Inspection on 16/06/09 for Meresbeck Care Home

This inspection was carried out on 16th June 2009.

CQC 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

Meresbeck Care Home 09/08/07

Meresbeck Care Home 24/10/06

Meresbeck Care Home 03/02/06

Meresbeck Care Home 16/08/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Meresbeck Care Home 125 North Road Carnforth Lancashire LA5 9LU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jenny Donnelly     Date: 1 6 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Meresbeck Care Home 125 North Road Carnforth Lancashire LA5 9LU 01524734176 Telephone number: Fax number: Email address: Provider web address: emmastephenson75@yahoo.co.uk Name of registered provider(s): Type of registration: Number of places registered: SKR Limited care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 20 Date of last inspection Brief description of the care home Meresbeck is situated in Carnforth fairly close to the town centre and is registered to provide personal care for up to 20 older people. Accommodation is provided in twelve single rooms, four of which have ensuite facilities, and four double rooms two of which have ensuite facilities. Bedrooms are situated on both floors of the home and there is a stair lift to help people with mobility 0 Over 65 20 Care Homes for Older People Page 4 of 28 Brief description of the care home problems get upstairs. There are two lounges and two dining rooms, for shared use. There is some car parking space and a patio area to the front of the home with seating and sun shades. There is a small garden at the back that people can access from the lounge. Current weekly fees range from £386.50 to £435.00 plus additional extras such as toiletries, transport, hairdressing, private chiropody and newspapers. The home has produced a statement of purpose and a service user guide which gives people information about the facilities and services offered, this includes a copy of the latest inspection report. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was the main or key inspection for the year. The lead inspector Jenny Donnelly asked the manager to fill out a form called the Annual Quality Assurance Audit (the AQAA). This asks for details of what has improved in the home since the last inspection and for the plans for the coming year. This was fully completed and returned to us by the date we asked. Jenny Donnelly made an unannounced visit to the care home on 16th June between the hours of 09.30 and 15.30. During this visit we (the Care Quality Commission) toured the building, spent time in the lounges, and dining room where we watched lunch being served. We spoke with people living in the care home, their visitors and with the community nurse. We also spoke with the manager and the staff on duty. We looked at files and documents that backed up what we were told and what we saw. Care Homes for Older People Page 6 of 28 Since the last key inspection in August 2007, we completed a random inspection in June 2008. This was to check how well the service was performing following an investigation by Lancashire County Council into some concerns they had about the home. We found the service was operating well and did not make any requirements or recommendations at that time. We also completed an Annual Service Review in September 2008. An annual service review is where we look at all the information we have gathered about a service in the last year, including the managers Annual Quality Assurance Audit and surveys that we send to people who live in the home. From this we make a judgement about whether the home is continuing to provide a good service to people, or whether we need to inspect sooner than planned. We received positive feedback about Meresbeck and did not alter our inspection plan. Copies of all these reports are available on request from us, or from the care home. What the care home does well: What has improved since the last inspection? What they could do better: The management of medicines in the home needs to be improved. The storage and record keeping of certain medicines known as controlled drugs was not robust enough. General medicine administration records also lacked accuracy, and we require the manager to rectify this. This is to ensure that all medicines in the home are safely stored, handled and accurately administered to people as the doctor intended. Care Homes for Older People Page 8 of 28 We also recommend that the manager introduce formal nutritional assessments and skin assessments. This is to make sure peoples needs in these areas are fully assessed and documented so staff know what additional monitoring and support, if any, people need. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was good written information available about the home and the services provided. The admission process was thorough and helped make sure the home could meet peoples needs and helped them to settle in quickly. Evidence: Meresbeck had produced an informative statement of purpose and service user guide that told people about the facilities and services provided. These documents had been updated in January of this year. Staff said a copy of the service user guide was given to new people and their families. A visiting relative we spoke with confirmed they had been given a copy. New people were only admitted to the care home following a full assessment of their needs. We looked at the records of two people quite new to the home and saw that the manager had completed these assessments. She had also gathered information from relevant people including social workers, hospital staff and relatives. One of the Care Homes for Older People Page 11 of 28 Evidence: visitors we spoke with said they had spent a lot of time with the manager going through all the admission details and talking about their relatives needs. The admission process helped to make sure that the manager only offered places to people whose needs they could meet. A visitor said they had been able to come and look around the home and had been offered the choice of two bedrooms. They told us the admission process was very thorough and helped their relative settle in quickly. People we surveyed told us they had been given enough information to help them decide if this home was the right place for them, and one person wrote, I am very happy at Meresbeck, they meet my needs. The service did not provide intermediate care, but did sometimes take people for short term respite care. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People received good quality personal care in a way that was acceptable to them, and they had good access to health care services. The management of medicines in the home needs to improve to ensure people are receiving the correct treatment. Evidence: Each person had a written plan of care in an individual file. These were well organised and followed a set format, including personal details, risk assessments, and a plan of care that guided staff to what level of support a person needed. There were also recording sheets for professional visits such as the doctor, district nurse or social worker. These showed that people had good access to health professionals. We received a satisfactory survey from one of the doctors who visits the home. We looked at a number of care plans including people new to the home, a person who was not well, and a person who had recently had a fall. The care plans were detailed and had been kept up to date to reflect any changes in peoples care needs. Where staff had noted concerns, such as a person being unwell, we could see this had been reported at the staff shift change and the doctor called. A small number of people Care Homes for Older People Page 13 of 28 Evidence: received input from the district nurse and we were aware that staff called the nurse that day about a person with a recurring skin problem. Staff recorded basic information about peoples dietary needs, such what they liked and disliked and whether they were diabetic, and people were weighed regularly. We recommend that a more formal nutritional assessment be carried out, to check if people have any problems that would make eating more difficult, such as a sore mouth, poorly fitting dentures or a need for special cutlery. The manager agreed to look into this. We also recommended that a skin assessment be recorded when people are admitted to the home. We noted for one person staff had noted in the daily record they had no bruises or pressure sores, but this was not recorded consistently for everyone. Regular skin assessments are important for people with frail skin prone to damage, so any deterioration can be detected and treated quickly. The manager agreed to set this up. People told us they were happy and well looked after, saying, Im very happy here, I think the home and the staff are wonderful, and I get all the help I need. A visitor told us he was extremely pleased with his relatives care and when he raised a health concern he was very happy that staff called the doctor to check it out. Surveys we received from people living in the home said, I am well cared for, Everything is as it should be and, We get loving care here. People looked well cared for and were helped to have a bath once or twice a week. We looked at the management of medicines in the home and saw that staff who dealt with medicines had received training on this and there were written policies and procedures to guide staff in all aspects of medicines handling. The service had recently changed their medication supply to a monthly pre-packed system, and had a new trolley to store the packs in. We noted there was no system to secure the trolley to a wall when it was not in use as there should be, and the manager confirmed this was to be addressed the following day. We saw staff had made a number of errors in the medication record charts. For example one person was prescribed a medicine once a day at night time, but staff had signed to say they had given this medicine both morning and night on two occasions. Another person was prescribed a medicine in the morning but staff had signed to say it had been given morning and night on twelve occasions. A third person also had an extra dose of medication signed for ten days that had then been crossed out. We do not believe the Care Homes for Older People Page 14 of 28 Evidence: extra doses of medication had been given to these people as there was not sufficient supply to do so. Much more care needs to be taken with administering medicines, and the manager needs to make sure staff fully understand, and follow the homes medicines procedures, and check the records regularly for compliance. We looked at the management of controlled drugs (those subject to the Misuse of Drugs Act) which require special storage and recording. The storage, a locked cash tin, did not comply with the Misuse of Drugs (Safe Custody) Regulations, and the manager is required to provide appropriate safe storage for these drugs. Records for the controlled drugs also showed some errors in that entries in the controlled drug register did not match entries in a persons medicine administration chart, and the stock balance for the drug was incorrect. Staff must take more care when handling controlled drugs. The manager said she was planning to re-train all staff in handling medicines and said that her end of month audit would have highlighted these problems. We saw that some people were having courses of antibiotics and these had been well handled, as had some other medicines prescribed to be given at intervals such as weekly. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were encouraged to maintain their independence and were offered a range of activities and entertainment. People enjoyed the quality and variety of meals served. Evidence: People were encouraged to maintain their independence and we saw that people were able to spend the day as they wished. The majority gathered in the main lounge, while others chose to use the quieter front lounge, one of the dining rooms or made use of the outside seating as it was a nice day. One person took themselves off into Carnforth in the afternoon and told us he regularly goes to visit his wife who lives nearby. We saw some visitors in the home and they told us they were always made welcome and offered refreshments, one person stayed to have tea with his relative most days. People we spoke with, and visitors, confirmed that recent events in the home had included a 100th birthday party with a barbecue, a visiting entertainer and a Tai Chi session, all of which had been very much enjoyed. People also told us a hairdresser visited regularly and so did members of the local clergy. The manager had asked people to fill in activity questionnaires earlier this year so she could provide the sort of activities and entertainment people wanted. Care Homes for Older People Page 16 of 28 Evidence: We noted that the televisions in the lounges were not on throughout the day, and music was playing during the morning. People said they liked the music, and staff said they only put the TV on if there was something most people wanted to watch as everyone had a set in their bedroom. We were told the TV was generally on during the evening when people liked to watch the soap operas. Staff said they sometimes took individuals into town to the shops and for coffee. One person especially enjoyed watching the garden birds, and several new feeders had been put up to attract the birds into the garden. Some people had a daily paper. We looked at the menus and saw the lunch being served. There was a five week menu in operation that showed traditional meals with two choices of starter and main course at lunch time. Tea was a lighter meal and breakfast was cereal and toast, and although a cooked breakfast was available nobody wanted this at the moment. People were asked in advance what they wanted for lunch, which was grapefruit or soup, followed by steak pie or roast chicken and fruit crumble. Everyone we spoke to said they had enjoyed their lunch and that the meals were always good. We saw that hot and cold drinks were offered regularly throughout the day with biscuits. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People told us they felt safe living at Meresbeck and said the manager would listen to them and act on any concerns. Evidence: The service had a complaints procedure, a copy of which was given to people as part of the service user guide. People we spoke to said if they had any complaints they would raise the matter with the manager, and were confident she put things right. The completed surveys we received indicated that people knew how to raise concerns and complaints if they needed to. There was no copy of the complaints procedure on display in the home for visitors to see. The manager thought this had been removed from the notice board by mistake and agreed to replace it. There had been no complaints made about the care home in the last year. There were policies and procedures in place to tell staff about abuse and to guide them in what to do should an incident occur. Staff said they had received training on safeguarding procedures both from an external trainer and as part of their National Vocational Qualifications in care. Staff were able to explain how they would safeguard somebody who was in any immediate risk and understood the process for reporting any concerns to the appropriate authorities. There had been no safeguarding referrals made in the last year. People said they were well looked after and did not suffer any abuse or neglect. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a comfortable home that was well maintained and met their needs. Evidence: Meresbeck is situated in a residential area in Carnforth about half a mile from the town centre. The home was well maintained and had benefited from a lot of redecoration and replacement of furniture over the last two years. There are two floors with a stair lift to help people with mobility problems access the upper floor. There are handrails in the corridors and grab rails in the bathroom and toilets to assist people. The home had a hoist. Other equipment such as pressure reducing mattresses and specialist beds were loaned through the district nursing service according to peoples needs. There are two lounges and two dining rooms, as well as outside space for shared use. There is a small lawned garden at the back of the home with a pond, and a patio to the front with seating and sun shades provided. Due to lack of space in the kitchen, freezers were kept in one of the dining rooms. Bedrooms are situated on both floors of the home and consist of a mix of single and double rooms some with en suite facilities. The shared bedrooms had privacy screens provided and separate furniture and clothes storage for both occupants. People had been able to bring their own furniture into the home if they wanted to and as space allowed. Bedrooms vary in size. Care Homes for Older People Page 19 of 28 Evidence: There is one bath with a bath seat and there were a number of toilets situated around the home near to the lounges. There were a number of old metal commodes in the bathroom, which were in a poor state, and staff said these were to be thrown away. We toured the building and saw that everywhere was clean, tidy, and fresh smelling despite the domestic being on holiday. The small laundry was well managed and there were separate baskets for returning peoples clothing to their bedrooms. People said the laundry service was good and their clothes were nicely laundered. Staff had completed training in infection control. Since the last inspection two years ago, many bedrooms had been painted and had new carpets and curtains. There was some new furniture and lamps. The main dining room had just been decorated and had new carpets and curtains. Chairs and tables had also been replaced since the last inspection. The kitchen had been painted and there were plans to replace the cooker. Some new patio furniture had been purchased. People said the home was comfortable. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by a caring and well trained team of staff. Evidence: Staffing rotas showed that there are two or three care staff on duty during the morning, supported by a cook and a domestic. Later in the day and overnight there are two care staff on duty. The manager works some shifts as one of the carers and has some office days. The domestic was on leave for part of this week and care staff were managing her duties. The manager said she was looking to provide three staff every morning now as resident numbers had recently increased. We think this would be appropriate. Staff we spoke with felt that three staff during the morning would be about right to make sure they could offer people regular baths and meet everyones care needs. The service employs a high percentage of staff who have completed a National Vocational Qualification in care. Currently 13 out of 14 care staff have achieved this which is very good. Staff told us of the various training courses they have completed, including handling and moving, fire safety, catheter care, infection control, mental capacity act and medicines. We saw training records and certificates on file from external training providers as well as in house training and the use of distance learning workbooks. Care Homes for Older People Page 21 of 28 Evidence: Recruitment of new staff was well managed in the home. We checked the files of a number of staff, both new and long term, and found full pre-employment checks were routinely carried out before people started to work in the home. Staff we spoke with were very positive about their work at Meresbeck and we received very positive staff surveys that told us; we are on courses all the time, we always have enough staff on shift to cover peoples needs, my references were checked before I started and we have criminal records bureau checks every 3 years and, we have courses on every aspect of the job updated every 6 months. People told us staff were pleasant and helpful and said, this is a happy place, the staff are nice and work together at all times. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a well managed home where their views were listened to and acted on. Evidence: Meresbeck is owned and managed by SKR Limited, and Emma Stephenson is the registered manager. She has worked at Meresbeck for 17 years, 11 of them as the manager. She holds a Registered Managers Award and a National Vocational Qualification (NVQ) at level 4. She is supported by other senior care staff who have also completed NVQ at level 4. Because the owners are not in day to day charge of the care home they undertake monthly monitoring visits to the home and complete written reports of these. This is required under the care home regulations. We saw copies of the most recent reports, which showed the owners spoke with residents and staff and carried out a number of quality checks whilst on site. The home has been awarded Investors in People and is ISO (International Standards Organisation) accredited. This means the home is subject to regular assessments by both of these bodies and we saw the most recent audits by them. The manager also Care Homes for Older People Page 23 of 28 Evidence: completes regular checks of the service to make sure standards are being maintained. She periodically sends out satisfaction surveys to people who live in the home and their relatives. We saw the latest surveys that were completed in January of this year and they were all very positive. There was one comment that the outside space could be improved and this had been done with some new furniture and flower boxes. There were also residents meetings where people could make suggestions and share their views about the home. There was a staff supervision system in place and we saw evidence that staff received supervision sessions every two months as well as annual appraisals. There were also regular staff meetings. Staff told us, the manager runs the home very well, we all work as a happy team and make it a home from home for the residents. There were good arrangements in place to promote and protect the health and safety of people living in the home, visitors and the staff group. We saw that all services and equipment in the home had been regularly maintained and serviced, and the home used an external contractor to undertake periodic health and safety inspections. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Medicine administration records must be correct. To demonstrate that people have been given their medicines as the doctor intended. 31/07/2009 2 9 13 Controlled drugs must be stored in a cupboard which complies with the Misuse of Drugs (Safe Custody) Regulations, and administration of these drugs must be accurately recorded. To ensure the safe keeping and safe handling of drugs that are liable to misuse. 31/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 8 People should have regular documented skin assessments Page 26 of 28 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations and nutritional assessments included in their care plan, so staff can identify any risks and meet peoples needs in these areas. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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