Inspection on 29/10/07 for Sandringham House

This inspection was carried out on 29th October 2007.

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

Sandringham House 25/10/08

Sandringham House 02/06/06

Sandringham House 15/03/06

Sandringham House 10/10/05

Sandringham House 03/02/05

Sandringham House 07/10/04

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

CARE HOMES FOR OLDER PEOPLE Sandringham House 26 Sandringham Road Lower Parkstone Poole Dorset BH14 8TH Lead Inspector Martin Bayne Key Unannounced Inspection 29th October 2007 09:00 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 Sandringham House DS0000020491.V353747.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. Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandringham House Address 26 Sandringham Road Lower Parkstone Poole Dorset BH14 8TH 01202 744409 01202 744409 bookstand@lineone.net 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) Miss E Smith Mrs Doreen MacLennan Care Home 16 Category(ies) of Dementia - over 65 years of age (16) registration, with number of places Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit two persons, as known to the NCSC, under the category DE (under 65) 2nd June 2006 Date of last inspection Brief Description of the Service: Sandringham House is situated in a residential area of Lower Parkstone, a short walk from the local shops and within easy reach by car or public transport of Parkstone, Poole and Bournemouth. A passenger lift and stairs provide access to the resident’s bedrooms, which are on both floors of the home. A half landing between floors is accessible only by the stairs and a single bedroom and assisted bath are situated on this level. The communal areas of a lounge/dining area and kitchen are located on the ground floor. The home provides adequate toilet and bathroom facilities as well as sluicing area on both floors. The laundry room is sited in the garden to the rear of the home and also serves as a staff room. The home provides some off road parking at the front of the home. The fees for the home are £660 for a shared room and £685 for a single room. Any additional charges are detailed within the Terms and Conditions of Residence. Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We carried out a key inspection of Sandringham House between 9am and 1:45pm. The aim of the inspection was to evaluate the home against the key National Minimum Standards for older people and to follow-up on the three requirements and one recommendation made at the last key inspection in June 2006. Mrs MacLennan, the Registered Manager assisted throughout the visit. During the inspection, records that the home is required to maintain as evidence of the care provided at the home were seen, a tour of the premises was made and staff and residents were spoken with. Comment cards were left at the home for the manager to send out to relatives, health and social care professionals. The returned comment cards were also used in forming the judgements contained within this report. What the service does well: What has improved since the last inspection? What they could do better: Many records that should be kept in the home available for inspection were being held away from the home. The procedure for medication administration must be adhered to in order to ensure that medicines are administered safely. Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sandringham House DS0000020491.V353747.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 Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2&3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from their needs being assessed prior to their being offered a place at the home; however, in order to comply with Regulations letters informing that needs can be met, and records of fees should be kept within the home. EVIDENCE: Before a person is offered a place at the home their needs are assessed. At the last inspection it was agreed that Miss Smith, the Registered Provider, would visit the person and complete an assessment using the home’s preadmission assessment form and then she should liaise with the Registered Manager for her to make the decision as to whether the needs of the person can be met. Should the Registered Manager have concerns about whether the home can meet the person’s needs, she discusses these up with the person’s Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 9 care manager or with the unit where the person was being referred. Mrs MacLennan, the Registered Manager informed us that this procedure had worked well and that the needs of people admitted to the home were being met. We tracked the paperwork and records that the home is required to keep concerning two residents who had been admitted to the home since the last key inspection in June 2006. A record of the assessment of need was found in the file for both residents and these assessments covered all of the topics required to be assessed under National Minimum Standards. Due to the mental frailty of the residents at the home, their relatives or care managers usually arrange the placement. Mrs MacLennan informed that relatives or the prospective resident are welcome to visit Sandringham House in order to help them choose a suitable home. Where placements are arranged through care managers, copies of the care management assessment and care plans are used as part of the pre-admission process. Mrs MacLennan said that a copy of the Service User Guide is given to relatives or the person’s representative prior to admission to also assist in choosing the home. We asked to see the records of charges paid by the two residents tracked through the inspection. These records are required by Regulation to be held in the home available for inspection. Mrs MacLennan informed that these records were held by Miss Smith and were not available. A requirement was made that these records be held in the home. We also asked to see the letters offering a place at the home following the assessment of need, that also inform that the person’s needs can be met at the home. Mrs MacLennan informed that Miss Smith also kept these documents due to the shortage of space in the office at the home. A requirement was made that copies of these letters be kept in the residents’ personal files at the home, as these letters must be available for inspection by Regulation. Sandringham House DS0000020491.V353747.