Inspection on 05/09/06 for Redholme Memory Care Ltd

This inspection was carried out on 5th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Redholme Memory Care Ltd 08/02/06

Redholme Memory Care Ltd 20/01/05

Redholme Memory Care Ltd 29/06/04

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

CARE HOMES FOR OLDER PEOPLE Redholme Memory Care Ltd 11 Carnatic Road Mossley Hill Liverpool Merseyside L18 8BY Lead Inspector Jeanette Fielding Key Unannounced Inspection 5th September 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Redholme Memory Care Ltd DS0000060551.V300787.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. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redholme Memory Care Ltd Address 11 Carnatic Road Mossley Hill Liverpool Merseyside L18 8BY 01517242016 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) Redholme Memory Care Ltd Ann McCann Care Home 55 Category(ies) of Dementia - over 65 years of age (55) registration, with number of places Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 10 PC (DE/E) within the overall number of 55 beds Date of last inspection 8th February 2006 Brief Description of the Service: Redholme is situated in the Mossley Hill area of Liverpool close to Sefton Park. Redholme Memory Care Home provides 55 places for people over the age of 65years that have organic mental illness. Mrs Ann McCann is the owner and Registered Manager. Mrs Mc Cann is a qualified nurse with many years experience working with the service user group. Nursing staff and qualified care staff are in attendance 24 hours per day to facilitate care. Accommodation is provided on three floors, because of the design of the original building, the first and second floor exit at ground level into a well maintained large garden area. The home has developed an additional garden facility for service users and this will provide wheelchair access. A sensory garden is sited at the bottom of the garden. There are pleasant well-decorated lounges, dining rooms and small sitting areas around the house. A selection of bathrooms and toilets are provided, walk in showers and assisted bathing facilities are available. 45 single rooms and 5 double rooms are available with some en-suite toilet and washbasin facility. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted in one day over a period of eight hours. A pre-inspection questionnaire was completed by the manager some four weeks prior to the inspection and provides information that was verified on the day of the site visit. During this visit, records relating to the care required by, and afforded to service users were inspected. A sample of the staff records was inspected to verify their skills and training. Discussion took place with service users, although the majority were unable to express themselves due to their dementia, the manager, staff and visitors to the home. A full tour of the premises was undertaken to evaluate the facilities offered to service users. The one area of concern was in relation to the handling of medications and confirmation that this has been addressed was given to CSCI subsequent to the inspection. What the service does well: What has improved since the last inspection? Issues relating to the improvement of photocopied documents and the preadmission assessment document have been addressed since the last inspection and are now good. Improvements have been made to the décor and furnishings with further improvements planned. Additional training has been given to the staff to further enhance service users quality of life. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Redholme Memory Care Ltd DS0000060551.V300787.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 Redholme Memory Care Ltd DS0000060551.V300787.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose and Service User Guide are well written and provide potential residents and/or their visitors with details of the services the home provides enabling an informed decision about admission to the home. The preadmission assessment of prospective service users provides full information regarding the care needs of individual service user and thereby enable staff to meet their needs. EVIDENCE: The home has produced a comprehensive pack for prospective and current service users. It contains a Statement of Purpose and full information regarding the services and facilities provided by the home together with information about funding. A copy of the information pack is given to all enquirers and further copies may be obtained from the home on request. The Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 9 Statement of Purpose, the service user guide and a copy of the last inspection report on the home are displayed in the entrance foyer. All service users are issued with a contract or a statement of terms and conditions on admission to the home. A copy of this is held on their personal file. Service user and their relatives are encouraged to visit the home prior to admission to give them the opportunity to see the rooms and to meet with staff and other service users. A full assessment is made on prospective service users, by senior nurses, to ensure that all care and social needs are identified and to identify any specialist equipment that the home requires to obtain in order to meet the service users needs. Information is gathered from the service user, their relatives and any other person involved in their care prior to admission to the home. Information such as individual preferences are also recorded in relation to food, the preferred form of address and the time that individuals like to go to bed or rise. New documentation for recording the information gathered at the time of the assessment is now in use. One relative spoken to confirmed that a nurse from the home visited her relative in hospital to assess the care needs and that the home’s brochure provided sufficient information to assist in choosing a care provider. The home does not offer intermediate care. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is excellent adequate. This judgement has been made using available evidence including a visit to this service. Care plans are detailed and informative to enable staff to provide the necessary level of care required by each service user and thereby meet their individual needs. Medications have not been addressed in a safe manner to ensure the protection of service users. EVIDENCE: Individual care plans are prepared for all service users, initially being based on the information gathered during the preadmission assessment process, and then updated as the care needs of service users are more clearly identified. The care plans are prepared by the senior nurses and are reviewed each month or more frequently as necessary. A sample of ten care files were inspected to evaluate the level of care required by service users and to balance this against the level of care given. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 11 The care files were found to be detailed and informative. Records are held of all visits to and by other healthcare professionals and it the records show that the services of the Tissue Viability Nurse Specialist, Dietician and GP are used whenever necessary. Full information is held of the changes to the service users care as directed by these professionals. The daily records completed by the nurses at the home are informative and provide evidence of the actual care afforded to the service users. Care plans are agreed by family members who sign these to indicate their agreement. The owner manager explained that plans are in place to change the format of the care plans incorporate additional information. It is planned that the changes will take place over the next four to six months. All potential risks are identified and detailed risk management plans are put in place to reduce or remove any risk to the service users. Skin mapping and photographic evidence for pressure sores is recorded in the service users personal file. The files provide evidence of great improvement in the tissue repair and viability of one service user who had been admitted with a pressure sore. The daily records show that every effort is made to avoid the risk of pressure sore development through care and the provision of specialist pressure relieving equipment. Some concerns with regard to the medications procedure were discussed with the owner/manager. Handwritten entries on the Medication Administration Record sheets had not been signed by a second person to ensure the accuracy of the entries. No discrepancies were recorded, but it is essential that the practice of ensuring accuracy, and evidencing this, takes place. All handwritten entries on MAR sheets are to be written clearly, with full information regarding the administration in line with the information printed on the medication label by the dispensing pharmacist. Some blank spaces were found on the Medication Administration Record sheets where nurses had failed to sign, to indicate that the medication had been administered. In view of this, it was not possible for an accurate audit of some medications to be made. The medications stock cupboard was found to contain excessive amounts of medications. This is due to a failure of the nurses to clearly mark on prescription forms, the exact amount of medications required from the GP. All excess medications are to be disposed of an only the necessary amount of medications held in the home. A full audit of all medications is to be undertaken to establish the amounts held and disposed of. All nurses are required to follow the home’s policy and procedure for the ordering, storage, administration, recording and disposal of medications. No excess medications are to be stored in the home. Subsequent to the inspection, the owner/manager has informed CSCI that all excess medications have been removed from the home and that additional training has been given to all nurses. Arrangements have been made to Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 12 change the pharmacist who dispenses the medications and that audit systems have been set in place to ensure that only those medications required are ordered on a monthly basis. Some medications are prescribed for service users on a PRN (as and when required) basis. The care files are to include full information for staff to clearly give the reasons for these medications, the indicators to identify the occasions when these are to be given, the minimum time between doses of these medications and the maximum dose that can be given in any twenty-four hour period. From observation of the interaction between staff and service users, it is evident that privacy and dignity are respected at all times. Personal care is afforded to service users in their bedroom or in the bathroom as appropriate. Doors were seen to be closed to protect the service users dignity. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users have choice and flexibility how they spend their day in the home, leisure activities are organised according to their choice and preferences. A balanced and varied selection of food is available to enable service users to exercise choice and control over their diet. EVIDENCE: Many of the service users at the home are severely cognitively impaired so individual choices are not always an option for them. Service users and or their relatives in the home are asked on admission about their lifestyle, choice of foods, and choices and preferences of the social activities they would like to participate in. This information is recorded in their individual care files to advise staff. Religious services are held in the home every two weeks and arrangements can be made for services for those service users who are not of a Christian Faith. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 14 The fees charged by the home include hairdressing, outings and transport. A good range of activities and stimulation is provided for the service users and family members are included in these as much as they wish. Some relatives take service users out and all visits out, together with activities that take place in the home are recorded to identify those activities that service users particularly enjoy. Family members are encouraged to inform the home of any specific activities that service users enjoyed, their individual preferences and of any special events that service users may enjoy celebrating. Every effort is made by the home to celebrate service users special occasions i.e. birthdays, wedding anniversaries. Visitors are welcome at the home at any reasonable time and the high number of relatives and visitors who were seen, were greeted warmly by the staff. Visitors spoke highly of the staff and one visitor said ‘the staff here are like family. They are open and honest and keep me informed of my relative’s condition all the time. It’s wonderful to have a place like this.’ The home provides a choice of meal on the menus and some meals are prepared additional to those indicated on the menu to meet service users preferences. Special diets are provided on the advice of the GP, dietician or on the service users request to meet medical, cultural or preferred needs. The meal served at the time of the inspection was attractively presented and smelled delicious. Assistance to eat meals is given discretely by the staff as necessary. Service users spoken to said that the meals were lovely and relatives said that there was always lots of variety. One relative said that he was often invited to take a meal with his mother and that the food was ‘incredible’. Service users can take their meal in the dining room, lounge or in their bedroom as appropriate. Fresh fruit and vegetables are used in the preparation of meals some frozen vegetables available to offer greater choices. The kitchen was seen to be very clean and organised the catering staff were able to confirm that they were aware of each individual service users likes and dislikes. The owner/manager stated that the catering staff were very understanding of service users needs and that they had requested to attend a training course on dementia to give them greater knowledge and understanding and thereby provide an improved service. Two new freezers have been provided for the kitchen together with a new dishwasher. New metal shelving has been provided in the dry store room and all goods are stock rotated in accordance with good practice. The provision of a new refrigerator is planned for the next few months in line with the home’s forward planning programme. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have a good knowledge and understanding of adult protection issues to protect service users from abuse. EVIDENCE: The home has an informative and robust complaints procedure which is detailed in the statement of purpose and is also displayed within the home. No complaints have been made to the home since the last inspection and none have been received by CSCI. Visitors spoken to on the day of the inspection said that they knew who to speak to if they had any concerns and would feel comfortable in making a complaint, although all stated that they had no cause to complain. One service user said ‘there’s nothing to complain about, everything is just fine. They do a great job’. Training has been given to all staff on the protection of vulnerable adults and staff spoken to during the inspection were able to demonstrate a good understanding of abuse and of the action to be taken in the event of it being suspected. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 23, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Continued investment in the home ensures that service users are provided with a comfortable and pleasant environment. EVIDENCE: Redholme is decorated, furnished and maintained to a high standard and work continues to take place to improve the environment for the service users. Since the last inspection, the reception area has been redecorated to provide a warm and welcoming area. Sluices have been redecorated and are clean and hygienic. New carpets have been fitted in the older part of the house, the John McCann unit, and plans are in place to redecorate and re-carpet the lounge in this area. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 17 One bathroom in the Linden unit has been retiled and is now bright and pleasant. The lounge in this area has been redecorated and fitted with new carpet and new armchairs have been ordered. Additional furniture has been ordered for the home including armchairs, sofas, recliner chairs, bookcases and TV stand. Fifteen bedrooms have been provided with new beds and seven new washbasins have been purchased for bedrooms. Redecoration in some areas of the home is being addressed where some minor damage has occurred following the recent installation of a new fire alarm system. Bedding and other linens have recently been replaced and was found to be in good condition throughout the home. The home provides sufficient bathrooms and toilets and assisted bathing facilities ensure that service users who have difficulty accessing bathing facilities are enabled to do so with the assistance of staff. Service users bedrooms are bright and decorated and furnished to a good standard. Service users are encouraged and assisted to personalise their bedrooms with pictures and items of memorabilia to further provide a homely environment. The home is well lit throughout and is centrally heated. Windows can be opened to provide natural ventilation, although the amount that these can be opened is limited to ensure the protection of service users. The home was found to be extremely clean throughout and no unpleasant odours were noted. At the time of the inspection, work was taking place to improve the garden area following completion of the new, adjacent, day care facility. The garden is secure and safe and provides the opportunity for service users to participate in small gardening tasks if they wish. Staff are available to supervise service users who wish to use the garden and risk assessments are undertaken with regard to gardening and the use of gardening tools. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home employs a team of well trained, enthusiastic staff who work positively with the service users to improve their quality of life. EVIDENCE: The home has a robust and comprehensive recruitment policy and the selection of staff files inspected provides evidence that the procedure has been followed. All prospective staff are required to complete an application form prior to being called for interview. Two references are taken together with checks on the Protection of Vulnerable Adults and Criminal Records Bureau registers. The qualifications of nurses are validated through the Nursing and Midwifery Council and records are held in the home to demonstrate that the nurses PIN numbers are valid. The home has a comprehensive staff development and training strategy. All members of staff at the care home have access to mandatory and specialist training and records are kept of courses attended. All staff receive documented supervision six times each year to ensure that their performance and work with service users is safe and protect the service users. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 19 85 of care staff hold N.V.Q Level 2 and other staff are currently working towards the award. Records are held of all training courses undertaken by the staff. Dementia training is given to all staff to expand their knowledge and understanding and to enable them to provide a high level of care to the service users. Some of the staff recently attended a training day in Dublin on dementia care and a large range of books are provided and are used for in house training of staff. The staff rotas show that the home is providing sufficient staff to meet the individual needs and preferences of the service users. The home employs qualified nurses, care assistants, domestic, catering, maintenance and administration staff. All staff are trained to a high level and evidence of professional development is held in the home. Redholme Memory Care Ltd DS0000060551.V300787.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has a clear development plan and vision for the home which has been effectively communicated to service users, relatives and staff. EVIDENCE: The home does not deal with any of the service users finances and family members are requested to collect the personal allowances of service users, on a weekly basis, where these payments are made to the home. Financial transactions made for service users on the request of family members are held in an independent bank account and the home’s accountant ensures that interest payments are apportioned appropriately. Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 21 All staff are given training in health and safety and are individually responsible for reporting any issues that require to be addressed. Health and safety records inspected were found to be well maintained and up to date. Employers Liability Insurance was in date and displayed in the foyer. The home holds the Investor In People Award and prepares improvement plans for the home. Relatives and visitors to the home spoke extremely highly of the manager, the staff and the care given. One relative said ‘I know I can’t provide the care at home, and I feel guilty about that, but it is so good to know that my relative is getting the same level of care that I would give, if not, a better standard. The staff show their love for the residents and are also their for us relatives when we need it.’ Redholme Memory Care Ltd DS0000060551.V300787.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 4 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 3 X 3 Redholme Memory Care Ltd DS0000060551.V300787.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 OP9 Good Practice Recommendations The care files should give detailed information regarding medications administered on a ‘when necessary (PRN)’ basis to identify the specific reason for the administration, the minimum time between doses and the maximum amount to be given in any 24 hour period. Monthly audits of medications should be undertaken to ensure that excess stocks are not held. The stock medications should be included in all audit checks. 2. OP9 Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Redholme Memory Care Ltd DS0000060551.V300787.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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