CARE HOMES FOR OLDER PEOPLE
Ravencourt Residential Care Home 60 Barrington Road Altrincham Cheshire WA14 1HY Lead Inspector
Kath Oldham Unannounced Inspection 13th September 2007 09:10 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 Ravencourt Residential Care Home DS0000005627.V348512.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. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Ravencourt Residential Care Home Address 60 Barrington Road Altrincham Cheshire WA14 1HY 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) 0161 928 8648 Miss Barbara Richardson Mrs J Richardson Miss Barbara Richardson Care Home 5 Category(ies) of Old age, not falling within any other category registration, with number (5) of places Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. All service users will fall within the category of old age but may additionally have learning disability 1st October 2006 Date of last inspection Brief Description of the Service: Ravencourt is registered to provide personal care and accommodation for up to five people in the category of old age who may additionally have a learning disability. Two registered providers, who are mother and daughter and who live on the premises, provide 24-hour support. One of the registered providers is also the manager. Ravencourt is situated on a main road, near to the centre of Altrincham and close to shops, public houses, a theatre, post office, public transport routes and parks and gardens. There is a small parking area at the front and a garden with a seating area at the rear of the property. There was one resident living in the home at the time of inspection. The fees for accommodation and care are approximately £1500 per calendar month. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This visit was unannounced, which means Ravencourt were not told we would be visiting, and took place on 13th September 2007, commencing at 9:10am. The inspection of Ravencourt included a look at all available information received by the Commission for Social Care Inspection (CSCI) about the service provided since the last inspection. This included Ravencourt filling in a questionnaire about the home, which gave information about the service user, the staff and the building. Ravencourt was inspected against key standards that cover the support provided, daily routines and lifestyle, choices, complaints, comfort, how staff are employed and trained, and how the service is managed. Comment cards were sent prior to the inspection for distribution to the person staying at Ravencourt, the views expressed in returned comment cards are included in this report. A tour of Ravencourt was also undertaken and a sample of care and health and safety records seen. The main focus of the inspection was to understand how Ravencourt was meeting the needs of service users and to make sure staff had the skills to meet the needs of service users. A brief explanation of the inspection process was provided to the manager at the beginning of the visit and time was spent at the end of the visit to provide verbal feedback. Ravencourt provide a good service to the service user accommodated. If Ravencourt were to increase the service to provide additional service users with accommodation, then the service would need to be developed further. What the service does well:
The service user accommodated at the time of the inspection said they were happy with the support and care offered by staff. The service user has been accommodated at Ravencourt for over twenty years and is part of family life. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 6 Staff demonstrated an awareness of the needs of the service user and commitment to deliver care, which meets service user needs whilst respecting their rights. The staffing arrangements at the time of the visit ensured the service user was supported and consulted on social, personal care and meal arrangements in the home. The home feels that they listen to the service user, treating them with respect, promoting informed choice, encouraging independence, protect their human rights and enabling them to live as full a life as possible. The manager said, “We respect their privacy and provide a safe, comfortable, worry-free environment which is flexible to meet the changing needs and wishes of residents” and Ravencourt, “recognise a persons needs as the ‘social and emotional ones’ of those living in the community rather than the ‘basic needs’ of a person in a rest home”. Their philosophy is: “if youre not enabling someone, youre disabling them”. What has improved since the last inspection?
