Inspection on 27/04/07 for Oakdene Nursing Home Limited

This inspection was carried out on 27th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Oakdene Nursing Home Limited 09/04/08

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Oakdene Nursing Home Limited 32-34 Stamford Road Lees Oldham Lancashire OL4 3LH Lead Inspector Sandra Buckley Unannounced Inspection 24th April 2007 09:30 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 Oakdene Nursing Home Limited DS0000068691.V333084.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. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakdene Nursing Home Limited Address 32-34 Stamford Road Lees Oldham Lancashire OL4 3LH 01248 450791 0161 633 0904 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) Regency Homes Limited Mrs Susan Theresa Hopkinson Care Home 37 Category(ies) of Dementia - over 65 years of age (9), Old age, registration, with number not falling within any other category (37) of places Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 37 service users to include: *Up to 37 service users in the category of OP (Old age not falling within any other category); *Up to 9 service users in the category of DE (E) (Dementia over 65 years of age) First Inspection under new owners and management. Date of last inspection Brief Description of the Service: Oakdene is a detached Victorian house situated close to Lees village, close to amenities and public transport. The home is registered to provide nursing and residential care for up to 37 service users. Accommodation is provided in 15 single rooms, six of which have en-suite facilities. There are 11-shared rooms, two of which have ensuite facilities. At the time of this inspection four of the shared rooms had been allocated as single accommodation. Three of the shared rooms and three of the single rooms are below the National Minimum Standards in respect of size. The home provides adequate toilets and bathrooms, situated close to bedrooms and communal areas. The ranges of fees charged are £449 to £583. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place on 24th April 2007, and was the first inspection of the home under new ownership and management. The home did not know we were going to visit. Regency Homes Ltd had purchased the home approximately 12 weeks before this inspection. The new manager is a qualified nurse with previous experience of managing a care home and is registered with the Commission for Social Care. On the inspection all communal areas were inspected, together with a selection of bedrooms. Interviews took place in private with seven people living in the home and two visiting relatives. Observations of working practices in the home were made throughout the day. A selection of records was examined, including care planning, medication, staff records and assessment procedures. The manager said the home is in a process of transition with the new owners and want to increase the involvement of the people who live in home and staff involvement. Policies, procedures and care planning were also being reviewed, with other plans to upgrade the environment. What the service does well: Staff training had been increased to include specific issues in health care needs, for example, Parkinson’s Disease and dealing with incontinence. The new manager had introduced a key worker system, giving staff accountability for record keeping and the personal needs of people who live there. Staff said any changes had been discussed with them and their views sought, leaving them feeling more involved. People who live in the home were enjoying a day of entertainment, including keep fit and arts and craft. Comments made at their interviews included, “I get very good care here. Staff treat me very well and do not make me feel embarrassed when attending to my personal care” and “I like to read and have a paper delivered. The mobile library comes and delivers large print books for us”. Another said “The change in management has not bothered me at all they are all very nice”. One relative said, “I visited the home and was given information on the service available. Unfortunately, there were no vacancies at this time, but people were so nice we were prepared to wait for a vacancy”. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 6 A senior person in Regency Homes Ltd has undertaken regular visits to discuss any issues or concerns with people who live in the home and their relatives. Food served is good quality and nicely presented, with a choice of hot meals at both lunch and dinner. Routines in the home have changed to give more flexibility. What has improved since the last inspection? What they could do better: Although outcomes for people who live in the home remained positive, the transition has not gone without problems. The inspector was satisfied the manager had the skills and knowledge to address issues which they had already recognised. However, the home must ensure people’s assessments address all their needs and that medication policies and procedures are adhered to. An emergency treatment policy must be developed to ensure people living in the home receive appropriate attention. Recruitment procedures need to be better for the protection of vulnerable adults. Staff training in recording factual non-judgmental information needs to be developed. Oakdene Nursing Home Limited DS0000068691.V333084.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. Oakdene Nursing Home Limited DS0000068691.V333084.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 Oakdene Nursing Home Limited DS0000068691.V333084.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): Standards 1, 2, 3. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People are encouraged to visit the home prior to their admission to assess its suitability to meet their needs. An assessment of a person’s needs is carried out before their admission, thereby ensuring that the home is confident they can meet those needs. EVIDENCE: The inspector spoke to one person in the home and their wife who said “I visited the home twice and was given information about the facilities available. Unfortunately there were no vacancies at this time but people were so nice we were prepared to wait”. People who had been newly admitted into the home had contracts of on their personal files. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 10 Four files were looked at in-depth, three of which were completed fully. On interviewing the people concerned it came to light that one person’s medical history had not been recorded in full, resulting in the lack of a care plan. The new manager said they were in the process of reviewing assessments completed by other senior staff to ensure this incident did not happen again. The home does not provide intermediate care. Oakdene Nursing Home Limited DS0000068691.V333084.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): Standards 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. In the main, arrangements in place provided for people to have their health and personal care needs met. EVIDENCE: Three care plans were looked at in depth, with an overview of three other care plans. Two care plans did not directly relate to assessment. For example, one assessment said congestive cardiac failure and Alzheimer’s disease. There was no care plan to say how these conditions present or signs and symptoms staff must be aware of. Wording in care planning was, at times, judgemental and did not directly relate to facts. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 12 There was evidence on file that professional visits like chiropody, audiology and GP visits being recorded. One relative said “Staff always send for the GP if my husband is not well’. People living in the home said “I am well looked after”, “I get very good care” and “Staff are very kind”. Comments were also made on the delivery of personal care; one person said “Staff treat me very nice so I am not embarrassed when they have to give me personal care”. The inspector noted that two people in the home had sustained accidents, details of which were recorded in the accident book and in case files. Unfortunately, both people had sustained head injuries. No emergency treatment policy was in place in order to provide details to staff in what situations medical help should be sought. Daily notes did not show any followup action. The inspector acknowledges that the new manager was on leave at the time of the incidents and was aware of changes that needed to be made. This had been placed on the agenda for the next staff meeting. Medication was seen to be stored appropriately and staff had undertaken training for the administration of medication. Medication systems had changed and a monitored dosage system introduced. Checks were made on all incoming prescriptions, which were then sent to the pharmacist and checked again on return. Examination of recorded sheets found that some medication had been hand written onto the sheet without being signed or dated, or dosages being recorded. In one instance, as and when required medication was being given on a regular basis. In this situation, medication should be reviewed. Gaps were also noted in recording when medication had been given. Two people were self-administrating medication; risk assessments were not in place. Medication was stored in their rooms. Examination of these showed that one lot of medication should have been stored in a fridge and another was out of date, which should have been removed for safety reasons. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 13 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, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. A range of activities was available for people to participate in if they wished. Meals were nutritious and balanced and offered a healthy and varied diet for people in the home. EVIDENCE: Social activities are displayed on the home’s notice board. The manager said that a newsletter had been published for information and it is hoped to publish this every three months. At the time of this inspection a pat dog was visiting the home, which the people really enjoyed. Tuesday is also keep-fit and arts and crafts day. One person showed the inspector their work, saying “I have made this card for my son and I really enjoyed it”. Another said “I like to read and have a newspaper delivered. The mobile library brings a range of large print books which is good”. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 14 All the people spoken to say the staff are good and nothing is too much trouble. One relative gave an example of having expressed concern over the lack of comfort and support her husband was receiving due to specific problems. A specialist chair was provided to give additional support and the relative said, “Nothing’s too much trouble for staff. They move the chair from the bedroom to the lounge on a daily basis”. The home had recently held a successful raffle for activities and trips out. One person said, “some people went out to the pub or for a meal, but I did not want to go; staff respect our choice”. Several people chose to stay in their rooms to take meals, which were served attractively on trays. Visitors are made welcome to the home with a hospitality tray being provided. Two religious denominations visit the home on a monthly basis to offer communion. People in the home discussed with the inspector routines throughout the day, “We can go to bed and get up when we want”. People said routines had been changed in the home under new management and that it was more flexible. One person said, “The change of management hasn’t effected me at all, they are all very nice”. Menus are planned on a four-weekly basis, which reflected a good choice in nutritional food. Hot food was available at both lunch and teatime. A choice of sandwiches was available for those not wishing a second hot meal. The inspector sampled the meal of the day, which was presented in an appetising manner and was tasty and nutritional. Everyone spoken with said how good the food was in the home. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 15 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, 17, 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People are confident that any complaints they may have will be dealt with appropriately. People are protected from abuse by the home’s policies and procedures. EVIDENCE: Oakdene has an appropriate complaints procedure made available to people on their admission to the home. This is included in the service user guide with a copy of the complaints procedure being displayed in the entrance hall of the home. One person and their relative said, “The home gave us information on how to make a complaint”. Another said, “If I did not like anything, I would report it”. The home maintains a log of complaints, concerns and compliments. There was one complaint logged which related to hygiene standards in one room only. The home had addressed this to the complainant’s satisfaction. The manager said voting cards had been received for the forthcoming local elections. The inspector spoke to three people who confirmed this but did not wish to participate in the electoral process. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 16 There had been one incident in the home which is being investigated under the protection of vulnerable adult procedures by the local authority adult protection team. The inspector was satisfied that the manager took appropriate action and followed procedures. Fourteen staff had undertaken protection of vulnerable adults training which was included in their NVQ training. The manager said that training had been applied for, for those staff who have not completed this training. Oakdene Nursing Home Limited DS0000068691.V333084.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): Standards 19 22, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service The home is appropriately maintained to provided a safe, clean and homely environment for people who live there. EVIDENCE: A tour of the building and grounds was undertaken. This included a selection of service users’ bedrooms. The new owners have completely refurbished two bedrooms and completely re-carpeted an additional two. New central heating boilers have been installed and there are plans to carry out further refurbishment of the upstairs lounge. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 18 People and their relatives who use this lounge were consulted and advised of the plans. This would mean that people would have to use both lounges downstairs for a short while. This had produced benefits of more integration of people living in the home and their involvement in daily life. The inspector noted that several people preferred to stay in their rooms, which were homely and personalised. One resident said, “I used to stay in my room all the time, but now I go down for dinner and I quite like it”. A few minor adjustments to the environment were needed, for example, one of the bathroom doors did not shut effectively. The manager was aware of this and said action would be taken. Although there are a high proportion of shared rooms, all these had privacy screens and were in close proximity to toilets and bathrooms. The home was clean and tidy throughout and provided a good hygiene standard. Oakdene Nursing Home Limited DS0000068691.V333084.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): Standards 27, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The recruitment procedure for new staff is not properly undertaken and potentially leaves people living at the home at risk from unsuitable staff having been recruited. EVIDENCE: Three newly recruited staff files were examined. The home had not undertaken all the necessary recruitment checks to ensure the protection of the people living in the home. Criminal Record Bureau Checks had been applied for but not returned. The manager said the staff were not working alone or without supervision. Staff are not allowed to work in the home without a POVA First check in place or a full CRB. In one instance, there was only one reference sent for, with another poor reference not being explored. The manager said this was discussed at interview. Unfortunately, nothing had been recorded. The inspector acknowledges the manager contacted the CRB to request POVA checks at the time of inspection. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 20 The manager had assessed the training needs of the staff and was in the process of organising training events. Interviews with staff provided evidence that training in Parkinson’s disease and management of incontinence had taken place. Fifty percent of staff had achieved NVQ level 2. Moving and handling training was being updated with half the staff in the home having received refresher courses. People interviewed in the home all said staff were caring and attentive. Comments made included, “It is very good care here”, “Staff are kind and helpful”, and “I am well looked after here”. The new manager had introduced a key worker system, which the staff felt had a positive impact on the roles and provided more accountability. Staff said they had been concerned originally with the change of ownership and management. However, they felt supported and consulted on the positive changes that had been made. Oakdene Nursing Home Limited DS0000068691.V333084.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): Standards 31, 32, 35, 36, 37, 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The manager is appropriately qualified and experienced to run a care home. Relatives, staff and people living in the home are consulted on developments, so increasing their involvement in decision-making. EVIDENCE: Regency Homes Limited is the new owner of Oakdene. The new manager had been in post approximately 12 weeks at the time of inspection. The registered manager is a qualified nurse with previous experience of managing a care home. She has commenced the registered manager’s award as part of her ongoing training and development. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 22 Discussions with the new manager highlighted her awareness of things that needed to be addressed in the home. The inspector was satisfied that systems were being developed to ensure consistent approach to care delivery would be implemented. These included regular care staff and nursing staff meetings and the introduction of a keyworker system to promote accountability. Staff meeting minutes stated routines were to be more flexible, especially promoting people’s choices on when they were to get up in the morning. The manager had already commenced reviewing the policies and procedures. A meeting had taken place with people who live in the home when the new owners took over and they had planned these meetings to be held on a regular basis. The owners make regular visits to the home to talk to people and relatives who had initial fears and were unaware of developments. There was written evidence of visits to the home that showed interviews with staff, relatives and people living in the home. One relative had initially discussed their concerns, feeling that there may be a period of instability. The owners followed this up after a few weeks and the relative had said they felt changes had been made for the better and their mother’s care was excellent. They also felt that the key worker system had improved communications between staff and relatives. There was documented evidence that staff received regular supervision, which was confirmed during their interviews. No finance was held on behalf of people in the home. Each person has an individual account with the home submitting invoices to families or people’s representatives to pay for chiropody or hairdressing or personal items. As stated previously in this report, irregularities in recording systems need to be addressed and staff awareness needs to be raised in completing daily notes in a non-judgemental manner. Checks on equipment in the home had been completed and fire alarm tests were conducted on a regular basis. First aid and health and safety training for staff were being arranged at the time of inspection. Oakdene Nursing Home Limited DS0000068691.V333084.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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 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 3 X 3 3 3 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 3 2 3 Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 13 Requirement Care plans must reflect people’s assessments and provide sufficient detail to staff in which to carry out their care duties. Emergency policies and procedures must be developed which include in what circumstances people must receive medical treatment. Risk assessments must be completed for those people who self-medicate. All medication administered must be recorded. A POVA First and a Criminal Record Bureau Check must be obtained for new staff prior to working in the home. Two references must be applied for and references must be explored. Timescale for action 31/05/07 2 OP8 13 31/05/07 3 OP9 13 31/05/07 4 OP29 19 31/05/07 Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 25 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 5 Refer to Standard OP3 OP8 OP9 OP9 OP37 Good Practice Recommendations The manager should ensure that the assessment of need for anyone entering the home reflects all the physical and emotional needs of people entering the home. Record keeping must reflect the ongoing progress of people who have sustained an injury through an accident. Medication reviews should take place for those people who regularly receive medication, which is prescribed when necessary. Out of date medication should be returned to the pharmacy. A review of record keeping must be undertaken ensuring policies and procedures are up to date. Daily notes of care delivery must be completed in a non-judgemental way. Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Greater Manchester Local Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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 Oakdene Nursing Home Limited DS0000068691.V333084.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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