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met through the care planning system; however there could be improvements in recording of some risk assessments, action taken by staff to meet care needs and medication administration recording to ensure that needs of residents are met. EVIDENCE: We looked at the personal files for the two residents tracked through the inspection. In the case of one of the residents, it was found that no photograph had been taken although the resident had been living at the home of five months. It was agreed that a photograph would be taken and placed at the front of their care records for easy identification of that person by a new member of staff. A photograph was on the front of the care records for the other resident. We found that both residents had a full care plan that had been developed from the assessment. At the last inspection a requirement Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 11 was made that the care plans be reviewed monthly. We found at this inspection that reviews had been taking place to this timescale as required. We found that a short life history had been obtained for both residents from their relatives, which provided good information for the staff in meeting social care needs of these residents. The care plans provided sufficient information for a new member of staff to assist a resident with their personal care. We found that together with care plans, risk assessments had been carried out, although moving and handling risk assessments could be improved for residents who were privately funded. In the case of residents funded through care management arrangements, moving and handling assessments were very detailed. We found that the home was using an assessment form for pain assessment to ensure the residents were free from pain. We found that bed rails were being used in some cases and although there were some risks recorded; it was recommended that a separate, more detailed risk assessment be carried out that included liaison with relatives and the GP. We also found in one person’s care plan, instructions for the staff to turn the person regularly in order to protect them from the risk of skin breakdown but no record of this was being maintained by the staff. We recommended that where care plans instruct staff to carry out certain tasks such as turning residents, that a record be maintained with staff signatures. We found that health needs of residents were being met. All the residents are registered with a GP. Mrs MacLennan informed that the home had good relationships with the local community mental health teams and that the home would often work with Community Psychiatric Nurses in meeting the mental health needs of residents. We found that other health needs such as dentistry, eye tests and chiropody were being attended to with visits from these health professionals. At the time of inspection one resident was at risk of skin breakdown and Mrs MacLennan informed that the tissue viability nurse was due to visit the home to make an assessment and advise staff at the home. Due to the mental frailty of the residents, it was not possible for them to provide much feedback about their experience of life at the home. The staff however, were observed working with the residents and there appeared to be a good relationship between the two. We found that residents looked well cared for with attention paid to their personal appearance. One resident was having their hair done ready a visit from one of their relatives later in the day. Screens were seen in the shared rooms and Mrs MacLennan informed that these were used when a person in a shared room receives personal care. We looked at the medication administration records for all of the residents. Mrs MacLennan conceded that she had administered the medication that morning but had not got round to signing the records due to our arrival at the home. The procedure should be that medication is administered to an individual resident and then their record signed, not for all medication to be given out and then the records being signed. A requirement was made to this effect. It was also found that on occasion hand entries were entered on to the Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 12 medication administration records. We recommend that in these cases a second person checks and signs the record that the entries made are correct. Within the office there is a small fridge for the storage of medications requiring refrigeration. The fridge has a maximum/minimum thermometer, which was recording the appropriate temperature; however Mrs MacLennan informed that no record of temperatures was kept. It was recommended that such records be maintained. The home it uses a unit dosage system with medicines being supplied to the home by the pharmacist. The home has a contract for the disposal of unused medication and a record was seen of the destruction of these medicines. Sandringham House DS0000020491.V353747.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. 