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Inspection on 08/09/05 for Rossmore Nursing Home Limited

Also see our care home review for Rossmore Nursing Home Limited for more information

This inspection was carried out on 8th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home offers residents the opportunity to make choices and decisions around their daily lives. Two residents spoken to said `we try hard to be as independent as possible, and it is so nice to be able to make decisions about the care being given and have the staff respect these`. Resident`s comments indicate they hold the staff in high regard, one individual said that `the staff were friendly, helpful and always supportive`. Two residents said that they `enjoy living at the home and that it has a very welcoming and pleasant atmosphere`.

What has improved since the last inspection?

The home cares for older people with special needs, and staff have extra training to help them do this well. 47% of the care staff have a qualification in care, and residents health and wellbeing are promoted by being looked after by staff with the right skills and knowledge for their work. The manager has got her Registered Managers Award giving her the right management skills to support the staff and do her job well.

What the care home could do better:

Care plans do not show the social and emotional care being given to the residents each day and do not record their likes and dislikes, so individuals may not receive all the care they require to make them happy and settled within the home. Medication recording needs to be improved to ensure all signatures are in place for medications received by the staff, so that there is no mishandling of medication and the residents health is looked after. Photographs of the residents must be put onto the files so staff can check they are giving medication to the right person and ensure the safety of the residents is promoted. The home has previously been asked to fit appropriate locks to the residents bedrooms This has not been done and the home cannot guarantee that residents have uninterrupted privacy or that their personal possessions are kept safe. The registered person must carry out monthly visits to talk to residents and staff and check out what is happening within the home, to ensure there is no risks to the health and safety of the people living at the home or working there. A report of what they have found must be sent to the Commission each month.

