Inspection on 02/02/06 for Perry Locks Nursing Home

This inspection was carried out on 2nd February 2006.

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

Perry Locks Nursing Home 26/02/10

Perry Locks Nursing Home 20/05/09

Perry Locks Nursing Home 25/11/08

Perry Locks Nursing Home 04/02/08

Perry Locks Nursing Home 26/09/06

Perry Locks Nursing Home 26/09/05

Perry Locks Nursing Home 07/12/04

Perry Locks Nursing Home 15/07/04

Perry Locks Nursing Home 21/01/04

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Inspirations

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

CARE HOMES FOR OLDER PEOPLE Perry Locks Nursing Home 398 Aldridge Road Perry Barr Birmingham West Midlands B44 8BG Lead Inspector Lisa Evitts Unannounced Inspection 2nd February 2006 09:45 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 Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Perry Locks Nursing Home Address 398 Aldridge Road Perry Barr Birmingham West Midlands B44 8BG 0121 356 0598 0121 331 1261 slyms@bupa.com www.bupa.com BUPA Care Homes (CFHCare) Limited 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) Mrs Sarah Elizabeth Slym Care Home 120 Category(ies) of Dementia (120), Dementia - over 65 years of registration, with number age (120), Mental disorder, excluding learning of places disability or dementia (120), Old age, not falling within any other category (120), Physical disability (120), Physical disability over 65 years of age (120) Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Males & females over 50 years Care Home for service user categories OP, DE(E), DE, PD(E) PD, MD and people over 50 with dementia or physical disabilities requiring continuing care. That two named service users (names held on CSCI file) under the age of 50 may be accommodated. 7th December 2004 Date of last inspection Brief Description of the Service: Perry Locks is a modern purpose built Nursing Home and is part of the BUPA organisation. The home comprises of four separate houses, each with thirty beds. Three houses are registered for nursing care: Lawrence, Brooklyn and Calthorpe and Perrywell house for dementia care. All four units take residents requiring respite care. All houses have access to small landscaped gardens (Perrywell is safely enclosed) and there are ample parking facilities at the front of the home. In addition to the Registered Manager, there is also a Clinical Team manager and a Senior Nurse on each house/unit. The home is situated beside a canal in a residential area, four miles from Birmingham City Centre. It is on a local bus route and local shops are only a short distance away. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was undertaken by one inspector over one day and was assisted throughout by the Registered Manager and Clinical Team Manager. There were 111 residents living at the home at the time of the inspection. Information was gathered from talking with the residents and staff and from examining care and health and safety records. The pharmacy inspector had carried out a further inspection since the last inspection at the home to monitor progress and the findings from the inspection are incorporated into this report. This is the second statutory inspection for the 2005-2006 year and it is recommended that this report is read in conjunction with the previous inspection report. One immediate requirement was made on the day of the inspection. What the service does well: Perry Locks provides a friendly, homely, clean and comfortable environment in which to live where residents are well supported by the care staff to meet their health, welfare and personal needs. Comprehensive pre admission assessments are undertaken so that residents are aware that the home can meet their needs prior to admission. The home has quality assurance systems in place to seek the views of residents and their representatives and this ensures a continuous improving service. Residents are well supported to continue to see relatives and maintain contact with the community. Comments from residents include: “Meals are very good, plenty to choose from” “You get tea and toast at 8pm” “I go out to the day centre twice a week, I’m never here” “I’ve got no grumbles here” “My room is cosy, my daughter brings in things from home” “I’ve got a nice room with everything I need” “Staff check on you during the night” “Staff are friendly and helpful” “Staff come quick when you need assistance” Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 6 “Staff treat you as a friend” What has improved since the last inspection? 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. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 7 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 Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home has comprehensive pre admission assessments in place and this ensures that the resident knows that the home can meet their assessed needs prior to admission. EVIDENCE: On the three resident files reviewed, all had had a comprehensive pre admission assessment undertaken prior to being accepted and moving into the home. One resident stated, “My daughters came and had a look around before I came in here and they were happy” The home does not offer intermediate care facilities. