Inspection on 09/09/08 for Sanstone Resource Centre

This inspection was carried out on 9th September 2008.

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

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Heathlands

Aston Court Nursing Home

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Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOMES FOR OLDER PEOPLE Sanstone Resource Centre Sanstone Road Bloxwich Walsall West Midlands WS3 3SJ Lead Inspector Amanda Hennessy Unannounced Inspection 9th September 2008 10:30 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 Sanstone Resource Centre DS0000071310.V371263.R03.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. Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sanstone Resource Centre Address Sanstone Road Bloxwich Walsall West Midlands WS3 3SJ 01922 710 572 01922 710 572 joy.sumner@housing21.co.uk www.housing21.co.uk Housing 21 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) Joy Sumner Care Home 38 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (38) of places Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 10 2. Old age not falling within any other category (OP) 38 The maximum number of service users to be accommodated 38. Date of last inspection First inspection under new ownership Brief Description of the Service: Sanstone Resource centre provides care for up to thirty eight older people; up to ten people may also have dementia. A separate day care facility is included the same building. All bedrooms are single occupancy located on both floors. Bathrooms and toilets are appropriately situated around the home with adaptations to assist people. A passenger lift is available to assist people go up and down between the floors. There are several lounges throughout the building, including a smoking lounge. The building is in mature and pleasant grounds. The home is just a short distance from the main road into Bloxwich and a main bus a route. Adequate car parking is available. The service user guide seen identified that fees charged are £420 per week and respite care is £102.90 per week. The fee information given applied at the time of the inspection; persons may wish to obtain more up to date information from the service. Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. The means the people who use this service experience adequate quality outcomes. This is the homes first inspection since its ownership changed in April 2008 although it has been a functioning care home for many years. This unannounced inspection was carried out over one day by one Inspector – Mrs Amanda Hennessy. The home had twenty-one people living there at the time of the inspection. Time spent visiting the home was seven hours. As it was unannounced neither the home nor the provider knew we were going. The homes manager was present throughout the majority inspection. Information for the report was gathered from a number of sources: a questionnaire- Annual Quality Assurance Assessment (AQAA) was completed before the inspection by the homes manager and was sent to us. We looked at the premises, records and documents. We had discussions with the manager and care staff and people who live at the home to gain their views on what it is like to live in and receive care at the home. We looked at how the service has responded to any concerns, how it protects people from abuse and how staff are recruited and trained. We also looked at the number of staff available to care for people at the home. Two people who live in the home were ‘case tracked’ this process involves establishing people’s experiences of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes of the care that they receive. Tracking peoples’ care helps us understand the experience of people who use the service. What the service does well: People told us that they liked living at Sanstone Resource Centre. They said “quite happy here.” Peoples’ needs are assessed before they come to live at the home. Assessment of peoples’ needs, gives confidence that staff are aware of their needs are and will be able to meet them. People are encouraged to visit the home prior to them deciding to come and live there. Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 6 People receive good standards of care and support meeting their individual needs and choices. Healthcare needs are met by the home. People told us that the food is “good and there is always a choice available”. Activities take place most days and trips outside the home are also arranged. The Home has an experienced Manager who provides appropriate and effective leadership. The manager and staff act on any concerns that are made, giving confidence that people are listened to and feel safe living at the home. The home has robust staff recruitment and selection, which minimises the risk of unsuitable people working at the home and protects people living there. Knowledgeable and friendly staff provide care at the home. Staff, are committed to caring for the people at the home. One person told us; “The staff are very good”. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Sanstone Resource Centre DS0000071310.V371263.R03.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 Sanstone Resource Centre DS0000071310.V371263.R03.