Inspection on 05/03/08 for Micron House

This inspection was carried out on 5th March 2008.

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

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

Other inspections for this house

Micron House 10/05/06

Micron House 01/11/05

Micron House 21/06/05

Micron House 27/09/04

Micron House 19/04/04

Micron House 25/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Micron House Micron House 41 Halesowen Road Netherton Dudley West Midlands DY2 9QD Lead Inspector Richard Eaves Unannounced Inspection 5th March 2008 10:00 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 Micron House DS0000025033.V360539.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. Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Micron House Address Micron House 41 Halesowen Road Netherton Dudley West Midlands DY2 9QD 01384 230504 01384 230504 micronhouse@blueyonder.co.uk 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 Gail Benita Butcher Mrs Gail Benita Butcher Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user (female) identified in the variation report dated 6 July 2005 may be accommodated at the home in the category MD(E). This will remain until such time that the service users placement is terminated. 30th October 2007 Date of last inspection Brief Description of the Service: Micron House is registered to provide personal care to a maximum of ten older people. It is located in Netherton, near Dudley. It is situated in a favourable position, as it has a number of amenities and facilities close by. Next to the home is a good sized park, a library and an arts centre. Further down the road are a number of shops including a supermarket, newsagent, butchers, a bakery and a post office. Nearby is an Age Concern centre and the main Netherton health centre where district nurses and local doctors are based. The home is on a main bus route leading to Cradley Heath in one direction and Dudley in the other. Micron House is a traditional, detached property. The ground floor houses the lounge, dining area, a conservatory, toilet, assisted bathroom, laundry, kitchen and bedrooms. The first floor houses the office, further bedrooms a toilet and a further bathroom that is not often used. The home provides six single bedrooms, four of which have en-suite facilities and two double bedrooms. There is a generous sized rear garden which is on two levels. Ramped access is available from the top to the bottom of the garden. The home has a small car park at the rear which can accommodate three cars; further car parking is available in a public car park opposite the home. The homes range of charges is currently £348 to £433.50 per week. The fee information given applied at the time of the inspection; persons may wish to obtain more up to date information from the agency. Micron House DS0000025033.V360539.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 the people who use this service experience good quality outcomes. This key unannounced inspection visit was undertaken by an Inspector from the Commission for Social Care Inspection using the following information: reports from the organisation relating to the conduct of the home, records maintained at the home, the annual quality assurance self assessment, comment card responses from service users and relatives and reports by other agencies. The inspection involved a full tour of the property including, a number of bedrooms, the communal rooms and service areas and provided an opportunity to speak with many service users. What the service does well: What has improved since the last inspection? Care planning has improved with more direction of actions required to address needs. Care plan reviews are undertaken at least monthly and short term plans are developed to meet needs such as infection treatments. Arrangements for the management of medications has been improved. The range of and delivery of appropriate recreational activities has increased and the joint and individual activity identified and recorded. Food and drink intake is monitored and the menus amended to show that supper is provided. Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 6 The Dudley multi agency adult protection procedure is available to staff who have all received training. The exterior of the home has been decorated and previous environmental requirements such as providing radiator guards addressed Staff rotas now include named on-call staff and previous shortfalls in recruitment practice addressed. The manager and deputy are undertaking the NVQ level 4 to obtain the care component. The quality assurance system now in place measures quality against the National Minimum Standards for Older People. The policy for safekeeping of residents money has been reviewed and updated 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. Micron House DS0000025033.V360539.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 Micron House DS0000025033.V360539.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): Standards 1 – 5. Quality in this outcome area is good. The homes statement of purpose and service user guide are good sources of information providing details of the service enabling service users and families to make informed decisions about admission to the home. The most experienced staff undertakes pre-admission assessments and confirmation is given to the service users that their needs can be met by the home and further confirmed by contract at the time of admission. Service users are invited to visit and trial the home before committing themselves to staying at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Copies of the Statement of purpose and Service User Guide were provided, last revised January 2008, these are issued to service users and fully meet the requirements of the regulation and schedule. A copy of the contract/terms and conditions were seen on each file viewed. Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 9 The manager undertakes a pre admission needs assessment and confirms that the home can meet those needs. Three files were selected to be case tracked, including the most recent admission, an established person and an older person The case files were seen to have extensive assessments thoroughly completed, informative and subject to monthly reviews. Risk assessments were undertaken for moving and handling, Nutrition, Falls and pressure risk. One person using the service had a history of falls and evidence of analysis and preventative actions implemented was seen and noted to have been successful over the last 6 months. The home maintains accident records in a Data Protection compliant way. The assessments are subject to review by Social Services or by the home if self funding, copies of both were seen on file. Over the day care practices and interactions between staff and service users were observed and discussions with staff and the service users, who said, “I am very happy here”, “It is a home from home” and a staff member said “I love working here”. The home demonstrates a commitment to training with 90 qualified to NVQ level 2 or better and can be seen to meet the assessed needs of service users. Trial visits were confirmed and documented within the file. No intermediate care service offered. Micron House DS0000025033.V360539.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): Standards 7 – 10. Quality in this outcome area is good. Care plans are derived from a comprehensive range of assessments and provide the basis for the delivery of care and detail the actions required of staff to meet the identified needs. Health care needs of service users are fully met. Medications are well managed all facilitating the promotion of service users health. Service users are treated with respect and their privacy upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of three service users were selected for case tracking including the most recently admitted service user. Care planning documentation is well organised, current, clearly written and comprehensively encompassed the range of ‘care areas’ necessary to ensure the delivery of care appropriate to the general needs of each service user. One service user had a short term care plan for needs identified during a period of illness. All care plans viewed gave clear directions to address the identified needs. Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 11 All service users are registered with a GP and allied medical services such as dentist, ophthalmic and chiropody are provided on a regular and as required basis. A Chiropodist attended three service users during the day of the visit. Service users are assessed by senior staff in such areas as pressure relief and continence equipment and referred as required for professional advice and supply. Nutrition and falls are risk assessed and necessary interventions and monitoring arrangements are in place including meals intake and weight monitoring, plans to minimise the risk of falls. The largest proportion of medicines are administered from a monitored dosage system, ‘Nomad’ that provides for a seven days supply. Booking in and returns records were good and the Pharmacist provides advice and independent audits quarterly. Staff involved with medication have all received accredited training. The procedures for medication were available with the medication administration records (MAR). Facility for receipt and storage of controlled drugs are available but none are currently in use at the home. None of the service users are assessed as able to self medicate. It was observed that a number of medications such as paracetamol and lactulose were regularly refused, it is recommended that the GP reviews these with a view to prescribing them ‘as required’ and care plans devised to cover this. It was observed that residents were treated with courtesy. Staff knocked on doors before entering and confirmed that they drew curtains and closed doors when necessary. Bedrooms were fitted with approved door locks that provided privacy and safety. Micron House DS0000025033.V360539.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): Standards 12 – 15. Quality in this outcome area is good. The home provides a varied social and recreational activity programme that provides interest and pleasure for service users. The involvement of family and friends is encouraged in agreement with the service users wishes. Staff support service users to access opportunities for their personal development and health promotion. Meals at the home are wholesome and meet the nutritional needs of service users while providing for choice and personal taste. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a programme of planned activities displayed but this is adapted at the wish of service users. Early in the inspection, seven of the ten people who use the service were in the lounge listening to the radio. Speaking with a number they said they like to have a relaxed start to the morning with the radio and talking amongst themselves, more active events are mostly for after lunch. Records are maintained of the activities and also individual records of involvement. In conversation they said that the amount of organised events was ‘about right’, that they enjoyed daily exercise together, sing-a-longs and occasional Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 13 bingo, during the afternoon a sing-along was fully engaged in by the residents and one octogenarian was happily dancing. Individually many go on shopping trips or when the weather is good visits to the park behind the home. Entertainers visit on a regular basis. The local church members visit frequently