Inspection on 05/06/07 for Orchard Hill

This inspection was carried out on 5th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Orchard Hill 26/09/06

Orchard Hill 04/10/05

Orchard Hill 01/08/05

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Orchard Hill 100 Orchard Hill Little Billing Northampton Northants NN3 9AG Lead Inspector Stephanie Vaughan Key Unannounced Inspection 5th June 2007 08:00 Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 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 Orchard Hill DS0000063584.V337926.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 Adults 18-65. 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. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Hill Address 100 Orchard Hill Little Billing Northampton Northants NN3 9AG 01604 403602 01604 403602 manager.orchardhill@tracscare.co.uk suehullin@tracscare.co.uk Tracscare Group Ltd 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) Bridget Adeseko Care Home 4 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (4) of places Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No one falling within category MD, Mental Disorder should be admitted into Orchard Hill unless that person also falls within the category LD ie dual disability The maximum number of persons to be accommodated at Orchard Hill is 4 26th September 2006 Date of last inspection Brief Description of the Service: 100 Orchard Hill is a detached home which provides personal care and support to 4 service users who require care due to a Learning Disability, some of whom may have an additional Mental Health Disorder. This is one of five homes run by the providers Compass Care and benefits from the support of a wider organisation. The home is situated near to a large shopping centre and has good transport links to other areas of Northampton. The provider gives information to prospective residents in the Statement of Purpose, and Service Users Guide. Information about the content of the Commission for Social Care Inspection reports is provided to residents verbally. The current fees range form £ 1,600 - £2,000 per week with extra costs for personal items such as clothing. This information was supplied on the 5th June 2007. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to this statutory inspection, a period of three hours was spent in preparation. This comprised reviewing previous inspection reports and associated requirements and recommendations; the service history, risk assessment, returned residents comment cards and other documentation. Since the last inspection the Commission have received no complaints about the home. However has received one Safeguarding Adults referral, which is addressed in the main body of the report. The Commission have a focus on outcomes for residents against Key Minimum Standards and Equality and Diversity, issues relating to these are included in the main body of the report. This site visit to the home was conducted over a period of six and a half hours during which the inspector made observations and spoke to residents and staff. A limited tour of the premises was conducted which involved viewing the communal areas and a selection of the private accommodation. Case tracking is the method used during inspection where of a sample of two residents were selected and all aspects of their care and experiences reviewed, including individual plans of care and associated documentation. The Registered Manager was present during this visit and confirmed that the current fees range form £ 1,600 - £2,000 per week with extra costs for personal items such as clothing. What the service does well: The staff make sure that they have the right information about new residents and that they are able to look after them properly before they are admitted. They make sure that residents who might move into the home have the right information and the chance to spend time in the home, meet the residents and staff before deciding whether they would like to live there. Staff involve the residents in the care planning process and make sure that the residents needs, wishes and preferences are taken into account. The care plans set out in detail how the resident needs to be supported and cared for, for all aspects of their health, personal and social care. Residents are able to make choices about their daily lives such as how they spend their time, maintain their faith and culture. They are also involved in decisions about the running of the home such as menu planning and the staff who come to work there. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 6 Residents are supported to develop their skills and are able to attend college and go to work. Residents go out to the cinema pubs and restaurants and use the local churches and shops and are supported to keep in touch with the families and friends. Routines are planned around the resident’s wishes and activities and they are able to spend time relaxing at home. Staff treat residents well, respect their privacy and spend time with them going out for walks, chatting or playing games. Residents are supported to look after their health and are able to see the right specialists and have the right health checks. Staff make sure that the residents know how to express their concerns and make sure that these are taken seriously and put right. The home is comfortable clean and tidy. Residents have their own rooms and are able to have keys to their rooms. Residents are able to choose the way their room is decorated and furnished they also have their own things such as televisions and CD players. Staffing levels are good and the manager makes sure that the staff have the right checks before they start working in the home and staff have most of the right training to make sure that they are able to care for the residents properly. The manager has the right skills to manage the home. Arrangements are in place to make sure that the residents are asked about their views about the way that the home is run. The service conducts the right checks to make sure that things are done properly. What has improved since the last inspection? All residents are now consulted about their views about getting older and the arrangements that they would wish to be made in the event of their death. The lounge has been redecorated and new carpets and new furniture has been provided. The bathroom is currently being retiled and there are plans to fit a new kitchen. Resident’s bedrooms have been redecorated. The path surrounding the house has been repaired. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2&5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service receive clear information to enable them to make a choice about whether or not they might wish to live in the home EVIDENCE: There have been no admissions to Orchard Hill since the last inspection. Existing residents confirmed that they had access to the enough information about the home before they decided that they would like to move in. They also confirmed that they had opportunities to visit the home on different occasions and to spend time with the existing residents and staff to decide whether they could be happy there. The Registered Manager confirmed that prospective residents are assessed prior to moving into the home to ensure that the service is able to meet the needs of the residents and that they would be compatible with the existing residents. Admission procedures are in place to ensure new residents are supported to settle into the home smoothly. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 10 Individual plans of care evidenced that residents have access to a pictorial summary of the Service Users Guide, which informs residents how they can make a complaint, and there are copies of contracts, which contain the recommended information and are signed by residents. Copies of assessments are obtained from appropriate agencies before admission and at appropriate times thereafter and these inform the care planning process. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives and play an active role in the planning of the care and support that they receive which enhances their quality of life. EVIDENCE: Each resident has an individual plan of care, which is developed from the assessment information and with the resident’s involvement. Plans are regularly reviewed and set out in detail the individual personal; health and social care needs of the resident. Care plans are person centred and address the specialist requirements that residents may have and include detailed information and instruction to staff Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 12 about resident’s preferences, routines and the management of challenging behaviour. Any restrictions placed on residents are in their best interests and based on appropriate risk assessments in agreement with individuals. The service continues to work with the Speech and Language Therapy Service to develop information in suitable formats for residents with communication difficulties and this is currently being applied to the individual plans of care to support residents to understand their health care needs. All residents have an allocated key worker who is able to spend time with the individual residents and residents are supported to make choices about aspects of their lives, including decisions about the running of the home, their individual activities and personal development. Residents have access to advocacy services that provide independent support specific to their needs. There is evidence that the service aims to support residents from ethnic minorities to access specific support services and to maintain their chosen faith and culture. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have control over their lives to enable them to enjoy a lifestyle that promotes choice and maximises their independence. EVIDENCE: Residents confirmed that they are supported to develop their educational and occupational activities. Each resident has an individual activities programme, which sets out the weekly activities. These are developed with residents and are produced in appropriate formats to enable residents to know what is planned. There is evidence that residents have a range of activities including individual tuition and attendance at local colleges to develop skills relevant to their interest and needs. All residents have access to work experience placements and are supported to obtain further employment should they wish to do so. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 14 The individual plans of care demonstrate that in the main the equality and diversity needs of residents are addressed. Age, gender, disability and faith are well catered for, however there is little evidence that the sexuality of residents is taken into account. This was discussed with Registered Manager who has agreed to develop care plans and review policies to ensure that Equality and Diversity is comprehensively addressed. Residents access a range of community and leisure facilities such as the local gymnasium, library, pubs, restaurants, cinema, churches and shops. Residents confirmed that they are supported to maintain links with their families and friends and that their visitors are made welcome in the home. Routines are flexible, within the constraints of their planned activities. However there is evidence that residents are able to make decisions about their routines such as times of rising and retiring to bed and how to spend their free time. Residents were seen to be involved in activities throughout the day, such a board games, going shopping, out for walks, spending time in the garden and participating in domestic activities including access to the kitchen. Staff were seen to relate well to residents being respectful in their communication and spending time with residents. Residents are able to have a key to their bedrooms and individual plans of care demonstrate that resident’s consent is sought for staff to enter their rooms and provide support with personal care and household chores. Breakfast times were seen to be flexible and seen to comprise of fruit juice toast and cereal, a cooked breakfast is available on Sundays. Residents confirmed that they were able to regularly contribute to the menu planning process, that they had enough to eat and that they were happy with the standard of the meals. The lunch comprised toasted ham and cheese sandwiches with coleslaw and salad followed by yoghurt. Sample menus appear to offer a slightly limited range of food which also appears be slightly high in carbohydrates, which may have implications for residents prone to weight gain and diabetes. This was discussed with the Registered Manager who confirmed that menus had been developed with support form the dietician, however residents had specifically requested specific items to be placed on the menu. The Registered Manager confirmed that the money spent on food had recently been increased and agreed to further review the menus with residents and the dietician. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, 20 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have a detailed plan of care, which indicates that they are treated as individuals and that their health care needs are fully met. EVIDENCE: Individual plans of care contained detailed instruction to staff about resident’s personal and health care needs and daily and other specific records demonstrate that care is delivered as specified. Residents are supported to maintain their independence and have prompts in appropriate formats to remind them of their personal care routines. Residents appeared well presented and confirmed that they were able to make decisions about their clothing and personal appearance. Staff are respectful of the residents privacy and dignity with personal care being provided in private. The Registered Manager is mindful of the need to Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 16 maintain an appropriate mix of staff that reflects the gender age and culture of the residents. Residents have access to a good range of external health