Inspection on 09/07/08 for Ranelagh House Residential Care Home

This inspection was carried out on 9th July 2008.

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

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

Ranelagh House Residential Care... 04/06/07

Ranelagh House Residential Care... 15/01/07

Ranelagh House Residential Care... 03/01/06

Ranelagh House Residential Care... 19/10/05

Ranelagh House Residential Care... 28/10/04

Ranelagh House Residential Care... 14/04/04

Ranelagh House Residential Care... 26/11/03

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

CARE HOMES FOR OLDER PEOPLE Ranelagh House Residential Care Home 533 Aigburth Road Liverpool Merseyside L19 9DN Lead Inspector Peter Cresswell Key Unannounced Inspection 09:00 9th July 2008 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 Ranelagh House Residential Care Home DS0000025364.V362739.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. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ranelagh House Residential Care Home Address 533 Aigburth Road Liverpool Merseyside L19 9DN 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) 0151 427 4486 lil@ranelaghhouse.com www.RanelaghHouse.com Prima Health Care Limited Margaret Lilian Martin Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th June 2007 Brief Description of the Service: Ranelagh House is situated in the Aigburth area of Liverpool, close to local amenities and on bus routes to the city centre, Speke retail park and John Lennon airport. The home provides care for up to 26 older people who have single rooms, with up to two rooms available for those who may want to share (for instance married couples or partners). Most of the bedrooms have en suite facilities. The rooms are on two floors and there is a passenger lift to the first floor. Three rooms on the first floor cannot be reached by the lift so people who live in that part of the home have to either use the stairs or a stair lift. There is car parking at the side of the house and on the main road, and a secure, well-tended garden to the rear. Fees for Ranelagh House are from £307.50 to £340 a week. Ranelagh House Residential Care Home DS0000025364.V362739.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 inspection included an unannounced site visit. We spoke to the Registered Manager and a number of staff as well as several residents. We toured the home, visiting about half of the bedrooms, and examined care plans, medication, fire safety records, recruitment files and the menu. Some survey forms were distributed but none had been returned by the time we wrote this report. The owner had completed a CSCI Annual Quality Assurance Assessment (AQAA) before the site visit but it had not been received by the time of the site visit. What the service does well: What has improved since the last inspection? What they could do better: New staff must be properly checked before they are allowed to start work at the home in order to protect residents from the possibility of abuse. The recording of medication must be reviewed to ensure that an accurate record is maintained, providing evidence that the correct medication has been administered. The staff training and supervision programmes need to be reintroduced and properly recorded. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 6 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. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 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 Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,5. Quality in this outcome area is good. Ranelagh House’s pre-admission assessment procedures ensure that residents are appropriately placed and therefore receive care that meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Everyone who lives at Ranelagh Lodge is provided with a statement of terms and conditions, plus a contract when they move in to the home. Someone who is considering moving in can visit the home or have an overnight or trial stay before they move in permanently. The Registered Manager or her deputy carry out a full assessment of prospective residents before they are admitted to the home, to ensure that their care needs can be met. Other professionals who know the resident – such as social workers - are also normally involved in the assessment and copies of their assessment kept on file. The completed document forms the basis of the resident’s care plan when they move in. Ranelagh House does not provide intermediate care, so Standard 6 does not apply. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. Care planning is generally good and the monthly reviews ensure that staff are aware of residents’ current needs. The system for organising medication is generally sound, protecting the welfare of the residents, but attention needs to be paid to the need for detailed and accurate recording. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents have an individual care plan, which is drawn up when they are admitted to the home. Care plans are reviewed each month by keyworkers and are checked and signed off by the manager or her deputy. Other staff also take part in the review process, which is well documented. Care plans are written manually and it would be easier to update them if they were kept on a computer. Care plans were in place for all of the residents whose files we checked. Care staff complete daily records for each resident and the manager has produced brief summaries of the care plan which are kept by the daily reports for ready reference by staff making the daily reports. It may be helpful for key workers to prepare brief social histories (pen pictures) of the resident in question. Despite the guidance on daily reports issued by the manager, many of the reports are brief and relatively uninformative, though they are Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 10 completed three times a day. One important piece of information concerning one resident had not been put into the care plan, even though it was evident that some care staff were aware of the information and acted on it appropriately during our visit. Apparently it was left out of the care plan on the advice of the local authority social worker. Care plans are of course confidential and all essential information needed for a person’s care should be included. Everyone has access to community and, if relevant, specialist NHS care. Where possible people retain their own GP when they are admitted to Ranelagh House but if necessary the manager will make arrangements for them to register with a local surgery or health centre. During the inspection we checked medication for three residents. Medicines were stored securely and the home uses a Monitored Dosage System in which most tablets are provided by the pharmacist in special blister packs. Medication was securely stored and on the whole well organised but in one case where blister packs were not yet being used it was not possible to account for the amount of a medicine that had been administered. Records must clearly and accurately record how many tablets have been received, and how many have been administered. In one case several tablets had been signed as having been administered though they were in fact still in the blister pack. If the MAR sheet is signed immediately after administration this kind of mistake should be avoided. All staff who administer medicine have been trained by the home’s community pharmacist. Medicine requiring refrigeration is kept in an ordinary kitchen fridge. Although it is secure there, such medicines are best stored in a dedicated fridge. Controlled drugs were recorded properly in a CD register and are stored securely. However, an approved CD cabinet must be installed specifically to store controlled drugs. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is adequate. Staff arrange some activities to enhance the lives of the people who live in Ranelagh Lodge though this has declined in recent months. The menu provides choices and meets the tastes and dietary needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are asked about their lifestyle, preferred foods, and the sort of social activities that they would like to take part in. The deputy manager and other care staff seek to organise outings and activities, but the level of activities has declined since the manager was ill and the deputy has had to devote more of her time to management duties. Some residents do still go to local churches for coffee mornings and other activities. Some other residents are able to go out on their own. The deputy had arranged for an entertainer to visit the home later in the summer. Ministers of religion visit the home every month and hold services for those residents who want to join in. There is still a need to arrange more activities, especially in the home – several residents told us that they do get bored. The owner may want to consider the appointment of a dedicated, part time activities organiser. Visitors are welcome in the home at any reasonable time and residents can entertain friends and relatives either in the communal lounges, or in their own bedroom. Volunteers from local churches also call in to see residents. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 12 People told us that they enjoyed the food at Ranelagh House and they enjoyed their roast lunch when we visited. The main meal is served at lunchtime and there is always a sweet. The evening meal is lighter but usually includes a cooked option. Residents have a choice of evening meal and can have something prepared individually if they do not like what is on offer. One resident told us that she has, for instance, egg and chips if she does not like the main meal. Residents can choose to have a full cooked breakfast Residents can choose to eat their meals in their own room rather than go to the dining room though when we visited most people seemed to have come down. The home buys its meat and vegetables from small local suppliers to ensure freshness and quality. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18. Quality in this outcome area is good. Procedures for complaints and adult abuse allegations are in place, providing protection for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have not been any complaints since the last inspection. The home has an adult protection policy, a copy of the Liverpool area protocols and guidance on adult abuse. Four staff have attended training in safeguarding adults and the manager needs to arrange for other care staff to receive similar training. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25, 26. Quality in this outcome area is good. Ranelagh House provides a comfortable, clean and homely environment for its residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The owner carries out routine and planned maintenance and the building is homely, clean and well maintained. There were no unpleasant odours in the home. Ranelagh House is on a main road which is well served by buses to Liverpool city centre, Speke retail park and John Lennon airport. Several small shops are within walking distance there is a large pub/restaurant next door. There is a shaft lift to the first floor but because of the layout of the upstairs bedrooms, it does not provide access to three rooms at one end of the house. This part of the home has its own staircase and a stair lift. There are two comfortable lounges and a dining room which overlooks the large and attractive garden through French windows. The television in the end lounge is rather small given the size of the room and the Registered Person may wish to consider getting a bigger one. The curtains in this room are very Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 15 badly hung and unsightly, spoiling the generally homely appearance. They need to be re-hung properly or replaced if they are the wrong size. The home has sufficient bathrooms and toilets, including a Parker assisted bath on the ground floor. Residents have single, lockable bedrooms though there is a bedroom available for sharing should residents (such as married couples or partners) choose to do so. Many of the rooms are light and spacious with good views. The rooms are clean and well furnished, many containing cherished personal items reflecting the personality and tastes of the resident. Most of the rooms have fitted carpets. The carpet in one room which was identified to the manager was stained and must be thoroughly cleaned or replaced. The carpet in the corridor to the old entrance also needs to be thoroughly cleaned or replaced. In some rooms incontinence equipment had been left out on open view. The manager said that there is a storage problem but some means should be found of storing such material out of view. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. Staff are not properly checked before starting work, so residents’ safety is not guaranteed. A stable, well qualified and competent staff group meets the residents’ needs, though some attention is needed to ongoing training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rotas showed that the home is adequately staffed to meet the needs of the people who live there. Residents spoke very highly of the staff and told us that staff were always available to help them when they needed it. As well as the manager there is a deputy manager, seven senior care assistants, seven care assistants two domestic staff and a cook. The staff group is remarkably stable, some having worked at Ranelagh House for over 20 years with at least one approaching her silver anniversary as a worker at the home. Three staff have been recruited since the last inspection. The appropriate checks had not been carried out on any of these staff. The home had not obtained Criminal Records Bureau certificates for any of them. All had CRB certificates from former employment but this is not adequate and it absolutely essential that new CRB checks are obtained for all new staff. If the need for new staff is urgent then staff may start with ‘POVA First’ (fast track) clearance. Most of the references were in fact testimonials rather than references; references need to be obtained directly by the home from the referee. The registered person should consider if additional administrative support would help to improve the current recruitment situation. New staff must be properly checked before starting work in order to protect the safety of the residents. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 17 12 care staff have NVQ2 and a further two are studying for the qualification. Training is still not very clearly recorded and it would be sensible to update the training matrix with dates so that it is apparent when refresher training (e.g. on manual handling and safeguarding) is needed. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38. Quality in this outcome area is adequate. Staff morale is high in Ranelagh House, resulting in an enthusiastic workforce that works positively with residents to improve their quality of life. Staff are not appropriately supervised. Safety checks are carried out to protect residents’ health and welfare but some action still needs to be taken to improve residents’ safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is highly experienced and has managed the home for three years. She has still not started her NVQ4 training and has had to take some time off as a result of illness recently. She places a great emphasis on teamwork and holds regular team meetings. There was a positive and open atmosphere in the home during the site visit. Staff are not receiving one to one supervision. A note in the communication book indicated that staff feel they do not have the time for supervision. It may be that the need for detailed one to one supervision is not so pressing for a staff group which is so Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 19 experienced and stable but it remains a key tool for ensuring continuing staff development and quality of care. The owner lives in the West Midlands but visits the home regularly. He or his administrative officer inspect the home at least every month and complete reports in accordance with Regulation 26. The owner also carries out spot checks at night and this recently resulted in the dismissal of two staff. This sort of visit is an excellent quality assurance tool. The manager occasionally distributes questionnaires to relatives, especially of new residents, but this is not a systematic part of a quality assurance system. The home achieved Investors In People (IIP) status three years ago and this is due to be reviewed by IIP imminently. IIP is a nationally recognised quality assurance measure. Where possible, residents look after their own financial affairs. Families of residents are consulted as regards bank accounts of their relatives. The manager does