Inspection on 31/01/08 for Mill Lodge Care Home

This inspection was carried out on 31st January 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

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Larchfield Manor

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

CARE HOMES FOR OLDER PEOPLE Mill Lodge Care Home 1a Moorside Place Off Leeds Road Thornbury Bradford BD3 8DR Lead Inspector Pamela Cunningham Key Unannounced Inspection 31 January 2008 10:30 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 Mill Lodge Care Home DS0000070555.V360135.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. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mill Lodge Care Home Address 1a Moorside Place Off Leeds Road Thornbury Bradford BD3 8DR 01274 668 874 01274 664 041 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) Southern Cross OPCO Ltd Miss Lynn Priest Care Home 42 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (42), of places Physical disability (42) Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following category of service only: Care Home with Nursing - Code N 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, maximum number of places 42 Physical Disability, Code PD, maximum number of places 42 2. Dementia, Code DE, maximum number of places 3 The maximum number of service users who can be accommodated is: 42 20th July 2006 Date of last inspection Brief Description of the Service: Mill Lodge Care Centre is a registered facility providing for 42 places in single room accommodation. The house is situated on the Leeds Road approximately 3 miles from Bradford City Centre and 10 miles from central Leeds. The home is registered to provide personal care and nursing to individuals over the age of sixty five. There are a limited number of places available for younger adults. The home has level access and a passenger lift is fitted to ease access to the first floor. All of the single bedrooms are equipped with en-suite toilets. There are a variety of bathrooms and communal disabled toilets as well as a kitchen area that can be used by service users and their visitors. There are a number of communal lounges and dining rooms. The home is situated within a busy community that is well serviced by local shops; post office and so on and bus routes to Leeds and Bradford are close by. Parking is provided within the grounds. At the time of writing the report, the fees charged for care provided are between £315 and £586.44 per week. Mill Lodge Care Home DS0000070555.V360135.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. One visit was made on 31st January 2008. The home did not know that this was going to happen. Feedback was given to the manager during and at the end of the visit. The purpose of the visit was to make sure the home was being managed for the benefit and well being of the residents. Before visiting the home the inspector asked for information from the manager (the Annual Quality Assurance Assessment - AQAA) which asks about what policies and procedures are in place and when they were last reviewed, when maintenance and safety checks were carried, staff details and training provided. Comment cards were sent to the home to be given to residents, their relatives and other visitors to find out what their views of the home were. These arrived on the day of the visit, and at the time of writing the report none had been returned. However there was plenty of opportunity to gain the views of the residents during the visit, and the view of the community Matron who was present sat the time of the visit. She said the home works very well with her, and they are particularly good at recognising illnesses such as chest infections and urinary tract infections. They are also very good at chronic disease management. She said ‘the nurses really do care.’ The Community Matron is also involved with the auditing of falls as part of her involvement with local GPs In order to find out how well staff knew residents, care plans were looked at during the visit and residents, visitors and staff were spoken to. Other records in the home were looked at such as staff files, training records and complaints received. What the service does well: This is a well-managed service, which is run in the best interests of the people who receive a service, and they are treated with respect and dignity. The atmosphere in the home is warm and friendly with cheerful and relaxed staff who are focussed on meeting the needs of the people who live there. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 6 People are fully assessed prior to admission to Mill Lodge and confirmation is given that the home can meet their needs. Care plans are clearly set out and detail the care to be delivered with evidence of either resident or relative involvement. Daily records give a good account of how people have spent their day and what care and support have been given. Meals are of a good standard and were spoken about favourably by some of the people who live at the home. Activities are inventive, person focussed and provided to meet the needs of the residents. Staffing levels are provided to meet the needs of the people who live there, and the recruitment process adopted by the home makes sure the people who live there are protected. There is an open, inclusive atmosphere where complaints are dealt with appropriately and treated as a learning opportunity. Medication policies and procedures protect the people living at the home. What has improved since the last inspection? What they could do better: All problems identified in the pre admission process need to be carried forward to the care planning, and the pre admission assessment of needs to be kept with the care documentation. In order to help make the planning of care more person centred, details of past life and hobbies of the people who live there should be better identified so that activities can be person led, instead of being provided for everyone’s benefit. Medicines arriving at the home outside of the monthly ordering cycle, (such as antibiotics) should be accounted for and amounts entered onto the medicine charts to provide a robust audit trail. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 7 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. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 8 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 Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good information about the home and services provided to make an informed decision about whether the home is right for them. EVIDENCE: The statement of purpose and service user guide, which was changed to reflect the changes in the provision of care, identified at the last inspection remains under review. It has also been amended to reflect the recent change in ownership. People who want to come and live at the home and their relatives are provided with enough information about the home and services provided. This is all included within the service user guide, which is available in each bedroom. The manager said the potential residents are also asked ‘what they expect’ Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 10 during the assessment prior to admission. This makes sure that individual’s expectations can be met. Before a person is admitted to Mill Lodge, a senior member of staff who had had appropriate training does an assessment of needs. The home’s manager obtains a care management/social work assessment when this is available. Two people recently admitted to the home said they remember the manager coming to speak to them at home. Contracts of residency are provided for each person, which clearly states what has to be paid for that it not covered by the fees, such as private chiropody. Residents and their relatives have enough information about the home to decide if it will meet their needs. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 11 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 good. This judgement has been made using available evidence including a visit to this service. The people who receive a service have their health and personal care needs are met and their privacy respected, but this is not always evidence in the care plans. EVIDENCE: The manager has been at the home since the home was first registered, and has worked hard to make sure the standard of care provided is reflected in the care planning and assessment of needs. The heath care assessments and care plans have much strength and give good detail about the care needs and how they are responded to. Service user involvement is identified, and people spoken to said they have been involved in the planning of their care from the day they were admitted to Mill Lodge. However this is not always documented. People who decide to live at Mill Lodge are talked through the assessment with their key worker soon after admission, and this is ongoing in the care plans Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 12 seen. If any individual does not have the capacity to understand what care they need or can expect, the staff consult with relatives, friends and other health professionals to make that the service user plan has the input from others. Pre admission assessments in three of the care plans seen were very detailed, and the plans of care included risk assessments where a risk to the person was identified. Care plans were appropriate to the care needs identified on admission. The daily information records seen recorded a substantial record of the care provided on a day-to-day basis. They were detailed, legible and well written. However the fourth set of care plan documentation looked at did not have any information about a pre admission assessment of needs, nor was there any social profile or record of personal belongings. The inclusion of social profiles would help to make the care plans more person centred. Care plans were however well written and informative and made particular reference to the type of pressure relieving mattress the person receiving the care needed and what pressure it was to be set at. This is good practice. All care documentation seen contained a night care plan, which gave information about the care the person should be receiving during the night. All care plans were reviewed monthly, or when a change in the person’s condition required it to be altered to reflect the change. There are appropriate policies in place in respect of the receipt, storage and administration of medicines. Individuals are able to self-administer their own medication and each service user is assessed in this respect. Individuals are given a choice to administer their own or have staff assist with medication. Each bedroom has secure storage for medication. The medication system was reviewed. All people who receive a service receive their own medication from a monitored dosage type system, which is prepared by the homes pharmacist, heat-sealed and tamper evident. People are identified on the medication administration record sheets by photograph. There is a list of current medications such as liquids or large boxes that cannot be put into the blistered. Allergies are clearly identified. Apart from one medication that had arrived out of the normal monthly ordering cycle not being accounted for on the MAR chart of one person, the system in use is safe. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 13 The manager said the training in the monitored dosage system had been provided by the pharmacy, and she had asked them to do an audit as part of the service they provide. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 14 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): All standards were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who live at Mill Lodge are offered an excellent range of social activities, they are helped to exercise choice and control over their daily lives and to maintain contact with family and friends. EVIDENCE: It was clear from speaking to some of the people who live at the home; they enjoy the entertainment provided by the organiser who clearly enjoys his job. He has been employed at the home in this capacity for nineteen months, and has done some training with Age Concerns for activities in the elderly. On speaking to him at some length, he told me that he makes a point of introducing himself to any new residents to get information about their past lives, and what activities they would like to be involved in and respects their wishes if they do not want to be involved in anything he organises. He also told me he spends quality time with those people who are bed bound, or who spend their days in their private accommodation. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 15 He also attends at breakfast time and helps with feeding those people who need assistance, and has had some training in feeding residents. He places great emphasis on making sure there are plenty of activities for all the people who live at Mill Lodge, and that they are what they want to be involved in. On the day of the visit was engaging them in a game of ‘who wants to be a millionaire’, which some of them said they always looked forward to. There is a very varied programme of activities provided some of which include reminiscence sessions, Karaoke, ten pin bowling, theatre trips, day trips, barbecues in good weather, and brick a brack sales for fund raising purposes. He also invites people from the sheltered housing association, and some of the people who live at Mill Lodger have form relationships with them. Residents told me they had been to the pantomime and the week before Christmas they had been involved in baking Christmas cakes. I visited the kitchen, which was exceptionally clean. I spoke to the cook who told me she has an NVQ 3 in catering and hospitality, and has received training in healthy eating and nutrition, and was certainly able to give a good response when asked about enriching foods. She showed me the records she keeps and these were all in order. Menus seen were very substantial, with evidence of a like hot alternative at the main meal of the day except Sunday, and fresh fruit platter offered as a snack in between lunch and tea. People spoken to who live at Mill Lodge said the meals were very good and just like home cooked meals, and confirmed there was a choice if they did not like what was the main choice. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 16 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel safe and can be confident any complaints will be taken seriously. EVIDENCE: The complaint procedure is prominently displayed in the home, is clear and easy to follow. There have been two complaints since the last inspection. One was about a staff member, and the other was about a heating problem. Both are documented in the homes records and were dealt with immediately and appropriately by the manager. All complaints are responded to in writing by the manager within 14 days of the complaint being made. There has been one Adult Protection issue, which was dealt with by the Bradford adult protection team and was not upheld. The training matrix produced for the purpose of the inspection identified 30 of the staff working at the home have received training in safeguarding adults between 1/11/07 and 25/01/08. Training files seen confirmed this. Care staff spoken to said that they would alert the manager in case of abuse taking place or if they suspected any was taking place Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 17 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, 22, 23, 25 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people who live in the home benefit from a well-maintained environment that offers appropriate space and facilities for those with a disability. EVIDENCE: Mill Lodge Care Centre is situated on the busy junction of Leeds Road and Killinghall Road. This results in the areas near the garden experiencing noise from passing traffic, but makes it easily accessible by public transport and car. Garden furniture including umbrella’s are available. The grounds are accessible and well maintained. There is adequate parking within the grounds. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 18 Contracts are in place for qualified engineers to regularly service and maintain equipment. Additionally a full time handy person is employed to undertake ongoing maintenance work. People spoke to at the time of the visit said the home was beautifully decorated and very spacious. They also said it did not smell. Rooms are provided with standard furniture, including one chair, wardrobe, single size bed, chest of drawers, lockable cupboard, occasional table and TV. There is main lighting and a bedside lamp. All bedrooms and en-suits are fitted with a call system. People who receive a service are also encouraged to bring small items of furniture and wall decorations with them the make their rooms theirs. Individuals are able to control the temperature in their own rooms. Appropriate thermostats are fitted that meet the needs of the service users. Ventilation is ensured and the air quality is fresh. There are sufficient bathrooms and showers all with equipment to suit the needs of the people who live there. The laundry in the home is well equipped and washing machines comply with hygiene standards. The laundry provides sufficient equipment and is organised in a way that ensures the control of infection. Staff are provided with anti bacterial soaps and paper towels to enable good hand washing. No decanting of laundering products take place, therefore there is no need for protective eyewear to be used whilst working in the laundry. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 19 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): All standards were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are competent and trained to do their job. People who live at the home are protected by the homes recruitment practices. EVIDENCE: Two weeks duty rotas were provided during the inspection. These showed that there was enough staff on duty to meet the needs of residents, and many of the staff having worked at the home since 2003/4. Information from residents and their relatives confirmed this. During the visit there were enough staff on duty to meet the needs of residents, call bells were answered promptly and there was a calm and homely atmosphere. From talking to the manager and staff it was clear that staff are encouraged to attend training sessions and events, and staff spoken to confirmed this. The AQAA said that there are now over 50 of care staff with NVQ level 2 training and that formal supervision now includes the ancillary staff. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 20 The AQAA also said recruitment procedures were robust. This was confirmed by the three sets of recruitment documentation reviewed at the time of the visit. These also confirmed proof of eligibility for one person to work in the UK, Statement of entry onto the professional register for qualified nurses and interview notes. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 21 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, 32, 33, 34, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed and run in the best interests of the people who live there. EVIDENCE: The manager is very competent and experienced registered nurse, has been managing the home since it was first registered, and has successfully completed the registration process with the CSCI. She has successfully completed the registered managers award, which is equivalent to NVQ level 4. People who receive a service, their visitors and staff said that she is open, approachable and supportive. Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 22 The manager said that residents and their relatives meetings are held regularly and are quite well attended. Surveys are sent out annually and information from these said that they thought the home was well managed, well run, very clean and did not smell. Staff meetings are also held to discuss any issues, training and to introduce new staff to the team. Staff said these were helpful and that the manager was accessible and supportive. Policies and procedures in place revised and updated by the organisation as needed and when laws change. Copies are kept in managers office and nurses stations and easily accessible to staff. Information from the AQAA showed that safety and maintenance checks of equipment and installations in the home were carried out and were up to date. Records of checks made on fire safety systems and equipment were up to date. Residents or their relatives deal with financial matters. The home will keep small amounts of money in safekeeping for residents and records of all monies received and returned are kept. Health and Safety is well addressed with all records seen. These are audited by the manager every twelve months. Accident records were reviewed and these were appropriate, however the ability to record information is limited by lack of space to document issues. These are audited quarterly by the operations director in order to identify and trends. The Community Matron is also involved with the auditing of falls as part of her involvement with local GPs. The Community Matron was present on the premises on the day of the visit and said the home works very well with her, and they are particularly good at recognising illnesses such as chest infections and urinary tract infections. They are also very good at chronic disease management. She said ‘the nurses really do care.’ Mill Lodge Care Home DS0000070555.V360135.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 x x 3 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 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x 4 4 x 4 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 x 3 Mill Lodge Care Home DS0000070555.V360135.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. 2. 3. 4. Refer to Standard OP3 OP7 OP9 Good Practice Recommendations It is recommended all pre admission assessment information is made easily available within the care plan documentation It is recommended all needs identified as a result of pre admission assessments are carried forward to the care plan documentation. Provide a better audit trail of medicines arriving at the home outside of the normal monthly cycle by recording the amount of tablets received. In order to be able to recognise the needs and preferences of the people who live at Mill Lodge, that details of past lives pastimes and hobbies are included in more detail in the care plans. OP12 Mill Lodge Care Home DS0000070555.V360135.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mill Lodge Care Home DS0000070555.V360135.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. 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