Inspection on 11/03/09 for Queensmead

This inspection was carried out on 11th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Queensmead 27/11/07

Queensmead 08/12/06

Queensmead 23/01/06

Queensmead 17/08/05

Queensmead 31/01/05

Queensmead 26/07/04

Queensmead 02/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Queensmead 1 Bronte Avenue Christchurch Dorset BH23 2LX     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gloria Ashwell     Date: 1 1 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Queensmead 1 Bronte Avenue Christchurch Dorset BH23 2LX 01202485176 01202487805 queensmead@care-south.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Care South care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 36 in the category OP (Old Age) and 4 in the categories DE(E) and/or MD(E). Date of last inspection Brief description of the care home Queensmead is registered with the Commission for Social Care Inspection to accommodate 40 older people including 4 places for people with a diagnosis of dementia or mental illness. Queensmead is operated by Care South, a non-profit making organisation with several residential homes and community services across the South West. 0 0 0 Over 65 4 4 36 Care Homes for Older People Page 4 of 30 Brief description of the care home Mrs L Thornhill is the registered manager. The home is situated in a residential estate close to Christchurch Hospital and one mile from the town centre. Queensmead is a purpose built home set in large, wellmaintained grounds. Local shops and amenities are available within a short distance. The premises extend over 3 floors with service users accommodated on every floor. The ground floor comprises 11 bedrooms, an assisted bathroom, 8 separate toilets, a dining room, three lounges and a conservatory. The first floor has 15 single bedrooms, 2 bathrooms, one shower room and two separate toilets. The second floor has the remaining 14 bedrooms, two further bathrooms and two separate toilets. Fees are charged weekly; the fee range quoted by the manager at the time of inspection was (per person) between £540 and £635. Up to date information on fees can be obtained from the service. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000. This inspection was carried out by two inspectors, and throughout the report the term we is used, to show that the report is the view of the Commission for Social Care Inspection. This inspection was unannounced; the inspectors arrived at 10.00 on 11 March 2009, toured the premises and spoke to residents, staff, observed staff interaction with residents and the carrying out of routine tasks and together with registered manager Care Homes for Older People Page 6 of 30 Mrs Thornhill and the deputy manager discussed and examined documents regarding care provision and management of the home. The duration of the inspection, being the combined hours both inspectors spent in the care home, was 11 hours and 30 minutes. During the inspection, particular residents were case tracked; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same residents were examined and the residents spoken with. In advance of the inspection an Annual Quality Assurance Questionnaire was completed by Mrs Thornhill and returned to the Commission, the information it contained has been used to inform the findings of this inspection. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 8 of 30 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. Evidence: The records of 3 residents admitted since the last inspection included details of pre admission assessments carried out by the registered manager while visiting the prospective residents at their previous addresses. In advance of making the decision to enter the home the prospective residents or their representatives visited the home to view the premises and meet residents and staff. When the new resident has been accommodated at the home for approximately a month a review involving the resident and their relatives or representative takes place to ensure the home is properly meeting their persons needs. At the review the closest relative of one of these 3 recently admitted residents stated that the person seems Care Homes for Older People Page 11 of 30 Evidence: very content. Following pre admission assessment of each prospective residents needs and circumstances the home writes to them confirming the agreement and ability to provide accommodation and care. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In general there is evidence that residents receive the care they need but some records and care practices require improvement to ensure staff have sufficient guidance to enable them to properly care for and protect residents from the harm and ill health that unplanned and potentially inappropriate care and incorrect medicine administration might cause. Evidence: The care records of 6 people who live at the home were examined and found to contain risk assessments forming the basis for care plans and daily records describing the care of each person. There was evidence that individual residents or their representatives had been involved in the development and review of planned care provision. The standard of record keeping is generally good with msot care plans and associated records clear and comprehensive providing staff with sufficient information upon which to base their practise and being evidence that the people received the care they needed, but for some people some components of the care plans had not been Care Homes for Older People Page 13 of 30 Evidence: updated to reflect their current condition, and thereby failed to provide reliable information and on occasion indicated that not all aspects