specialists including consultant specialists, general practitioners, dentists, podiatrists, dieticians, physiotherapists, occupation therapists and speech and language therapists. Residents have access to a range of aids and adaptations to support them in their daily lives. Residents have access to regular health checks and screening programmes. Medication systems were reviewed and seen to be generally in good order. Individual plans of care evidenced that resident’s consent is obtained for staff to administer medication to residents and residents are assessed to see if they are able to administer their own medication. The ordering and storage of medication was satisfactory. Medication Administration Records were in good order and in general the remaining stock was found to correspond with the records. However there were some examples where a clear audit trail could not be identified between the amounts prescribed, amount administered and the amount remaining. Since the last inspection all residents have now had plans of care, which take into account their views about aging and death. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive procedure for handling complaints and abuse is in place, ensuring residents are protected. EVIDENCE: There is an appropriate complaints procedure, which is available to residents and their representatives in varied formats. Residents’ confirmed that they knew how to complain and that they would feel able to raise concerns with staff if they were unhappy with confidence that the appropriate action would be taken. There has been one allegation made about this service since the last inspection. Appropriate referrals have been made in line with Local Authority Guidelines for the Safeguarding of Adults. A full internal investigation has been conducted and although the initial allegation was not upheld the investigation highlighted some areas for improvement and these have now been addressed by the senior management team. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment is good providing residents with a safe and comfortable place to live. EVIDENCE: The standard of the environment is good; the premises provide residents with a pleasant, comfortable and safe place to live that is close to local amenities. The communal areas are spacious and have recently been redecorated and refurbished with new carpets and furniture. The bathroom is currently being refurbished and arrangements are being made to refit the kitchen in the near future. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 19 Each resident has their own room with a washbasin and appropriate fixtures and fittings. The bedrooms have recently been redecorated and residents confirmed that they had been involved in the selection of the colour and furnishings. Rooms are personalised with resident’s own property and are fitted with privacy locks. The home was clean and hygienic throughout. Following a requirement made at the last inspection repairs have been made to the pathway surrounding the exterior of the building. Residents confirmed satisfaction with the environment and that it was always clean and hygienic. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels and recruitment are generally managed well however the shortfalls identified in staff training has the potential to adversely affect the care delivered to residents EVIDENCE: The staffing levels are consistent with the needs of residents and are maintained at three carers during the day and one waking staff at night. These levels ensure that residents are able to attend their activities with staff support and receive appropriate levels of supervision. Staffing levels are additional to the hours worked by the Registered Manager. Staff files are in good order and evidence robust recruitment procedures including appropriate Criminal Records Bureau Clearances, references, contracts, probationary periods and staff supervision. There was evidence that residents are involved in the staff selection process. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 21 Staff training records evidenced access to appropriate Induction and other mandatory training such as Fire Safety, Basic Food Hygiene, First Aid, Safe Administration of Medication, Health and Safety and Infection Control. However there was no evidence that any staff had received training in Movement and Handling. There was some evidence that staff have training specific to the needs of the residents in that staff are trained to manage challenging behaviour, however there was no evidence that staff have training specific to the individual conditions of residents. In addition staff spoken to during the inspection were unclear about some aspects of the management of Safeguarding Adults incidents and the training records identified that although some staff had received this training that this was not consistent even though some of these staff are currently in charge of shifts. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in an organised manner, which promotes the health and safety of residents. EVIDENCE: The Registered Manager is qualified and competent to run the service. She is an experienced Registered Nurse and has completed the Registered managers award and National Vocational Qualification in Care level 4. The Registered Manager is supervised and supported by the senior management team within the provider organisation. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 23 Quality Assurance systems are in place within the organisation, resident’s views are sought on a regular basis through formal surveys and residents meetings. The views of others who have contact with the service are also sought. Regular audits are conducted according to the quality assurance documentation and include audits of medication, care plans, staff files, staff training, policies and procedures and provider reports to the Commission. Arrangements are in place to support safe working conditions; accidents and incidents are appropriately recorded and followed up. There are regular checks to ensure that equipment is well maintained and no hazards were identified. The organisation employs a person with specific responsibility for the general maintenance of the homes within the group. Residents confirmed satisfaction with the way that the home is run and confidence in the manager. Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP20 Good Practice Recommendations Medication systems should be reviewed to ensure that there is a clear and accurate audit trail of medication stored in the home at all times and that the remaining stock corresponds with the Medication Administration Records. The staff training programme should be reviewed to ensure that all staff have access to the full range of mandatory training and training to meet the specific needs of residents. 2. OP35 Orchard Hill DS0000063584.V337926.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Orchard Hill DS0000063584.V337926.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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