The home feels that in the last 12 months they have constantly updated their knowledge to ensure they provide the best care possible. Ravencourt are developing a booklet called ‘Good Care Practice’. The first section is on Valuing the Individual. It was recommended on the last inspection that the home’s adult protection policy makes reference to Trafford Social Services’ adult protection procedure. This has been carried out. It was a requirement on the last inspection that a full audit of carpets and floor coverings was carried out to ensure that they do not create a tripping hazard. Since the last inspection, the carpet in the hall, landing and stairs has been replaced. In the bathroom, the toilet, wash hand basin and flooring have been renewed. In addition, a hydrotherapy shower has been installed. The room has been tiled and wallpapered. The bedroom accommodated by the service user has had a toilet installed, this was arranged to promote the continence of the service user. In the downstairs toilet, the flooring has been renewed and the room re-decorated. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 7 Ravencourt plan to replace the carpeting in the combined lounge and dining room to improve the appearance of this room What they could do better:
There are a number of recommendations arising from this inspection. These need to be addressed by Ravencourt. Ravencourt need to amend the statement of purpose and service user guide, detailing up-to-date information that Ravencourt is registered with CSCI and also update the registration categories as indicated on the certificate of registration. This will ensure prospective service users have accurate information. The contract/terms and conditions of residency need to be amended to indicate that there is a trial period of up to six weeks’ stay and also needs to include the fees for staying at the home, so that prospective service users have all the information they need and all the rules and regulations within the contract. When reviewing the care plan, Ravencourt need to ensure that any changes to care needs are recorded, as this will ensure that service users receive the care they need when and how they need it. To safeguard service users, risk assessments need to be put in place which identify when service users are at risk and what action can be taken to minimise that risk. Arrangements need to be put in place for the service user to be weighed monthly, or more frequently if the care plans dictate this. This will ensure that Ravencourt are aware if the service user is gaining or losing weight and then investigations can be arranged. The medication policy needs to be reviewed and revised to include a homely remedy policy; reference should be taken from recognised publications to undertake this. This will safeguard the service user. The opportunity for service users to take part in activity needs to be reviewed to ensure they are not isolated from others and the occupation and stimulation provided is of interest and meets their needs. A record needs to be made of all meals taken by service users to enable a judgement to be made, if necessary, as to whether the diet is sufficient and satisfactory in relation to nutrition. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 8 Staff who have the responsibility of preparing or serving food need to update their food hygiene training to ensure they are up-to-date with changes in food hygiene regulations and requirements. To ensure staff are able to recognise potential abuse and are aware of what to do in this situation, Ravencourt needs to provide all staff with specialist training on the protection of vulnerable adults. Ravencourt need to contact the Fire Authority and discuss the security arrangements to ensure these actions do not compromise service users and staff safety and comply with fire regulations. 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. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 9 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 Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 10 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 &3 (Standard 6 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Procedures were in place to ensure that service users’ needs were identified and assessed. EVIDENCE: There is a service user guide and statement of purpose in place, which gives details of what service users should expect of the service provided at Ravencourt. The documents make reference to the home being registered with Manchester and Trafford Social Services when, in fact, they are registered with the Commission for Social Care Inspection. This needs to be changed, so the correct information is given to prospective service users. Also, the categories of registration included in the documents need to be changed to reflect the conditions of registration on the certificate.
Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 11 There is an assessment procedure in place if referrals are made to the service. Ravencourt has not had any new service users since 1998. The service user accommodated at Ravencourt has lived there for over 20 years. The manager said she would go out to see any prospective service users before a decision was made to accommodate them at Ravencourt. The assessment would include checking that they were compatible to live with the current service user and they would also check that staff had the skills and knowledge to look after someone else before a decision was made. The service user had a contract and it was reported that all details were explained to them to ensure their understanding. The contract needs some slight amendment to ensure it is reflective of the detail of the local authority contract for service users funded in this way. The fee for living at the home also needs to be included, so prospective service users know how much they have to pay to live at Ravencourt. Ravencourt does not offer intermediate care facilities. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence, including a visit to this service. Ravencourt met the service user’s health and personal care needs. EVIDENCE: A care plan was in place for the service user accommodated at Ravencourt. The manager said as the service user’s needs change, the care and support change also. There was a record of a review of the care plan. No written changes to the plan of care were evident. The care plan detailed the support needed for bathing when the service user now had a shower. This change should be recorded. There was no documentation to suggest that the local authority had undertaken a review of the placement for the service user. This should be undertaken annually by the local authority to ensure the placement continues to meet service user’s needs. The manager should ensure that the local authority is contacted to undertake this review.
Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 13 The service user was not prescribed any medication from their doctor. From time to time, homely remedies are used, when the service user has a cold, for example. Ravencourt does not have a homely remedies policy, which needs to be in place to safeguard the service user. A format needs to be put in place to record the weight of service users monthly. This is not routinely undertaken, so Ravencourt cannot be sure if the service user is maintaining or losing weight. This needs to be arranged and the service user weighed routinely. Risk assessments need to be in place which identify when people are at risk and what action can be taken to minimise that risk. The privacy of service users is promoted through discreet support and care being provided. Toilet and shower room doors have privacy locks fitted to promote privacy whilst using the facilities. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The lack of recent recording does not evidence regular activity and occupation and the meal choices provided. EVIDENCE: Ravencourt arranges routine daily trips into town and periodic trips to National Trust houses, which were reported to be enjoyed by the service user. There are currently no opportunities for the service user to spend time with people, other than the three staff at Ravencourt. The manager said that the service user doesn’t like mixing with other people. In response to the question, are there opportunities arranged by the home that you can take part in, the service user responded “always”. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 15 The manager said the service user likes their own company and has tried a variety of day centres over time, which were not always enjoyed. As the home accommodates one person, there are no daily opportunities to talk or interact with others. The service user is a keen football fan and spoke with enjoyment of past trips to Manchester United Football Club and of watching football on television. The questionnaire completed by Ravencourt identified that the service user enjoys many activities, which include going out regularly to National Trust properties. The manager indicated in the questionnaire that the service user “is given a choice as to whether they want to go or not. Sometimes the service user doesn’t feel like it and prefers to watch something on television, usually football”. There were no recorded outings or activity since the beginning of August 2007. The manager described this as an oversight, as her time had been taken up on providing documentation for CSCI in recent weeks and other recordings had not been kept up. There were no menus available or an up-to-date record of meals taken by the service user. Ordinarily, a record is made in the diary of the main meal of the day but this record was not up-to-date. The manager said that they know the service user’s likes and preferences in relation to meals and these requests are accommodated. The service user chose to have pasta for lunch, being something they fancied having to eat on the day. This was provided. It was not possible to look at a record of meals served to the service user to judge whether the diet was sufficient in terms of nutrition. A record needs to be maintained of all meals taken each day. The comment card indicated that they “Always” liked the meals at the home. The manager and the owner completed food hygiene training in 2004, this needs to be updated to ensure their knowledge of safe handling of food and food preparation procedures are up-to-date. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Procedures for dealing with complaints were in place. Staff need to undertake specialist training in adult protection. EVIDENCE: Ravencourt had a complaints procedure in place. The procedure is displayed within the entrance hall. Ravencourt had received no complaints in the previous 12 months. No complaints or concerns had been raised with the Commission for Social Care Inspection. Ravencourt plans to continually promote service users’ rights and wishes and ensure any worries are addressed and remedied early on, so as not to cause any distress. The manager said that staff know and would follow the home’s policies and procedures on protecting and safeguarding the rights of service users. Video training has been undertaken in relation to adult protection. The manager was aware of the training available from external trainers. Staff at Ravencourt have not received specialised training in adult protection, which would further assist in their understanding of these issues. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The standard of the environment at Ravencourt meets the expectations of the service user. EVIDENCE: The layout of the home is that of a private house. It is situated within easy reach of Altrincham town centre. This provides easy access to the library, the Garrick theatre, bus, train and metrolink and a number of public houses. There are three single and one double bedrooms within accommodation, which is used by the manager and her family. the living Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 18 Ravencourt feel that they provide “safe, comfortable and a happy environment, a home from home and an environment where service users are respected and cared for”. Since the last inspection the carpet in the hall, landing and stairs has been replaced. In the bathroom, the toilet, wash hand basin and flooring have been renewed. In addition, a hydrotherapy shower has been installed. The room has been tiled and wallpapered. The bedroom accommodated by the service user has had a toilet installed, this was arranged to promote the continence of