Inspection on 09/01/06 for Selwyn House

This inspection was carried out on 9th January 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Selwyn House 21/10/08

Selwyn House 25/10/06

Selwyn House 03/12/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Selwyn House Selwyn House 52 Southway Drive Yeovil Somerset BA21 3ED Lead Inspector Lesley Jones Unannounced Inspection 9th January 2006 14.30p Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 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 Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 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 Adults 18-65. 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. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Selwyn House Address Selwyn House 52 Southway Drive Yeovil Somerset BA21 3ED 01935 479143 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) a.helliker@somerset.gov.uk Somerset County Council (LD Services) Ms Amanda Jane Helliker Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service Users may be admitted who have concurrent physical disabilities and/or sensory impairment Service Users will be admitted for a maximum of 3 months between each admission and discharge Selwyn House to provide temporary accommodation for 2 named Service Users until 30th September 2006 27th June 2005 Date of last inspection Brief Description of the Service: Selwyn house is a respite, assessment and emergency service provided by Somerset Community Directorate, for people with a learning disability. Selwyn House was until recently one of three units for people with a learning disability situated within one large single story building at 52 Southway Drive, Yeovil. The two other units are currently being converted and upgraded to provide a permanent unit t for ten people with profound multiple learning disability, and it is estimated that the work will be completed shortly. It is a condition of Selwyns Homes’ Registration that no respite or assessment stay exceeds three months. Although Selwyn House has a dedicated night staff team, night staff can also call floating staff from a nearby home for assistance, in case of emergency. Selwyn House provides a service for up to ten people at any one time, this includes up to two places for emergency and assessment. A total of 49 people currently use this service, with stays varying from two nights a week to a fortnight. Staff are expected to follow existing individual programmes with respite clients. Service users look well cared for, and it was clear that staff are committed to the work they do and like and respect the clients. As this was an unannounced inspection, there was no feedback from parents available at the time of this visit. Observation of the communications book and discussion with staff suggests that there is good contact and liaison with parents. The home now looks lived inand that the teathing troubles with the premises experienced after its opening have been addressed. Miss Helliker is no longer the Registered manager and has been replace by Mrs Sandra Doughterty. Mrs Dougherty is the acting manager and subject to passing registration requirement will become the registered manager. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Monday 9th January from 2.30 to 6.00pm. The home caters for individuals with a wide range of disabilities. It is possible to question some residents to seek their opinion of their care, but not others. There were eight people staying at the home during this visit and I was able to see all of them and spend time with them. During this visit, to make my assessment, I observed residents interaction with care staff, with each other and the environment. I looked at a selection of care plans, medication and training records, and the testing of fire alarms and fire training for staff. I spoke to the acting manager, and two of the three members of staff on duty. During this visit I inspected the building. Four service users were staying at the home. This includes two people who currently have an extended stay, due to special circumstances. The one requirement made at the last inspection had not been implemented, as there were still a number of staff that had not read the homes policies and procedures relating to the management of medication. One of the recommendations had been actioned and staff are in the process of receiving training in infection control. It has not yet been possible to arrange visits from the local pharmacist to assist the home with the management and administration. I have asked the CSCI pharmacist Inspector to visit the home to offer advice, although this visit had not been carried at the time of writing this report, his finding will be available to the public if requested. It was evident at this inspection that many of the National Minimum Standards had been met and that the care delivered to service users is good. Staff interaction with service users was thoughtful, kind and very patient. Service users looked well care for and content. During this inspection, the majority of the standards were inspected. Those not inspected are indicated in the body of the report. I would like to thank the staff group on duty and the deputy manager for their help and time during this inspection. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? Since the last visit, the staff have continued to work on setting up good routines in the home following its upgrading and reopening as a ten bed home. Most of the minor issues relating to the premises that were outstanding have now been addressed. New carpets have been provided in the communal areas previously identified as in need or replacement. A gate leg for the kitchen, allowing for some separation between the cooking and eating areas in this room has been provided. I understand that although this was not part of the original plans for the kitchen, staff indicated that this would be useful in the management of service users in the kitchen. Staff are working on improving communication with residents, and to this end have accompanied residents to school and developed a menu in picture form. Additional training has been provided for staff in specific clinical tasks such as Bolus Feeding. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 7 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. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, There is detailed information on each ‘guest’ (as they are referred to in the home). Information is regularly updated and there is excellent contact with carers and parents. EVIDENCE: Individual assessments were seen on files sampled. To provide respite care, staff need and have detailed information on each guest. The records show and staff confirm that information is regularly updated and there is good contact with carers and parents. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 There is ample evidence to confirm that standards 6,7,and 9 are met. Observation on the day of this visit, examination of care plans and conversations with staff all support this judgement. EVIDENCE: All guests have care and support plans which are geared to individual need. These plans are drawn up with the involvement of families and carers and anyone else involved in the individuals’ life. There are evaluation sheets to monitor activities, guidance for managing certain behaviours and where required, charts to help staff understand and try to change behaviours which are distressing to the individual or those around him. There is an expectation that there are regular written summaries or reviews, and I was told that guests are reviewed regularly at staff meetings. Staff follow existing patterns with guests, and try hard to ensure that they are able to meet all their regular commitments during their stay at Selwyn House. There is regular contact with carers regarding any changes, in an individuals care needs. Staff training promotes individual rights and NVQ training in particular focuses on this area. The whole ethos of the home is geared toward communication which the objective that this is the key to promoting individual rights and Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 11 enabling individuals to make choices. Most guests are supported to manage any money they bring with them during their stay, with regular checks carried out by the manager, network manager and county auditors As this is a respite as opposed to a developmental provision, risk assessments centre on ensuring that existing routines that service uses follow at home are maintained. Moving and handling risk assessments are carried out for all service users who need assistance from staff to transfer. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The evidence indicates that standards 12, 13, 15, 16, and 17 are met. Service users have access to a range of appropriate activities. Staff aim to continue to meet existing commitments in the community. As this is a respite service, it is essential to have good contact with families, and this is well evidenced. Observation between residents or ‘ guests demonstrate that they are treated kindly and with respect. Food is plentiful and staff are flexible in responding to individual needs and wishes. EVIDENCE: Whilst at the home, guests continue to follow regular weekday commitments. This includes using day services and the local college. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 13 The home does not have its own transport, and individuals pay for petrol for trips out. The manager has arranged for the home to have the mini bus from the local resource centre every weekend. This has meant that provided there are staff on duty that can drive the mini bus and the home is fully staffed, trips out are available over the weekends. Staff try to arrange activities in advance. A record of activities, both in and out of house is maintained. This showed that guests are offered a selection of activities. There are good systems in place to maintain family links and the communication book showed regular contact. Observation of daily routines, talking to care staff and reading care plans demonstrate that the daily routines and house rules promote independence, individual choice and freedom of movement. Menus are planned on a weekly basis, and guests are involved in shopping. A record is kept of meals prepared, and a healthy eating programme followed. There are two dining areas, and guests can choose to eat together or not. Some guests who need a quieter environment at mealtimes are able to eat in the lounge/diner at the far end of the home. As a respite service, Selwyn has to cope with a wide range of likes, dislikes and special dietary requirements. This includes, individual allergy, weight management, special cutlery and assisted feeding. Staff have managed to create a homely atmosphere at mealtimes. All staff have food hygiene training To promote better communication and choice, menus are displayed in picture form. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Occupational Standards and NVQ Training underpin good practice, and set the expectation that staff treat guests as they would wish to be treated themselves. Staff work hard to meet the physical and emotional health care needs of guests and there is good evidence to support this. This could be further improved by the introduction of bacterial\hand rubs in all bedrooms and bathrooms and toilets. The records did not demonstrate that all staff were familiar with Somerset’s own policies and procedures for the management of medication, and this was commented on in the last inspection. It was clear, however that robust systems are in place for the daily management of medication. A pharmacist last visited the home to check the systems in place and offer advice more than two years ago. It remains a recommendation that the manager contacts their local pharmacist to try to reinstate this service. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 15 EVIDENCE: Occupational Standards and NVQ Training underpin good practice. Staff were observed to interact with service users in a respectful way and kind manner. With the exception of emergency placements, the majority of service users retain their own GP. Changing health care needs are discussed with families or care managers. The local district nurse and learning disability nurse provide support as required. Care plans sampled demonstrated input from specialist services such as speech and occupational therapists as well as the learning disability psychology service. Standard County Council procedures regarding the storage and management of medication are available in the home. It was disappointing therefore to find that not all of staff employed in the home had signed the medication book to say that they had read these procedures. This was commented on at the last inspection. This is a matter that must be addressed as a matter of urgency as all staff are responsible for giving out medication. There is ongoing training for staff have in the medication administration course at Strode College, although only a small number of the total staff group have completed the course to date. To assist the acting manager in reviewing the management of medication, the CSCI pharmacist inspector will be visiting the home shortly. There were also a number of outstanding training issues for staff. This included giving phosphate enemas, administering oxygen, and use of epipens for allergies. A pharmacist last visited the home to check the systems in place and offer advice more than two years ago. It remains a recommendation that the manager contacts their local pharmacist to try to reinstate this service. To reduce the opportunities for error, the provision of a “flat space” wide enough for staff to stand next to each other when administering medication should be considered. Current storage arrangement for medication in individual’s room (a locked drawer) are not ideal for the hygienic storage of liquids and an alternative should be considered. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Systems are in place to ensure that guests are listened to and their views are valued and taken seriously. EVIDENCE: There is a local authority complaints procedure, which is also available in total communication. A record is kept of complaints, but there have been no complaints since the last inspection. A video, which explains how to complain, is available for service users. There is a whistle blowing procedure and staff have access to the ‘raising concerns leaflet’. A County finance officer carries out monthly financial checks All staff are subject to CRB and POVA checks before they are confirmed in post. Staff have training in the use of physical restraint. When restraint is required, this has to be agreed in consultation with the community multidisciplinary team. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Selwyn has recently been re-modernised and upgraded and now look much more attractive. Areas in the home, which were identified as in need of attention at previous inspections have been addressed and now offer improved quality accommodation, which is in keeping with current standards. A gate to separate the eating from the cooking area is due to be fitted shortly and will assist staff in managing guests in these areas. It is unfortunate that the design of the kitchen seating area is not really ‘wheelchair friendly’ as it is relatively small. Service users are, however, also able to eat meals in the second lounge, which also doubles as a quiet room. There were some examples of where certain areas in the home would benefit from greater attention to detail. Individual privacy and dignity would be enhanced through the discrete storage of incontinence pads. The premises are clean and in good order. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 18 EVIDENCE: Selwyn has a good sized and homely kitchen with a separate larder. This room has been upgraded and divided into a working and seating area. Four of the ten bedrooms have en suite facilities. It was evident that in some bedrooms greater attention to detail was needed, For example, there was a bedside cabinet with a missing shelf, another with a missing knob, sticky labels had not been removed, and net curtains were loosely fitted. It is recommended that the acting manager introduce a system to ensure that minor details such as this are monitored and addressed. Current storage practice/arrangements in bedrooms makes it difficult to store pads discreetly. This should be addressed. There are two shower rooms with toilets, one bathroom and toilet, a separate toilet, and a laundry room. One of the shower rooms would benefit from a new floor as the existing one is stained and some of the wall tiles need replacing. I understand that there are plans to address this in the near future. Office space is large enough to hold private meetings with service users, their families or staff. Waking night staff, provide the necessary cover so there is no need for sleeping in facilities. Improvements to the gardens include the provision of garden seating, and there is ongoing work to improve the appearance of the garden. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Overall training for staff is good, however during the course of this inspection a number of important gaps have been identified. This relates mainly to the training of staff for certain clinical tasks. This includes giving phosphate enemas, administering oxygen, and use of epipens for allergies. Particularly important as the client group is so varied and have such diverse needs. There are residents staying at Selwyn who need all of these interventions. It is a requirement of this inspection that this training is provided as a matter of urgency. It is excellent that staff are attending Strode College for training in the management and administration of medication, but the traffic of staff through this course is disappointingly slow. It is a recommendation of this report that if possible steps should be taken to improve this. Recruitment records were sampled and demonstrate that proper procedure are followed. EVIDENCE: Staff reported that they have good access to training that they work well as a team and that there is good support from the acting manager. There is little staff turnover, and many of the staff group have worked together for many years. The records indicate that there is ongoing mandatory training for staff. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Guests’ views are sought on all aspects affecting their daily lives, and good systems are in place to support this practice. Practice in the home promotes the health, safety, and welfare of guests. Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 21 EVIDENCE: Quality assurance tools are in place. The network manager carries out monthly reports, covering areas in the Care Standards. Staff advocate for service users, using guestures and actions to determine preferences. Specialist communication techniques, such as total communication are used to communicate with service users and promote choice. There are plans to introduce a service users questionaire as part of this process. Feedback from staff confirmed an open and inclusive atmosphere. All staff have mandatory training which is appropriately updated. Hazardous substances are kept locked away, and COSHHE regulations followed. A member of staff has special responsibility for health and safety tours within Selwyn House as part of the County Councils Health, Safety,and Welfare Policy. There is electrical testing from County Hall every year and three monthly in house checks.Risk assessments are carried out in relation to the premises and individual safety. The home has appropriate insurance Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 2 33 3 34 x 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x x x 3 x x 3 x Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 18(1) ( c) (1) 18(1) ( c) (1) Requirement Timescale for action 01/03/06 2 YA32 All staff must be aware of the homes policies and proceedures relating to the management of medication. Overall training for staff is good, 01/04/06 however during the course of this inspection a number of important gaps have been identified. This relates mainly to the training of staff for certain clinical tasks. This includes giving phosphate enemas, administering oxygen, and use of epipens for allergies. Particularly important as the client group is so varied and have such diverse needs. There are residents staying at Selwyn who need all of these interventions. It is a requirement of this inspection that this training is provided as a matter of urgency. 0 Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 24 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 19 Good Practice Recommendations Practice could be further improved by the introduction of bacterial\hand rubs in all bedrooms and bathrooms and toilets. A pharmacist last visited the home to check the systems in place and offer advice more than two years ago. It remains a recommendation that the manager contacts their local pharmacist to try to reinstate this service. 2 20 3 20 To reduce the opportunities for error, the provision of a “flat space” wide enough for staff to stand next to each other when administering medication should be considered. Current storage arrangement for medication in individual’s room (a locked drawer) is not ideal for the hygienic storage of liquids and an alternative should be considered. It was evident that in some bedrooms greater attention to detail was needed. It is recommended that the acting manager introduce a system to ensure that minor details relating to the premises are monitored and addressed. Current storage practice/arrangements in bedrooms makes it difficult to store pads discreetly. This should be addressed. It is excellent that staff are attending Strode College for training in the management and administration of medication, but the traffic of staff through this course is disappointingly slow. It is a recommendation of this report that if possible steps should be taken to improve this. 4 20 5 24 6 24 7 35 Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Selwyn House DS0000031414.V276364.R01.S.doc Version 5.1 Page 26 - 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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