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. Residents are supported to make decisions commensurate with their abilities in meeting social and recreational needs but more detailed records of this should be kept to provide evidence of this. Visitors are made welcome and residents benefit from a balanced and varied diet. EVIDENCE: We found that where possible, a life history is obtained through a resident’s relatives in order to meet the social and recreational needs of that person. On the morning of the inspection old-time music was being played in the living room where most of the residents were seated and residents appeared to enjoy the music. Staff were seen to interact appropriately with residents and one resident was having their hair done. Mrs MacLennan informed that once a week an ‘Extend’ session takes place to help keep residents mobile and fit. She also informed that a new DVD player had been purchased for the residents to enjoy old movies. Mrs MacLennan informed that the majority of residents had relatives who take them out of the home and that visitors are welcome at Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 14 any time. This was corroborated through comments made by relatives in the survey forms. Mrs MacLennan informed us that occasionally outside entertainers are brought into the home. A small firework display and bonfire night celebration was being planned for November 5th. Residents’ birthdays are celebrated. Two relatives informed that they thought more could be done to keep residents occupied. It was recommended that the staff record the individual time that they spend with residents to provide better evidence of meeting residents’ social and recreational needs. On the day of inspection shepherds pie with fresh vegetables was being prepared for the residents. One of the dishes had been finely blended for those residents who required a soft diet. Residents who need assistance with eating were identified through their care plan. We noted the likes and dislikes with regards to food were recorded as part of the assessment process. Sandringham House DS0000020491.V353747.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. 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. Residents benefit from the complaints procedure for the home being well publicised and the staff having been trained in adult protection. EVIDENCE: Since the last inspection there have been no complaints made to the management of the home and none have been brought to the attention of the Commission. There was however one adult protection investigation, when it was identified that the home had not provided appropriate equipment for one resident who was very frail. Appropriate equipment has now been obtained for this person and a full moving and handling assessment was seen to be in place on laminated sheets within this person’s bedroom. The home’s complaints procedure complies with the guidance set out in the National Minimum Standards for older people. The complaints procedure is displayed in the hallway of the home, within the Statement of Purpose and Service User Guide and also within the Terms and Conditions of Residence. Due to the mental frailty of the residents at the home, they rely upon their relatives or other people to complain on their behalf. Relatives are sent a copy of the Statement of Purpose when a person is admitted to the home and in the majority of cases relatives sign the Terms and Conditions of Residence, and so Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 16 they are made very aware of how to make complaints should the need arise. Mrs MacLennan informed us that the home had copies of all the relevant procedures concerning adult protection and that all the staff have received training in this field. Sandringham House DS0000020491.V353747.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 home provides a ‘homely’ environment for the residents with improvements being carried out since the last inspection. Infection control measures are in place. EVIDENCE: At the last inspection it was recommended that the floor and walls of the laundry room be made impermeable and readily cleanable. We found at this inspection that the laundry floor and walls had been painted with nonpermeable washable materials so that they are now easily cleaned. Mrs MacLennan informed us that the ground floor bathroom was to be refurbished with a walk-in shower, providing a choice for residents who may Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 18 prefer a shower to a bath. On the day of inspection the home was found to be clean and largely free from adverse odours. Since the time of the last inspection the hallway has been repainted and new replacement windows have been fitted to the front and back of the home. A new ramp has been provided to the front door and another ramp leading from the patio to the garden. At the last inspection we were informed that the home was considering purchasing an awning for the main patio windows in the lounge, as this room is south facing and would benefit from shading as it can become very warm on hot days. Mrs MacLennan informed that this was still being considered. On the day of inspection the bathrooms were found to be clean with soap and paper towels provided. Staff are provided with protective clothing such as gloves and aprons and an alcohol gel dispenser was provided at the front reception. It we noted at this inspection that there is only one sink in the laundry area and this is used for rinsing, there being no separate handwashing sink. Mrs MacLennan informed that staff wear gloves and protective clothing in laundry area and that alginate bags are used for soiled linen. It was recommended that an alcohol gel dispenser be sited in the laundry room in the interest of infection control. Sandringham House DS0000020491.V353747.