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 Only a small sample of care plans were reviewed on this occasion to monitor progress therefore it is not possible to determine if the home sets out care plans for all the residents individual assessed needs. Clear comprehensive arrangements had been installed to ensure service users medication needs are met. EVIDENCE: Three care plans were reviewed at this inspection, one each from Brooklyn, Lawrence and Calthorpe House. All three files had comprehensive pre admission assessments in place. Wound assessment charts were in place and photographs of wounds had been taken. One care plan was still in place for a pressure sore which had now healed and staff must evaluate and discontinue care plans as required to ensure that care plans reflect the current needs of the resident. Care plans had not been written for acute medical needs such as infections and therefore staff have no instructions to follow. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 10 Daily records for one resident indicated an infection and treatment commenced however there was no further documentation as to whether the treatment had worked and if the infection had been resolved. Daily records for another resident stated that the patient was for review by the GP but there was no evidence that this review had taken place. Staff must ensure that follow up actions and outcomes are recorded. On the third file reviewed there were specific instructions recorded in the daily records from a visiting healthcare professional, however it had not been put into the care plan and it is not clear how staff would have this information relayed to them. Some care plans had good details recorded as to the type of hoist and sling to use to assist with transfers but this was not consistent across the houses and some care plans did not have specific details for staff to follow. Care plans were written for some identified needs but generally need improvements to ensure that specific details are recorded. For example, size and type of incontinence pad and personal preferences at to baths or showers. Some of the information detailed on the pre admission assessments had not been incorporated into the plans of care. An example of this was a resident who was clearly identified at pre admission to require a beaker to receive drinks, however this was not on the care plan. The care plan reviewed on Brooklyn House had good instructions for care staff to follow and detailed type of hoist and sling and the colour of incontinence pads to be used. It also detailed the type of pressure relieving equipment to be used. Night time/sleeping care plans are well written and include actions to take to help residents settle for the night and ensure adequate rest periods. Waterlow pressure risk scores and nutritional risk assessment scores had been completed but were not consistently recorded each month. There are separate pages for the recording of doctor’s visits and other professionals and this helps with ease of monitoring visits. There was evidence that residents have seen General Practitioners, chiropodists, community stroke team, physiotherapists and occupational therapists. The inspector did not review medication on this occasion. Since the last inspection the pharmacy inspector has visited the home and the majority of the audits undertaken were correct indicating that the medicines had been administered as prescribed. The manager had worked hard to improve the practice within the home and nursing staff practice has improved to ensure the safety of the service users. The home has a good relationship with the community pharmacy and both work proactively together to maintain and improve the service in the home. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 11 Some nursing staff are regularly audited to confirm staff competence in medicine management. This needs be extended to all nursing staff. Good systems had been installed to check the prescriptions and dispensed medicines received into the home. Service users are risk assessed to self-administer their medicines but further compliance checks need to be undertaken to confirm the service users correctly take the prescribed medicines. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 Residents are encouraged to maintain links with the community and contact with their families. EVIDENCE: The home has an open visiting policy and residents commented that their relatives could visit at anytime. There was evidence in the daily records that residents had received visitors throughout the day. One resident on Lawrence House had just come back from a shopping trip with a relative and a resident from Calthorpe House said “I go out to the day centre twice a week, I’m never here” At the last inspection the manager discussed plans for a bedtime “snack box”, however this had not yet been finalised. Comments from residents regarding food included: “Meals are very good, plenty to choose from” “You couldn’t go hungry here” “You get tea and toast at 8pm” Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The complaints procedure is comprehensive and is accessible to residents and their representatives should they need to make a complaint. The home has a robust adult protection policy in place, which ensures residents are protected from harm. EVIDENCE: A range of compliment and thank you cards are displayed on the notice boards in each house/unit. The home has recorded three complaints since the last inspection and these had been dealt with in a timely and satisfactory manner. Acknowledgement letters are sent out along with letters giving the outcome of any investigations and actions to be taken to prevent a further occurrence. The home also keeps a monthly audit of any complaints received and this is good practice as would help to identify any trends occurring. CSCI have not received any complaints pertaining to the home. Comments from residents included: “If I had a problem I would talk to the nurse” “I’ve got no grumbles here” “I would talk to some of the staff if I had a problem” The adult protection policy has been amended since the last inspection and now includes all the relevant information to ensure that staff are aware of the correct procedure to follow should they suspect any form of abuse is taking place. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23, 24, 25, 26 Perry Locks provides a clean, homely and comfortable environment in which to live, where residents are safe, relaxed and secure. Resident’s rooms are individualised and provide residents with adequate facilities to meet their needs. EVIDENCE: A tour of the building was not completed, but areas seen were homely in style and found to be clean and odour free. Furniture, fixtures and fittings were all of a high standard. Since the last inspection signs to identify toilet and bathroom facilities have been provided for the residents on Perrywell house. At the last inspection it was identified that locks were required to the sluice room doors. One of these had been fitted, however the second sluice door still requires a lock to ensure the safety of the residents. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 15 One of the storeroom doors was still not locking on Brooklyn house and one door was left open. The doors were fire doors and had “keep locked” signs in place and staff must adhere to this. Bath seats were reviewed and were all found to be thoroughly cleaned. Water temperature checks had not been recorded since the last inspection in September and it is required that random water temperature checks are undertaken to ensure that the potential risk of scalding to residents is reduced. All of the bedroom areas seen were personalised with resident’s own possessions to ensure that their surroundings are as comfortable as possible. Comments from residents included: “My room is cosy, my daughter brings in things from home” “I’ve got a nice room with everything I need” Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 Improvements are required to the number of staff who hold the NVQ Level 2 certificate to ensure that staff have the knowledge and skills to provide the care to meet the requirements of the residents. Improvements are required to the recruitment process to ensure that the process of recruiting staff protects residents. EVIDENCE: Some improvements have been made since the last inspection to the number of staff who hold the NVQ Level 2, however the home must continue to work towards the required 50 of staff who hold this qualification. 25 staff currently hold NVQ Level 2 with a further six staff working towards the qualification. Four staff hold NVQ Level 3. 12 staff have completed the Care skills course that is a prelude to NVQ. Two staff files were reviewed. Protection of vulnerable adults first checks had been completed and Criminal Records Bureau checks had been requested. Both files had application forms and medical health questionnaires. Both of the files, although had two references, neither file had a reference from the most recent or current employer and an immediate requirement was made that any new member of staff must have a reference from the most recent or current employer. One of the files had gaps in the employment history and the employment did not correspond to the referee names given and was confusing. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 17 There was no evidence that this had been explored and it is required that any gaps in work history are explored and outcomes documented. The home sends out letters of offer including rates of pay and hours to be worked. There is a copy of the job description on file. There was evidence that an induction process had been commenced on one of the files. Comments from residents included: “Staff check on you during the night” “Staff are friendly and helpful” “Staff come quick when you need assistance” “Staff treat you as a friend” On the day of the inspection interviews were taking place for a new activities coordinator and care staff. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 The Registered manager ensures that a good standard of service is provided at the home. The home has quality assurance systems in place to ensure a consistent improving service. A robust system for the management of resident’s personal allowances is in place, and ensures that residents are safeguarded from harm. EVIDENCE: The Registered Manager has now completed the Registered Managers Award and is awaiting her certificate. Senior managers undertake visits to Perry Locks and provide CSCI with written reports as per regulation 26, in order to monitor the service provided at the home. The BUPA group undertakes random auditing in the form of a customer satisfaction survey. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 19 Perry Locks has a yearly survey performed and questionnaires are sent to residents. An external body formulates the responses. Each year the company also undertake a service organisational profile, which looks at the service provided by the manager and from this an action plan is formulated. Residents meetings are held every month, and the manager holds heads of department meetings every three months, unit managers meetings every month and each house then holds staff meetings as required. Resident’s personal monies were reviewed and found to be well maintained. Any resident who wishes to can open his or her own account and interest is generated on this if the account is in credit. Balances are checked every month. Receipts are issued when money is paid in and statements can be issued at anytime. Chiropody and hairdresser bills are paid from the account if the home has the residents permission otherwise invoices are sent to the families. Residents have individual receipts for newspapers delivered, dental treatments and for