Inspection on 12/03/09 for Orchard House

This inspection was carried out on 12th March 2009.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Orchard House 17/07/08

Orchard House 30/05/06

Orchard House 23/01/06

Orchard House 29/09/05

Orchard House 26/10/04

Orchard House 17/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

CARE HOMES FOR OLDER PEOPLE Orchard House 155 Barton Road Kettering Northants NN15 6RT Lead Inspector Ansuya Chudasama Unannounced Inspection 12th March 2009 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Orchard House DS0000012879.V374566.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. Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard House Address 155 Barton Road Kettering Northants NN15 6RT 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) 01536 514604 01536 485599 daryl.wilson@btopenworld.com rsonshomes@btopenworld.com R Sons (Homes) Limited Mrs Daryll Louise Wilson Care Home 33 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (33), of places Physical disability over 65 years of age (10) Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total number of service users must not exceed 33 No one falling within the category of PD(E) may be admitted to the home when there are 10 persons of category PD(E) already accommodated in the home. No one falling within category DE(E) maybe admitted into the home when there are 18 persons of category DE(E) already accommodated in the home. 17th July 2008 Date of last inspection Brief Description of the Service: Orchard House is located in a quiet residential area in Barton Seagrave, on the outskirts of Kettering. It is an extended detached property offering accommodation, in 26 single bedrooms and 2 double bedrooms, on the ground and the first floor, which can be accessed via stairs or a lift. Orchard House offers 32 places for older people over the age of 65 who require personal care and support due to age. Its registration includes the capacity to care for older people with physical disabilities and some with Dementia conditions. The service user guide states that the Fees charged for staying at the home range from £330.00 to £450.00 a week. Items not included in the fees include hairdressing, newspapers, private health cost, dry cleaning and TV concessionary licence charge. Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This home has 1 star rating and this means that the people using the service receive an adequate service. This inspection was carried out in accordance with the Commission for Social Care Inspections (CSCI) policy and methodologies which require review of key standards for the provision of a care home for younger adults, that takes account of the service users views and information received about the service since the last inspection. Evidence used and judgements made within the main body of the report include information from this visit. The report refers to ‘we’ this is because the report is written on behalf of the commission. This key inspection visit was unannounced carried out on the 12th of March 09. The planning for the visit included looking at the last inspections report, and a Random inspection undertaken on the 19th of January 09. The home had a pharmacist inspection carried out on the 16th of March 09 and the information from this visit is included in this report. The Manager assisted with the inspection During this inspection we tracked the care of three people who use this service. This involved reading their care records and also talking to them wherever possible to obtain their views on the service. Documentation relating to staff recruitment, training and supervision, complaints and health and safety were also examined. We had the opportunity to talk to some of the staff who were on duty and a tour of the home was also conducted. The home sent us a completed Annual Quality Assurance Assessment (AQAA) when we asked for it. What the service does well: These are some of the things that we saw and the people living in the home say: Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 6 • • • • • • • • • • ‘I like living here’ ‘Its always clean’ ‘Given information about the home’ ‘Food have a choice’, ‘its nice’, and ‘nothing to grumble about’’ ‘The food is excellent; ‘‘Visit any time’ ‘Staff are very nice’ ‘If I have any concerns I go to the manager’ ‘They knock on my door and wait for me to say come in’. ‘They look after us too well’. The staff says they • ‘Like working at the home’ • ‘We are shown how to do things’ • ‘Look forward to coming to work’ • ‘Good team’ • ‘Get supervision and its good’ • ‘Manager has time for us’ • ‘The residents get good care’ We saw the staff and the people in the home working well together The staff were talking to the people in a nice manner. The relatives of the people said that their family member was happy and atmosphere in the home was calm. It was said that if they had any concerns, they would speak to the manager or staff What has improved since the last inspection? What they could do better: Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 7 The home should: • • • • • • • • • Make time for staff to read the care plans so they understand the needs of the people. Provide an activity list in advance so the people know when activities will take place. Take detailed assessments of the people and ensure the form is signed and dated. Provide regular supervision to care staff Ensure all staff receive an induction when they start work Ensure that the garden is safe and accessible for all the people. The Statement of Purpose must be very clear about who is responsible for additional costs. Ensure that the proper agencies are informed about incidents/accidents that happen in the home. Ensure that the medication policies and procedures are followed to keep people safe. 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 House DS0000012879.V374566.