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 adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from a longstanding, caring, staff team, however recruitment and staff training records must be kept in the home available for inspection to provide evidence of good recruitment practices and adequate staff training. EVIDENCE: Mrs MacLennan informed us that the home continues to provide the same staffing levels as at the time of the last key inspection in June 2006. At all times there is one trained nurse on duty on the premises. During the daytime there are also two care assistants on duty, a cook and also a cleaner. During the night-time period there is one nurse on duty and one care assistant, both of whom are on an awake duty. We saw the staff duty roster in the office that reflected the above staffing. Mrs MacLennan informed that this level of staffing met the needs of the residents accommodated in the home. Mrs MacLennan informed that since the time of the last inspection there had been one new member of staff recruited to the staff team. We requested to view this person’s recruitment records but were told that Miss Smith, the Registered Provider had these records. A requirement was made that these records be kept in the home available for inspection. Mrs MacLennan informed Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 20 that the home rarely had to use agency staff and she was made aware that she should obtain a letter on these occasions from the agency to inform that all the recruitment checks of Schedule 2 had been satisfied. We requested to see the staff training records and again were told that Miss Smith holds these and were not available for inspection. A requirement was made that these records be kept in the home as required by Regulation. Mrs MacLennan informed that there was a training schedule for the staff and that all staff received training in core mandatory areas such as, moving and handling, first aid, fire safety, infection control, medication administration, health and safety and fire safety. She also informed that staff had recently received training in pain management, the Mental Capacity Act. Mrs MacLennan informed that regular staff meetings are held with minutes taken and that there was a stable long standing staff team. Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 21 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. Residents benefit from the home being well managed and run in the interests of the residents. EVIDENCE: Mrs MacLennan is the Registered Manager of the home and has held this post since March 2003. She informed us that she has now neared completion of NVQ level 4 management training. Mrs MacLennan is also a trained nurse. Miss Smith, is the Registered Provider of the home and visits the home at least twice a week. Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 22 At the last inspection two requirements were made. One concerned carrying out tests to the portable electrical equipment in the home. We found at this inspection that these tests had been carried out with stickers on the equipment with a date of when tested. The other requirement concerned developing a quality assurance framework to ensure that the home is run in the interests of the residents. Since the last key inspection a quality assurance framework has been developed and we were shown some of the documentation as evidence of this. Returned comment cards all informed that the home was efficiently managed and run in the interests of the residents of the home. The home does not look after any residents’ monies, with relatives or their representatives fulfilling this role if needed. We inspected the fire logbook and it was found that tests and inspections to the fire safety system were being carried out to the required timescale as required. A current Employer’s Liability Insurance Certificate was on display in the hallway. Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 23 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 ENVIRONMENT CHOICE OF HOME Standard No Score 1 2 3 4 5 6 Standard No 19 20 21 22 23 24 25 26 Score X 2 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 24 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. 1. 2. Standard OP2 OP3 Regulation Schedule 4 14 (1)(d) Requirement The records paid by in respect of each service user must be kept within the home. Should an offer of a place at the home be made to a prospective resident, the Registered Person must confirm in writing that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of health and welfare. The home’s procedure for administration of medication must be followed in order that recording and safe administration of medicines is carried out in the home. You are required to keep records pertaining to staff training and staff recruitment within the home. Timescale for action 30/11/07 30/11/07 3. OP9 13 (2) 30/11/07 4. OP29 OP30 Schedule 4 30/11/07 Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP8 OP8 OP8 OP9 OP9 Good Practice Recommendations It is recommended that in respect privately funded residents, more detailed moving and handling assessments be carried out. It is recommended that risk assessments on the use of bed rails be more detailed. It is recommended that where care plans indicate action to be taken by staff, (such as turning a resident), records of the action carried out by the staff be completed. It is recommended that a record be kept of the maximum and minimum temperatures of the fridge used for storing medication. It is recommended that where hand entries are made on medication administration records, a second member of staff checks and signs that the record is correct. Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sandringham House DS0000020491.V353747.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!