Inspection on 29/08/07 for Melton House

This inspection was carried out on 29th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Melton House 04/05/06

Melton House 02/10/05

Melton House 25/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Melton House 47 Melton Road Wymondham Norfolk NR18 0DB Lead Inspector Ruth Hannent Unannounced Inspection 29th August 2007 09:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Melton House Address 47 Melton Road Wymondham Norfolk NR18 0DB 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) 01953 606645 01953 857390 melton.house@fshc.co.uk www.fshc.co.uk Four Seasons Health Care (England) Limited (wholly owned subsidiary of Four Seasons Health Care Ltd) vacant post Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th May 2006 Brief Description of the Service: Melton House is a care home providing personal care and accommodation for 34 older people. The home is a large detached building situated in the market town of Wymondham. Bedrooms are on the ground and first floors and consist of five double bedrooms (four with en suite facility) and twenty-four single bedrooms (twenty-two with en-suite facility) The home has a variety of communal rooms, one of which is designated for service users who wish to smoke. A shaft lift is provided to aid service users to the first floor. Car park to the front with a small garden to the rear of the premises. The fees range from £385 - £431 per week. Email melton.house@fshc.co.uk Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report has been completed following a site visit to the home. Prior to the inspection information had been sent to the Inspector that include comments from residents, comments from relatives, an Annual Quality Assurance Assessment (AQAA) and an action plan on how the past requirements will be met that were made at the last inspection. Throughout the last four months and since the last inspection the Peripatetic Manager has kept the Commission informed of all appropriate changes that have taken place within Melton House. The day of the visit took place over a period of five and a half hours with the Pharmacist Inspector looking at standards relating to medication also assisting for approximately two hours. Records looked at during the day included care plans, menu’s, rota’s, personnel records, training programmes, risk assessments, staff induction packs and training certificates. A tour of the building took place with no changes to the environment to date. This home has been through many changes of management over the last year but now has a new Manager in post who knows the home and who has many ideas on how to move and improve the service offered to residents. What the service does well: The home has a core of staff who have worked in the home for a number of years and residents state the care support offered by them is very good. The residents are offered personal choice at mealtimes that suits the individual. Relatives are made to feel welcome by the staff team. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process has improved and potential residents will have a thorough assessment prior to admission to ensure the service can meet those needs. EVIDENCE: There is some literature about the home that is out of date and held in wallets that are issued to potential residents. The new Manager has recognised the information that is no longer relevant and is in the process of rewriting up to date information. (It was noted that some information showed the name of a manager of three years ago.). Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 9 A new format for assessing residents is now used on a regular basis and the latest one completed was thorough and gave enough detail to evidence that the care needs of the person could be met within the service offered at Melton House. The Peripatetic Manager who had been covering the home up until two weeks prior to the inspection had contacted the Inspector regarding a referral that appeared to need a specialist service. The information sent was comprehensive and more details were obtained with a joint decision made that this person could be cared for while awaiting her own home. The contingency plan made was that full support would be offered by the Community Psychiatric Nurse by visiting on a regular basis and also be on call in an emergency. Reading the information on the assessment and talking to staff about this person, the care support given has worked well and staff knew to contact the CPN at any time. This person is about to move on and the stay has been successful. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are cared for appropriately and the home has nearly all the paperwork completed to ensure that information on residents is available for care staff to follow. The medication procedures have improved but further monitoring/auditing is required to ensure residents are completely safeguarded. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 11 EVIDENCE: The Four Seasons care plan paperwork is now in half of the resident’s folders. The information seen in two folders gave a picture of care needs regarding health and personal care but still lacks more information that shows social care needs. The documents the staff have to use are sometimes clinical and not ideal for use within residential homes, although information is there on searching. Now the new care plans are in situ the updating and reviewing needs to be planned. The new manager is very aware of the importance of getting records up to date and has a compiled list of care plans waiting to be updated. (Recommendation) The home has good support from the local GP practice and has regular visits when required from the district nurse. One resident told of the visits from the nurse to dress her leg and a comment card from another resident told of the availability of the GP as and when required. One comment card from a relative stated she was pleased the home had improved the contact with the dentist and opticians. Another gentleman talked about the new hearing aid that he is waiting for and how his appointments have been planned. The chiropodist came to the office during the inspection to collect some money for foot care that had taken place that morning and a planned date for the return visit booked in the diary. For part of this inspection visit Mr. Mark Andrews the Pharmacist Inspector carried out a pharmacy inspection following three previous visits to the home over the last eight months. The visit on this occasion was to check if the home had been compliant and met the requirements and repeat requirements set. The information gathered showed that some concerns of medication management was still in place and that one requirement that had been repeated three times over the eight months was still not satisfactory. The new manager in post had already made some changes and also recognised the urgency to meet the requirements. Certificates were seen in personnel folders of medication training that had taken place in July of this year and also a questionnaire on the learning that proved competency of the staff member. Although two medication requirements are listed in this report there is a recognised drive to improve the standards. The staff were observed throughout the day and conversations overheard were appropriate. No staff member entered a bedroom without knocking and all of the residents spoken to (6 in total) said the staff offered them privacy and dignity when ever they were assisted with care. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The daily lives and social activities for residents is improving and they are offered choice of suitable and nutritional food. EVIDENCE: The home has just recruited an Activities Organiser who was in the building getting to know residents and carrying out a group game in the main lounge. This is an improvement on previous inspection visits and hopefully will develop with time as residents become more involved in the stimulation offered. There is still a need for more social interaction with all staff and more information on the social needs recorded for each resident to be able to offer the social care needs that will interest the individual person. (Recommendation) Comments that have been made in relatives and residents meetings and recorded talk of the lack of activities and outings. These comments were also reflected in the comment cards received at the commission prior to inspection. ‘My mother has lived in the home for many years but has only ever been on an outing once’. (Requirement). Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 13 During the day residents received many visitors (eleven names were in the visitors book who had arrived during this inspection). A total 8 comment cards had been received prior to this inspection visit and all positive comments were mentioned on how welcoming the staff are and how they can visit whenever they wish. One relative was contacted by phone who wished to speak to the inspector regarding some feedback and who overall was happy with the way the home kept in touch as she lives a distance away and can only visit on occasions. The Home has a new chef who has recently compiled a four weekly menu that is to be shown to the residents at the next planned meeting to discuss and tweak as required. Talking to residents throughout the day the majority of them enjoy the meals offered. A meal was taken with residents at lunchtime roast chicken, sprouts, cabbage, potatoes and yorkshire pudding and an alternative of minced meat pie. The sweet was apricots, apple crumble and custard or ice cream. One person had a liquidised meal that was presented appropriately to try and keep flavours and textures separate. Some people were eating in their rooms and noted in one persons daily records was information on how much food had been eaten for nutritional monitoring. On talking to two residents it was evident that choice is always available. One man talked of a ‘great fry up’ he has daily for breakfast, another person talked of the bacon sandwich and another of the bowl of porridge. Meal times could be improved if the tables looked more inviting and menus were made available with vegetables served separately, to allow choice of quantity at the table and served on table mats with cloth napkins. (Recommendation) Throughout the day a trolley of drinks was regularly seen and again residents were asked what they preferred to drink with hot and cold drinks available. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. 