CARE HOMES FOR OLDER PEOPLE
Offington Park Care Home 145 Offington Drive Worthing West Sussex BN14 9PU Lead Inspector
Mrs J Farrell Unannounced Inspection 2nd February 2006 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 Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 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. Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Offington Park Care Home Address 145 Offington Drive Worthing West Sussex BN14 9PU 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) 01903 260202 offingtonpark@btinternet.com Claremont Care Service Limited ** Post Vacant *** Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 30th November 2005 Brief Description of the Service: The property is a detached three-storey building situated in a residential road on the outskirts of Worthing, a West Sussex seaside town with shops, train stations and other amenities. Accommodation is provided in twenty-two single and one double room. However the double room is used for single occupancy unless there is a specific request for it as a double. The rooms are arranged on ground and first floors only and thirteen have en-suite facilities. There is a passenger lift. Communal rooms including a large conservatory are on the ground floor. The home has pleasant gardens with a decking area to the rear of the home, all of which are accessible to residents. Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 1 day in February 2006. This is the second statutory inspection of this year. The purpose of this inspection was to assess compliance with the requirements of the last inspection and to generally monitor care practices. This report must be seen in light of the previous inspection report, which was carried out in November 2005.The Inspector would like to acknowledge the hard work undertaken by the manager who has been in post since October 2005. It was noted that care staff are committed to the residents well being and good interaction and support was observed. There was evidence that requirements from the last inspection have not been complied with and at the time of this inspection there were serious concerns regarding health and safety, mandatory training, supervision of staff. There were 19 residents living at the home. Residents, staff and relatives were interviewed and their views and comments have been taken into account when reporting on the conduct of the home. The Inspectors would like to thank the management, staff and service users for their hospitality and cooperation throughout the inspection. What the service does well: What has improved since the last inspection?
Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 6 The assessment process has improved which means residents who cannot be looked after safely or who do not fall within the homes registration will no longer be admitted. Care plans are now developing into workable documents that provide meaningful support plans. However care planning needs to provide evidence that the resident has been consulted about its content where possible. The homes’ understanding of and response to incidents has improved considerably. Both management and staff now demonstrate a reflective approach to dealing with incidents that occur in the home and discuss with other professionals the action needed to prevent future occurrences. The home is making progress in achieving 50 of care staff holding the required NVQ in care. Feedback from one relative included the comment that they had noticed a lot of improvements at the home over the last few months. What they could do better:
The majority of the requirements made at this inspection have previously been raised as areas for improvement at Offington Park and concern at the level of documentation and recording in the home. The danger of not maintaining accurate records is always that people may not provide safe and consistent care and that changes in needs cannot be tracked. As identified, the level of supervision of care staff needs to be drastically improved to ensure their safety and to protect the rights of the people living at the home. Induction and foundation training for care staff should follow the TOPSS specifications. All staff must have training in how to protect vulnerable adults. Similarly, the documentation given to residents prior to admission needs to be updated to provide prospective residents with clear and correct information about the services offered at Offington Park Home. At the present time, some activities occur on an ad hoc basis, residents and relatives at the home told the Inspector that a plan of regular activities would be better. The way risk assessments are recorded should be reviewed to cover all potentially risky activities and to more comprehensively detail how the controls in place manage the risk. Policies and procedures need to be reviewed to reflect current good practices. Enable the manager’s hours to be supernumerary to the rota hours to enable her to fully manage the home, supervise the staff team and undertake the many responsibilities she will have if she becomes registered. Regulate the hot water at all outlets used by residents to prevent scalding from excessively hot water. Provide evidence that water is stored and distributed at correct temperatures to prevent risks from Legionella. Some other maintenance issues were identified throughout the inspection process and these should be addressed as not only do they impact on the appeal of the home, but some are also matters of health and safety.
Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 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. Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 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 Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6 The documentation available does not provide prospective residents’ with the information they need to make a choice about whether to live at Offington Park. The home is able to demonstrate that residents’ needs will be met prior to admission. Arrangements are in place to ensure that the health care needs of residents are identified and recorded. EVIDENCE: The Statement of Purpose and a Service User guide were seen and both documents need to be reviewed and changed to accurately reflect what the home can offer and both documents need to be available to all residents. A copy of the terms and conditions (contract) was seen and residents and relatives said that it was clear and that they understood what was in it. It does require one small amendment to meet the regulations. This is that a room number needs to appear on the contract. Four pre admission assessment documents were looked at and they clearly showed that the admission procedure was thorough and well recorded. This procedure ensures that new residents needs are properly assessed and planned for. Six residents spoken to were able to provide significant
Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 10 information about their care needs, these had all been recorded. The staff members on duty were aware of the assessments and were able to fully undertake the care needs. Staff are looking forward to the dementia training they are to receive later this month. In discussion with the manager and documental evidence no person is admitted to the home without a full assessment. In the event of an emergency the manager still goes to see a possible resident and produces a written assessment before a potential resident is admitted. There was evidence to demonstrate that residents are offered a trial period at the home, before a placement becomes permanent. This should be followed up by the home informing residents in writing that they are able to meet their needs at the end of the trial period. Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Staff practice reflects a good understanding of residents’ healthcare needs. The documentation in place does not fully reflect the high level of care provided. Aspects of medication handling including preparing several residents’ medicines at the same time, potentially put residents at risk. EVIDENCE: A sample of care plans were viewed and significant improvement has been made in this area. However, it was noted that the positive outcomes observed for residents at this time are still dependent upon staff knowledge and memories, rather than full and detailed recording systems. This should include how staff can support the resident’s wishes and their relatives in the event of the resident reaching the end stage of life. One member of staff in particular, has invested a lot of time reviewing and updating care plans. She acknowledges there is still work to be done and indeed it is required that all care plans provide a comprehensive plan of how residents should be supported. There was evidence that care plans are starting to be reviewed. However residents are not being included into this process. It was possible to audit how
Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 12 advice from a range of healthcare professionals had been incorporated into care notes. Risk assessments are currently inadequate. It is required that where risks are identified, they are followed through with an assessment of the controls in place to minimise those risks. This is particularly important in respect of the resident who was found smoking in his bedroom on the day of inspection. Staff said that medicines were prepared for several residents at a time and recorded on the medicine chart, before starting administration. Following a training session by the supplying pharmacist some changes had been made but there were difficulties. The list of staff authorised to administer medicines was not up to date. The reasons for not administering medicines prescribed to be taken regularly were not recorded. For medicines prescribed with a variable dose, the actual dose administered was not recorded. Lockable medicines storage was clean and tidy. Two medicines, with manufacturer’s directions for cool storage, were not kept in a fridge. Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Residents are encouraged to live healthy and fulfilling lives, although there is a lack of planned activities. The home promotes positive relationships between service users and their relatives. Service users enjoy a range of appealing and nutritious meals. EVIDENCE: Conversations with residents highlighted that community presence and participation in social activities was varied across the home. Some residents are able to go out independently and do so frequently. For others, staff support is required and the frequency of their outings is dependent upon staff availability. Two residents informed the Inspector that an activity programme ‘is sort of in place’ ‘but that care staff who are supposed to carry out activities in the afternoon often have to do other things’ There is a monthly music afternoon which residents really enjoy and a movement class every other week. It was evident from the comments received that residents would benefit from a more robust plan of activities – which would take place both inside and outside the home. Offington Park promotes an open door policy during the day. Residents spoke of visitors they had received and the home maintains a record of the contact each resident has with his or her relatives and friends.
Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 14 The lunchtime meal was taken with all of the residents and found to be appetising and well presented. Menus viewed were varied and service users spoke positively about the food they receive. One service user told the Inspector he regularly had his favourite meal cooked for him. Five residents spoken with said they had never heard any complaints about the food at Offington Park and that personal choices and preferences were always respected. This inspector noted that residents had not had a nutritional assessment and as the home at the time of inspection did not have a set of a working weighing scales it was impossible to tell if residents were gaining or losing weight. This needs to be incorporated into the care plan. Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17,18 The residents right to participate in the political process is upheld. EVIDENCE: Residents are encouraged to vote and postal votes are provided. All staff must have training in this important area of how to identify possible abuse and what to do about it. The staff interviewed were knowledgeable about the vulnerability of residents and the systems in place to protect them. Staff spoken with were less confident in describing the importance of the POVA (Protection of Vulnerable Adults) register introduced in July 2004. The registered manager confirmed that not all staff have had training in how to protect vulnerable adults. However she hopes that this will be addressed very shortly. Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,25,26 Residents live in a well maintained, clean and homely environment but there are some issues relating to safety which could put them at risk. EVIDENCE: The home was seen to be nicely decorated throughout and furnishings comfortable and suitable for the resident group. The communal areas which include a dining room, lounge and large conservatory are bright, cheerful and welcoming and the general feeling is one of homeliness. Resident’s rooms provide suitable storage space including lockable storage, which has been provided in response to previous recommendations made in reports. It was noted that residents had many of their own possessions in their rooms enhancing their homeliness. Radiators remain uncovered. When some of the radiators were tested by hand they felt hot to the touch. One resident spoken with stated that there have been problems with the boiler which either runs cold, as it was on the day of inspection or runs very hot. This resident warned the inspector to take care when testing the temperature of the radiator as she could ‘get a burn’. As there was a problem with the boiler on the day of inspection the inspector could not accurately test the temperature of the water
Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 17 running in the baths or hand basins. Staff and residents spoken with confirmed that at times the water in some parts of the home run at a very hot temperature. Hot water testing has taken place in the past but records could not be found for the last eight weeks. At the time of the inspection, all communal areas and the six bedrooms seen by the Inspector were found to be clean, tidy and well maintained. All residents spoken with confirmed that the home was always clean and free from odour. Residents commented that they were happy with their rooms and were able to bring with them (within reason) items from home. The staff interviewed stated that they take pride in maintaining a very clean environment and all were very clear regarding the issues of infection control. No evidence was available to show that testing has taken place to ensure that water is stored and distributed at the correct temperatures to prevent risks from Legionella. It was noted that several fire doors were being wedged open. The inspector at the last inspection noted that this was happening and made a requirement that advice should be sought from fire safety officers. An immediate requirement notice was left at the home on this occasion and this will be followed up with a serious concern letter. Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,30 The home has not reached the target of a minimum ratio of 50 achieving an NVQ in care or equivalent by 2005. The home needs to fulfil its requirement to ensure that all new staff receive induction and foundation training to the Skill for Care standards as if this is not done it may effect the quality of care received by the residents. EVIDENCE: Working within the home there are twenty-one caring staff. At present there are three care staff with NVQ level 3 or level 2 in care there are also 12 care staff currently undertaking an NVQ level 2 in care. The manager is hopeful that staff will complete these qualifications shortly. The manager confirmed that the home is not currently using a Skill for care specification induction programme. This is for the induction or foundation levels. She also confirmed that staff are not receiving a minimum of three paid days training per year. Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36,37,38 Residents 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 responsibilities fully. Training staff who undertake supervision of junior staff could improve practice and potentially reduce risks to the residents. Staff must have regular mandatory training to safeguard residents and themselves. EVIDENCE: A sample of records pertaining to residents’ finances and other issues were viewed and found to be satisfactorily maintained. The home undertook an audit last year, but did not include outside professionals. This produced an action plan, which identified that residents would like to have more activities. The process will be ongoing. Residents spoken with confirmed that they were not asked their opinion about the running of the home.
Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 20 Staff are monitored during induction. A formal supervision programme has started this was confirmed by staff and records maintained. There was some evidence to show that it is occurring six times a year. It was also discussed with the manager that staff undertaking supervision should be trained to carry out this task. Records are maintained and kept safe in a locked area. Residents do have access if they wish to access any records. Residents interviewed had not requested to see any records but felt that if they wanted to they could. Both inspectors viewed the policies and procedures of the home and found them not to reflect the workings of the home or in some cases highlighting out-of date practice this was particularly noted in the case of what to do regarding abuse and medication. All policies and procedures must be reviewed annually. The inspector advised that when this happens the policy should be dated and signed by the reviewer. Throughout the inspection, a number issues in relation to fire safety were identified. These included a requirement outstanding from the last inspection. Fire doors were noted to be wedged open. If a fire door has to be held open for any reason such as meeting a resident’s particular need, it must be fitted with an approved means of doing so after consultation with the fire officer. When fire doors are wedged open all persons in the home are put at risk. Staff had received fire safety training in November 2005. No evidence was available to show that testing has taken place to ensure that water is stored and distributed at the correct temperatures to prevent risks from Legionella. As previously mentioned there are no regulators to control the temperature of hot water at the point of delivery. Risk assessments for all safe working practice topics have not been carried out. Accidents and injuries were seen to be recorded appropriately and notified to the Commission and RIDDOR as necessary. The home has employed a manager and the Commission has received her application to become the Registered Manager. Staff were very positive about the working environment and made very positive statement about the new manager. They felt confident in her abilities to move the home forward. They were very enthusiastic about her new ideas and the way she approached the problems the care staff were experiencing. They talked about meeting’s they had with the manager, which they felt benefited the resident. The manager was interviewed and described herself as part of the workforce and therefore had limited time to carry out any management tasks such as staff meetings, supervision and paper work. The manager was reminded that Reg 26 visits should be sent to the Commission monthly. Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 1 1 3 3 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 2 1 3 3 3 x 3 1 3 STAFFING Standard No Score 27 x 28 2 29 x 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 2 3 3 1 2 1 Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2OP1 Regulation 4(1-3) 1&5(1-2) Requirement That all the requirements of Standard 1 and Schedule 1 be included in the Statement of Purpose. That the Service Users Guide be amended to include all the requirements of Standard 1.2. These documents need to be forwarded to the Commission as soon as completed. The registered person confirms in writing to the resident that the home is able to meet his/her needs. Comprehensive risk assessments are carried out in respect of all areas of resident’s lives and the controls in place evaluated. That the home’s care planning system to effectively monitor resident’s health and welfare needs. This should include a nutritional assessment and what to do at the end stage of life That the home’s care planning system to effectively monitor resident’s health and welfare needs. This should include a nutritional assessment and what to do at the end stage of life
DS0000043533.V280998.R01.S.doc Timescale for action 01/04/06 2 OP5 14(d) 01/04/06 3 OP7 13(4) 01/04/06 4 OP8OP11 15(2) 01/04/06 5 OP7 15(2) 01/04/06 Offington Park Care Home Version 5.1 Page 23 6 OP9 13(2) 7 OP12 16(2)(m& n) 13(6) 13(4)(c) 8 9 OP18 OP38OP25 10 OP38OP19 23(4)(c)(i ) 11 OP37 26(2)(3)( 4)(5) 12 OP38 13(4) Preparation, administration of medicines and recording must be completed for a resident before this process is started for another resident. The Registered Person consult with residents and relatives about a fulfilling programme of activities. All staff must have training on how to protect vulnerable adults The registered person shall ensure that unnecessary risks to the health or safety of residents are identified and so far as possible eliminated. (Fit regulators to all hot water outlets in areas used by residents and cover radiators as necessary) (produce a Legionella. policy) The registered person shall after consultation with the fire officer make adequate arrangements for containing fires. (keep all fire doors closed unless fitted with approved devices)(This is an outstanding requirement from the last report) Where the home is an organisation or partnership, the care home shall be visited in accordance with this regulation and a report on the conduct of the home prepared. (copies of reports to be sent to the Commission)(outstanding from the last report) Environmental risk assessments must be carried out. 01/04/06 01/04/06 01/04/06 01/04/06 02/02/03 01/04/06 01/04/06 Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 24 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 OP2 OP9 OP9 OP9 Good Practice Recommendations The room number should appear written on the contract. Medicines should be stored according to the manufacturers instructions. The list of staff authorised as competent to administer medicines should be updated. Records should show the reason for non-administration of medicines prescribed to be taken regularly and the actual dose administered for medicines prescribed with a variable dose 50 of care staff should acquire an NVQ in care at level 2 or above or equivalent. All new staff should have induction and foundation training which meets the TOPSS specification and this should be achieved within the time framework set out in standard 30.There should also be three days of paid training provided per year. 5 6 OP28 OP30 Offington Park Care Home DS0000043533.V280998.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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