of care had been properly met. For example, the records of one person stated that during November treatment for an infected wound was necessary but there was no more recent record for this aspect although the deputy manager said the condition had improved and required no current treatment. For the same person daily records stated that staff were applying a skin care cream and that stocks had run out, so staff used an alternative, but neither the care plan nor medications charts made reference to this, the treatment had not been formally prescribed and persons responsible for ordering medications were unaware the cream was needed and had run out. Some records of daily care provided to another resident were so poorly written as to be unintelligible, with neither the registered manager nor the deputy manager able to comprehend the precise meaning. For this person the monthly record of body weight indicated a sudden weight loss but this was not referred to in the care plan and accordingly no review had taken place to consider this aspect of health. One person uses an alarm pad to alert staff if the person rises from bed during the night but the home has not recorded risk assessment for this item. Alarms pads may constitute a form of restraint but the home has not obtained the consent of the resident or their representative to use of the item. It was noted that since the previous inspection there have been improvements to specific aspects of record keeping, in particular the information provided regarding the management of diabetes was seen to be clear and accurate, and for people assessed at risk of dehydration up to date fluid intake records were kept. For medicine handling the home uses a monitored dosage system, whereby most medications are stored in blister packs, to simplify the process of administration. Staff trained in this work carry out medicine handling, and subject to risk assessment some residents manage their own medicines. From examination of a sample of Medication Administration Records (MARs) and discussion with the Registered Manager we identified a number of areas where improvement is necessary, although the manager audits medicine handling processes twice each year and confirmed her awareness of some of these weaknesses which Care Homes for Older People Page 14 of 30 Evidence: remain ongoing despite having been previously brought to the attention of the staff concerned. The Controlled Drug register stated that 100ml of the medicine Oramorph remained in the home, although there was none in the Controlled Drug cabinet. The cabinet was being used to store Hydroxycobalamin for injection although this is not a Controlled Drug and therefore should not be in the Controlled Drug cabinet. The home was advised to use the Controlled Drug register index to simplify the process of auditing when records for particular residents continue over a number of pages. Medicine records of a number of residents included handwritten instructions and alterations which had not been signed and dated by the writer, and countersigned by a person who had checked the amendment for accuracy. For a number of people medicine administration records had not been completed on each occasion of administration to confirm that the prescribed medicine had been given and from discussion with the deputy manager there were indications that on at least one recent occasion this was because the home had run out of the particular medicine. The medication record provides a Key of abbreviations to be used when a prescribed medicine is omitted but on a number of recent occasions the key has not been adhered to, so the reason for omission is not known. It was also noted that when a variable dose is prescribed, for example Give one or two tablets, the amount actually given is not always recorded, so accurate audit cannot be carried out, and it is not known how much of a particular medicine the resident has received. The home has met the requirements and recommendations contained in the report of the last inspection having obtained a larger trolley for medicine handling, and recording the dates on which eye drop containers are first opened. Residents confirmed that felt they are treated with respect and that their dignity is preserved by the staff at the home. Staff were observed to knock on doors before entering and carrying out personal care tasks in a discrete and respectful manner. Residents said they are called by the name they like to be known by. We received the following comments from residents I am quite happy here, its a very nice place, The staff are very good, they talk to me as I would want, They look Care Homes for Older People Page 15 of 30 Evidence: after us well. If theres anything wrong with you they get the doctor, They come quickly to see what is the matter, We get the care we need. If you want help you get it, I dont think youd get this kind of service anywhere else. Press the button and they come fairly quickly. Care Homes for Older People Page 16 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have opportunities to engage in social and recreational activities and are encouraged and supported to pass the time according to individual preference. A choice of menu is provided and meals are nutritional and appetising. Evidence: The home employs an Activity Organiser for 20 hours each week; a weekly Activity Programme is displayed in the home. Frequent social and recreational activities and seasonal celebrations are arranged e.g. during the morning of this inspection a visiting activity leader was holding a lively Reminiscence session in the main lounge which was attended by many residents who later told us they had enjoyed it. During the