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 Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people and their relatives are encouraged to visit the home prior to admission but further development is needed to ensure that the people’s needs assessments are detailed to meet their needs. EVIDENCE: Most of the families of the people living in the home had visited the home prior to making a decision to stay at the home. A copy of the statement of purpose/service user guide was available and we were told that a copy is given to the people visiting the home. During this inspection we viewed the pre-admission assessment of the most recent admission to the home. This was the only admission to the home since Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 10 the last inspection. The pre-admission assessment was very poorly written and had not been signed and dated. The manager told us that they used social services documentation to aid the assessment of a new admission. However, not all admissions admitted to the home would be via this route, and the home need’s to be confident that they can meet the needs of all prospective people coming to the service. This home does not provide intermediate care. Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people’s health care needs are met, however medication systems are in need of action, the registered person is working towards improvements to ensure the people who use these services are not put at risk. EVIDENCE: During this inspection we looked at three care plans and this included looking at a new admission, one with high needs and some one who spent much of their time in bed. The care plans covered every aspect of a person’s life, whether staff provided the care or not. One of the people tracked had 29 pages of care plans in place. This meant that there was a lot of information for staff to read through. The detail in the care plans was sufficient to ensure that a consistent level of care was provided. For example, one person’s plan identified the need for staff Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 12 supporting personal care to meet their needs. There was information recorded for when a person liked to get up and how they liked their personal care to be provided. We did not see any evidence stating that the person had been involved with their care plans. We were aware that relatives were involved in the information gathering in providing life history information. This provided staff with more information about the individual person. We were told that the staff read the care plans when they get time to read them and knew where these were kept. The home should make time for staff to read care plans. Each file had risk assessments on moving and handling, nutrition, falls and pressure areas. When reading the care plans the reader was referred to the associated risk assessments. In some areas the risk assessment identified a risk but it was not clear how this was to be managed. The manager needs to ensure that this information is explained clearly. There was documentation to show that the staff called health professionals, and acted on the advice given in a timely manner. The plans seen had information recorded on what name the people preferred to be known as by staff. We saw staff respecting this and treated the people with respect and dignity. The CSCI pharmacist had carried out a visit to the home on the 16th of April 09. We were informed that the policy on medication was not always being followed satisfactorily by the home. Four requirements and three recommendations were made from this inspection visit. We were informed that management train staff that will be giving out medication. The home has recently started to take part in Managed care training programme package that enables care workers to safely administering medicines in care homes. This is being rolled out at the home in March 09 and senior staff will be trained first then other care workers will have this afterwards. Orchard House DS0000012879.V374566.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): 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. The meals served in the home are good offering both choice and variety to meet the people’s needs. EVIDENCE: The home did not have an activity person. There was no activity plan displayed or available. The deputy manager told us of a number of planned activities for the forthcoming month, including an entertainer, a church service, a coffee morning and an Italian night following the successful Indian theme evening. We discussed with the manager that they needed to provide an activity list on a weekly or monthly basis. This was so the people and their visitors could see what activities were going to take place to stimulate the people. Staff told us that the people enjoy talking to them but because they were so busy, they did not have enough time to talk to them. Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 14 As we arrived at the home we met one person who was supported to walk to the garage next to the home to buy a newspaper. We observed visitors being welcomed by staff. A Family spoken to at the inspection stated that their family member was happy and had a ‘nice bedroom’ On the day of the inspection the meal was pork meatballs or quiche. The main kitchen was central to the home and by lunchtime the whole house had an appetising aroma of home cooked food. People that needed support to eat their meal were provided with this help in a relaxed manner, with staff sitting with them and talking to them about the meal and about things in general. One person was asked about his opinion of the food and patted his stomach and said, ‘they look after us too well’. Another person said ‘staff are very nice’. And other comments were ‘very nice food’; they ‘knock on my door’ and ‘wait for me to say come in’. Drinks and snacks were provided between meals. The kitchen assistant who was giving out drinks said, “I always ask what they want in case they fancy something different and if they want a cooked breakfast the cook will do it for them”. Orchard House DS0000012879.V374566.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): 16,18. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people and their representatives know that their concerns are being listened by management. EVIDENCE: The home had a complaints policy. Some of the people spoken to were mentally alert and knew how to complain to the staff and the manager if they were unhappy. The relatives told us that if they had any concerns, they would speak to the staff or the manager. Information about making complaints was recorded in the service user guide. A record of concerns raised was being recorded in a book. Information read showed that the concerns were being resolved in a satisfactory manner. Staff said that they had completed the in house training in understanding safeguarding of vulnerable adults procedures. No safe guarding referrals had been made to the CSCI or the Social Services safe guarding team. (See section on making referrals to the appropriate agencies) Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home is clean and the people’s rooms are individualised to meet their needs EVIDENCE: The home was clean and tidy. The manager told us that the Maintenance programme was on going and that bedrooms were being redecorated as they became vacant. During the tour of the building we noted that the bedrooms were decorated and furnished to personal taste, and had photographs, ornaments and items that reflected the individual’s life history. The owner told us that ‘two residents who had purchased their own bed and chair did this through choice. The bed has been donated to the home by the family and the other resident wanted to Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 17 replace her own reclining chair with a new one. We had offered her one but this was declined’. During the visit the manager told us that she had spoken to the family of a person living in the home about buying a suitable chair for their relative. The Statement of Purpose must be very clear about who is responsible for additional costs. This is so the people know what the home provides and things that they will be responsible for purchasing. There had been many changes to the environment since the last inspection. The manager told us that the ground floor bathroom was finished a week ago. although the ceiling still needed to be painted and many of the carpets in communal areas had been replaced. The central lounge had new comfortable seating, which were positioned in clusters and not all around the wall. Appropriate pictures had been hung to brighten the home. We were concerned that staff and people who went out of the home to smoke via the doors in the main lounge or dining room, caused a draught, which some of the people complained about. This was particularly concerning as at the time of the inspection the radiators were not working to full power and there were three additional electrical radiators in the lounge. The manager said that she would sort this out. The home had received £500 from the distribution of the dignity and care grant. This money was to be used for landscaping the garden at the home. The proprietor of the home also donated money for the garden project. The home had recruited 18 volunteers and this included families, friends, and staff to help landscape the garden and a plan had been drawn up. The people were excited, as this work was to take place on the 28th of March 09. The conservatory was now in use and blinds had been fitted to prevent it getting too hot in the hot summer months. Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The, and the manager is aware of some gaps in the training and plans to deal with this to meet the needs of the people. EVIDENCE: The service recognises the importance of training and on the day of the inspection the NVQ assessor was carrying out NVQ training. We were told that She came once a month to the home. This person also worked at the home as a senior bank staff. We were told that some staff had completed their NVQ training and the rest of the staff were booked or were already doing the training. The staff recruitment files were inspected and evidence showed that the relevant information required was being obtained. One new staff file showed that a new member of staff had not received any induction when they first started at the home. Two new staff on duty told us that when they first started, they had a few hours of induction and they had a tour of the home. They had also been shadowing staff and the manager when carrying out care duties. We were told that they were completing the skills in care induction training. One staff had been at the home two months and had received training on manual handling, health and safety, infection control and was given Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 19 procedures on safeguarding of vulnerable adults. We were told that they were going to do dementia training soon. We were provided with information on training undertaken by staff. Evidence showed that there were gaps in some of the training provided. The manager told us that this was being looked at and further training had been booked. The staff told us that they had team meetings and these were good. Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Management has good understanding of the areas that need improving to run the home in the best interests of the people living in the home. EVIDENCE: We acknowledge that since the last inspection the manager and the deputy, along with the owner and the staff team have worked very hard to make the improvements. The manager needs to ensure that these improvements are sustained. Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 21 The manager has many years experience of managing the home. At present she was completing the dementia degree and will graduate in August 2009. She has also undertaken other refresher training to keep up to date with the training. The staff spoken to stated that the manager was ‘approachable’ and has ‘time for you’. An annual survey was carried out in September 08. There were lots of positive comments as well as areas that needed action from the home. The accident /incident records showed that the staff were recording unexplained bruises and completing the body charts. However the home was not reporting these to the CSCI under regulation 37 notifications and to Social Services safe guarding team. We discussed with the manager how she would deal with unexplained bruises found on the people. The manager told us that she would investigate this herself. The manager was informed that she needed to follow Social Services safeguarding of vulnerable adults (SOVA) procedures when dealing with any issues of potential abuse. The manager needs to review the home’s SOVA policies and procedures in line with current practice. Refresher training on SOVA procedures is needed for all staff. Evidence showed that not all staff were receiving supervision on a regular basis. This must be provided at least 6 times per year and this should be recorded. The risk assessments needed reviewing to explain clearly the risk and hazards information as discussed with the manager (See also section on health and personal care). The staff were receiving fire drill practices and weekly fire alarm and monthly emergency lighting was being completed. We asked to check the monies that the home held on behalf of the people. We noted that one of the people come to the office for their money. This person was given their money as it had arrived from a solicitor. The documentation supporting the handing over of the money was satisfactory. However it was not possible to check other people’s money because the manager had the keys at her home. We were told that in the case of a person needing money, the manager would be able to get the key quickly. The reason for the key being held at the manager’s home was because the office was refurbished and many of the items were moved out. We will need to check the people’s finances at the next inspection. We did see the book that recorded the transactions and balances and we checked that the figures were correct. However we could not balance the figure with the total recorded. We were concerned that the method used for recording the cost of hairdressing and chiropody was not transparent. Currently the chiropodist Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 22 provided a list of the people visited and the manager or deputy wrote a receipt out for the cost for each resident as they took the money out. This system did not provide the proof that this was the amount charged by the chiropodist. The receipt should come from the person receiving the money and not a third party. This was discussed with the manager and she was going to look into this. Orchard House DS0000012879.V374566.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 X 2 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 2 X 2 Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 24 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 OP3 Regulation 14 Requirement Assessments of peoples needs must be completed in full and linked to the care plans to make sure that their needs are met in full. This date 19/01/08 and 29/11/08 was not met Timescale for action 19/05/09 2 OP30 18 2 OP9 13 All new staff must be given an induction when they start work at the home. This is to ensure that they know understand the health and safety information to keep every one safe. All medication must be administered to people as prescribed and in a timely way as to ensure optimal therapeutic effect and to avoid any potential risks of over dosing or treatment failure. Timescale 31/05/09 On all occasions when a person is given the right to selfadminister their prescribed medication this should be DS0000012879.V374566.R01.S.doc 30/05/09 31/05/09 3 OP9 13 31/05/09 Orchard House Version 5.2 Page 25 managed by a medicine specific risk assessment which details to carers the potential signs or symptoms of a persons condition that requires immediate referral to GP. 4 OP9 13 Timescale 31/05/09 All medicines that have been prescribed with the direction of “when required” need to be fully care planned as to ensure the carer giving the medication knows what situations would warrant an administration and when a referral back a prescriber is needed. Records for reasons why a “when required” medicine is given should be completed. All Controlled Drugs must be stored according to the Misuse of Drugs Regulations on Safe Custody. All medicines that require cold storage (2-8’C) must be stored in an appropriate fridge and regular monitoring is made to ensure the desired temperature is maintained. Incidences of safeguarding must be reported in accordance with local policy to safeguard the people living at the home. 31/05/09 5 OP9 13 31/05/09 6 OP38 12(1), 13(6) 29/05/09 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 OP9 Good Practice Recommendations The management carry out regular medication audits to ensure that medicines are given out correctly and that DS0000012879.V374566.R01.S.doc Version 5.2 Page 26 Orchard House 2 OP9 3 OP9 4 OP19 documentation is accurately completed. Also competency assessments are carried out on carers that given out medicines. The outcomes for these should be recorded. That the manager requests that the supplying pharmacy checks all the medication administration sheets to ensure the directions for the medicines are as the prescriber intended and that a time is printed on these. The home should use a second person who is appropriately trained to countersign all handwritten medication sheets to ensure the correct information had been copied. The home should ensure that the people sitting in the lounge do not get a draught when the people who go out of the home to smoke via the doors in the main lounge or dining room. Orchard House DS0000012879.V374566.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 House DS0000012879.V374566.R01.S.doc Version 5.2 Page 28 - 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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