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. Residents and families can be assured that any complaints will be listened to and dealt with appropriately and timely. Residents are protected from abuse. EVIDENCE: The home has not received any complaints and none have been sent to the Commission. The procedure on how to complain is available in information issued to new residents and on the display board and folder in the entrance hall along with concerns and compliments. One comment card from a family member mentioned the new folder in the entrance hall and thought it was a good idea. All the comment cards from residents all had ticks in the boxes that said they know who to talk to if they are not happy. The home now has a training matrix in place and this shows the staff who have now completed the training on the protection of vulnerable adults. Four Seasons have a whistle blowing policy that is available in the main office. The new staff induction pack (seen) also has a section on potential abuse. No staff are left with a resident alone until a CRB clearance has been returned to the home and no staff member starts work without the POVA register checked against the staff members name. (This is evident in the personnel files kept in the home.) (3 seen.) Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The environment lacks comfort, cleanliness and homeliness and still offers poor facilities. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 16 EVIDENCE: Nothing has changed with the environment of the home and the condition has worsened since the last inspection with areas in the lounge that show more damage to the ceiling. Carpets have not been replaced and the whole home is shabby and lacking homeliness. The gardens are untidy; the smoking room is not sealed and the smoke moves into other areas of the home; the bathrooms are outdated and the toilets by the dining room are very institutionalised with leaking and cracked cisterns. Four Seasons have made the refurbishment of this home a priority and plans for the updating and improvement are to begin straight after this inspection and hopefully completed by the end of December. Many items throughout the environment have been past requirement and must be complied with. (Requirement). Although no unpleasant odours were noted on this visit, comments from visitors in 2 comment cards talked of the not so clean toilets with one family member saying she has cleaned the toilet on a number of occasions. On the day of this visit only one domestic was available to clean and over the weekend no domestic was available. The two comment cards received are from people who say they visit at weekends. (Requirement). The home does have a maintenance folder that has been seen on previous visits that were current at the time showing water temperature tests, emergency lighting test and portable electrical testing. The water in one area was hand tested on the day of the inspection and appeared to be running at a suitable temperature. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported by competent staff who are recruited following the homes policies and procedures that ensures they are cared for by safe hands but more effort in recruiting permanent staff for continuity of care is required. EVIDENCE: The level of staff on duty is the same as noted on the last inspection with 4 care staff plus a senior on in the morning and 3 plus a senior on the late shift and two waking staff over night. Through the week this level of staff is suitable as also on duty are 2 domestics, 1 laundry domestic, the Manager and part time administrator. At the weekends these levels decrease with domestic and management/administration duties often carried out by the care staff. Comments received from families as mentioned previously in this report talk of the home being unclean when they visit with one stating this is always at the weekends and I have to clean myself. (Requirement). Other comments that have caused concern is the amount of agency staff that has been used by the home. The Manager was able to show how this had greatly reduced and how the home is recruiting more staff that will eventually lead to only using agency staff in emergencies. (The recent advertisement was Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 18 seen and interviewing procedures noted with recently short listed possible staff recorded by a Manager from within Four Seasons). The Home still has not increased the level of qualified staff. It was noted that on previous inspections that staff turn over has been high. With more permanent staff being recruited the drive to improve the number of staff qualified needs to take place. (Annual Quality Assurance Assessment talks of only 2 staff qualified with another 2 part the way through. This is not acceptable and the numbers must increase. (Requirement). Also identified by the new Manager is the inadequate filing system for personnel files. Although 2 files of recently recruited staff were look at and all the correct paperwork appeared in place the order and checklist for the files was not in place and records were all mixed up. (Recommendation) Training of staff and checks on competency and understanding have started to take place. The files looked at showed a recently completed questionnaire on the learning gained from a medication training (July 2007). This person is now competent to administer medication and that competency was observed over the lunch time period during this inspection. A training matrix compiled by the Peripatetic Manager has led to dates booked for the next few months for training to be undertaken. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Management of the home has started to improve with a new Manager now in post who is of good character and is able to carry out his duties responsibly. However, the home has some way to go to improve some of the standards within the home that have not been met National Minimum Standards in the past. