Inspection on 07/05/08 for Ovenden House

This inspection was carried out on 7th May 2008.

CSCI found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ovenden House 06/05/09

Ovenden House 15/11/07

Ovenden House 04/12/06

Ovenden House 22/05/06

Ovenden House 09/11/05

Ovenden House 26/07/05

Ovenden House 06/09/04

Ovenden House 18/05/04

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Snydale Care Home

Larchfield Manor

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Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Ovenden House Ovenden Road Ovenden Halifax West Yorkshire HX3 5QG Lead Inspector Lynda Jones Key Unannounced Inspection 7th May 2008 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 DS0000059091.V362911.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. DS0000059091.V362911.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ovenden House Address Ovenden Road Ovenden Halifax West Yorkshire HX3 5QG 01422 362487 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) ovenden@pcslimited.net Pennine Care Services Ltd Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places DS0000059091.V362911.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2007 Brief Description of the Service: Ovenden House is owned by Pennine Care Services Limited and is registered to provide accommodation and care for up to twenty-three older people. It is a stone built detached period property situated in a residential area in the Ovenden district of Halifax, with easy access to the town centre by public transport. Accommodation is provided in thirteen single and 5 shared rooms. Externally, there are garden areas for people to enjoy in the warmer weather with parking facilities for staff and visitors. The current weekly charge at the home is £356.00 plus £18.60 top up for a single room and £339.00 plus £18.60 top up for a double room. People pay for their own personal toiletries, hairdressing and chiropody. A copy of the last inspection report and information about the facilities is available at the home. DS0000059091.V362911.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was our first visit to the home since the last inspection in November 2007. This inspection took place to assess the quality of care provided to people living at the home. The visit was unannounced and was carried out by two inspectors between 09:30am and 3:45pm. The inspection process included looking at the information we have received about the home since the last key inspection, as well as an unannounced visit to the home. We talked to people who live there and the manager and staff on duty. We observed care practice, looked at various records and looked round the home. As we had some concerns about the way medication was managed when we last visited we decided to look at this area in more detail on this visit. One of the inspectors is a Pharmacist Inspector. What the service does well: People are assessed before they move in to make sure their needs can be met. The staff know people very well, they have a good understanding of their needs and preferred daily routines. People look well cared for and relaxed. One person told us “ we have a good laugh here”. The staff are friendly and they make visitors feel welcome. Staff recruitment procedures are good, all staff are checked before starting work to ensure that they are suitable and people who live there are safe. Staff have received adult protection training and are aware of their responsibility to make sure that people are safe. DS0000059091.V362911.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The daily records could be improved. They are quite repetitive, they do not reflect the care and support that staff actually provide. Accurate records must be kept for all medicines held in the home. There needs to be an up to date list of all staff who administer medication. There should be a photograph of everyone with their medication records as an extra check to make sure medication is given to the correct person. Redecoration and refurbishment of the home needs to continue to make sure that all parts of the home are pleasant and comfortable for people to live in. DS0000059091.V362911.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000059091.V362911.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 DS0000059091.V362911.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. Standard 6 does not apply. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before they move in. This tells the home about the type of support and care they will need. EVIDENCE: The home has a Statement of Purpose and Service User Guide, which gives people some information about the home. It is available on request from the home. The manager said people are welcome to visit the home to see if their support and accommodation needs can be met there before making any decision about moving in. She told us that two people who took up residence recently had visited before they moved in. DS0000059091.V362911.R01.S.doc Version 5.2 Page 10 We looked at some of the care plans and we saw that people are assessed before they move in. This is done to make sure that the home is the right place for them and that all of their needs can be met. The home does not provide intermediate care. DS0000059091.V362911.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. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The care plans have improved recently; they give staff the information they require to meet people’s needs. Personal support is given in a way that promotes and protects people’s privacy and dignity. Accurate records must be kept for all medicines held in the home. This will make sure that people receive their medications correctly and safely. EVIDENCE: We looked at a selection of care plans because we wanted to see what individual needs had been identified and what action staff are expected to take to meet these needs. Since the last inspection, time has been invested in reviewing the care plans and bringing them up to date. We found DS0000059091.V362911.R01.S.doc Version 5.2 Page 12 improvements in the format of the plans and in the quality of the information recorded; this work needs to continue. The records show that people are now more involved in drawing up and reviewing their care plans. People sign the records showing they have been involved, relatives also sign if they attend reviews. This is an improvement since the last inspection; it shows that people are being consulted about the care and support they require. Some of the plans contain good information about the sort of life experiences people have had and the sort of daily routine that they prefer, this is also an improvement on what we found when we last visited. This information is useful because it helps staff understand something about people’s backgrounds, families, work experiences etc. It also helps staff to make conversation with people and to make sure they continue to live their day to day life as they want to. The daily records are quite repetitive, they do not reflect the care and support that staff actually provide. These could be improved. When we talked to staff, they demonstrated a good understanding of what people like and dislike; they know about preferred routines and how people like to spend their time. Throughout the day we observed staff treating people with dignity and providing personal care in private. People looked well cared for, comfortable and relaxed. People we talked to said the staff are helpful and kind; they said they are satisfied with the care and support they receive. We could see from the plans that people are receiving health care from a range of people such as doctors, district nurses, chiropodist and opticians. The current and previous month’s Medication Administration Record (MAR) charts were looked at. There is a list of staff authorised to administer medicines and examples of their signatures. This needs to be updated to include all staff that administer medication. This means it is possible to identify who was involved in administration if a query or problem occurred. A number of photographs were missing from the dividers between each MAR chart. Having a photograph provides an extra check for staff to make sure medication is given to the correct person. There were very few gaps on the MAR charts but there were a number of examples where the quantity of medicine received and the number of doses recorded as administered were different. The recording of the administration of antibiotics in particular was not accurately done. For example, one MAR chart DS0000059091.V362911.R01.S.doc Version 5.2 Page 13 had an entry for 56 penicillin tablets. At the time course complete was written the number of tablets recorded as administered totalled 60. Accurate records of administration must be made in order to demonstrate that people are getting their medication as prescribed. There was inconsistency in the quality of handwritten entries on the MAR charts. To make sure there is an accurate record of how medicines are to be given the quantity supplied, the date of entry, the signature of the person making the entry and a witness signature where possible should be included. There was inconsistency in the recording of the quantity of medication supplied and the date received. The quantity of medication from one monthly cycle to another is not recorded on the new MAR. This means it is difficult to have a complete record of medication within the home and to check if medication is being administered correctly. The code ‘O’ was used on a number of occasions to record no administration. However there was no definition on the chart to explain why the person had not received their medication. It is important that a clear reason is given so there is accurate information on how a person is taking their medication. The prescriber, who may wish to review the medication, may also use this information. An audit of current stock and records showed that some medication had been signed for but not given. For example one person had 28 tablets prescribed as 1 daily. The MAR chart had 3 records of administration recorded but 27 remained in the box. Medication must be given as prescribed so that a person’s medical condition is treated correctly. There is a lockable medicines trolley kept in the dining room. A number of medicines were found in the trolley that require storage at cold temperatures. It is important to check and follow the storage requirements for medicines so they are safe to use. The storage of controlled drugs is not suitable. It is now a legal requirement for all care homes to store controlled drugs in a cupboard that meets the specific legal requirements. A good record of medication returned to the pharmacy for disposal is kept. However there is no facility for safely storing the medicines before returning them to the pharmacy. This means there is a risk that these medicines may be tampered with or used without authorisation. DS0000059091.V362911.