CARE HOME ADULTS 18-65
Meadow & Ivy Cottages 39-40 Bentinck Crescent Pegswood Morpeth NE61 6SX Lead Inspector
Janine Smith Announced 3 August 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Meadow & Ivy Cottages Address 30-40 Bentinck Crescent Pegswood Morpeth NE61 6SX 01670 511776 01670 511776 n/a Community Integrated Care Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Elizabeth J Costelloe CRH 7 Category(ies) of LD Learning Disability (7) registration, with number of places Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: There are two additional conditions of registration, 1) Four residents may also have a physical disability and, 2) Two residents may also be over the age of 65. These conditions of registration are being complied with. Date of last inspection 25/10/04 Brief Description of the Service: Meadow and Ivy Cottages provides a home for up to seven adults with a learning disability who need residential care. Some of the residents also have physical disabilities. Nursing care is not provided. The building has the appearance of two modern semi-detached bungalows. The bungalows are linked internally by a corridor. The design of the house is in keeping with other houses on the estate and is close to local facilities, such as the health centre and transport networks. Each bungalow has a lounge, dining kitchen and bathroom and toilet facilities. Residents can use the shared facilities in either house. The house is surrounded by large, maintained gardens which have a summerhouse, paved areas for sitting and are easily accessible. Residents also have a mini-bus. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The home was given prior notice of this inspection, which took place over nine hours. A partial tour of the premises took place and a sample of care records were inspected as well as other records. The Manager, three of the staff and six of the residents were spoken to. Prior to the inspection comment cards were made available in the home for residents and relatives to complete and forward to the Commission. Seven comment cards were received from residents who were given help by the staff to complete these. Five comment cards were received from relatives/visitors to the home. This was a very positive inspection and there was good evidence that the home is well run and that residents were satisfied and happy living here. What the service does well:
The home provides a good standard of care to the residents living there. The staff team are kind, caring and enjoy their work. They seem to have a genuine regard for the people living in the home. The staff work hard to provide a range of choices to the residents at home and to ensure that they are able to participate in a range of fulfilling activities inside and outside of the home. Relatives also seem pleased with the care provided by the home. A comment card received from a relative said, ‘I am very happy with the way my relative is being care for’ and another said, ‘My relative is loved and well cared for by all the staff.’ The building provides a comfortable and pleasant home for the people living here. Most of the staff team now have an National Vocational Qualification in Care at Level 2 or above, which means that they have more than met the required standard for this training. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better:
Contracts between the home and residents and placing authorities are in place but do not include information on all the additional charges that may be made to residents, which means that residents or their representatives are not fully informed about these matters. The contracts therefore need to include details of all the additional things that residents may be asked to pay for when they live in the home. Since the last inspection, work has been ongoing to improve the assessment and care planning. This work needs to continue to ensure that the needs of residents and how these are being met are clearly identified and recorded in sufficient detail within the care plans as well as risk assessments. Some of the meals being provided are repetitive and lack variation, which means residents may not be receiving a nutritionally balanced diet. The Manager was therefore advised to seek advice from a dietician as to the menu content. Some residents may require staff to given them a particular medication from time to time if they become unwell. Specific guidance has been provided to
Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 7 home in writing by health professionals as to when and how this medication should be given. The home need to ensure that this written guidance is available in full within the medication records. They also need to ensure that the reason why any medication is not given is always recorded in the medication records. The Manager is now meeting with staff on a 1-1 basis to regularly review their work (known as supervision) however the frequency of this should be increased. This enables staff to be fully supported in the work they do. There seemed to be a generally thorough approach to ensuring the health and safety of residents, however, a risk assessment requires updating in respect of new bed rails being used by resident to ensure that these remain safe for him to use at all times. 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. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 5. Contracts between the home and residents and placing authorities are in place but do not include information on all the additional charges that may be made to residents, which means that residents or their representatives are not fully informed about these matters. Standards 1 to 4 were not assessed as all of the residents have lived at the home since it was opened. EVIDENCE: A contract was seen to be in place for a resident of the home which specified the main contract terms and fees. The contract also specified certain items not covered by the fee, including purchase of clothing, toiletries and dry cleaning. However, in practice, residents are also paying additional costs such as expenses for the social activities they participate in. Such additional costs should be made clear within the contract and agreed with the Local Authority funding the placement. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9. The work being undertaken to improve the content and presentation of the care plans needs to continue to ensure that the complex needs of the residents are readily identified in the records. Residents’ rights to make decisions about their day-to-day lives are respected by the staff team, which ensures that their lives in the home are fulfilling and satisfying. EVIDENCE: A requirement was made at the last inspection to ensure that care plans included full details of how residents care needs were being met. The Manager also confirmed that care records are being updated. Staff training has been provided but some staff reported that this had resulted in some confusion amongst the staff team. During this inspection one care file was inspected which contained a great deal of detailed information about the personal, social and complex needs of the resident, however some of the risk assessments gave conflicting information, were insufficiently detailed and were not fully up to date. It was agreed with the Manager that the timescale for meeting the requirement issued at the last inspection would be extended to 30/9/05.
Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 11 Although some of the information on the care file examined was confusing, discussion with a member of staff showed that they were well informed about the needs of the resident concerned. Not all of the residents use verbal communication, however staff could describe how they offer choices to them and carefully observe their body language or other means of communication, which helps the staff to know what they like and dislike. Staff were seen doing this throughout the day. During discussion with individual members of staff, they provided further examples of how they assist and respect residents’ rights to make decisions about their day to day lives. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15 and 17. The support provided by the staff team means that residents can enjoy educational, work, leisure and social activities in the community which gives them a fulfilling lifestyle. Relatives and visitors are welcomed into the home which means residents can maintain contact with them. Some of the meals being provided are repetitive and lack variation, which means the residents may not be receiving a nutritionally balanced diet. EVIDENCE: Discussion with staff and examination of records showed that residents use a variety of facilities in the community, such as the swimming pool, bowls club, shops, over 55s club. Residents enjoy walks locally and lunches out. A music therapist and an aromatherapist visit the home and residents’ wishes about participating in these activities are respected. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 13 Some residents attend day services. One resident is being assisted to develop independent living skills. It was confirmed with staff that arrangements are made for holidays for residents. The atmosphere in the home was cheerful and relaxed. All seven residents had indicated by comment cards that they liked living in the home and felt well cared for. Five comment cards were received from relatives and all stated that they were satisfied the overall care provided. Two made additional comments:‘I am very happy with the way my relative is being cared for. I have no complaints.’ ‘My relative is loved and well cared for by all the staff. All of the relatives completing comment cards indicated that they could visit at any time and were welcomed into the home and that they could see their relative in private. All seven residents indicated by comment card that they liked the food. The lunch time meals were observed in both Meadow and Ivy Cottages and residents were seen to enjoy them and be assisted appropriately. There is a menu plan in place but these needs review as there was some lack of variety in the meals being provided. Sausages had been provided three times and chicken twice within one week. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 and 21. The health and well-being of residents is carefully monitored to ensure that they remain fit and well or medical advice is sought when necessary. The systems for the storage, handling and administration of medication are sound but specific guidance about one medication needs to be kept with the medication administration records to ensure that medication is handled safely and appropriately. EVIDENCE: Inspection of care records and discussion with the Manager and staff showed that residents are provided with the support they need with health care. Since the last inspection, there have been two occasions when medication errors have occurred. Additional procedures have been put in place to prevent this happening again. The medication process was discussed with a member of staff who described safe methods for administration and handling of medication. It was confirmed from discussion with the Manager and staff records that the staff team have received updated training in medication. Training is being arranged for staff recruited recently. A random sample of medication records were also examined which were fine apart from:Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 15 - the reason a particular medication had not been given was not recorded; - pages were missing from guidelines on the circumstances in which a particular medication should be administered to a resident. A letter was left about this matter requiring the home to take immediate action to address this. The staff are required to administer a particular buccal medication. They have received training in these procedures but there is no documentary evidence from the responsible community nursing staff to confirm that each member of staff has been assessed as being competent to carry out this task. This should be obtained. Discussion with the Manager provided evidence that appropriate steps are taken to address the care needs of residents who become ill, including ensuring that palliative care support and any special equipment is provided. A recommendation was made at the last inspection that bereavement training be provided for staff. This was subsequently arranged but was later cancelled. This training should be provided as soon as possible. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23. The home has a satisfactory complaints system and staff have been trained in adult protection which helps to protect residents from abuse. EVIDENCE: A complaints procedure is in place. No complaints had been received since the last inspection. The Manager described how she endeavours to create a culture within the home to encourage residents to make clear their feelings and wishes. Some residents have difficulties communicating verbally, but discussions with staff showed that they were well informed about how residents communicate non-verbally and knew what to do if they felt any resident was unhappy about anything. An adult protection policy and whistle blowing procedure is in place. Some of the staff have received training in adult protection issues and the rest are to receive this shortly. Evidence of this training was seen within staff records. A member of staff spoken to during the inspection showed an understanding of the issues and was very clear about the action he would take if he had any concerns. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 and 30. The home is designed to meet the needs of people with learning and physical disabilities and fits in well with other houses in the neighbourhood providing residents with an attractive and homely place to live. It is a well maintained and clean home providing a safe place for people to live. EVIDENCE: The residents’ bedrooms were seen which were a suitable size, attractive and reflected the interests of their occupants. The shared kitchens, dining rooms and lounges were pleasant areas to use and relax in. New kitchen units and flooring have been fitted in one part of the home and redecoration has taken place. There are an appropriate number of bathrooms and toilets. The home is equipped with hoisting equipment and a tracking system for lifting people. There was evidence that as residents’ needs change, the Manager ensures that their need for specialised equipment is reviewed by appropriate specialists. The home was very clean and no unpleasant smells were noted. Protective clothing is available to staff and suitable laundry facilities are in place. Outside, there is a large garden providing plenty of space for residents to use.
Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 and 36. The number of staff and type of staff on duty throughout the day and night is sufficient to meet the needs of residents. Staff morale is good resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. The procedures for the recruitment of staff are robust which helps to ensure that residents are protected. Training is provided to the staff team, which ensures that they have the skills necessary to support the residents living in the home. Supervision is not currently provided at frequent enough intervals to ensure that staff are fully supported in their work. EVIDENCE: Examination of staff rotas and discussion with members of the staff team provided evidence that there are an adequate number of care staff. There are a minimum of four support staff on duty between 8 am to 10 pm when the home is fully occupied. Through the night there is one waking night carer and a second carer sleeps in on the premises in case further assistance is needed. The support staff carry out food preparation, laundry and cleaning tasks as well as day to day care of the residents living in the home. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 19 Staff turnover has been high with over 50 of the staff team leaving the home over the past year. However, the Manager stated that all of these posts have now been filled and there has been greater stability in the staff team. Staff conditions of service have been reviewed to help retain staff. The staff on duty were observed to be kind and respectful when supporting residents and to have a good relationship with the residents living in the home. Staff spoken to during the inspection said they enjoyed their work and were keen to develop their skills further. They were skilled and knowledgeable about the needs of the residents they were supporting. The records of two recently recruited members of staff were examined. Vetting procedures were thorough. It was confirmed through discussion with the Manager and staff and examination of records that induction training to Learning Disability Award Framework (LDAF) Standards is carried out. A staff training plan is in place. The Manager confirmed that ten of the care staff team have now achieved a National Vocational Qualification at Level 2 or above which means that 77 of the staff team now have this qualification. Certificates were seen on staff files. Other relevant training is also provided, such has positive communication, challenging behaviour. Since the last inspection training has also been provided in report writing skills, although it was reported that some staff have been confused by this. This should be teased out in supervision. The Manager also ensures that supervision is used as an opportunity to ensure that staff are fully aware of and understand the aims and objectives in the home and the standards of care required. Supervision is not currently being carried out at a minimum of two monthly intervals but the Manager aims to address this shortly. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 42. The Manager provides clear leadership, which ensures that the home is well run and the staff team are fully aware of their roles and responsibilities. The organisation regularly reviews aspects of its performance through a programme of self-review and consultations, which include seeking the views of residents, relatives and staff, however feedback is not given to the home on its own individual performance which means this information cannot not be used to develop the home further. There is a generally thorough approach to health and safety, which ensures the home provides a safe environment for residents, however, a risk assessment was out of date which could place a resident at risk. EVIDENCE: Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 21 The positive comments of relative and members of staff give confidence that the Manager, Mrs Costello, provides good leadership throughout the home and has an ‘open door’ policy which encourages good communication. Mrs Costello has now commenced the Registered Manager’s Award training and hopes to complete this by the end of 2005. Since the last inspection Mrs Costello has also received training in carrying out supervision and appraisal. The organisation has a quality assurance programme in place, which includes seeking the views of residents, relatives and other interested parties, to provide feedback on the quality of care provided across all the homes it runs. Feedback is given back to the homes in terms of the overall performance of the organisation, however, the Manager said that she did not receive feedback on the individual performance of Meadow & Ivy. There is a system in place to ensure that staff are given training in moving and handling skills, fire safety, infection control and good hygiene. Risk assessments are carried out in respect of particular areas of health and safety. One concerning the use of bed rails on one service user’s bed was out of date, as new equipment had been provided. Servicing/maintenance contracts were not examined during this inspection. Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x 2 Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 2 Standard No 31 32 33 34 35 36 Score 3 4 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Meadow & Ivy Cottages Score x 3 2 3 Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 5 Regulation 5(1)(c) & 17(2) Requirement Ensure that there is clear agreement with residents or their representatives, including the funding authority, about any additional charges and that this is included in the contract. Continue revising and updating care records to ensure that the needs of residents and how these are being met are clearly identified and recorded in sufficient detail. Ensure that risk assessments are valid, up to date and contain all relevant information. Seek advice from a dietician and draw up a nutritious balanced menu plan. Ensure that specific guidance from external professionals about the circumstances when a particular medication should be given are kept in full with the administration records. Ensure that the reason why any medication is not given is fully recorded. Staff supervision must take place at a minimum of two monthly intervals. The Manager must confirm Timescale for action 31/12/05 2. 6 15 30/9/05 3. 4. 5. 9 17 20 13(4) 16(2)(1) 13(2) 30/9/05 31/10/05 5/8/05 6. 7. 36 37 18(2) 9(2)(b) 31/10/05 31/12/05
Page 24 Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 8. 42 13(4)(c) successful completion of the Registered Managers Award in 2005. Revise risk assessment in respect of new bed rails used by resident. 30/9/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 32 20 Good Practice Recommendations Discuss and review report writing training with the staff team to ensure that staff are clear about their responsibilities. Each member of staff required to administer a buccal medication should be assessed by the responsible community nurse and certified as competent to perform this task. Provide bereavement training for staff. The organisation should provide feedback to each individual home on their own performance following the quality assurance audits to enable this information to be used to improve services. 3. 4. 21 39 Meadow & Ivy Cottages B53-B03 S610 Meadow&Ivy Cottages V202395 030805 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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