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 20 EVIDENCE: The home now has a new Manager who is yet to be registered. This person has many years of experience and has just left a home that was rated as “good” through their last inspection. Through the tour of the home and looking at records held within the home it became apparent that this person, in three weeks of employment, had worked out many areas that could improve and had already started the plan of action required. The Four Seasons quality assurance system has started but to date no report has been completed on the outcomes. The staff team have been taking part and some of these questionnaires have been seen. It was noted that again something had started but not continued regularly with some documents completed and some not. One family member spoken to said she had completed a questionnaire and had given her name and phone number to receive feedback but had heard nothing. (Requirement) The administrator of the home keeps good accounts and although she was not at the home on the day of the site visit the paperwork to ensure balances were correct and the amount of money held in the safe were all seen and correct. Staff supervision is still to be carried out in a formal manner at least 6 times a year. The Senior staff team have received some training on how to manage supervision but planned and recorded events are still to be seen. (Requirement). The home has procedures in place to ensure health and safety is part of the day to day life of the home. Unannounced checks are carried out on regular occasions where health and safety issues are discussed. The statutory health and safety training is slowly being completed by all staff such as moving and handling and infection control. Through observation throughout the day it showed staff were carrying out their duties in a safe manner. The Environmental Health Officer had visited the week previous to this inspection and had made some requirements of the kitchen that is slowly being addressed. The accident records were seen but the method of recording is unusual and on very small formats. There did not seem any method to collate the information or systems put in place to see if any improvement could be made. (Recommendation) The Manager has informed the Commission of incidents and accidents. Information on development of the service and relevant risk assessments have been carried out. (Seen.) Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 1 x x x x x x 1 STAFFING Standard No Score 27 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x x 2 x 3 Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13.2 13.4 Requirement People who use the service must have medicines administered by staff in line with prescribed instructions at all times and this can be demonstrated by recordkeeping practice safeguarding people’s health and welfare. – repeat requirement from 12/06/07, 24/04/07 and 16/02/07 inspections. People who use the service must have medicines promptly obtained on their behalf so they can always be given by staff as scheduled. The home must show how they consult with the residents about their social interests and how they help them to engage in those interests. Timescale for action 28/09/07 2. OP9 12.1 13.2 13.4 28/09/07 3. OP12 16.2m 31/12/07 Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 23 4. OP19 23.2b The carpets need to be replaced 31/12/07 where worn and stained, Some areas need to be made less institutionalised and more homely, the smoking area needs sealing and bathroom areas need decorating and refurbishing. Repeat requirement x 2. The home must be clean at all times. The home must ensure that at all times suitably qualified, competent and experienced staff are working in numbers that are appropriate for the health and welfare of the residents. Staff must be suitably qualified to meet the needs of the residents. (Still within timescale) All staff should receive suitable supervision. Repeat requirement 30/09/07 31/10/07 5. 6. OP26 OP27 23.2d 18.1a 7. OP28 18.1a 01/12/07 8. OP36 18.2 31/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP9 Good Practice Recommendations It is recommended that action is taken to ensure staff use MDS containers correctly. It is recommended that regular medication reviews are instigated for an identified resident prescribed diazepam 2mg tablets. Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 24 3. OP9 It is recommended that the risk assessment for an identified resident self-administering insulin by injection is reviewed. It is recommended that the home puts in place a system of auditing to promptly identify medicine quantity discrepancies arising. It is recommended that depot injections given by CPNs are recorded as prescribed on resident’s MAR charts The home should have a separate sluice facility from the sink used for hand washing clothing. The home should plan the dates for the reviews as care plans are completed. The home should explore different ways to obtain the social interests of each resident. The personnel files need to be tidy and contain a check list to ensure all relevant paperwork is in place and easy to find. The quality assurance obtained through surveys etc should be collated and fed back to all stakeholders. The home should use the accident forms proactively and see if there are any trends happening and ways to monitor the situations. 4 OP9 5. 6. 7. 8. 9. OP9 OP26 OP7 OP12 OP29 10. 11. OP33 OP38 Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Melton House DS0000065210.V349711.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!