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People who use the service are able to make choices about their lifestyle. The staff have plenty of contact with people and they respect their preferred routines. A choice of stimulating activities is on offer, which are organised to meet a range of individual needs. EVIDENCE: Routines at the home are flexible and people are encouraged to make choices about their lives and how they want to spend their time. People confirmed that they get up when they wish, breakfast is prepared when people are ready to eat. Meals at lunchtime and teatime are served at set times which seems to suit everyone. DS0000059091.V362911.R01.S.doc Version 5.2 Page 15 There has been a significant improvement in the amount of time that staff spend interacting with people. At the last inspection we noticed that staff only had contact with people when they were carrying out tasks such as giving out drinks, taking people to the toilet or taking people to the dining room at lunchtime. Staff routines are now better organised and they are able to spend more time with individuals. The atmosphere in the home was pleasant and relaxed. Throughout the day the staff were polite and friendly, they made time to sit and talk to people. The staff know people very well and some good humoured banter was exchanged. Some people sat outside chatting to staff while others took part in a lively game of bingo. People told us they take part in art and craft sessions, play board games and sometimes go to the local pub. An organisation called “Active Minds” that provides stimulating therapeutic activities has recently visited the home and proved to be a success. Plans are underway for these sessions to take place every two weeks. During the day the cook asked everyone individually what they would like to eat from the menu for the day. From talking to staff it is clear that they have a good understanding of what food people like and dislike, this information is also recorded on the care plans. People told us the food was “very nice” and “I have no complaints about the meals”. To improve their understanding of the importance of good nutrition in the care of older people, several staff attended a training session during the afternoon that was provided by one of the dieticians from the Primary Care Trust. DS0000059091.V362911.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Staff have received adult protection training, which means that they are aware of their responsibility to make sure that people are protected and safe from harm. EVIDENCE: Since we last visited in November 2007 we have not received any complaints and none have been made directly to the home. There is a complaints record in the office where details can be recorded of any issues raised. We asked some people what they would do if they were unhappy about anything at the home. They told us they would tell a member of their family or tell staff. Staff told us they know individuals well; they said that they would know if people were unhappy. The manager told us that all staff have received training about safeguarding people. We talked to three members of the team specifically about this, they confirmed that they had received training and they gave a good account of their responsibility to protect people from any form of abuse. Staff told us about the homes adult protection and whistleblowing policy but we were unable to find a copy of the policy during our visit. DS0000059091.V362911.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 ,24 & 26. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The shared areas of the home are comfortable and the fittings and décor are adequate. Most people have comfortable personalised bedrooms. EVIDENCE: There has been an improvement in the overall appearance of the home since we last visited. We found bedrooms and shared areas clean, tidy and odour free. There is evidence that attention has been paid to detail in the bedrooms, waste bins have been provided, mirrors are clean and wall lights and bedside lights are in working order. DS0000059091.V362911.R01.S.doc Version 5.2 Page 18 People are encouraged to personalise their own rooms when they move in, some individuals have done this to great effect having photographs, ornaments and other prized possessions around them. Some rooms are carpeted; others have non-slip floor covering which gives them a clinical rather than homely appearance. These are some of the points we raised with the manager at the end of the visit: • • • • • • The mattress and discarded furniture in the back garden looks unsightly and needs to be removed. In one bedroom a nylon string is being used as an extension to the light switch pull cord. This needs to be replaced. The lid for a commode in one of the rooms is missing; this is unhygienic and needs to be replaced. The manager said this was already on order. The downstairs shower room would benefit from redecoration so that it provides a pleasant place for people to bathe. The overhead strip lighting in the shower room requires cleaning as the housing unit contains a number of dead insects. The main corridor and landing would benefit from redecoration. The overhead strip lighting on the main landing requires cleaning, as the housing unit is full of dead insects. DS0000059091.V362911.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Recruitment procedures are good; all new staff are checked before they take up post to make sure they are suitable to work with older people. EVIDENCE: There are three staff on duty during the day plus the manager, at night there are two “waking” night staff. There is also a daily domestic cover and a cook on duty from 8am –2pm. At the last inspection we were concerned that a member of staff was taken off care duty to prepare food at tea time. The manager told us that an additional member of staff is now on duty over this period, leaving three care staff to assist people. At the time of our visit one person needed to be cared for in bed. To accommodate this, the manager had arranged for an additional member of the team to be on duty to make sure that the needs of everyone living at the home could be met at all times. Throughout the day there seemed to be enough staff available and they were always friendly and helpful in their dealings with people. DS0000059091.V362911.R01.S.doc Version 5.2 Page 20 We looked at