previous day a PAT dog and owner attended the home enabling residents to meet the animal. Visitors are welcome at any time and those spoken to during the inspection said they are always made to feel welcome and placed at ease by the staff. Residents believe they are shown respect and properly treated; comments made during the inspection included staff talk to us and have a chat, they treat us well, Care Homes for Older People Page 17 of 30 Evidence: we can do what we want, Ive never been unhappy here about anything. Meals provide good nutrition and in general they are liked by residents but many commented on the frequent toughness of meat. Similar comments were received at the previous inspection. The manager said that this will again be brought to the attention of catering staff. The home takes very seriously all comments received; it has established a Residents Catering Committee and during February 2009 carried out a survey of residents opinions of the new 4 weekly rotating menu that is soon to be introduced. On the day of this inspection the main midday meal was roast turkey with vegetables. The alternatives offered were omelette or salad. In general, there are more options available, but due to the popularity of this meal, which is served once each week, the options are reduced. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this 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 know how to complain and are confident their complaints would be listened to. Residents are safeguarded against risks of abuse in its various forms. Evidence: Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. The home has a complaints policy and procedure. No complaints have been received and there have been no allegations or investigations regarding the safeguarding of vulnerable adults. All staff receive training on the safeguarding of vulnerable persons and the home has a written policy and procedure for the protection of vulnerable adults. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable, clean, well equipped and suited to the needs of residents. Evidence: Queensmead is a purpose built care home, set in its own grounds, with car parking spaces and gardens. On the day of inspection the home was clean, tidy and comfortable throughout. Resident accommodation is on the ground, first and second floors. There is a passenger lift in the home, enabling level access between the floors. All bedrooms are for single occupancy, those seen were personalised and reflected the wishes of residents. No bedrooms have en suite hygiene facilities. There are sufficient bathrooms and toilets, including baths with adaptations enabling use by people with impaired mobility who require assistance. A variety of communal areas provide residents with a choice regarding what they would like to do, and if they would like to be alone, in the company of staff and other residents or in private with family and friends. There is a designated hairdressing room. Care Homes for Older People Page 20 of 30 Evidence: The home has good procedures in place for the control of infection in the home. Staff are taught effective hand washing techniques including the use of alcohol gel, to minimise risks of spreading infection between residents. The laundry room is equipped with equipment compliant with hygiene requirements, including a sluice cycle washing machine. It has been recently improved including provision of a second washing machine and larger driers. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort but must improve aspects of employment practice. The home promotes the achievement of nationally recognised care qualifications. Evidence: The home is at all times in the charge of an experienced person and staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. The records of 3 recently employed care staff were examined and found to contain most essential information including written references, interview assessment, health details and evidence of identity. For each of these persons a Criminal Records Bureau (CRB) disclosure had been obtained in advance of employment. Some weaknesses in recruitment practise were found including the following. For one of the applicants the written reference from the most recent employer arrived 6 weeks after the person started work in Queensmead; the registered manager explained this was due to the previous employer having ceased trading and thereby being difficult to contact. A verbal reference had previously been obtained from this Care Homes for Older People Page 22 of 30 Evidence: person. The applicant had been previously employed by a registered care service but no reference had been sought from that employer. We recommend that even if two other references have been provided, a reference be also obtained from previous employment working with vulnerable people, if there has been such previous employment. Another applicant had commenced employment at Queensmead a day before a verbal reference was received, and 10 and 21 days in advance of the 2 written references being received. Each prospective employee completes an application form giving details of past employment. Although details of previous employment were provided by each of the 3 persons whose recruitment records were examined, it was noted that on occasion only the years on which previous employment commenced and ceased were recorded. We recommend full employment dates to be recorded enabling an accurate history to be established. The home meets the standard for at least 50 of staff to hold the National Vocational Qualification (NVQ) in care. There was evidence that recently employed staff had received induction training and that staff are encouraged and supported