CARE HOMES FOR OLDER PEOPLE Rossmore Nursing Home Limited 68 Sunnybank Spring Bank West Kingston upon Hull HU23 1CQ Lead Inspector Eileen Engelmann Unannounced 8 September 2005 th 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 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. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rossmore Nursing Home Limited Address Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 68 Sunnybank Spring Bank West Kingston upon Hull HU3 1CQ (Incorporating premises at 325 Spring Bank West) 01482 343504 Rossmore Nursing Home Limited Mrs Vernica Euginee Slee Care Home with Nursing 56 Category(ies) of OP Old Age (56) registration, with number DE(E) Dementia over 65 (56) of places PD Physical Disability (8) PD(E) Physical Disability over 65 (56) TI(E) Terminal Illness (56) Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Registration includes twelve (12) stroke rehabilitation patients and 6 day places. Date of last inspection 4TH November 2004 Brief Description of the Service: Rossmore Nursing and Residential Home is a two-storey building, which has been converted from a number of terraced houses for its present use. It is situated about a mile and a half from the centre of Hull in a quiet residential area of west Hull overlooking the playing fields of Hymers College. There is a range of shops and pubs within a few minutes walk. There are bus stops close to the home and the main train station is within walking distance. Car parking is available on the street outside the home. The home provides nursing and residential care to people over the age of 65 years (male and female) within the categories of Dementia, Physical Disability and Terminal Illness. The home also has a contract with Eastern Hull and West Hull Primary Care Trust to provide stroke rehabilitation services to eight people and the home provides specialist facilities for this group of service users. Accommodation is provided on two floors within single or double rooms; two of the shared rooms have en-suite facilities. Access to the upper floor is available through the use of stairs or the passenger lift. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out with the provider, the manager and residents of Rossmore Nursing and Residential Home. The inspection took 5 hours and included a tour of the premises, examination of staff and resident files and records relating to the service. Seven of the residents were spoken to in an informal manner; their comments have been included in this report. There have been two additional visits made since the last inspection to investigate complaints at the home. The first visit was in response to a complaint from a service user about a member of staff. After talking to the individual and the manager about the issues raised and looking at records, the complaint was not upheld and no further action was needed. The second visit was in response to an anonymous complaint around employment of staff. Investigation of the records and staff files showed that the employment policies and procedures had not been strictly followed, and requirements and recommendations were made to improve this practice. These have been complied with by the home. What the service does well: What has improved since the last inspection? The home cares for older people with special needs, and staff have extra training to help them do this well. 47 of the care staff have a qualification in care, and residents health and wellbeing are promoted by being looked after by staff with the right skills and knowledge for their work. The manager has got her Registered Managers Award giving her the right management skills to support the staff and do her job well. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 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. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 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 standard(s) 3 and 6. The needs assessment process at the home is robust and thorough, enabling residents to be confident that their needs can be met by the service. Intermediate care facilities and service are excellent, with individuals receiving the care and support needed to maximise their independence and return home. EVIDENCE: Each resident has their own individual file and all four of those looked at had a full needs assessment completed within them. The information from the assessment process is used to formulate the individuals care plan. Seven residents spoken to were able to give detailed information about their care needs and the input they required from the staff, service and outside professionals, and this was found to be accurately documented within their care plans. Those residents at the home who receive nursing care have undergone an assessment by a NHS registered nurse from the Health Authority, to determine the level of nursing input required by each individual. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 9 The home has built specialist facilities for the stroke unit within an adjacent property and residents from the unit have access to a rehabilitation kitchen; dining room, lounge and therapy room. There is also a purpose-built shower room on the ground floor for residents’ use, and a bathroom on the first floor. Within these facilities residents are encourage to practice their self-caring skills, ready for their discharge home. Specific staff are allocated to this unit and information within their personal files indicates they receive training and supervision from the physiotherapists and occupational therapists who attend the home. These outside professionals provide care to the intermediate care residents and record their input and instructions for the staff within the care plans. A computer has been installed in the stroke-unit lounge since the last inspection and one resident was using this facility during the visit. The resident said that the computer helped him occupy his time and his coordination and typing skills were improving. One individual was seen cooking her breakfast in the kitchen, under supervision, whilst four others were doing tabletop games with the staff. Everyone spoken to was very satisfied with the care being given and the range of facilities on offer; they felt their health was improving and were positive about being able to go home after their stay was complete. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10. The systems for care planning and medication must be improved as they contain practices that could potentially place the residents’ health and safety at risk. EVIDENCE: Individual care plans are in place for all residents and detail the health and personal care needs identified for each person. The plans are well laid out but tend to focus on nursing needs. Little information is recorded about individual wishes and likes/dislikes or the social and emotional aspects of care. Not all care plans have been evaluated on a monthly basis with one going four months between checks, and risk assessments for cot sides and nutrition were seen to be missing in one plan although these had been identified as problem areas. One plan had been evaluated, but the changes in care had not been transferred onto the problem sheets to update the plan in full. These issues were discussed with the manager and she assured the inspector that she would audit the plans and ensure they were brought up to date. Residents spoken to were aware of their care plans and satisfied that they could input to their care through discussions with the staff and at reviews. Six residents commented that they have good access to their local GP, one individual said that the hairdresser comes twice a week to do their hair and Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 11 that chiropody and dental services were also visitors to the home. Information in the care plans indicates that residents have access to opticians, hospital services, Macmillan and tissue viability nurses (where needed). Physiotherapy and occupational therapy are available to the stroke-unit residents on a weekly basis and other residents in the home can access these services through a GP referral. The medication policy for the home says that individuals can self-medicate if they want to and after a risk assessment has been completed and agreed. All seven of the residents spoken to prefer to have staff administer their medication. The home has three medication points for the home, each with their own paperwork. Two are for the ground and first floor of the nursing home and one is for the stroke unit. Examination of the medication system for the nursing home showed that not all residents have a positive identification on their file (photograph). Concerns about this were raised with the manager as new staff could having difficulties giving tablets out to the right individual. All medication received, administered and returned by the nursing home is signed and accounted for, with stock levels corresponding to the records kept. Controlled medication and the register for this were checked as correct and up to date. Discussion with the nurse in charge indicated that as there is no medication trolley for the upper floor of the home, there is a tendency for the person administering the medication to dispense it all into named pots before giving it out to the residents. This is called double dispensing and is not an acceptable practice as mistakes can be made and residents’ health and welfare put at risk. The provider should consider what alternative arrangements could be introduced to make the medication giving process safer. Inspection of the stroke-unit medication and records showed that this area of the home also has no photographs of the residents in place to aid identification during administration of the medication. There were a number of missing signatures from the staff who had given out medication to residents and staff were not signing medication received from the pharmacy into the system. The above practices could lead to medication errors being made and are not acceptable to the Commission. Seven residents were pleased with the way that care is given in the home; they spoke highly of the staff saying that they were friendly, helpful and supportive. Staff, residents and visitors were seen to be talking to each other in an open and informal manner, demonstrating that there is a good rapport between all parties. Comments received from the residents indicated that although they are not aware of their individual key workers names, they feel comfortable and secure in asking any of the staff questions about their care and life at the home. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13. Residents are provided with choice and diversity in the activities provided by the home. Individual wishes and needs are catered for and people have the option of where, when and how they participate in leisure activities. EVIDENCE: Residents said that they are offered choice and flexibility in their care and activities of daily living, and expressed their satisfaction about the relaxed and friendly approach of the staff and the welcoming atmosphere within the home. There is a range of social activities on offer within the home and trips out into the community. Six residents said they enjoy playing Bingo, reading, going to the pantomime and watching television. One individual said that she gets fed up at times and would like more to do, but the others were happy with the amount of activities available. The residents said that their families and friends are able to visit regularly and they enjoy trips out with them when the weather is fine. Individuals at the home commented that they are consulted about life within the home and have the chance to discuss any changes taking place within it. They attend resident meetings every couple of months and have a newsletter in their rooms that details people’s birthdays and forthcoming events. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. The home has a satisfactory complaints system with evidence that residents’ views are listened to and acted upon. Staff and residents are confident about reporting any concerns and the manager acts quickly on any issues raised. EVIDENCE: The home has a clear and simple complaints procedure that residents, relatives and staff are aware of and are confident of using if needed. The complaints records show that there has been one complaint made to the home since the last inspection and two have been received and investigated by the Commission (see information in the summary). Residents spoken to said they would talk to the manager if they had any problems and that ‘she regularly comes round to see us, and talks to us about any niggles we may have’. ‘She tries to solve them immediately and will get back to us if she needs to take time to resolve them’. The seven residents spoken to said they felt safe and well protected at the home. The home has policies and procedures to cover adult protection and prevention of abuse, whistle blowing, aggression, physical intervention and restraint and management of resident’s money and financial affairs. Information in the staff training files showed that they have received Protection of Vulnerable Adults (POVA) training and that this was an ongoing part of the homes staff development programme. There has been one POVA referral made to the authorities since the last inspection. This is currently being investigated. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 and 26. Residents are provided with a safe, comfortable and clean environment. They are able to personalise their own rooms, however their belongings cannot be kept safe as no progress has been made on the provision of door locks. EVIDENCE: The home has had the corridors upstairs and down redecorated since the last inspection and all areas seen were bright, clean and odour free. The manager has an ongoing programme of maintenance and renewal and this showed that new carpets have been fitted to the upstairs corridors since the last visit. Outside of the stroke rehabilitation area is a patio with colourful displays of flowers in hanging baskets and tubs, making this an enjoyable place for residents to sit out in the sunshine. The small kitchen on the upper floor needs some attention to the walls as a leak from the gutter is making the plaster bubble and bringing the paint off in flakes. Discussion with the provider indicated that he is aware of the problem and is negotiating to have the gutter repaired and the room redecorated. This will be followed up at the next inspection. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 15 Seven residents spoken to were very pleased with their individual rooms and said that they had ‘brought in a number of personal possessions to make them feel more homely’. They said that they could have single rooms if wished, however some preferred sharing a room as it was nice to have company. All shared rooms have screens in place to offer individuals privacy during care giving. The rooms are decorated to a high standard and the home provides lockable storage space for resident’s monies and other valuables in the bedrooms. The provision of bedroom door locks and keys for individual rooms remain outstanding requirements from previous inspections. The provider told the inspector that door locks would be fitted if requested by a resident or relative. Six residents said that they were satisfied with the laundry system at the home and that there was a quick turn around on the clothes sent for cleaning. All those who spoke to the inspector said the home was kept clean, warm and comfortable, and that bedrooms and communal areas were spotless. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29 and 30. Since the last additional visit the standard of vetting and recruitment practices has improved, with appropriate checks being carried out to protect the residents from risk of harm. EVIDENCE: The home has a comprehensive recruitment policy and procedure and when two staff files were checked it was evident that the manager follows the procedure, and ensures the interview process, police/CRB checks, written references, health checks and past work history are all obtained and satisfactory before the person starts work. Nurses at the home undergo regular registration audits with the Nursing and Midwifery Council to ensure they are able to practice. There is an induction and foundation course that meets National Training Organisation (NTO) specification for new members of staff, and 47 of the care staff have achieved an NVQ 2 or 3, with other staff members going through the training. The home offers staff a wide range of training including mandatory and specialist subjects, aimed at meeting the needs of the residents. Staff-training files are in place and each staff member receives in excess of three paid days training a year. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36 and 38. The management of the home is satisfactory overall and the home regularly reviews aspects of its performance through a good programme of self-review and consultations, which includes seeking the views of residents, staff and relatives. EVIDENCE: The manager has completed her Registered Managers Award since the last inspection, and discussion with her indicated that she has a wealth of experience in nursing care and regularly up dates her skills and knowledge through attending relevant study sessions. The home has an up to date quality award from the local council (QDS) parts one and two, and the local councils Heartbeat award for its kitchen. Continuous monitoring and assessment of the home and its practice/service by the manager and the various authorised bodies is an essential part of the process leading to the awards being reaffirmed year after year. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 18 Resident and relative meetings are held on a regular basis and minutes are circulated to people living in the home. Residents’ comments indicate that they are able to express ideas; criticisms and concerns without prejudice and the management team will take action where necessary to bring about positive change. Policies and procedures within the home have been reviewed and updated to meet current legislation and good practice advice from the Department of Health, local/health authorities and specialist/professional organisations. Staff supervision files show that individuals receive formal supervision with their line managers on a regular basis and staff appraisals are also completed each year. The provider must carry out monthly regulation 26 visits to the home and provide the Commission with copies of the reports generated from these visits. This was asked for at the last inspection visit and has yet to be complied with. Maintenance certificates are in place and up to date for all the utilities and equipment within the building. Accident books are filled in appropriately and regulation 37 reports completed and sent on to the Commission where appropriate. Staff have received training in safe working practices and the manager has completed generic risk assessments for a safe environment within the home. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x 4 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x 2 x 3 STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 4 x x 3 x 4 Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 20 Are there any outstanding requirements from the last inspection? 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 7 Regulation 15 Timescale for action The residents care plan must set 5/12/05 out in detail the social and emotiional care needs of the individual, and the action to be taken by the care staff to ensure these needs are met. The care plan must be evaluated at least once a month and updated to reflect changing needs. Risk assessments must be put into place where a percieved risk to the individual has been recognised. Medicines in the custody of the 5/12/05 home must be handled in accordance to the requirements of the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society, the requirements of the Misuse of Drugs Act 1971 and Nursing staff must abide by the NMC Standards for the administration of medication. Doors to residents private 1/4/06 accommodation must be fitted with locks suited to service users’ capabilities and accessible to staff in emergencies (given timescale of 1/8/04 was not met) . Version 1.40 Page 21 Requirement 2. 9 13 3. 24 12 Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc 4. 24 12 Residents must be provided with bedroom keys unless their risk assessment suggests other wise. 1/4/06 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 9 Good Practice Recommendations The registered provider should consider what changes can be made to the medication administration system for the upper floor of the home, to prevent staff from double dispensing the medication and stop potential errors from occurring that may jepordise the health of the residents. Rossmore Nursing Home Limited 20050906 Rossmore IR J54 v221248 s62082 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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. 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