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): 1,2,3,4,5 and 6. Quality in this outcome area is good. People have their needs assessed and have required information about the service to enable them to make the decision that the service is suitable to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service provides required information about the services they offer. The statement of purpose and service user guide have recently been updated to reflect the changes to the homes ownership and give an accurate picture of what people can expect from the service. “The welcome pack” as the service user guide is referred to is given to people either when they come to visit the home or when staff visit them. People have an assessment of their needs carried out by a senior member of staff. People are all invited to visit the home before they make the decision that the home would be suitable for them. If people are able to visit the home Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 9 the assessment is undertaken during their days visit. If people are unable to visit the home staff go out to assess their needs before a decision is made that the home is suitable for them. We looked at these assessments and found them to be comprehensively completed. The assessment of needs then forms the basis of the person’s plan of care, giving staff information about their care needs. The home does not have an “interim care unit” although this unit had been closed since December 2007. Sanstone Resource Centre DS0000071310.V371263.R03.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 and 11. Quality in this outcome area is adequate. The lack of detailed and updating records of care needs means that people may not always have their needs met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We found that people have a plan of care that gives staff information on how people’s needs should be met. It is positive that people are involved in the development of their plan of care. Care plans highlighted people’s needs, choices and capabilities. Some instructions were basic or were not available. We found that when people’s needs had changed or deteriorated their plan of care had not been changed. One person we spoke to needed to wear a collar and cuff to raise their arm to reduce swelling. There was no information about their collar and cuff in their plan of care. Daily records of care given highlighted that people we case tracked had problems with incontinence. Care instructions seen for incontinence said: Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 11 “ promote independence” but failed to say how this would be done. There was a prompt for “ assistance required,” and “aids and adaptations” both statedN/a. We found that this was not correct as incontinence pads were being used. Staff were able to tell us what difficulties people had and the support that they needed to aid their continence. One person who had recently come to live at the home did not have required risk assessments. We saw records of care highlighting that staff were having difficulties moving this person yet; the moving and handling risk assessment had not been completed. Entries seen included: “we are breaking health and safety procedures doing this”, and another which highlighted that staff were attempting to use available equipment to assist them unsuccessfully “ poor mobility leaning on staff at all times. Tried belt on X but not big enough and no other available”. There is a need for all people to have a moving and handling risk assessment. The moving and handling risk assessment should detail how staff assist people to move and the equipment that is needed to do so. The same person did not have a pressure sore risk assessment yet difficulties that this person had moving and tight footwear has resulted in pressure damage to their heels. We did find that staff have contacted District Nurses for their advice on the management of these pressure sores. People have access to a wide variety of healthcare professionals according to their needs. Doctors regularly visit the home to see people. People confirmed this during the inspection; they told us: “Oh yes I go my hospital appointments” and “they get the Doctor for me when I’m not well”. The storage and administration of medicines at the home is undertaken by trained care staff and is done both safely and appropriately. We did advise staff that further (but minor) improvements could be made to reduce the risk of potential errors. For example’ some people are prescribed medicine “when required” but instructions should be available to tell staff when it should be given. Staff do sign to confirm that they give medicines but don’t always sign to confirm that prescribed creams and lotions are applied. Staff also need to confirm the accuracy of handwritten entries. The homes induction programme includes a section on treating people with respect. We observed staff to knock before entering bedrooms and toilets and interact in a friendly and open way using people’s choice of name. When we asked people using the service if they felt that staff respect them, they told us: “Oh yes most staff are very good”. The home has end of life care core care plans to provide staff with information about the person’s choices of “end of life care”. Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. People have the opportunity to make choices about their life at the home and maintain relationships with friends and relatives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Peoples’ interests and choices are recorded within their care records. A ‘life history’ is requested and in most cases is available to give staff a good insight to people’s life and preferences. People told us that they are able to get up and go to bed when they wanted. The home has a two week activity programme with activities organised on a daily basis by care staff. Staff told us that they have allocated tasks to undertake which includes a least one activity a day. On the day of our visit they had a game of “play your cards right” other activities include: sing-alongs, movement to music, pamper sessions, games, quizzes and reminiscence sessions. The home also has a selection of books that people can read if they wish to. People told me that they can choose whether they take part: “I like to be quiet on my own” someone else said “ Oh yes I enjoy the quizzes”. Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 13 People using the service are able to choose where or how they spend their day. They told us that they could go into any of the lounges or stay in their rooms if they wanted to. People told us that there are regular meetings which update them in any issues affecting the home. All people we spoke to were aware of proposed changes to the home and that they would be helped to look for other places to live. Visitors are able to visit the home at any reasonable time in the day. We observed several visitors arriving and leaving during the day of the inspection. The home offers people using the service the opportunity to take communion on a monthly basis if they wish to. The Home has a four-week rolling menu. There are at least two meal choices available at each mealtime, although staff did say that if people do not like either choice an alternate is offered. People using the service confirmed that they always have a choice offered and can have their meals in the dining room or if they prefer their own bedroom. People told us: “the food is very good here,” and “ the food is ok.” Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18. Quality in this outcome area is good. People are listened to and can feel assured that the home will act in their best interests and protect them from harm and abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure. The complaints procedure in the Service User Guide and is also displayed in the home. The home is proactive in the management of complaints and takes all concerns seriously. The home has had five complaints in the last year. We looked at records of all complaints and found that they have all been investigated and required actions undertaken. The Commission for Social Care Inspection have received no complaints about the home since the change of ownership. People we spoke with all told us that they know how to make a complaint, one person told us: “I would go to the office.” People are supported to maintain their political right to vote with some choosing to request a postal vote. Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 15 Staff we spoke to said that they would highlight any concerns to whoever is in charge of the shift or the manager. It is positive that all staff have all had adult protection training. Sanstone Resource Centre DS0000071310.V371263.R03.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is adequate. The home is a clean and homely place to live although its facilities are outdated and require development and or replacement to meet current standards. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is homely and clean. Décor throughout the home is generally satisfactory although there are areas where the woodwork has been marked and damaged and some of the décor is dated. Staff spoken to agreed that the facilities are now outdated and were positive about the new home which will offer people improved facilities. The manager said that there is an ongoing maintenance and refurbishment plans despite plans to close the home in the next three years. A number of Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 17 peoples’ bedrooms have been redecorated and carpets have been replaced. The home has large, pleasant and well maintained grounds. The home has a number of lounges including a quiet lounge, smoking room, pool room and separate lounge come dining for people requiring interim care (if this unit is reopened). Lounges are comfortable and have domestic style furniture. The home does not have en-suite bedrooms but toilets and bathrooms are located close to people’s bedrooms and all have adaptations for dependent people. The home has a range of aids and adaptations to assist dependent people. We did highlight within the “Health and Personal care” section of this report that there was not appropriate moving and handling equipment available. There is a staff call system throughout the home, a small passenger lift, grabs rails and two hoists. All bedrooms in the home are single occupancy. We found bedrooms to be clean and tidy with personal pictures etc, although a number visited were very small. The home is clean and generally free from odour. There are good arrangements with the provision of gloves, aprons, liquid soap and paper towels available throughout the home to minimise the risk of cross infection. We did raise concern that staff were wearing their own clothes and although aprons are available there is an increased risk of taking infections both into and out of the service. Sanstone Resource Centre DS0000071310.V371263.R03.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. The home has knowledgeable staff who understand and meet peoples’ needs. Recruitment and selection processes protect people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We found that generally the home is staffed with appropriate numbers and skill mix to meet people’s needs. People told us that: “I usually get the care and support I need,” and “Someone is always there to help.” Staff we met spoke positively about support and training they receive and were knowledgeable about peoples’ needs. We observed good interaction between staff and people living at the home. All staff that we spoke to either told us that they had a care qualification (minimum of National Vocational Qualification level 2) or were undertaking one. This gives confidence that staff are knowledgeable and understand peoples’ care needs. People were complementary about the staff and told us: “They are very good”. Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 19 We did feel that it would be helpful for staff to wear name badges and should wear a uniform as it both makes it easy to identify them and minimises the risk of cross infection. Staff recruitment and selection is completed to the required standard. All staff files seen contained appropriate checks such as criminal records checks and references. The Manager also keeps a record of the interview. We were told that new staff have, induction training that meets the “Skills for Care” standards. Records of staff induction were available. It is also positive that since the change in ownership all staff have had an updated induction to inform them of Housing 21 and its policies and procedures. Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33, 34, 35, 36, 37 and 38. Quality in this outcome area is good. The home has effective leadership and appropriate health and safety practices that keep people safe and will help them move forward into their new homes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes manager Ms Joy Sumner is an experienced manager. Ms Sumner told us that there are plans for her to undertake a recognised qualification for Care Home management. Evidence shows us that the transition to Housing 21 has been well managed Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 21 with people telling us that they have ‘been informed of the changes’. The home also has a plans of the new home. The manager holds frequent staff meetings and maintains a record to ensure that staff are kept updated and informed of information given during the meetings. The home has a quality assurance programme. It is positive that managers of the home do audits of practice based on the National Minimum. Managers are each given an area to review such as health and personal care, the environment and staffing view they assess whether they are meeting the standards and when appropriate actions that is needed, which forms the development plan for the home. The homes Annual Quality Assurance assessment (AQAA) was sent to us when we asked and gave us a reasonable account of the services provided and identified areas for development. We do feel that more information would have given an even better account of the service-, for example there was insufficient information about activities that take place and what trips out have taken place. The AQAA also told us “The home has an effective Quality Assurance and Quality Monitoring system that reflects the care standards, the policies and procedures held within ensure that the health, safety and welfare of service users are protected and audited” yet it did not tell us how this was done. Surveys of peoples’ views were undertaken last in August 2007 when the home was part of Walsall council. We were told that since there has been the change of ownership surveys are sent to all people who are discharged from the service, these surveys are sent directly to Housing 21 head office and to date the home manager has not been made aware of the findings. The financial records of the organisation were assessed at the time of the change of ownership and found to be appropriate. The home does not act as appointee for people using the service. There are appropriate arrangements in place when people request it to keep small amounts of money for services such as hairdressing and chiropody. There is a record of all transactions and receipts are available to confirm the transactions. It was also positive to be told that daily checks on the contents of the safe are undertaken. Staff told us that they receive supervision at regular intervals, records seen showed us that it covers all aspects of practice. The home has an up to date health and safety policy for safe working practice with a range of risk assessments. Staff receive training and regular updates in all mandatory training. We were told that all staff have had training in Housing 21 policies and procedures since the change of the homes ownership. Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 22 Maintenance contracts were randomly selected and were found to be up to date. Sanstone Resource Centre DS0000071310.V371263.R03.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 CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 2 2 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 3 3 3 2 3 Sanstone Resource Centre DS0000071310.V371263.R03.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 Standard OP7 Regulation 12(1), 15 Requirement Care plans must be sufficiently detailed to highlight all peoples’ needs and how they should be met. People who use the service should have a moving and handling risk assessment. This would mean that staff have required instructions to move people safely and the equipment that is needed to assist them. Timescale for action 09/10/08 2 OP8 13(5) 09/10/08 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 Refer to Standard OP8 OP8 OP9 Good Practice Recommendations Risk assessments should be in place for the risk of pressure sores. Professional advice should be sought on the promotion of people continence. When medicines are prescribed “when required” DS0000071310.V371263.R03.S.doc Version 5.2 Page 25 Sanstone Resource Centre instructions should be available to tell staff when it should be given. 4 OP9 Two staff should sign to confirm the accuracy of handwritten entries. Sanstone Resource Centre DS0000071310.V371263.R03.S.doc Version 5.2 Page 26 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Sanstone Resource Centre DS0000071310.V371263.R03.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!