to undertake training in subjects relevant to their work. During our inspection a Dementia Awareness training day took place in the home with at least 10 staff attending. All seemed attentive and interested throughout the day which was part of the homes established 1 day a month training programme. It was noted that of the 4 kitchen staff employed, one started work during July 2008 but has not yet trained in Food Hygiene. The manager explained that this was because the staff member is in the process of first improving English language skills. It is recommended that all staff involved in food handling undertake relevant training to ensure their understanding of good practise and the consequent protection of service users from risks of harm. Residents we spoke to expressed satisfaction with the staff and we were shown a letter recently written by the relative of a person who had been resident in the home, stating The staff at Queensmead are among the most caring people I have ever had the good fortune to meet. Nothing was too much trouble, even when they were busy. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is properly managed and maintained in the best interests of service users. Evidence: The registered manager is Mrs Thornhill; she holds the Registered Managers Award and is an experienced manager. The home also has a deputy manager to support MrsThornhill and to lead the care team by working with them on the floor. Throughout our inspection Mrs Thornhill and the deputy manager ensured that the day to day running of the home was maintained and individual residents interests considered. They are a strong management team, whose care for residents was reflected in their work. Prior to this inspection the home completed an annual quality assurance assessment (AQAA) identifying what they feel they do well, what they have improved during the Care Homes for Older People Page 24 of 30 Evidence: past 12 months and their plans for improvement over the next twelve months. The home has an internal quality assurance system which gives a realistic picture of areas for improvement. At the centre of this is consultation with residents and their families including questionnaires and residents meetings to discuss aspects which people living in the home want to talk about. With the exception of safekeeping small amounts of money for some residents for which records and receipts are kept of all transactions, the home does not manage the finances of residents. Residents who are unable to undertake this responsibility personally have nominated relatives, friends or other representatives to do this on their behalf. Staff trained in First Aid and health care are on duty in the home at all times. The home has a written assessment of the Health & Safety of the premises and working practices and keeps records of fire safety checks and tests, including drills and staff training, and has developed a fire safety assessment and escape plan making specific reference to the currently accommodated residents. At present, the home does not use bed rails but for at least one person a pressure mat is in use. As stated in the Health and Personal Care section of this report, a process of risk assessment and consent must be developed and implemented in this regard. During the inspection a sample of records regarding equipment servicing and maintenance were examined and found to be in generally good order but the home is recommended to obtain documentary evidence of the safety of the gas and electrical installations. Care Homes for Older People Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The registered person shall, 22/04/2009 after consultation with the service user, or a representative of the service user, prepare a written plan (the service users care plan) as to how the service users needs in respect of health and welfare are to be met, and shall keep the plan under review Care plans and other care records must be improved to ensure provision of accurate information to staff to enable them to properly care for residents. 2 8 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home.This means that: 22/04/2009 Care Homes for Older People Page 27 of 30 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action An accurate record of each instance of medicine administration must be kept for each resident. When a variable dose is prescribed e.g. give 1 or 2 tablets the amount actually administered on each occasion must be recorded. 3 38 13 The registered person shall 22/04/2009 ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. This means that: there must be reliable evidence that when potential restraints e.g. alarm pads are used it is in accordance with robust consent and assessment processes, kept under continuous review and designed to ensure the safety of service users. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 When a medicine is prescribed for administration as required, the reason for potential administration should be Care Homes for Older People Page 28 of 30 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations stated in the administration instructions. 2 3 9 9 The index of the Controlled Drug register should be used to simplify later audit processes. Handwritten medicine administration instructions and alterations to instructions should be signed and dated by the writer, and countersigned by a person who has checked the accuracy of the instruction. The home should obtain and make available for inspection documentary evidence of the safety of the gas and electrical installations. 4 38 Care Homes for Older People Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - 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!