the service user. In the downstairs toilet, the flooring has been renewed and the room re-decorated. Ravencourt plan to replace the carpeting in the combined lounge and dining room to improve the appearance of this room. The information provided by Ravencourt prior to the inspection indicated that the requirements of Environmental Health and the Fire Officer are complied with. A kitchen cleaning schedule and fridge, freezer and food temperature record were maintained and Ravencourt adheres to the infection control policy, “essential steps to safe clean care”. Family members undertake the cleaning of the house. unpleasant odours. There were no Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff are in sufficient numbers to meet the needs of the service user at Ravencourt. EVIDENCE: The registered manager/proprietor manages the home on a day-to-day basis with the support of her mother. Another relative provides relief weekend cover. There had been no changes to the staffing arrangements since the previous inspection of these standards. There have been no staff appointments. The manager said that there are recruitment and selection procedures in place if they need to recruit additional staff. The manager is a member of Trafford Training Consortium which means that Ravencourt has access to traing provided by or on behalf of the local authority to further develop the skills of the staff. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The health and safety of service users is promoted by the policies and procedures in place. EVIDENCE: The owners and manager have owned and managed Ravencourt since 1984. The manager has diplomas in management and health and social welfare. In addition, the manager is an NVQ internal assessor. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 21 The manager is appointee for the service user living at Ravencourt. There were small amounts of money held on behalf of the service user for payment for trips out and such like. Receipts are maintained for any purchases made and a record kept of balances. The checks to fire safety equipment were recorded as having been completed as required by the fire authority. This practice safeguards service users and staff. The front door of the house is bolted at night before retiring to bed. This practice needs to be discussed with the fire authority, as it may delay exit from the house in an emergency situation. In the written information provided to the Commission, Ravencourt indicated that they have developed a quality assurance and service user survey, which is formally reviewed each year. As the manager and owners all live together, the manager said that quality is informally reviewed much more frequently. Trafford Local Authority monitors the contract they have with Ravencourt to provide accommodation and care. The manager said that earlier this year, a visit by Contracts was undertaken and Ravencourt “satisfied them on all aspects”. Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP1 Good Practice Recommendations Amend the statement of purpose and service user guide detailing up-to-date information that Ravencourt is registered with CSCI and also update the registration categories as indicated on the certificate of registration. This will ensure prospective service users have accurate information. Update the contract to indicate that there is a trial period of stay of up to six weeks and include the fees for staying at the home; so prospective service users have all the information that they need and all the rules and regulations within the contract. When reviewing the care plan, ensure that any changes to care needs are recorded, this will ensure that service users receive the care they need when they need it. 2 OP2 3 OP7 Ravencourt Residential Care Home DS0000005627.V348512.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. 4 5 Refer to Standard OP7 OP8 Good Practice Recommendations Risk assessments need to be in place which identify when service users are at risk and what action can be taken to minimise that risk. Arrange for service users to be weighed monthly, or more frequently if the care plans dictate this. Record service users weights. If a service user’s weight was to fluctuate significantly, then take action to investigate the loss or gain. Review and revise the medication policy taking reference from recognised publications and include a homely remedy policy to safeguard service users. Further promote the opportunity for service users to take part in activity to ensure they are not isolated from others and the occupation and stimulation provided is of interest and interesting to service users. Record all meals taken by service users to enable a judgement to be made, if necessary, whether the diet is sufficient and satisfactory in relation to nutrition or otherwise. All staff that have the responsibility of preparing or serving food need to update their food hygiene training to ensure they are up-to-date with changes in food hygiene regulations and requirements. To ensure staff are able to recognise potential abuse and are aware of what to do in this situation, provide all staff with specialist training on the protection of vulnerable adults. Discuss with the Fire Authority the arrangements for locking of the front door of the house to ensure this complies with fire procedures and does not compromise the exit route in the event of an emergency situation. 6 7 OP9 OP12 8 OP15 9 OP15 10 OP18 11 OP38 Ravencourt Residential Care Home DS0000005627.V348512.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Old Trafford, Manchester M16 9HU 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
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