a sample of staff records to see what checks are carried out before new staff start work. Recruitment practice is good, references are always taken up and checks are carried out with the Criminal Records Bureau to make sure that staff are suitable to care for the people that live there. We checked this out with staff and they confirmed that all pre-employment checks had been carried out before they started work. Staff confirmed that they had received induction training and that they had worked alongside experienced members of the team when they first started work at the home. One recently recruited member of the team appeared on the rota as supernumerary when we visited. Arrangements are in place for all staff to receive food hygiene training. Eight staff are scheduled to attend the first 3x3 hour sessions, the remaining staff will attend the next training series. Staff training needs are now beginning to be addressed through supervision, this is an improvement on our findings when we last visited. There is still no training matrix showing what training people have undertaken and what needs to be renewed. The manager said she is making arrangements to secure mandatory training for all members of the team; this is to make sure that all care is delivered safely. DS0000059091.V362911.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are consulted about the service and asked if it can be improved in any way. EVIDENCE: The current manager has been in post since September 2006 but she is not yet registered with us. In the last report we made a requirement for the manager to submit an application for registration. This has been done and a date has been set for the manager to be interviewed by us. It is important that a manager is registered. This will mean that there is someone legally responsible for the direct management of the home. DS0000059091.V362911.R01.S.doc Version 5.2 Page 22 The home owner has arranged for the manager to undertake a management training course. The details of this course were not available at the time of this visit. We were told the home owner visits once a week and the general manager visits approximately twice a week to make sure that the home is run in the interests of the people who live there. The company has nominated the general manager to carry out monthly visits to the home. The purpose of these visits it to monitor the quality of the service being provided, to give support to the manager and to provide feedback to the owners by way of a written report. The most recent report available was done in March 2008 and was available for inspection. We were told that all staff, with the exception of the cook and domestic, have received supervision, this is an improvement. Plans are in place for the manager and deputy to provide staff supervision in the future. Quality assurance questionnaires were issued to people living at the home and their relatives in April 2008. To date only eight have been returned although the manager is expecting more surveys to come back, when these are received the results will be summarised and displayed in the home. So far the surveys indicate that people are satisfied with the service provided. The manager holds some money for people for safekeeping purposes. This is usually money deposited by relatives for hairdressing, trips out etc. We looked at some of the records and checked that the money held for safekeeping matched the records, the records checked were satisfactory. We were concerned to note that people had been charged for one of the activity sessions that had taken place; we raised this with the manager because there is nothing in the literature provided by the home that suggests that a charge will be made. The manager has since confirmed that this charge was made in error and the money has now been fully refunded to each persons account. DS0000059091.V362911.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 3 X 2 DS0000059091.V362911.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement All medication must be administered as prescribed. Accurate records must be kept for all medicines. A system must be in place to check storage requirements of medicines and to make sure medicines no longer in use are stored safely and securely. This will make sure that people receive their medications correctly and safely. Controlled drugs must be stored according to current guidance and safe custody regulations. This provides the extra security needed for this type of medicine and will help to prevent loss or diversion. Work needs to continue to upgrade and refurbish the premises to make sure that all areas are decorated and furnished to an acceptable standard. This will make sure that people live in a pleasant, hygienic and comfortable home. DS0000059091.V362911.R01.S.doc Timescale for action 30/06/08 2 OP9 13 (2) 31/08/08 3 OP19 23 31/10/08 Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP9 Good Practice Recommendations A current photograph of each person should be attached to their MAR chart. This helps to reduce the risk of medication being given to the wrong person. A system should be in place to record all medication received in to the home and medication carried over from the previous month. This helps to confirm that medication is being given as prescribed and when checking stock levels. Handwritten entries and changes to MAR charts must be accurately recorded and detailed. This makes sure that the correct information and dose is recorded so a person receives their medication as prescribed. The homes policy on safeguarding and whistleblowing needs to be located so that all staff have access to it. 3 OP9 4 OP18 DS0000059091.V362911.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000059091.V362911.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!