Inspection on 08/07/08 for Meadow & Ivy Cottages

This inspection was carried out on 8th July 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadow & Ivy Cottages 26/07/06

Meadow & Ivy Cottages 19/01/06

Meadow & Ivy Cottages 03/08/05

Meadow & Ivy Cottages 25/10/04

Meadow & Ivy Cottages 06/05/04

Meadow & Ivy Cottages 04/02/04

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Craigmore House

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

CARE HOME ADULTS 18-65 Meadow & Ivy Cottages 39-40 Bentinck Crescent Pegswood Morpeth Northumberland NE61 6SX Lead Inspector Janine Smith Key Unannounced Inspection 8th July 2008 10:00 Meadow & Ivy Cottages DS0000000610.V368092.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 Meadow & Ivy Cottages DS0000000610.V368092.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. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow & Ivy Cottages Address 39-40 Bentinck Crescent Pegswood Morpeth Northumberland NE61 6SX 01670 511776 01670 511776 bentinckcrescent@c-I-c.co.uk www.c-i-c.co.uk. Community Integrated Care 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 Elizabeth Jane Costelloe Care Home 7 Category(ies) of Learning disability (7), Physical disability (4) registration, with number of places Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary needs on admission to the home are within the following categories: Learning Disability, Code LD, maximum number of places 7 2. Physical Disability , Code PD, maximum number of places 4 The maximum number of service users who can be accommodated is 7 Date of last inspection 26th July 2006 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 fees are £723 per week. The building has the appearance of two modern semi-detached bungalows. A corridor links the bungalows internally. 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. Information about the service, including inspection reports, is readily available. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. How the inspection was carried out: Before the visit: We looked at: • Information we have received since the last visit on 26th July 2006. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 8th July 2008. During the visit we: • • • • • • Talked with people who use the service, relatives, staff and the manager. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit We told the manager what we found. What the service does well: People who are considering using the service are given plenty of information and time to look around. Two visitors were very pleased with the care provided to their relative since he moved in and said that his quality of life had improved. Service users are involved in decisions about their lives and play an active role in planning the care and support they receive. Some residents cannot communicate verbally, but the staff team understand the other ways in which they express their views. The residents receive good support from the staff, which helps them to make choices about their day-to-day lives. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 6 A relative said, the home ‘provides my relative with the support necessary to live a full and meaningful life’ and ‘My (relative) now lives a very active and varied life engaging in numerous activities outside of the home which he thoroughly enjoys’. The staff make sure that residents receive routine health checks and carefully watch for signs that they may be unwell and take any action needed. A health professional and a relative both said that the staff looked after the residents’ health well. Relatives and health professionals who visit the service are confident that, if they had any concerns, these would be properly dealt with. The building is looked after well and provides a clean, well-equipped and homely home for the people who live here. Staff in the home are trained, skilled and in sufficient numbers to support the people living in the home. One relative said in a survey, ‘their personalities are first class’. 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. This helps ensure that residents receive a good service. What has improved since the last inspection? What they could do better: The instructions for some medications had not been recorded as accurately as they should have been. This could lead to mistakes being made which could harm the health of residents. Record keeping needs to be improved in this respect so that all staff are clear about what medications need to be given and when. A senior manager within the organisation running the home should be visiting the service monthly to check the quality of the service being provided and provide support. This is a regulatory requirement, but these visits are not being carried out sufficiently regularly. This means the manager is not getting the support and guidance she needs from the owners of the home. It also Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 7 reduces the opportunities for residents and staff to tell the organisation how well the home is being run. 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. Meadow & Ivy Cottages DS0000000610.V368092.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 Meadow & Ivy Cottages DS0000000610.V368092.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, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who may use the service have the information needed to ensure that the home will meet their needs. EVIDENCE: A visitor said that they had been able to visit the home and received plenty of information about it, which helped them decide it was the right place for their relative. They had been happy with the care provided to him and felt that his needs were fully met and his quality of life had improved. An assessment of his needs had been carried out to make sure that the home could meet these and a plan of care put in place. Contracts were seen in the care records looked at. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are involved in decisions about their lives and play an active role in planning the care and support they receive. EVIDENCE: Three care records were examined. These were very detailed and up to date and provided the staff team with the information they need about each resident’s needs and wishes for their care. Pictures and photographs were used within the care plans to make them more easily understood. Staff were aware of each residents’ needs and how their care should be provided. Some residents cannot communicate verbally, but the staff team understood the other ways in which they expressed their views. The staff were observed and heard supporting residents to make choices throughout the day. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 11 All seven residents indicated in a survey, that they can decide what they want to do each day, evening and weekend. Three relatives said in a survey that their relative gets enough information to help them make decisions. Any risks arising from residents’ day to day lives have been identified and strategies put in place to reduce the risk of any harm occurring to residents or anyone else. Consultation has taken place with relevant specialists where appropriate. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to make choices about their lifestyle and enjoy a full, meaningful life. EVIDENCE: Each resident has a regular range of activities that they participate in. These are individualised and vary according to their interests and age. For instance, some enjoy visits by a music therapist or baking sessions in the home. They regularly go on outings in the community, for example, walks and shopping and day trips. One relative said, ‘they have a better social life than I have’. Another said, the home ‘provides my relative with the support necessary to live a full and meaningful life’. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 13 All three relatives who completed a survey said the care home helped their friend or relative to keep in touch with them. One said, ‘I always get xmas and birthday presents from my (relative), courtesy of the staff’. Another said, ‘From manager down to the staff, you are made very welcome and also provided with a cup of tea or coffee when you arrive’. All three relatives said the care service ‘always’ or ‘usually’ support people to live the life they choose. Staff described the routines in the home, which are based on the wishes and needs of the people who live there. The staff follow a four week menu plan, which is adapted slightly for each half of the home. A support worker said that alternatives were readily available if any resident did not want any menu item. The inspector had lunch with some residents, who were having a tasty soup followed by chicken sandwiches and cheese scones. They looked like they enjoyed the food and the meal was relaxed and leisurely. Staff gave appropriate support to those residents who needed it and meals were prepared how they liked them. There were a range of foodstuffs in stock to provide choices of meals and there were plenty of fresh fruit and vegetables. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Some weaknesses in medication management could put people at risk of not receiving prescribed medication safely. EVIDENCE: Care plans clearly described the routines people preferred and how they wanted their personal care provided. Discussion with the manager and staff, as well as observations showed that they were aware of how they should support individual residents. A relative spoken to during the inspection said specialist equipment to help her relative with his physical disabilities was obtained before he moved in. She also said the staff had been ‘proactive in following up (health) concerns’. Rotas are managed well to ensure that residents who prefer male or female carers, have their wishes respected. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 15 Two surveys were received from health professionals and both said that the care service ‘always’ respected people’s dignity and privacy and ‘always’ seek advice and act upon this when necessary to manage and improve individuals’ health care needs. One also said, the staff ‘have a sound knowledge of all clients’ history and this enables any health/social concerns to be raised/acted on immediately.’ The records and discussion with two relatives during the inspection, confirmed that routine health checks are carried out regularly. The system for storage, handling and administration of medication was looked at and found to be generally in order, except for the following:One resident was prescribed two similar medications. The medication administration record did not show clearly, when these should be administered. A carer could not explain this and the supporting care records also did not show clearly, when these should be given. The manager provided an explanation but the signatures in the medication administration record did not comply with this and she could not find any written confirmation in the care record. This indicates that staff may be relying on verbal communication for some medication, rather than clear written instructions, which could lead to mistakes being made. o There were not clear instructions stating when and why an ‘as required’ medication should be given, which could lead to mistakes being made. o One instruction handwritten by staff on the medication administration records was not signed and dated. The amount received of the medication had not been recorded, which means that the home cannot accurately check how many medicine doses should be in the home at any one time and whether all medicine doses have been given correctly. o Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff know and understand how each resident communicates their feelings, which helps ensure that any concerns they have are acted upon and they are protected from abuse. EVIDENCE: Relatives confirmed in surveys that they had had no concerns about the care provided but would readily raise any if they did. Relatives spoken to during the inspection said they would discuss any concerns with the manager if they had them. They also felt that the staff understood how their relative communicated his feelings. Staff could also describe how they would know if someone was not happy. Pictorial versions of the complaints procedure were held in each resident’s care record. Health professionals who visit the service also said that any concerns were always followed up appropriately. The manager ensures that new staff are given relevant training about protecting people from harm and managing challenging behaviour as soon as this is available. Evidence of training was seen on staff records and confirmed by the staff spoken to. Staff help residents with their finances by holding money on their behalf and making withdrawals from their bank accounts. Records are kept of transactions and there are audit procedures in place. Records were looked at Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 17 for three residents and a check was made of the cash amount held for one resident, which tallied with the record held. The cash amounts held are checked three times a day. Receipts were kept for purchases made on residents’ behalf. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment. EVIDENCE: The home is situated on a pleasant estate in Pegswood village, not far from Morpeth. There are good transport links. The home was clean, tidy and well maintained. There are a sufficient number of bathrooms and toilets. Repairs were being carried out to one bathroom at the time of inspection. Three relatives who completed a survey said that the home was always clean and tidy. Bedrooms are decorated to suit the tastes and gender of their occupants. Hoists and other special equipment has been provided to meet the needs of residents, following assessment by appropriate specialists. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 19 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): 31, 32, 33, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people living in the home. EVIDENCE: There was a pleasant, friendly atmosphere in the home and residents appeared very relaxed in the company of staff. Staff spoken to felt well trained and supported to do their jobs. Two health professionals, who regularly visit the home, agreed in a survey that the staff ‘always’ or ‘usually’ have the right skills and experience to support the people living in the home. One said, ‘I am not aware of staff qualifications/experience but in my opinion they appear confident in their roles’. The following comments were received from two relatives, who completed surveys; ‘Their personalities are first class’; ‘I would say the majority of the staff do have the skills necessary to care for my (relative), they do however, have times when there appears to be a lot of changes of staff at the home, but more recently this appears to have settled down’. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 20 The manager said that increases in the wage rate had helped with staff retention. Four staff were on duty from 8 am to 3 pm, and then four more from 3 pm to 10 pm. The rota and staff confirmed that it was normal practice to have four staff between these periods and that one member of staff slept in overnight to assist a waking member of staff if necessary. Additional staff work when residents are pursuing particular activities, such as swimming, when more staff are needed to assist them. A carer said that the staff levels were good, giving them time to spend with residents. The Manager works as part of the care staff team, which limits the amount of time she has for management duties. The cultural and gender make up of the staff team is appropriate for the people living in the home, which means that resident’s preferences can be respected. The records of three recently recruited staff were looked at, which showed that robust vetting checks had been carried out before they were employed. The records also showed and discussion with two recently recruited staff confirmed, that induction training was provided. The manager has stated that 50 of the care staff have achieved a National Vocational Qualification (NVQ) at Level 2 or above. Other staff are receiving this training. Evidence of this training was seen on four of the staff records looked at. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 21 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, 41 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. This helps ensure that residents receive a good service. However, there are weaknesses in the organisational support of the home, which means the manager is left relatively isolated. EVIDENCE: Evidence obtained through surveys of relatives, visiting health professionals and discussion with staff showed that the home has been and continues to be run well by the Registered Manager, Mrs Liz Costelloe. She has completed the Registered Manager’s Award. She is employed full time but spends a lot of Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 22 time acting as a carer, which reduces the time she has for managerial and administrative tasks. One relative commented, ‘The care home is run very efficiently’. A health professional said, ‘Home Manager always provides detailed report for 6 monthly care management reviews’. CIC carry out a quality assurance survey of its service users, staff, and other stakeholders on an annual basis. The company then produce a report of the overall findings, which is also available on the internet. The manager now receives copies of the surveys, which enables her to address any issues raised. A senior manager within the organisation running the home should be visiting the service monthly without notice to check the quality of the service being provided and provide support. This is a regulatory requirement, but written reports of these visits were not available. The manager did not feel she was always receiving enough support from her manager. These factors mean the manager is not getting the support and guidance she needs from the owners of the home. It also reduces the opportunities for residents and staff to tell the organisation how well the home is being run. CIC has a training programme in place to ensure that the staff are given training in moving and handling skills, fire safety, first aid and infection control. Evidence of the training was seen on a sample of staff files examined and staff confirmed the training they had received. Evidence of maintenance and servicing of essential equipment in the home was seen. The entries in the fire log book showed that routine checks on the fire safety systems are made and staff are given training. No health and safety hazards were seen during this inspection. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 23 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 3 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 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 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 2 x 3 X 3 X 2 3 x Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 24 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 YA20 Regulation 13(2) Requirement If a person has medicine labelled ‘as required’ or ‘when necessary’, there must be clear written instructions on the medication administration record as to (1) how much to give, (2) when and (3) why. This helps ensure the person gets the right medication at the right time and reduces the likelihood of mistakes being made. If a person has medication prescribed for a particular period of time, which replaces another medication, then the medication administration record must clearly state when each medication is to be given. This helps ensure the person gets the right medication at the right time and reduces the likelihood of mistakes being made. Staff must record whether a medication has been given or not. This ensures that other staff know whether someone has received their medication or not, and reduces the likelihood of Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 25 Timescale for action 31/07/08 mistakes being made. 2. YA41 26 The registered provider must 31/08/08 ensure that the care home is visited monthly unannounced by an employee of the organisation who is not directly concerned with the conduct of the care home. The person carrying out these visits must interview service users (or their representatives) with consent, inspect the premises, and check other systems in the home. This is so that the organisation can be confident the home is being run well in the interests of its residents. A written report of each visit must be and copies supplied to the Commission and the registered manager. 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 YA20 Good Practice Recommendations Staff should sign and date handwritten entries they make on MAR charts. Each entry should be checked and countersigned by a second person to reduce the risk of error when copying information. The quantity of any new medication prescribed should be recorded on the medication administration record. This helps to confirm that medication is being given as prescribed and assists in checking stock levels. A written format should be produced for regular audits of the medication system. The cash sums held on behalf of residents are checked three times a day, which is onerous for the staff. Review whether the number of checks can be reduced, whilst DS0000000610.V368092.R01.S.doc Version 5.2 Page 26 2. YA23 Meadow & Ivy Cottages safeguarding the interests of residents. Meadow & Ivy Cottages DS0000000610.V368092.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Meadow & Ivy Cottages DS0000000610.V368092.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. Re-publishing this information is in breach of the terms of use of that website. 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