Inspection on 27/11/07 for Sedra Nursing Home

This inspection was carried out on 27th November 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Sedra Nursing Home 66 Gordon Road Ealing London W5 2AR Lead Inspector Mrs Rekha Bhardwa Key Unannounced Inspection 27th November 2007 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 Sedra Nursing Home DS0000070651.V355290.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. Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sedra Nursing Home Address 66 Gordon Road Ealing London W5 2AR 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) 020 8998 2543 020 8998 0997 Dr Ezzat Abu-Mostafa Mrs Bimla Bains Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0), Physical disability of places over 65 years of age (0) Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2006 Brief Description of the Service: Sedra Care Home (Nursing) is a 22-bedded care home sited in a converted detached building providing nursing care for service users within the categories of old age, physical disability, and physical disability over the age of 65. The home comprises of three floors, which are accessed via a stairway and a lift. The home is situated in a residential area, within close proximity to Ealing Broadway and some local shops. Disability access is available at the front via a ramp. There is parking for approximately three cars on the front patio and street parking is also available. The closest public transport and shopping facilities are about a five to ten minute walk away. A local GP Practice provides medical input to the home. Where additional specialist medical services are needed, service user would be referred through the GP. Chiropody services are available at a charge. The fees range from £561 to £580 per week. Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process. A total of 8 hours was spent on the inspection process, and was carried out by 1 Inspector. The Inspector carried out a tour of the home, and service user plans, medication records & management, staff rosters, staff records, financial & administration records and maintenance & servicing records were viewed. 14 residents, 3 staff and 2 visitors were spoken with as part of the inspection process. The pre-inspection Annual Quality Assurance Assessment (AQAA) document completed by the home, plus comment cards from residents, representatives/visitors and health & social care professionals have also been used to inform this report. What the service does well: What has improved since the last inspection? What they could do better: Shortfalls in the formulation and review of the care plans and associated documentation were identified and staff must ensure all documentation is completed in full. Residents and representatives’ wishes in respect of end of life care are not being recorded. Shortfalls have been identified in the management of kitchen records and how meals are served. Further work is required to ensure that choices are offered to the residents. Some areas of the home are beginning to look shabby and the home is in need of a full environmental audit from which a redecoration and refurbishment programme Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 6 can be drawn up. Overall infection control was being managed, however the shortfalls identified in infection control training need to be addressed. Work is required to address malodours in the home. Shortfalls were identified in staff training to include Induction and Foundation training and some areas of health& safety training. Systems for the vetting and recruitment of staff must be improved and the Registered Manager must ensure that all information required is obtained prior to employment. Systems for quality assurance have been introduced however shortfalls in fully completing audits do not allow for review and development of the home. 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. Sedra Nursing Home DS0000070651.V355290.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 Sedra Nursing Home DS0000070651.V355290.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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are fully assessed prior to admission, thus the home ensures they are able to meet each persons needs. EVIDENCE: The home has a comprehensive pre-admission assessment document that provides a good picture of the resident and their needs. Copies of the Social Services assessment are also obtained. Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 9 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 & 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service user plans were not always up to date and did not accurately reflect the condition and needs of the resident, thus placing the resident at risk if not having their needs met. Medication management is good and the medication needs of the residents are being met. Staff were observed caring for the residents, in a gentle and professional manner, respecting their privacy and dignity. Shortfalls in identifying end of life care needs place residents at risk of not having there needs fully met. EVIDENCE: Two service user plans were sampled during the course of the inspection. Generally these had been completed and provided information on the residents needs. Both service user plans had not been updated since August 2007. For one of the service user plans the resident’s needs had changed but this had not been reflected or updated in the care plan. Risk assessments for falls were not in place even though both residents had a history of falls. Risk assessments for the use of bedrails were in place and written consents had Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 10 been signed. The Inspector discussed the need to ensure that the actual risk to the resident was clearly recorded. There was evidence of input from the residents and their representatives in the service user plans viewed. Assessments for continence, pressure sore prevention, nutrition and moving and handling assessments were in place. The Inspector noted that moving and handling assessments had not been reviewed and updated to reflect the needs of the residents. Where moving and handling issues had been identified no care plans on mobility were available. For one resident their pressure sore risk assessment had been inaccurately calculated. There was written evidence of regular weight monitoring. There was evidence of input from healthcare professionals to include GP and dietician. The Inspector viewed the medication management for the home. The home uses a monitored dosage system for medication management. All receipts, administration and disposals had been clearly recorded, and the correct method of disposal was in use. Several of the medication administration records were viewed and were complete and up to date. A list of nurse signatures was available. Controlled drugs records were being kept up to date and the register was being completed correctly. Stocks were checked and correct. For one resident being fed via a percutaneous endoscopic gastrostomy tube this had been clearly recorded. The fridge temperatures were within safe range. Professional lancing devices for blood glucose monitoring were in use. The home has a policy and procedures in place for the management of medications this was viewed by the Inspector and found to require updating. No details were available on the management of any drug errors. Generally the medications are being well managed at the home. Staff were seen caring for residents in a gentle, caring and professional manner, respecting residents privacy and dignity. It was clear from speaking with residents and visitors that the staff have a very high regard for the care of the residents throughout the home. Residents looked well cared for and had been dressed to reflect individuality. Several of the bedrooms viewed were personalised. Information regarding the wishes of residents and their families in respect of health deterioration and also care in their final days was not available. Care plans for this were not in place and the importance of ascertaining this information to ensure the wishes of residents and their families are recorded and respected was discussed with the Registered Manager. Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 11 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 good. This judgement has been made using available evidence including a visit to this service. The activity provision at the home is generally good, however further work is needed in this area to ensure the interests of all residents can be catered for. The home has an open visiting policy, thus encouraging people to maintain contact with family and friends. Information regarding advocacy services was available, thus residents right to individual representation is respected. The food provision in the home is satisfactory, offering variety and some choice, thus meeting resident’s individual needs. Shortfalls in the kitchen area place residents at risk. EVIDENCE: The home has two part-time activities co-ordinator who plan activities for the residents in the home and works hard to provide a variety of activities to meet the resident’s needs. Residents who spoke with the Inspector confirmed that they enjoyed the activities provided. Records are available of the activities that the residents participate in. It was not clear from discussions with the Registered Manager what budget is available for the provision of activities. Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 12 Input is received from various religious representatives, and the home can arrange input to meet the needs of residents from different religious and cultural backgrounds. The home has access to local advocacy services. The information on how to contact these agencies had yet to be displayed. The home has an open visiting policy and visiting is encouraged. Residents can receive visitors in their own bedroom or in one of the communal areas, as they so wish. The visitors spoken with said that they are always made very welcome at the home. Representatives are kept up to date with any issues. The kitchen was viewed and this was clean and tidy. The kitchen records were not complete and were not up to date, to include fridge /freezer temperatures and hot food temperatures. There is a choice offered at mealtimes and menus are displayed. It was not clear from speaking with the residents whether and viewing the lunchtime meal that resident’s choices are actually accommodated. The Inspector noted that the meals provided at the home are pre-plated before they are taken into the lounge area. The need to have a hot trolley was discussed with the Registered Manager. Residents have their meals in the lounge area as there is no separate dining room. The Registered Manager stated that plans are in place to create a dining area within the home. An Environmental Health Officer visit had taken place since the last inspection and a report of this visit was available for inspection. The requirements from this report had still not been addressed. Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 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. 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. The home has policies and procedures in place for the management of complaints and adult protection issues, and these are followed, thus safeguarding the residents. EVIDENCE: The complaints procedure was on display in the main entrance and since the last inspection this had been printed in larger print. The Registered Manager reported that there had been one complaint since the last inspection. The Registered Manager has an ‘open door’ policy for visitors, and does deal promptly with any concerns raised. Information on the surveys completed by residents and representatives evidenced that they are aware of the complaints process and that any issues raised are effectively addressed. The home has adult protection policies and procedures in place that dovetail with the Ealing Safeguarding Adults documentation. The training matrix viewed had recorded that staff had received POVA training. One POVA case had been investigated since the last inspection. Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is evidence of some work having been done on the environment, however shortfalls are still being identified and thus the home does not provide a good standard of accommodation for residents to live in. Systems for the management of infection control are in place, however shortfalls in infection control training place residents at risk. Malodours present in some areas of the home do not provide residents with a pleasant environment to live in. EVIDENCE: A tour of the home was carried out. Although the home is being maintained, overall the furnishings are old and in places shabby and the home is in need of refurbishment. A full environmental audit must be carried out and a full redecoration and refurbishment plan with timescales for completion drawn up to address the shortfalls identified. The maintenance man does keep a list of the redecoration work carried out. The Inspector noted that some beds within Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 15 the home are a divan style of bed. The Registered Manager must also include in the refurbishment and redecoration plan details of replacing divan beds with height adjustable beds. On the day of inspection the metal guard plate on the frame of the lounge door had come away and was a potential hazard, this was dealt with at the time of the inspection. The Registered Manager reported that plans were in place to replace the ground floor corridor carpets and the lounge carpet. The laundry was viewed and was clean and tidy. At the time of the inspection there was no laundry person in post and care staff were undertaking laundry duties as well as care duties. The Registered Manager reported that the post of laundry person had been advertised. All the residents looked well dressed. The washing machines have sluice programmes for the management of soiled and infected laundry. Protective clothing to include gloves and aprons were available. Not all staff had received training in infection control, this is a repeat finding. The inspector noted malodours in places and the staff work hard to manage these, however replacement of some furnishings and floorings will aid with odour control in the home. Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 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 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. The home is appropriately staffed and staffing levels are kept under review, thus ensuring that the needs of the residents can be met at all times. Systems are in place for the vetting and recruitment of staff, however shortfalls identified could place residents at risk. There is an training programme, however shortfalls in the provision of training in some areas could lead to staff not having the knowledge and skills to meet the full needs of the residents. EVIDENCE: At the time of the inspection the home was being appropriately staffed to meet the needs of the residents. This will be further enhanced with the recruitment of a laundry person and administrator. The AQAA detailed that only two care staff had completed their NVQ level 2 and that seven staff are currently undertaking NVQ level 2 in care training with Thames Valley University or Uxbridge College. The importance for NVQ in care training to bring the home back to a minimum of 50 of care staff with such a qualification was discussed with the Registered Manager. A sample of staff employment records were viewed. One staff file contained only one reference and both files did not record any gaps in employment or reasons for leaving previous employment. The Registered Manager reported Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 17 that a new application form had been introduced into the home. The Inspector also noted that a reference had been obtained from a home that is not registered by the CSCI. The Registered Manager was asked to ensure that the employment history given by this member of staff was accurate. The home has in place an induction and foundation programme based on the TOPPS induction programme. This induction programme has been replaced by the Skills for Care Common Induction Standards. The Registered Manager must ensure that the induction programme being used by the home meets the Skills for Care requirements. There was evidence that training in topics relevant to the specific diagnoses and needs of the residents had taken place. The training matrix viewed by the Inspector detailed that not all staff had received training in moving and handling, infection control and health and safety. This is a repeat finding see requirement under National Minimum Standard 38. Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager has the experience and qualifications to manage the home. Systems are in place for quality assurance, however some shortfalls identified could lead to the quality of care provision not being fully monitored. Money held on behalf of residents living at the home is robustly managed, thus safeguarding the resident’s interests. Staff are receiving regular formal supervision, thus individual practice is being reviewed. Health & safety is being managed at the home, however repeat shortfalls in relation to training potentially place residents at risk. EVIDENCE: The Registered Manager is a first level registered nurse and has recently completed the Registered Managers Award, NV Q level 4 in management. She has undertaken recent training and updates in topics relevant to her role and Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 19 to the needs of the residents. She has several years experience of working with older people. Comment was received that the Registered Manager ‘takes the trouble to have regular meetings with family and carers, informing us of any changes to the home’. Regulation 26 visits by the Responsible Individual are carried out and reports are available. The home has in place an audit system, this included accidents, pressure sores, falls and medication. The audits viewed by the Inspector were not fully complete. Satisfaction surveys had been completed by the residents and their relatives, but it was not clear when they had been completed, as all the surveys were not dated. The Inspector sampled the records for monies held on behalf of residents living at the home. These were up to date and clearly identified all income and expenditure. Receipts are kept for all expenditure. The Registered Manager is the only member of staff who manages the resident’s monies. The Inspector suggested that all transactions are signed. The home does not have an administrator and this had led to the Registered Manager undertaking all administrative duties as well as running the home. The Registered Manager provided details of staff supervision that was taking place, and this evidenced that supervision is taking place for all staff on a regular basis. Servicing and maintenance records were sampled and those viewed were up to date. The fire risk assessment had been reviewed and the Fire Safety Officer had visited in September 2007 and was satisfied with the homes fire safety. Not all staff had received health & safety training to include Infection control and moving & handling. Fire drills and fire safety training take place. The fire risk assessment had been reviewed and updated since the last inspection. Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 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 2 X 3 3 X 2 Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 15(1) Requirement Care plans must be formulated for each identified need, so that all the needs of each resident are identified and can be met. All service user plans must be reviewed monthly or whenever the needs of the resident change to ensure that all needs are appropriately met Risk assessments for falls, moving and handling and the use of bedrails must be in place and up to date, to clearly identify any risks and how these are to be minimised, to safeguard the residents. Information regarding service users wishes in the event of deterioration in their health, plus their care in their final days must be ascertained and recorded. All kitchen records must be kept up to date to ensure that the residents are safeguarded. The Registered Individual must make provision for the purchase of a hot trolley, in order that meals are served at the correct temperature. DS0000070651.V355290.R01.S.doc Timescale for action 01/01/08 2. OP7 15(2) 01/01/08 3. OP8 13(4), 17 01/01/08 4. OP11 12 01/01/08 5 6 OP15 OP15 13(4) 16(2)g 01/01/08 01/02/08 Sedra Nursing Home Version 5.2 Page 22 7 OP19 13(4) 23(2) 8 OP26 16(2)k 9 10 OP29 OP30 19 Schedule 2 18 11 12 OP33 OP38 24 13(4)(a) A full environmental audit of the home must be carried out to identify all areas in need of repair, redecoration, replacement and refurbishment. This must contain timescales for completion. Systems must be place for the effective management of malodours to ensure that the residents live in a pleasant environment. Staff employment records must contain all required information to safeguard residents. Induction and foundation training undertaken in the home must meet the requirements of the Skills for Care common induction standards, to ensure that the staff have the knowledge to undertake their roles and responsibilities. Quality audits undertaken must be fully completed in order that shortfalls are identified promptly. All staff must receive training in Food Hygiene, Moving and Handling, and Infection Control. Previous timescale of 01/03/07 not fully met. 01/02/08 01/01/08 01/01/08 01/01/08 01/01/08 01/01/08 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. Refer to Standard OP9 Good Practice Recommendations The medication policy and procedure must be updated to include details of how medicines are to be disposed. Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Sedra Nursing Home DS0000070651.V355290.R01.S.doc Version 5.2 Page 24 - 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. 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