming Garth DS0000028033.V366171.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): Outcomes for standards 12, 13, 14, & 15 were looked at. People who use the service experience good quality outcomes in this area. People who use services are able to make choices about their lifestyles. Activities are provided and generally meet people’s expectations. The home offers meals that are well presented, offer choice and are of a satisfactory quality. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Service users who spent time with the inspector expressed their satisfaction with their lifestyles within the home. All said that they were happy with the activities provided and were able to decide how they spent their day. The home has an activities co ordinator who works 20 hours per week.Service users’ files seen during the inspection contained records of activities that person had participated in. Information contained in nine service user surveys returned to CSCI indicated people were generally satisfied with the activities provided, for example ‘are Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 14 there activities arranged’, 4 people said always, 2 people said usually and 2 people said sometimes. Comments in one relatives survey expressed concern that more time could be spent with individuals. Staff who spoke to the inspector also said more one to one time would be beneficial. An activities programme, details and photographs of previous activities were seen to be displayed within the home. A monthly news letter is produced. People did confirm that visitors were welcomed into the home at any time, and the visitor’s book confirmed this. A church service is regularly offered and people can access the pleasant grounds. The lunchtime meal was observed. This was seen to be well presented and served in pleasant surroundings. Staff were seen to be available to give people assistance as needed. The home uses a four-week menu that was displayed in the entrance hall, daily menus were seen to be available in the dining rooms. Care staff and catering staff confirmed people are given a choice of menu and alternatives are available. Service users who spoke to the inspector said they were happy with the standard and choice of meal available. Comments in surveys returned indicated people were generally satisfied. Comments received included ‘the meals are lovely’, ‘meals are fairly good’ and ‘the meals are not so bad’. Staff who spoke to the inspector told her the quality of food could vary and soft diets were not always pureed sufficiently. Leeming Garth DS0000028033.V366171.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): Outcomes for standards 16 & 18 were looked at. People who use the service experience good quality outcomes in this area. People who use the service are able to express their concerns and have access to a complaints procedure, are protected from abuse, and have their rights protected. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Information in the AQAA received by CSCI indicated the home has a policy and procedure in relation to handling complaints. The information also indicated the home has not received any complaints within the last 12 months. The complaints policy was seen to be available to people. Service users who spoke to the inspector told her they were satisfied with the care they receive and had no concerns. Information in the surveys returned to CSCI indicated people knew how to raise any issues should they have any. Seven people said concerns were always addressed, and 4 said concerns were usually addressed. Comments received included ‘ we have no concerns’, ‘ staff are always approachable’ and ‘I can always talk to staff and things get done, so there has been no need to complain’. A training matrix seen by the inspector indicated 37 of the staff have received training in relation to prevention of abuse and safeguarding. Staff who spoke to the inspector confirmed this, and were able to describe the actions they would take in relation to any concerns. Leeming Garth DS0000028033.V366171.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): Outcomes for standards 19 & 26 were looked at. People who use the service experience good quality outcomes in this area. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The generally well maintained environment provides specialist aids and equipment to meet their needs. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: On the day of inspection the home was found to be clean, tidy and odour free. The inspector walked around the building with the manager. The home was seen to be generally well maintained, however some of the external paintwork was seen to be old and flaking. Damage was also noted to a first floor corridor ceiling outside bedroom 40. Work has been carried out to refurbish the bathrooms identified as a concern at previous inspections. This now gives service users a greater choice with bathing. The inspector also noted that work was being carried out to refurbish one of the toilet rooms. The toilet itself had been replaced leaving ill fitting flooring. The manager told the inspector Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 17 they were awaiting a replacement sink and flooring. A number of bedroom carpets have been renewed. Information in surveys returned to CSCI indicate people generally find the home clean and odour free. Comments received included ‘the home is always clean’ and ‘the rooms are kept tidy’. One person did comment ‘some décor and bedding would benefit from refurbishment’ and another said more cleaners would be of benefit. Service users who spoke to the inspector all expressed their satisfaction with the home and the environment it provides. Leeming Garth DS0000028033.V366171.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): Outcomes for standard 27, 28, 29, & 30 were looked at. People who use the service experience adequate quality outcomes in this area. The service has a recruitment process that should protect the service users, however there were some gaps in information recorded. There are generally sufficient staff on duty to meet the needs of the people who live there. Staff training takes place. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: On the day of the inspection the home was accommodating 42 service users. A staff rota was seen, this indicated that on duty between 8am and 1pm were 3 qualified staff and 7 care assistants, 1pm till 4.30pm 3 qualified and 5 care assistants, 4pm and 8pm 2 qualified and 5 care assistants, and overnight 2 qualified and 3 care staff. Since the last inspection the home has recruited a deputy manager and an administrator, allowing the manager to have supernumerary hours. Staff files for 3 staff employed since the last inspection contained application forms, 2 references, PoVA first and CRB checks obtained prior to employment. One file of a qualified member of staff contained confirmation of a satisfactory PIN (professional identification number) check, however this had been carried Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 19 out after the person was employed. The manager told the inspector PIN checks are carried out prior to employment, but could not find evidence in this case. It was seen that the PIN of existing qualified staff are checked on a regular basis to confirm continued eligibility to practice. Information contained in the AQAA indicated the home had recently used both qualified and care staff supplied by agencies. The manager was not able to evidence that checks had been carried out with the agency to verify satisfactory recruitment information had been obtained for individual staff. Information contained in the AQAA and the training matrix seen by the inspector indicated that in the last 12 months 38 staff had completed manual handling training, 38 fire safety, and 37 PoVA training. A further 10 staff had completed infection control. Information in the AQAA stated 95 of care staff had achieved NVQ at level 2 or above. Staff who spoke to the inspector confirmed they had received training in the above, and had also received recent mouth care training. Service users who spoke to the inspector told her there were sufficient staff to meet their needs. Comments received in 2 relative and 2 staff surveys returned to CSCI indicated that at times the home had been short of staff. Staff who spoke to the inspector confirmed this, however they felt that service users needs had been met. The manager told the inspector that there had been issues in the past and the home was currently recruiting more staff. Leeming Garth DS0000028033.V366171.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): Outcomes for standards 31, 33, 35, 36, & 38 were looked at. People who use the service experience good quality outcomes in this area. The management and administration of the home is based on openness and respect. There are quality assurance systems in place. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The manager of the home is a registered general nurse who is in the process of completing her NVQ Level 4 in management. Information in the AQAA indicated this should be completed in July 2008. The manager has now completed the registration process with CSCI. Evidence was seen that regular Regulation 26 visits take place and are recorded. The manager carries out audits of care plans, kitchen services, and Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 21 the environment. She also plans to carry out a quality audit survey with service users and relatives. Whilst there has been no recent service user / relative meetings, the manager holds a weekly drop in session and has an ‘open door’ policy should people wish to speak to her. During discussions with staff the inspector was told formal supervision has taken place, this has not always been on a regular basis. Records of recent supervision indicated these had focused on staff training only. Staff told the inspector that there was opportunity for informal supervisions with senior staff, information was given during handovers at the start of each shift and communication was usually good. Records seen on the day indicated the home carries out regular fire alarm checks, fire drills, and checks on water temperatures. Accidents were seen to recorded appropriately. Other information in the AQAA indicated the home has a range of policies and procedures, which were last reviewed in 2006 to promote the health and safety of service users, and the home and equipment are maintained as required. No issues regarding health and safety were raised by people using the service or staff. The home does not deal with people’s finances directly. A personal allowance computerised account is available and records for this were available. Receipts of all transactions are held at the home. A regular audit of the account is carried out by staff from the companies finance department. Leeming Garth DS0000028033.V366171.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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 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 2 X 3 Leeming Garth DS0000028033.V366171.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 OP7 Regulation 14 Requirement Assessments for all identified areas of risk must be reviewed on a regular basis to promote the safety and wellbeing of service users. Plans of care must be developed for all areas of acute health needs identified, these plans must be reviewed and updated to reflect that service users current needs to promote the health and wellbeing of service users. Staff who administer medication must receive training with regard to safe practice to promote the safety and well being of service users. Eye drops and ointments must be discarded once the use by date is reached to promote the health and wellbeing of service users. The PIN of all qualified staff must be checked prior to employment to ensure that person is eligible to practise, to promote the safety of service users. Timescale for action 01/10/08 2. OP7 15 01/10/08 3. OP9 13 01/09/08 4. OP9 13 01/08/08 5. OP29 19 01/09/08 Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 24 6. OP29 19 Evidence must be obtained that all agency staff employed by the home have had satisfactory recruitment checks carried out, to promote the safety of service users. 01/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP9 Good Practice Recommendations Information regarding how and when PRN (as required) medication is to be administered should be recorded. Hand written entries on MAR charts should include the signature of the person making the entry and the signature of a second person confirming the accuracy of details to promote the safety and wellbeing of service users. Consideration should be given to increasing the activities resources to allow more individual one to one time. Consideration should be given to repaint the external wood work that is flaking, and to repair the damaged ceiling. Staffing levels should be reviewed on a regular basis to ensure they continue to meet the needs of the service users accommodated at the home. Quality assurance systems should be developed further to include service user and relative surveys. Formal supervision systems should be developed further and take place on a regular basis. 3. 4. 5 6 7 OP12 OP19 OP27 OP33 OP36 Leeming Garth DS0000028033.V366171.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Leeming Garth DS0000028033.V366171.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. 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