CARE HOMES FOR OLDER PEOPLE
Longworth House Higher Ramsgreave Road Ramsgreave Blackburn Lancashire BB1 9DJ Lead Inspector
Mrs Janet Proctor Unannounced Inspection 21st March 2006 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 Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Longworth House Address Higher Ramsgreave Road Ramsgreave Blackburn Lancashire BB1 9DJ 01254 812283 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) Mrs Julie Elizabeth Hayes Mr Steven Michael Hayes Care Home 28 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (28) of places Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service should employ a suitably qualified manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 28 service users to include: Up to 25 service users in the category of OP (over 65 years of age, not falling within any other category) 3 named service users within the category of DE(E) (Dementia over 65 years of age). Date of last inspection 17th June 2005 Brief Description of the Service: Longworth House is registered to provide personal care to 28 people from the age of 65 years plus. Two of these service user are also suffering from dementia. The registered persons are Mrs Julie Elizabeth Hayes and Mr Steven Michael Hayes. Mr Hayes undertakes the day-to-day management of the home. Longworth House is situated in a rural location, between Ramsgreave and Mellor, with general amenities being available in Brownhills, which is 5 minutes away by car or bus. More extensive facilities can be located in the local town of Blackburn, which is approximately 3 miles from the home. The property is detached, and stands in its own extensive, established and well-maintained grounds, with a panoramic view of the Ribble Valley from the back garden. Longworth House has increased the number of persons it can accommodate from 22 to 28. There have been 8 new bedrooms provided, all en-suite. An additional small lounge has also been created to supplement the communal space already provided in the existing two lounges and two dinning areas. Service users may use any of these facilities as required, and can use their own private bedroom as they wish. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 1 day on the 21st March 2006. The Pharmacy Inspecting Officer also attended the home and examined the standard relating to the control of medications. The previous inspection was done on 17th June 2005 and information on the findings of this can be obtained from the home or from www. CSCI.org.uk . One additional visit has been made since the previous inspection. This was in order to investigate a complaint about staffing. One requirement and one recommendation were made at the end of the visit. On the day of the inspection there were 25 residents at the home. Wherever possible the views of residents were obtained about their life at the home. Information was also obtained from staff records, care records, and policies and procedures. Information was also got from talking to 8 residents, 1 visitor, the Deputy Manager, the Manager and 2 staff members. Comment cards were received from 6 residents and 7 relatives and visitors. Detailed notes were taken, which have been retained as evidence of the inspection findings. What the service does well:
The manager and deputy manager ensured that residents were assessed before they came to live at the home. This meant that the staff at the home had details of their needs and could ensure that everything they needed was in place before they arrived. There were good relationships between residents and staff and a friendly atmosphere at the home. Staff were seen to treat residents in a kind, considerate and patient manner. Residents spoken to were very complimentary about the staff. They said, “I’ve no grumbles at all”, “ The staff work very hard, they do all they can to make things right for you”, “ The staff are all wonderful. They’re so helpful. They’re a right good bunch” and “They’re marvellous. Nothing is too much trouble.” These good relationships also applied to the relatives and visitors. The comment cards received all said that they were made to feel welcome when they visited the home. Additional comments had also been added to these and said,” I have been visiting Longworth House weekly for the past two years and always found the staff most helpful, friendly and very caring”, “A fantastic home providing good quality care to residents and family” and “There is always a warm welcome for all relatives and friends”. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 6 All of the residents spoken to praised the food at the home. They said, “The food’s very good and you get a choice. They write on the board so you know what’s for lunch”, “Everything’s home made and well cooked. In fact they over feed you” and “We get good food and you have a choice”. Four of the comment cards from residents said that they liked the food and 2 said they sometimes liked the food. Two of the files for residents showed that they had gained weight since coming to live at the home. What has improved since the last inspection?