physiotherapy. The chiropodist and hairdresser provide one receipt for all residents, however staff sign when they collect the residents and these were easily cross-referenced to the individual accounts. Receipts are attached to the monthly balance checks. Accident records were reviewed and were recorded in line with the data protection act. The file is divided into separate parts for each house and has separate areas for kitchen, laundry and staff accidents to be filed and this aids with ease of monitoring. The clinical team manager reviews all accident forms and any follow up action is documented on the forms. The home also undertakes a three monthly audit of RIDDOR and staff injuries in line with BUPA’s own policy. CSCI are informed of all accidents as per regulation 37. Fire records were reviewed and the fire alarm, fire doors and emergency lighting are checked on a weekly basis. All fire fighting equipment is checked on a monthly basis. Staff had received fire training in September 2005. A recent fire drill had been held in November when 16 staff attended. Whilst the outcome of the drill had been recorded, there was no record of the names of the staff that had attended and this is recommended in order to ensure that all staff receive training in at least two fire drills per year. Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X 3 2 2 3 STAFFING Standard No Score 27 X 28 2 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 21 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 OP8OP7 Regulation 12(3) 13(4c)(5) 15 Requirement The registered person shall ensure that: - Consent forms for photography must be signed by the resident or their representative. Previous timescale of 27/01/06 not met. - There is demonstratable evidence of resident/family involvement in the review of care plans across all units. Previous timescales of 31/03/05 & 27/01/06 not met. - Care plans are further developed to ensure that all care needs are met, and that changes in care needs are reflected. Care plans require regular evaluation. Previous timescale of 27/01/06 not met. - Continence needs across all units require developments to ensure that details of size and type of pad required are documented. Previous timescale of 27/01/06 Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 22 Timescale for action 19/04/06 not met. - Care plans for acute care needs such as chest infections need to be implemented. Previous timescales of 27/01/06 not met. - Staff must follow up and document outcomes of treatment and reviews. - Key worker diaries require consistent entries to reflect resident needs. (Not assessed on this occasion) - Risk assessments need to be completed in respect of manual handling, use of bed rails and challenging behaviour. Not assessed on this occasion. - Moving and handling assessments need to include instructions on how to move a resident from the floor. Previous timescale of 27/01/06 not met. - Bed rail consent forms should identify the potential hazards when using bed rails. Not assessed on this occasion. Store room locks are to be reviewed and repaired or replaced on Brooklyn House as they will not close and are labelled as fire doors. Previous timescale of 27/09/06 not met. Sluice room on Perrywell house must be fitted with a lock to prevent residents entering the room. (Partly met, one of the two sluice room doors have been fitted with Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 23 2. OP24 12(1)(a) (4)(a) 22/03/06 3. OP25 4. 5. OP28 OP29 6. OP29 7. OP36 8. OP38 a lock.) 13(4)(a-c) The manager must ensure that weekly random water temperature checks are taken and recorded. 18(1)(a,c) Arrangements must be made to ensure that 50 of care staff are trained to NVQ Level 2. 7 One reference must be obtained 9 from the current or most recent 19 employer prior to new staff Sch 2&4 commencing employment at the home. (The manager received this as an immediate requirement) 7 Any gaps in employment history 9 must be explored and reasons 19 documented. Sch 2&4 18(2) The registered manager must ensure that formal staff supervision is documented at least six times per year and ensure that senior staff are aware of what issues can be discussed within supervision. Not assessed on this occasion. 13(4)(a-c) Bedroom doors which are left 23(4)(a) open at residents request, must have a written risk assessment on file, as the doors are not on magnetic closures. Not assessed on this occasion. 17/03/06 30/06/06 02/02/06 10/03/06 27/01/06 06/01/06 Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP7 OP9 OP9 OP26 Good Practice Recommendations It is recommended that staff receive instruction on how to measure residents for slings, to use with the hoist. Carry over the balances of all liquid preparations on the new Medicine Administration Record (MAR) chart so accurate audits can be undertaken. Undertake regular staff drug audits for all nursing staff to confirm staff competence in medicine management. It is recommended that alternative arrangements for male staff changing are sought and that personal belongings and clothing are not stored in residents toilets, due to the risk of cross infection. Names of staff attending fire drills should be recorded to ensure all staff receive two fire drills per year. It is recommended that only recent maintenance certificates/reports are kept in the maintenance folder and old documents are stored away separately. 5. 6. OP38 OP38 Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 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 Perry Locks Nursing Home DS0000024879.V281658.R01.S.doc Version 5.1 Page 26 - 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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