retain some day to day spending money for some residents and keeps accurate records, including any receipts if anything is spent on residents’ behalf. Fire checks were up to date and gas and electrical safety certificates had been obtained. Numerous fire doors were propped open during the site visit – one of them on a main corridor. If a fire door is propped open it is ineffective as a barrier to the spread of smoke and fire. If a door needs to be kept open this should be done using an approved hold-open device, such as a ‘Dorgard’ or an electro magnetic device (already used in some parts of the home) which close automatically if a fire alarm is sounded. Some combustible material (boxes, equipment) was stored in one of the protected stairwells. Areas such as this need to be kept free of any moveable material which could catch fire. The door to a boiler cabinet in an upstairs bedroom was propped open by a wire. This is unacceptable and potentially dangerous; the manager agreed to make this good on the day of our visit. Doors to boiler rooms must always be kept secure. One resident had a ‘bedleaver’ bar fitted to her bed but no risk assessment had been completed. Where equipment of this sort is used (it is a bar to help someone get out of bed) a risk assessment must be completed and the Medical devices Agency guidance consulted. There was a bedrail in another room and this had been assessed by a district nurse, but there was no copy in the home. The cook checks and records fridge and freezer temperatures every day but the form used for this purpose is not entirely clear and should be redesigned. The home does have a copy of the Food Standards Agency programme Safer Food, Better Business but this did not appear to be used consistently to check food safety. Accidents are properly recorded and the home’s Accident Book complies with the Data Protection Act. However, not all relevant incidents (such as accidents requiring medical intervention) have been referred to the CSCI. One resident told us about a theft from her room which had been notified to the police. The manager conformed that this was so. No Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 20 arrangements had been made to reimburse the resident and the registered person should check the circumstances and arrange, if appropriate, to compensate the resident for her loss. Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 21 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 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 2 x 2 Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 22 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 OP9 Regulation 13(2) Requirement The Registered Person must make arrangements for the recording and administration of medicine and must therefore ensure that each medication episode is accurately recorded and all medication can be fully and properly accounted for. (Original timescale 17/01/07) 2. OP9 13(2) Controlled drugs must be stored in an approved controlled drugs cabinet. The registered person must keep the home in a good state of repair and must therefore: *Thoroughly clean or replace the carpets in the identified bedroom and the identified rear corridor; *Re-hang or replace the curtains in the rear lounge. 4. OP29 19 The registered person shall not employ a person to work at the home unless the person is fit to do so and the documents DS0000025364.V362739.R01.S.doc Timescale for action 01/09/08 01/11/08 3. OP19 13(4), 23(2) 01/11/08 01/08/08 Ranelagh House Residential Care Home Version 5.2 Page 23 required in Schedule 2 of the regulations are in place; in particular, CRB checks, POVA clearance and references. 5. OP38 23(4) The Registered Person must take 01/08/08 adequate precautions against the risk of fire and must therefore: *remove any combustible material from the stairwell; * ensure that fire doors are only propped open by an approved device which closes the door if an alarm is sounded; *conduct and record checks on fire safety equipment (Original timescale 19/06/07) 5. OP38 13(4) The registered person shall ensure that all parts of the home are free from hazards and must therefore keep secure the boiler cabinet on the first floor. The registered person must complete a risk assessment when ‘bedleaver’ bars or other bedrails are in use. The registered person must notify the CSCI without delay of any serious injury to a service user, theft and all of the other matters set out in Regulation 37. 09/07/08 6. OP38 13(4) 01/08/08 7. OP38 37 01/08/08 Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 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. Refer to Standard OP9 OP12 Good Practice Recommendations Medicines requiring refrigeration should be kept in a secure fridge, preferably solely used for medication. People who live at the home should have access to leisure and social activities of their choice. The appointment of a part time activities organiser may assist in this. The registered manager should keep an accurate record of staff training. Staff should receive formal one to one supervision at least six times a year. The form on which fridge and freezer temperatures is recorded should be redesigned to make it clear what has been checked. The owner should investigate the circumstances of the theft at the home and, if appropriate, compensate the resident in question for any loss incurred. 3. 4. 5. OP30 OP36 OP38 6. OP38 Ranelagh House Residential Care Home DS0000025364.V362739.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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. 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