There had been some significant improvements in the recruitment of new staff. This was now being done correctly and all necessary documents were obtained before the member of staff started work. This meant that residents were safeguarded. Further improvements had been made to the environment of the home. New carpets had been fitted in some bedrooms and areas decorated. Residents were happy with the way the home was decorated and furnished. The style of the care plans was in the process of being changed and the new style contained much more detail. This meant that staff would have the information to enable them to care for the resident in the way that they needed or wanted. These new plans had been reviewed each month so that the details in them were current and accurate. Risk assessments were being done for the risk of falling. This meant that staff were made aware of who needed observation or assistance to prevent them from falling. Staff members were now receiving supervision on a regular basis. This meant that any training needs or deficiencies in performance were identified and action taken to remedy these. It also gave staff the opportunity to talk about any issues that may concern them. The number of staff on duty was now enough for the needs of the residents. All of the comment cards received from relatives and visitors said that in their opinion there was always sufficient staff on duty. The number of staff with an NVQ qualification had increased. There were now 57 of the staff with this qualification. This meant that the staff had the knowledge and skills to be able to do their work. There was a business plan/development plan for the coming year. This showed that the management team had considered priorities for the year ahead and made plans on how they were to achieve these. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 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. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Residents could be confident that the home could meet their needs. This was because they had their needs assessed before moving into the home and received a letter confirming whether the home could meet these needs. EVIDENCE: From the residents files viewed it was evident that a pre-admission assessment had been completed by the Deputy Manager before they moved into the home. She then made a decision about whether there was sufficient staff, equipment and other resources at the home to meet the needs of the prospective resident. Once this decision was made she wrote a letter to the prospective resident confirming that their needs could be met. This letter was ‘warm’ and ‘friendly’ in its tone and made a pleasant start to the relationship between the prospective resident and the staff at the home. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 11 The new style of care planning documents meant that the personal, health and social care needs of residents could be fully recorded. The fact that not all residents had these documents in place meant that there was the potential for these needs not to be met. The details recorded in respect of dying and death meant that residents could be assured that their wishes would be known and carried out. EVIDENCE: A new style of care plan documentation was being introduced and had been started for three residents who had been recently admitted. This new documentation had all of the personal, health and social care needs identified and directions were given to staff on how to meet these. The style of writing included the strengths of the residents as well as their needs and the plans were individual to each resident. There was a record sheet to show that the resident or their relative had been consulted about the plan of care. One of these had been signed by the resident and her comments about the plan of care also noted. These new style plans had been reviewed monthly. The new style of care plans included details about the personal and oral hygiene needs of the resident. Health assessments were done for: moving and
Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 11 handling; risk of falls; and nutrition. Risk assessments for the risk of pressure sores were not being done by the staff at the home due to their lack of confidence in using the form. Discussion took place on whether training in this aspect could be obtained for the staff at the home. The residents’ weight was recorded monthly. Two of the residents had gained weight during their stay at the home. Continence needs and any aids to be used were noted. Arrangements were made for residents to be seen by GPs, District Nurses, Chirpodists and other specialists. The plans of care for the remaining residents had not yet been transferred to the new format. The information that was in these old style care plans was not in enough detail to enable staff to know precisely what to do for the resident. The plans of care were not reviewed monthly and there was no evidence of consultation. The management team were aware of the need to get these updated as soon as possible. Details on preferred last wishes at the time of death had been recorded. These included details such as the fact that a resident was a devout Catholic and wanted the last rites from a Priest at the time of death. This meant that staff had the information they needed to be able to care for the resident as they would wish at the time of death. The Pharmacy Inspector looked at the control of medications within the home. A separate report has been issued. The requirements and recommendations from that report are also included in this one. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 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 the following standard(s): 12 and 15 The range of activities on offer need to be extended to ensure that they satisfy residents’ social and recreational needs. Residents were satisfied with the meals at the home. EVIDENCE: The Community Library visited on a regular basis and residents said that staff ensured that their library books were returned and changed. There was no formal programme of activities on display. Staff members spoken said that they chose which activity to do at the time that it was being done. There was a book to record when activities had been done and who had attended. These records showed only 6 activity sessions between 21st February 2006 and 16th March 2006. The staff spoken to said that it was difficult sometimes to get the residents to become involved in activities. Residents spoken to did not seem to have any particular complaints about the lack of activities. They said, “I go out for a walk when the weather’s nice. There’s not much to do otherwise – they play Ludo sometimes. But I’m quite happy”, “What I like best is to go and sit outside in the garden when the weather’s nice. I’m not bothered about anything else” and “I usually spend my time reading. My family’s near so I go out a lot”. There was a three-week rota of menus. The day’s menu was displayed on a board in the hallway so that residents knew what was for the meals.
Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 13 Alternatives to the menu were available. Records were kept of the meal choices made by residents. Drinks were served at meal times and in-between. Residents said that they received a cup of tea at about 7.00 am. The meal served at the time of the inspection looked appetising and was enjoyed by residents. The tables were nicely set and the atmosphere in the dining room was pleasant. Staff were seen to offer discrete assistance to those residents who needed this. The kitchen was stocked with sufficient supplies of food and there were fresh vegetables available for residents. There were records to show that the fridge and freezer temperatures were monitored and a kitchen cleaning schedule. A new waste disposal had been fitted and a new kitchen work surface had been fitted. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 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 the following standard(s): 18 The lack of staff training in protection of vulnerable adults meant that there was the potential for abusive practices to be unrecognised and unreported. EVIDENCE: The procedures for reporting abuse should be made more specific. This is in order that staff are aware that they must in all cases of allegations, suspicions or incidents, inform the Social Services and the Commission for Social Care Inspection before taking any in-house investigation. Only 3 staff had received any formal training in Protection of Vulnerable Adults to supplement their understanding of the procedures. Discussion took place on arranging for a senior member of staff to become an in-house trainer for Protection of Vulnerable Adults. All of the comment cards received from residents said that they felt safe living at Longworth House. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 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 the following standard(s): 19 and 23 Residents were very happy with their accommodation at the home and lived in a safe, clean, and well-maintained environment. EVIDENCE: Recommendations were made at the previous inspection for staff to enter the details of any repair needed directly into the record book and for the record of repairs undertaken be kept up to date. There was an up to date record of any repairs needed and when they had been attended to. These records also showed any redecoration or refurbishment to the premises. Since the last inspection a number of areas of the home had been improved. Some bedrooms had had new carpets fitted, the laundry and front porch had been decorated, a new front door had been fitted, new curtains had been fitted in the lounge and office and a new boiler installed. A protocol to demonstrate the discussions and actions when a place became available in a shared room had not yet been completed. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 There were sufficient numbers of staff on duty to meet the needs of the residents. Staff shortages had been addressed and as a result residents were receiving consistent care from regular staff. Recruitment practices had improved. Pre-employment checks were carried out, providing safeguards for residents. The amount of staff training was not sufficient, which may place residents at risk of harm or result in their needs not being met. EVIDENCE: There was a duty rota for the home that showed the name of the staff and the hours they worked. This showed that the previous staffing difficulties had now been resolved. There was one senior and 2 carers on duty during the day and at night-time there were 2 carers and a senior person on sleep-in. The Deputy manager had some hours each week to enable her to concentrate on administrative duties. She said that she found this helpful. Liquid paper was still being used on the duty rota. As the duty rota is a legal record any additions or amendments should be clearly identifiable. There was a Cook on duty each day. A domestic was on duty during the week-days. A number of new staff had been employed since the previous inspection. The files for 3 of these were examined. These files showed that the recruitment procedures had now been strengthened and were being done correctly. The recruitment procedures needed to be up dated to reflect the current practice. Each file seen included: an application form; employment history and reason for leaving; references; CRB and POVA First details; proof of qualifications; and a recent photograph. Copies of the GSCC code of conduct and practice were
Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 17 available. These should be given to each member of staff as and when they start employment. A short Induction was done at the beginning of employment. This covered fire safety and other important issues. Only 1 file viewed had a record of this Induction. Arrangements were being made to send some staff on a course for the Common Induction standards. Discussion took place on developing an inhouse Induction course that covered all these issues and of ensuring that staff are competent on these issues. At the present time all staff were not receiving 3 days training each year. The Deputy Manager was aware that a full training needs analysis needed to be done for all staff so that their training needs were identified and met. There were 14 carers employed at the home. Five of these had NVQ level 2 and 1 had nearly completed the course. Another 3 of the carers had NVQ level 3. This meant that 57 of the staff had qualifications to show that they had the knowledge and skills to care for residents. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 36 and 38 The Manager was competent and capable and had a business plan for the coming year. Residents and staff had confidence about the management the home. Staff were being supervised with the result that they fully understood their role and responsibilities. The practices of, and records kept by, the home meant that the financial interests of residents were safeguarded. The lack of risk assessments and health and safety training updates had the potential to put the residents and staff at risk. EVIDENCE: The day- to-day management of the home was done by one of the registered persons. The Deputy Manager was doing the NVQ level 4 in care with a view to becoming the registered manager for the home in the future. There was a development plan and a business plan. These documents set out the intended improvements for the home over the next 12 months. These
Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 19 included: improved training opportunities for staff, refurbishment of the kitchen and reducing staff turn-over levels. The home had the Investors in People award. There were no formal auditing systems in place, although the management team said that they did informal audits of the environment, care and attitude of staff each day. The lack of formal audits meant that there were no records to show effective selfmanagement. There were no ways of identifying their own shortfalls and of plans to remedy these. Recent survey forms had not been issued to residents and the previous information obtained had not been analysed and made available. A compliments book had been started. This contained some very nice comments about the staff and the home itself. Regular residents meetings were not held. There was day-to-day contact by the manager and the Deputy and anyone could approach them at any time they were in the home. The last staff meeting was in November 2005. Residents were able to control their own money if willing and able. There were safe keeping facilities and money was kept for a number of residents. There was a record to show the transactions and the balance. Three of these were chosen at random and were checked against the cash held and found to be correct. If any valuables or money was given in for safekeeping a receipt was given. Staff supervision had been commenced and was being done every two months. There was a supervision policy and a form for recording when it had been done. The supervisee kept their own records of the issues discussed. Appraisal for staff was being started. Staff had been given information on the process and what this involved. The manager said that he was intending to do a course about risk assessments so that he could do these for the health and safety issues and safe working practices. He was also intending for an independent person to do the work based fire risk assessment. There was a schedule to show which items had been PAT tested. From the training records seen it was evident that not all staff had received an annual update in: manual handling; Protection of Vulnerable Adults; and basic food hygiene. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 20 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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X 2 X X X STAFFING Standard No Score 27 3 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 3 3 3 X 2 Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 21 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 15(1) Requirement Each resident must have a written plan as to how their needs in respect of their health and welfare are to be met. (Previous timescale of 17/10/05 not met.) Wherever practicable the resident or their representative should be consulted about the details in their plan of care. (Previous timescale of 17/10/05 not met.) The plan of care must be kept under review. (Previous timescale of 17/10/05 not met.) The health care needs of all residents must be assessed and identified in the plan of care. This should include the risk of developing pressure sores. Where risks are identified there must be directions in the plan of care on how to reduce or manage these. (Previous timescale of 17/10/05 not met.) The registered person must ensure that the manager liaises with the pharmacy to ensure all medication is clearly identifiable. Staff must not administer medication that is not correctly described on the pharmacy label.
DS0000009451.V280554.R01.S.doc Timescale for action 31/07/06 2. OP7 15(1) 31/07/06 3. 4. OP7 OP8 15(2)(b) 15(1) 31/07/06 31/07/06 5 OP9 13(2) 14/04/06 Longworth House Version 5.1 Page 22 6. OP18 13(6) 7. OP30 18(1) (c )(i) 24 8. OP33 9. OP33 24 10. OP38 12(1) 13(4) 11 OP38 18(1)(c) That all staff receive training in Protection of Vulnerable Adults. (Previous time scale of 17/08/05 not met.) There must be a record of Induction training given to staff and of their competency to perform these tasks. There must be quality assurances systems that enable self-auditing of the home and the services it provides. That a document that includes the findings of the most recent service users survey is produced. This information must be made available to current and prospective service users, their representatives and the Commission for Social Care Inspection. (Timescale of 28/02/05 not met) The registered persons must carry out risk assessments for all safe working practice topics, with findings being recorded. (Time scale of 31/12/04 not met) All staff must receive training in: manual handling; Protection of Vulnerable Adults; and Basic Food Hygiene. 31/07/06 31/03/06 31/09/06 31/07/06 31/07/06 31/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations You should review medication policies and procedures in line with Royal Pharmaceutical Society of Great Britain guidelines to cover all aspects of medicines management. The receipt, administration and disposal of Controlled Drugs should be recorded in a Controlled Drug register or bound, paginated hard-backed book. Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 23 Criteria for the administration of when required and variable dose medication should be clearly defined and recorded for all service users prescribed such items. A second member of staff should witness all hand written annotations on Medication Administration Record charts. Medicines must be stored at the appropriate temperature. A record of temperature must be maintained for all areas where medicines are kept (fridge should be monitored daily) Manufacturers Patient Information Leaflets should be available for medicines in the custody of the home The range of activities on offer to residents must be extended. A record should be kept of the activities actually provided and the residents involved in these. The procedure for Protection of Vulnerable Adults should be made more explicit for staff. A protocol to demonstrate the actions and consultation undertaken when a place in a shared room becomes available should be developed. Liquid paper should not used on official documents and records. The policies and procedures for recruitment should be amended to describe current practice. Each staff member should be given a copy of the GSCC code of conduct and practice when they commence work. The person undertaking day-to-day management of the home should obtain NVQ level 4 in care and management. The Lancashire Fire & Rescue Service should be consulted about the appropriateness of the work based fire risk assessment. 2. 3. 4. 5. 6. 7. 8. 9. OP12 OP18 OP23 OP27 OP29 OP29 OP31 OP38 Longworth House DS0000009451.V280554.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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