providing companionship, services and bible reading. Over the afternoon many visitors arrived and joined in making for a very pleasant atmosphere. All spoke very positively about the home and said they always were made welcome and involved in the life of the home. One said, “the home is marvellous, mum loves it hear”. Families take responsibility for residents’ finances, where small amounts are left for safekeeping, full records are amounts received, spent and receipts kept. Information was displayed of Dudley local advocacy service and records are maintained on individual files of contacts made. During the tour of the building it was observed that all rooms were personalised with ornaments, pictures and some furnishings, such as display cabinets, favourite chair and television/radios. One lady said she had her important items and that suited her. Meals served at the home were described by service users able to comment were very good and enjoyed by all. The lunch viewed was nicely presented and well received, including homemade soup. The menus provide for choice and at most meals although some lunches such as Sunday roast are agreed by the residents. Breakfast is a free choice including cooked, cereals and toast. Tea menu included cooked and cold options. Supper is provided. Records are maintained of meals taken and nutrition is monitored, a service user who had lost a lot of weight while in hospital was seen to be gaining weight since return to the home. Fresh fruit is available every day and the home has a ‘Healthy Eating’ recognition. Micron House DS0000025033.V360539.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): Standards 16 – 18 Quality in this outcome area is good. The home complaints and protection policies are robust providing a safe environment in which service users feel they can voice concerns and that these will be listened and responded to. Legal rights are protected by efficient administration. Staff demonstrate excellent knowledge and understanding of adult protection issues which contributes to an environment that is safe from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and Service Users’ Guide held copies of the complaints procedure and a copy of the procedure was also displayed in the entrance of the home. Complaints policy viewed, fully compliant for timescales for responses and stages. No complaints have been received since the previous inspection. In conversation with service users they said they would speak with any of the staff if any concerns or the manager, relatives also said they would know how to complain but emphasised how satisfied they were and the good relations they had with the home. Staff confirmed that they would know how to deal with concerns raised by residents or visitors. The electoral roll has been completed for this year and some have requested postal votes, while others indicate they will attend the polling station. Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 15 Policies relating to the protection of Residents from abuse were observed to be in place and readily accessible, these included, ‘Whistle Blowing’, ‘Abuse Awareness’ and ‘Adult Protection’. Staff training files indicated that Staff had received training in respect of these Policies. Speaking with individual staff it was apparent that they were conversant with adult protection. No Secrets guidance document and the Dudley multi agency policy document were available. Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 16 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): Standards 19 & 26 Quality in this outcome area is good. The Home provides a comfortable, attractive, safe and ‘homely’ place to live. Specialist equipment, consistent with the needs of the Residents and the demands of tasks carried out by care staff, is available to facilitate the provision of care. The home is clean, hygienic and free from odours. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The external areas were well maintained appropriate to season and accessible to residents, external decoration has been undertaken over the past summer. A tour of the building including an inspection of most bedrooms and were found to be nicely personalised and included some items of own furniture. Furniture in the lounge and dining areas are of good order and present a ‘domestic’ ambience. The Home has a full range of maintenance contracts in place, and an on-going refurbishment/redecoration programme, radiator Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 17 covers have been provided and locks fitted to bedroom doors. Decoration was in good order and infection control measures were in place addressing a previous requirement in respect of storing the kitchen mop. It was observed that liquid soap and disposable towels were appropriately placed and staff confirmed that they always had personal protective equipment available to use. Clinical waste facilities were provided. The home was found to be clean and hygienic and free from any odours. The laundry was maintained in a clean, tidy manner. Equipment was appropriate and met the needs of the home. Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 18 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): Standards 27 – 30 Quality in this outcome area is good. The home has a stable, well-motivated and trained staff group offering consistency of care and enthusiasm to maximise the quality of life for the service users. Service users are further protected by good recruitment and selection practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An inspection of current and recent rotas confirm that staff numbers across the 24hour period are appropriate to the needs of service users. An on-call system of senior staff is provided to support the lower staffing numbers overnight. Previously night staff levels have been increased to meet individuals needs, it is recommended that a formal record be kept of call outs, calls for advice or reports of problems experienced to enable analysis over time. The current level of NVQ qualified is 54 with a further 5 staff enrolled to undertake the level 2 qualification. The manager and deputy are currently undertaking level 4 in care management. A sample of two staff files including the most recent employed staff, show these to be completed to a good standard with appropriate pre-employment checks being undertaken. Job descriptions appeared satisfactory for roles and Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 19 support the underlying values of the home. Staff are subject to a thorough, and relevant orientation/skills for care induction programme. Staff are issued with the General Social Care Councils code of conduct. Staff files and the training matrix show that all mandatory training provided is up to date and certificates are kept on the individual file. Staff receive additional elective training in such areas as mental health and dementia care. Senior carers have completed an accredited medication administration course and further carers are currently undergoing training. Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 20 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): Standards 31, 33, 35, 36 & 38 Quality in this outcome area is good Leadership of this home is good and staff demonstrate an awareness of their roles and responsibilities. The managers approach is open and positive and develops positive relationships amongst service users and with staff. The home regularly reviews its performance, which includes seeking the views of service users, families and other stakeholders. Service users financial interests are safeguarded. Staff receive up to date and relevant formal supervisions. The best interests of service users are safeguarded by the homes record keeping, policies and procedures. Environment management and staff training in respect of health and safety ensures service users safety and welfare are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 21 The manager is also the proprietor and is well qualified and experienced in home management, in addition she and her deputy are currently enrolled on the NVQ level 4 Care Management course. Care staff were relaxed and friendly and said they enjoyed working in the home and good working relationships with the nurses. The few visitors seen said they were always made welcome and that the staff are marvellous. Staff meetings are held monthly in each unit led by the senior nurse for that area. Staff spoken with said they were kept well informed. The organisation has an excellent Quality Assurance programme, including an annual self-assessment and quality audits monitor compliance with the National Minimum Standards. Annual resident satisfaction surveys are undertaken and regular meetings held. Residents receive high standards of service confirmed by feedback from them, their families and other stakeholders. Financial records are kept in accordance with best practice and procedures. Insurance certificates are displayed and meet requirements. The Finance procedures cover safeguarding of residents money and personal belongings. The home does not generally handle service users money or finances, preferring they remain independent or a family member. Detailed systems are in place to control and record any transactions. The home has a safe for residents use and all rooms have a lockable facility. All staff are supervised at least 6 times a year, topics are appropriate covering aspects of care delivery, the homes philosophy and individual development. The sample of staff files inspected confirmed that supervisions are up to date. Records viewed during this inspection were found to be up to date and accurate. The case files evidence the involvement of service users in care planning and their access to the information held in the file. Arrangements for keeping records secure are satisfactory and comply with requirements. Documentation was seen of a full range of servicing, maintenance and regular monitoring of services and equipment is undertaken, staff receive training in health and safety and first aid. Monitoring of hot water is good and records show that the standard of 43°c is achieved consistently, legionella prevention is also undertaken. Fire safety including tests, staff training and equipment maintenance were seen to be up to date. Records of all accidents are recorded, using data protection compliant documentation and reported as necessary. Induction and foundation training is provided to Skills for Care standards. Overall the premises were observed to be well managed to meet safety requirements. Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 22 Micron House DS0000025033.V360539.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 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 4 X 3 Micron House DS0000025033.V360539.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Care plans must be prepared to address identified needs even when other providers undertake actions required. For example, care of hearing aid by son, or District Nurse attendance. The manager should liaise with the GP where medications are frequently refused such as analgesia and consider if as required should be prescribed. Where as required medication is prescribed these should be covered by a care plan describing the circumstances to be given. The manager should formalise monitoring of night staff allocations, keeping a record of all contacts and call outs of the on-call person. 2. OP9 3. OP27 Micron House DS0000025033.V360539.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Micron House DS0000025033.V360539.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!