Inspection on 14/09/07 for McGillicuddy House

This inspection was carried out on 14th September 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

McGillicuddy House 02/08/06

McGillicuddy House 20/02/06

McGillicuddy House 13/09/05

McGillicuddy House 08/02/05

McGillicuddy House 02/11/04

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Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 McGillicuddy House 18 Vicarage Road Strood Rochester Kent ME2 4DG Lead Inspector Mrs Michele Etherton Key Unannounced Inspection 14th September 2007 10:00 McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 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 McGillicuddy House DS0000028900.V348183.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 Adults 18-65. 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. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service McGillicuddy House Address 18 Vicarage Road Strood Rochester Kent ME2 4DG 01634 711781 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Dennis Gover Payne Mrs Assumpta Ann Payne Care Home 8 Category(ies) of Learning disability (8) registration, with number of places McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home to continue to monitor the 4 service users whose dates of birth are: 3.5.38, 27.6.38 and 18.1.35 and 6.2.40 to ensure their good health mobility is maintained. 2nd August 2006 Date of last inspection Brief Description of the Service: McGillicuddy House is an eight bedded home providing twenty-four hour care to adults who have a mild to moderate learning disability. The home is a large semi-detached Victorian property situated in a quiet residential road close to Strood Town centre and a short journey from Rochester and Chatham. It has easy access to a variety of amenities and shops and is close to local bus routes and the train station. The accommodation is situated over four floors and following some recent building works is now able to offer all eight residents their own individual bedrooms. There is a large open plan communal room that provides living, dining and kitchen facilities. There is a small well maintained garden with a summer house for residents use to the rear of the home. Restricted residential parking is available in the surrounding streets. Fees range from £360-£390 per week. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection has been undertaken on this service that has taken account of information received by CSCI from and about the service since the last inspection, and also included a site visit to the home on 14/9/07 between 10.00 – 14:30 pm. The site visit incorporated a tour of the premises, a review of some documentation, and interviews with staff and residents, their full participation and contributions have been helpful in the compilation of this report. Survey information has been returned post site visit from relatives/frends, staff and residents, responses have been very positive and have been used in compiling this report. What the service does well: The home provides a comfortable and homely environment that promotes the independence of residents within a risk framework and provides opportunities for them to express their views and opinions and to be listened to. The home has demonstrated a willingness to comply with regulation and also to adopt good practice recommendations to improve the service provided The home provides opportunities for residents to lead active lives and recognises the importance of stimulation outside of the home. Residents are enabled to take an active role in some of the daily routines of the home Indirect and direct observations of staff and residents indicate relationships within the house are good with interactions between staff and residents supportive, and respectful. Staff comments include: “ The home create a comfortable clean safe and happy environment for our service users to enjoy, I feel it is a small family home and the service users are happy” Relatives and friends reported that: “There is a homely atmosphere staff have good relationship with clients” “they let me know if there is anything he needs and I visit regularly” “ I have never had to raise any concerns but any questions I have have always been fully answered” McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 6 residents commented that: “I like to go to church every Sunday and to go on outings , I like to sit in the summer house” “staff treat me very well” “I can decide what I want to do” What has improved since the last inspection? What they could do better: Clearly people in the home currently are able to express their needs and wishes and seek appropriate levels of support from staff as needed, preferred routines and level of staff interventions are not always clearly detailed within support plans and this is an area that needs developing. Whilst residents are offered opportunities to develop independence and as a consequence take risks, risk assessment information needs to be expanded to clearly evidence how judgements around risk and capacity have been made. Recent improvements to administration and recording of medication would be further enhanced by implementation of medication profiles, and individual PRN guidelines. Safeguarding improvements to medication administration records, would benefit from ensuring that all handwritten entries onto medication sheets are signed and dated for audit and accountability purposes. The home has made good progress in the training of staff but needs to evidence clearly through the development of a staff training matrix and individual training profiles training achieved and identified gaps. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 7 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. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are provided with information about the service and the terms and conditions of residence, new people are offered opportunities to visit, their needs are assessed prior to admission. EVIDENCE: The service user guide has been updated; an audio version of this has also been produced and made available to existing residents. Those who cannot read felt that the audio version was a good idea and they had found this informative. One resident indicated that they had successfully used audio information in the past care of a hamster and this format might be extended to other relevant documentation to make this more accessible to all residents. No new admissions have been made since the last inspection, referrals are predominantly through local authority social service departments and a sample of files viewed, provided evidence that full joint assessment of needs is undertaken prior to admission. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 10 A staff member confirmed that it is usual for prospective residents to be given opportunities for visits and short stays before admission, and that the views of existing residents would be taken account of in this process. Terms and conditions information is provided for all residents and this was noted on sample files viewed. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. People living in the home have a lot of input into their day to day routines and staff are very familiar with their needs, individual care plans would benefit from improved detail around how needs are currently supported and inform how judgements are made around capacity and risk. The home is supportive and enabling of residents in achieving greater independence, EVIDENCE: Residents spoken with during the site visit were articulate and able to express their views and opinions, they are actively involved in their daily routines and undertake the majority of this for themselves, improvements have been made to the content of care plans but these would benefit from being written in a more person centred manner with improved clarity around routines, aspirations and goals and it is strongly recommended that these areas are developed. People spoken with during the site visit expressed interest in the inspection process and participated well, giving clear information about their experience McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 12 of living in the home and confirming the active part they play in the day to day running of the home. Comments in residents survey feedback ranged from: “I like living here” “I do want to live in this home” “I can play my music” “I can decide what I want to do” The home is supportive of residents developing increased independence and as a consequence accepting the risks this entails; risk assessments are in place but improved clarity is needed to support judgements around risk and capacity that link with information provided in the care plan and this is a recommendation. Care plans viewed provided evidence of regular reviewing although the home should consider how they could more evenly space the two current reviews to six monthly frequencies. People living in the home are actively involved in their reviews and those spoken with were satisfied with their current daily routines, where able to they should be asked to sign their care plan to encourage ownership, the home may wish to explore how they can ensure residents have full access to and understand their support plan McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. People lead an active lifestyle and are encouraged and supported to maintain links with the community and their families, and take an active role in the running of the home. They are actively involved in menu selection. EVIDENCE: Discussion with residents during the site visit indicated that most people lead a busy and active lifestyle with two or three days per week spent at centre, they have chores that promote development of living skills, and they are supported by staff to access the community for shopping, church, trips out, visits to cafes, Chinese restaurants etc, weekly and monthly evening clubs are also available. The home manager has identified that activities is an area the home would like to continue to develop and this was a view shared by younger residents who indicated that they would like to do more than they currently do. Residents indicated that activities are routinely discussed at resident meetings. Residents reported that: McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 14 “I like to go to church every Sunday and to go on outings , I like to sit in the summer house” “I like to help clean the house” “I like to go shopping at the weekend” The home is supportive of family contacts and residents spoken with confirmed regular visits to or from family members. Residents are supported to attend church. “They let me know if there is anything he needs and I visit regularly” Residents reported that they had had an enjoyable holiday on the Isle of Wight and indicated that they liked going as a group. Residents were observed moving freely around the home and some have keys to their rooms, where they have declined to do so this is recorded in their plan of care and should be reviewed routinely. Meals arrangements are flexible with the main meal of the day being either lunchtime or evening dependent on how many people are at home, cooked meals are provided for those who are out. Residents reported that they discuss menus at resident meetings and are actively involved in shopping for the home. The home is supportive of residents adopting a healthy eating plan and several are following weight reduction diets. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. People are encouraged to maintain or develop independence in their daily routines; they have access to routine healthcare. Medication arrangements are satisfactory but, would benefit from minor improvements; residents should be provided with opportunities to be more actively involved in their medication regimes. EVIDENCE: Residents are generally responsible for their own daily routines and through discussion indicated that they are happy with these, one or two people need some staff support. Residents were relaxed and chatty during the site visit actively participating when needed but otherwise getting on with their own activities. If people are not going to a day centre they tend to have a more relaxed routine for the day, this would benefit from being more clearly evidenced within a person centred support plan to ensure that individual diversity issues such as times of getting up, taking medication etc are taken account of within this (see standard 6). McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 16 A review of a sample of support plans provided evidence of health care appointments and interventions, residents reported that they attend local dentists and opticians for routine health checks, one person indicated they would be visiting the doctor for a repeat prescription. None of the current residents undertake any self medication, as part of the ethos of the home is to develop greater independence, the home should be actively looking at ways in which residents can become more involved in their medication regime even if under supervision. Some recommended improvements have been made to Medication administration records to safeguard residents; a further safeguard would be to ensure that all handwritten entries are signed and dated by the person making the entry. In addition the quality and consistency of medication administration can be further enhanced by the development of individual medication profiles and PRN guidelines, and these are all recommendations for improved practice. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. People are able to express their views and feel listened to, satisfactory systems are in placer to protect them from abuse and exploitation EVIDENCE: The home has advised in pre-inspection information that no complaints have been received since the last inspection. Residents were relaxed and confident about expressing their views and opinions, the possibility of an audio version of the complaints procedure being produced was discussed and the home should consider ways in which the complaints procedure is most accessible to residents. “If I am not happy about something I speak to my carer” “ I have never had to raise any concerns but any questions I have have always been fully answered” The home has raised an adult protection concern and this is receiving attention from the adult protection co-ordinator. Staff reported that they have received adult protection training and know how to make use of procedures. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 18 The home has addressed shortfalls in the recruitment procedure vetting arrangements for staff. One resident indicated that they were experiencing some bullying by another person attending the day centre, other residents of the house witnessed this, the acting manager was asked to liaise with the day centre regarding this matter. Residents have savings accounts and have access to their personal allowance, which is kept secure for them by the home; cash sums and the relevant records were audited at the site visit and found to be accurate. Improved detail in support plans would clarify the level of involvement individual residents have in aspects of their finances. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27,28,30 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. People enjoy living in a comfortable and homely environment that has been developed to better meet their needs, they will benefit from routine upgrading of fabric and furnishings to maintain this standard. EVIDENCE: The home has now upgraded the bathroom areas, one bathroom on the middle floor was dusty and the slip mat in the bath in need of replacement, although this bathroom is less used with the installation of new shower room, there is a need to ensure that schedule of cleaning includes all communal spaces whether used or not. Bedrooms viewed with resident permission are very spacious and personalised to reflect individual tastes and interests, some rooms smelled of damp and there is a need to review ventilation in these rooms, black mould on the ceiling McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 20 of the new shower room may also indicate issues of ventilation and should be investigated. The home has made some changes to the schedule of accommodation, this has enabled all residents to now have their own bedroom, they have use of a shower room and this has proved very popular, as has the installation of a summer house in the garden. The summer house has electricity installed and is furnished comfortably, discussion with residents indicated that this is a popular alternative more frequented that the previous quiet room, one resident who previously stayed in their room is making daily use of it. The acting manager present at the site visit indicated that there are plans for some form of heating to be installed for the winter. The shower room and summer house have been a success with residents who are enjoying the benefits these bring, none indicated they disliked the changes and missed the quiet room. A shower located in a user bedroom on the basement floor is in need of attention, use of this facility by other residents needs reviewing as it poses an infringement of privacy for the resident and is no longer necessary with the installation of the shower room. Residents indicated that they had everything they needed in their bedrooms, or where they had identified a problem felt confident about bringing this to the manager’s attention. This is a generally well maintained property, that will continue to benefit from a programme of routine upgrading as areas become worn, the home has some aging residents and will need to consider their future mobility needs and how these will be met. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35, Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. People living in the home are protected by robust recruitment systems, the home is committed to ensuring staff are trained but must clearly evidence that all mandatory training is in date EVIDENCE: The home has indicated through pre-inspection information that approximately 80 of staff have achieved NVQ 2 or above, staff spoken with reported that they had all completed mandatory training and updates, this could not be clearly evidenced from documentation viewed at the site visit and it is recommended that the home manager develop a training matrix and individual staff training profiles to clearly record training undertaken and to identify skills gaps or need for updates. The last inspection highlighted some shortfalls within the mandatory checks undertaken on staff within the recruitment process; all staff files were reviewed at this site visit and confirm that current CRB information requested by the home is now in place. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 22 Staff spoke positively of the home and the ethos of the home in survey feedback received. “ The home creates a comfortable clean safe and happy environment for our service users to enjoy, I feel it is a small family home and the service users are happy” Staff reported that they had regular supervision interviews with the manager, records of these meetings are maintained on personnel files. Staff confirmed access to staff meetings and minutes of these were also noted. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 This outcome area is good, This judgement has been made using available evidence including a visit to this service. The home is well run in the best interests of the people living there and they are routinely consulted with, systems are in place to promote and protect their health safety and welfare. EVIDENCE: The home has demonstrated a commitment to improving and developing the service for the benefit of the residents. The resident group is stable with no new admissions over the last two years, they are actively involved and consulted about day to day routines of the home and have regular house meetings. Residents are surveyed annually and through these and house meetings influence some aspects of service delivery e.g. activities, menus, holiday venues etc, the home would benefit from further strengthening the quality McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 24 assurance system, and should consider amongst other things drafting a service development plan, and implementing a system for self audit. The home has confirmed through pre-inspection information that all necessary gas, electrical and fire alarm systems have been serviced and a sample of servicing certificates was viewed and are satisfactory. Records indicate that Fire alarm and equipment tests and checks are being undertaken in a timely manner. The accident book indicates that the level of accidents amongst residents iis negligible over the past three years. McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 26 NO 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. Standard Regulation Requirement Timescale for action 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 YA6 YA9 YA20 Good Practice Recommendations It is strongly recommended that care plans are written in a more person centred manner and that the level of detail around routines is improved It is strongly recommended that the home can evidence clearly within documentation how judgements about risk and capacity have been made The home should develop individual medication profiles and PRN guidelines to aid consistency of administration and inform staff. Handwritten entries on MAR sheets should be signed and dated The home should develop individual staff training profiles and a training matrix for the home identifying training achieved and skills gaps. 4. YA35 McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 McGillicuddy House DS0000028900.V348183.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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