CARE HOMES FOR OLDER PEOPLE
Smyth House Residential Home 106 High Street Leiston Suffolk IP16 4BZ Lead Inspector
John Goodship Key Unannounced Inspection 7th July 2006 9:20 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 Smyth House Residential Home DS0000024489.V302765.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. Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Smyth House Residential Home Address 106 High Street Leiston Suffolk IP16 4BZ 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) 01728 831373 Mr Peter Michael Mayhew Mrs Tracy Dawn Emsden Care Home 9 Category(ies) of Old age, not falling within any other category registration, with number (9) of places Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 8th February 2006 Brief Description of the Service: Smyth House is a private residential care Home providing care and accommodation since 1995. The Home is registered under the Provisions of the Care Standards Act 2000 to accommodate 9 older persons. Located on the main road in the town of Leiston, Smyth House is close to all the amenities, with a regular bus service. The Home is semi-detached with a restaurant one side and an unmade road on the other side. Level access to the Home is via the side or rear entrance as there is one step to the front entrance. The Home is on three levels and access to the upper floors is by stair lifts. The accommodation comprises seven single and one shared bedroom. Two bedrooms have en-suite facilities and one bedroom on the ground floor benefits with an en-suite shower and toilet. There is one communal bathroom and five toilets within the Home. The lounge and dining room are located on the ground floor and are to the centre of the Home with a conservatory at the rear, which leads out to the garden area. The garden is laid to lawn with a vegetable patch and a summer house. Car parking is available opposite the Home. A major extension is underway at the rear of the property. Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was the first under the Commission for Social Care Inspection’s new policy entitled “Inspecting for Better Lives”. This inspection was aimed at assessing at least all the key national minimum standards, indicated under each Outcome Group. The visit lasted five hours, with the manager present throughout, and the owner present for part of the time. The home was full with 9 residents two of whom were a married couple. The inspector spoke to all the residents, two visitors, and the other member of staff on duty with the manager. Each room was inspected, and two care plans were examined, one staff file and some maintenance records. Comment cards had been received before the visit from four residents and six relatives. Some of the comments have been included here and under the relevant Outcome Group. What the service does well:
The residents are cared for by staff who have been there some time, so that residents know them well. Staff are also very familiar with how residents like to be cared for, and how they prefer to spend their time. Staff are highly praised by all the residents. “Staff are kind and helpful at all times. Nothing is too much trouble for them.” “They have a wonderful sense of humour.” “I think we are a happy family and always have a good laugh.” A relative said: “There is always a happy atmosphere.” The staffing outcome group has been rated as excellent. Most residents choose to use the lounge during the day, rather than stay in their room, which encourages social activities and interest for residents. However those who decide to spend time in their rooms are free to do so, and are monitored by the staff. Staff are encouraged to spend time with the residents, talking and listening to them, which creates a friendly and homely atmosphere, which is commented on by residents. The daily Life and social activity outcome group has been rated as excellent. The home is well served by its local GP practice, which ensures rapid attention for sick residents. Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better:
A Statement of Purpose and a Service User’s Guide must be given to all new residents to allow them to make an informed choice about the home, and to tell them how the home is organised for them. All residents must have a copy of the Terms and Conditions of living in the home which they or their representative have signed. Recommendations have been made regarding best practice in aspects of medication. Assessments on admission would give a fuller and more rounded picture of the needs and preferences of new residents, which would form the basis of the care plan. Medications requiring to be kept in a fridge must be in a secure container. The training policy for staff on Adult Protection should indicate how frequently refreshers sessions should take place. A method should be found of lowering the temperature of the bedroom containing the hot water tank. All bare wooden surfaces must be treated or painted as soon as possible to reduce the risk of infection and aid hygienic cleaning. The en-suite shower in room 1 may not be not appropriate for the needs of the resident. The manager will be asked to provide a risk assessment regarding aspect of safety and privacy. Staff must have adequate supervision sessions in line with the good practice of a minimum of six sessions a year.
Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 7 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. Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 8 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 Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have sufficient information and help to make a choice. Although there was a lack of written evidence for two standards, the outcomes for residents had not been detrimental as their comments show. EVIDENCE: The Statement of Purpose and Service Users’ Guide had been updated to include the temporary fire procedures while the extension was being built. A copy of these was available in the hall. However service users were unable to confirm when they had received these documents. There was no record in the admission procedures showing when these documents had been issued. The home had contracts with the funding authority, and there was an example of an Agreement Form in the service users’ guide listing the terms and conditions for living in the home. However there was no evidence of these being issued to residents.
Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 10 At previous inspections, residents and relatives have confirmed that they were able to visit the home before deciding to come in. Some residents used to live very close to the home and had re-united with old neighbours. Pre-admission assessment forms were filed in the care plans, identifying relevant aspects of the care needs of each admission. The two most recent admissions had not visited the home before moving in, as one came in to join their spouse, and the other had to move quickly from a home that was closing. Residents who had been spoken to at previous inspections had confirmed that they or their relatives had visited the home prior to moving in. One resident said this home was much better than the previous one they were in. The home does not offer intermediate care, so Standard 6 is not applicable. Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ care plans are comprehensive to ensure that their needs are identified and to monitor how they are being met. Residents’ safety is ensured by the proper procedures for medication. Residents can expect their wishes at the time of their death to be recorded and followed. EVIDENCE: The home used a commercially available care plan system which served the staff and the residents adequately. It contained appropriate aspects of care needs and daily living records. The care plans of two residents were examined. One had been in the home for two years and the other for four weeks. The older resident’s plan had much information on personal care needs and social activities. The information in the daily report was full and recorded care and social events during each day. This enabled the monthly review to be based on comprehensive information about the resident. These reviews were signed and dated. There were records of visits by the GP, district nurse and chiropodist. Risk assessments for falls, and moving and handling were up-toSmyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 12 date. Aspects of the care plan were confirmed later in discussion with the resident. The newer resident had similar sections in their care plan. This person managed their own stoma care with the help of the district nurse. The resident was able to change the bag themselves with some help from care staff to fix it in position. The manager reported that the district nurse had given staff training in cutting the attachment fixer to size. There was no record of when the bag was changed nor of the training. A member of staff did confirm that they had been instructed, but written evidence was not kept. There was no risk assessment of the competence of the resident to continue to undertake their own stoma care. This assessment would normally be done by the NHS staff. Although each new resident had a full pre-admission assessment, there was no record of a post-admission assessment to provide a complete and more rounded picture of the resident, which would inform the initial care plan. There was no section available in the system used by the home to record this information. For example there was no record of a new resident’s preferences for meeting their needs, nor their likes and dislikes, nor their life story. The MAR charts were examined. There was one gap in signatures which the manager agreed to check. Otherwise the charts were complete, and there was good use of the back of each chart for recording changes in medication, reasons for non-administration, and reasons for giving PRN medication. The NOMAD boxes were checked and were correct to date. All staff had completed “The safe administration of medication” distance learning course with a local college. No certificates had yet been received, but a member of staff confirmed their successful completion and showed competence through the observed practice during the inspection. The manager had asked for the Commission’s advice on the storage of low dose Oramorph. The advice from the CSCI pharmacy inspector had been that although the law does not require this level of the drug to kept in a controlled drugs cabinet, it is considered good practice to do so. This advice had been followed. The home was currently storing the antibiotic for one resident in the fridge in the kitchen. This was the only item requiring refrigeration. However it was stored in an open container which could allow cross-contamination. Some bottles of medication were dated upon opening but not all. Privacy and dignity was respected and examples were seen of staff knocking on doors before entering, and closing the door if personal care was about to be given. Staff said they always asked residents if they wished to take a bath. There was no fixed bathing rota. One resident chose to stay in their room
Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 13 because they felt embarrassed when they had a coughing fit in public. Another chose to eat in their room because “I can’t eat when others are around.” The policy of the home was to continue to care for each resident in the home during illness or when nearing death, unless medical needs required transfer to a hospital. The manager stressed that the home received excellent support from the local surgery and one GP in particular. That GP would advise the home when a transfer was needed. Relatives were always encouraged to visit, and if necessary could stay at critical moments. The district nurse had obtained a special mattress for one resident during their last days. Residents’ wishes were recorded in the care plan. Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are cared for in a homely way, with many of them in touch with the local community and friends. Choice is an important feature of the way the home is run, giving residents control over their lives. EVIDENCE: All the residents who spoke to the inspector, and those who completed comment cards, described how happy they were living in the home. During the visit, two residents were busy knitting in the lounge, providing clothes for the local church to send to Africa. One resident was crocheting cushion covers, which the manager said were for use in the new extension. Six residents were in the lounge altogether. One said they were very happy knitting and chatting to the others. They had frequent visitors, some of whom arrived during the visit. They said they also went out for special family occasions. Residents were asked when they wanted a bath. There was no set rota for this. Residents could choose to stay in their rooms if they wished. All who were visited in their rooms explained why they preferred to be there. Devices were fitted to all rooms to allow residents to choose to keep their door open if they wished without compromising fire protection measures.
Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 15 The menu for the day provided several options. On one table, one resident had a poached egg and vegetables, another had fish cakes, another ham salad, and a fourth had fish fingers. The dessert was rice pudding or a cold dessert. All residents said that the food was good and there was always a choice. The cook, the manager and a senior carer had attended a local Council day about the new Food Safety Regulations hazard controls, although many of the requirements were already being used. The kitchen was hot (it was a very hot day) but it will be enlarged and upgraded in the new extension. The cook said that the environmental health officer had been asked for advice on the layout. Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. Residents can be confident that their concerns will be taken seriously and acted upon. Residents are protected by the home’s policy on abuse, which will be strengthened by refresher training for staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No complaints had been received either by the home or by the Commission. The complaints policy was displayed and was included in the required documents. There was also a suggestion box in the hall but the only content had been some coins. Residents confirmed by their comments that they would always voice any concerns they had, and staff did their best to help them. A member of staff confirmed that they understood how to recognise and respond to the different kinds of abuse of vulnerable people. However there had been no training update for two years. All residents were entered on the electoral roll at the relevant date. The manager said that all those who wished to vote, did so by post. If residents needed an advocate, their allocated social worker acted in that capacity. . Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,24,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to live in a safe, hygienic and comfortable environment that is well-maintained, with a policy of timely furniture and furnishing replacement. Specialist equipment is available for safe moving and handling for the protection of residents and staff. EVIDENCE: The environmental standards, which were all met at the last inspection, continued to be met, apart from one aspect. One downstairs room had been fitted with an en-suite shower. This had a high tray so a wooden ramp had been built to give access with a shower chair. There was a hoist in the en-suite room. The opening to the original WC had been widened and the wooden door frame was still unpainted. The manager said that the owner would be painting the wood as the extension was built. However, untreated wood exposes porous surfaces that could harbour bacteria and impede good hygiene control practices. No risk assessment was seen for the access arrangements.
Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 18 The room where the most recent resident was living had been newly recarpeted before their arrival. Room 4 was a small room which housed the cupboard containing the hot water cylinder. It was very hot, 82°C according to the thermometer on the wall. There was a tower fan in the room which the manager said was put on when the resident was in the room. All bedroom doors had devices to automatically close them in the event of the fire alarm sounding, which allowed the doors to be kept open if residents wished. A planned extension at the rear had started. The manager had prepared a risk assessment and contingency plan for the safety of the residents during the building, which was included in each care plan, and which had been signed by each staff member as read. Access to the garden was temporarily restricted by using the side door only, and residents had to be accompanied by staff. From a tour of the building, cleanliness and hygiene standards were being maintained. The most dusty period of the building work had finished, but the manager said that every effort had been made to keep the home clean. It had been difficult with windows open because of the hot weather. Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are cared for by competent staff whose training is kept up–to-date, to ensure that residents are in safe hands. EVIDENCE: There were two care staff on duty during the visit, including the manager. The cook was also on duty. Both manager and carer were very experienced and had been at the home many years. The level of staffing appeared suitable for the needs of the residents. Residents described the staff as very kind and helpful at all times. “Nothing is too much trouble for them.” “They have a wonderful sense of humour.” There were several staff off sick but the gaps in the rota were being filled internally. The home was advertising for night staff for relief work. The home offered placements to the local school for work experience. There were two girls working in the home for two weeks. They received an induction day with the manager and were supervised at all times. Their duties were to observe, to take drinks to residents, to play games and help in activities, to make beds, and to fetch items for the home from the town. They were expected to talk to residents which they were doing during the visit. They also organised a game of bingo in the afternoon and conducted it with confidence
Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 20 and enthusiasm. One resident said how nice it was to have the youngsters around. One of them had helped this resident look through their photo album. The manager and one of the senior carers had NVQ Level 4, one carer had Level 3, and one had Level 2. Three staff were on the Level 2 course. All staff had completed “The safe administration of medication” distance learning course with a local college. No certificates had yet been received, but a member of staff confirmed their successful completion and showed competence through the observed practice during the inspection. There had been no refresher training in Adult Protection for two years. The manager, a senior carer and the cook had all attended a Food Safety seminar earlier in the year to learn about the new Regulations. One new member of staff had been appointed since the last inspection in February 2006. All recruitment, identification and protection records were in place. There was also the induction checklist in the file and the supervision record. The home required applicants to offer three referees before appointment. This low turnover rate showed that the home had a stable workforce, who were well known to the residents. This contributed significantly to the comfort and happiness of the residents. Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the way the home is run and managed which provides them with a homely and safe place to live. The home’s policy on staff supervision must be improved to further ensure the best interests of staff and residents. EVIDENCE: The manager continued to ensure that the home remained a friendly place with a family ethos. This was evident from the interaction between staff and residents. Because of the size of the home, staff were very close to residents, and there was continuous talking and listening to them. This was evidenced also by the comments made by residents. The manager said that a separate residents’ meeting would be unnecessary as staff were in constant contact with all residents. This was re-inforced by the comments of residents that, if they were unhappy with anything, they knew staff would listen to them.
Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 22 Although the manager and a member of staff confirmed that, in such a small home, the manager was talking to staff all the time, this was not meeting the required standard of evidence on staff supervision as these conversations were not always recorded. Those that were did not meet the good practice recommendation of a minimum of six sessions per annum . The stair lift had been maintained on 24/11/05 and the certificate was seen. The water temperature log was up-to-date and showed that hot water temperatures were at the required level. This was confirmed by a sample check on one outlet. Fire equipment had been tested the previous month. A risk assessment had been written to cover risks from the extension work which started in May 2006. All staff had signed to confirm that they had read it. There was no change to the Fire Exit arrangements. The petty cash accounts for two residents were checked. The receipts, records and cash all tallied. Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 2 3 X 3 X 2 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 2 3 3 Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4(3),5(2) Requirement The registered person must ensure and evidence that all residents are issued with a Statement of Purpose and Service User’s Guide on admission. The registered person must ensure that all residents are issued with a statement of the terms and conditions of residence on admission, as well as existing residents who do not have one. The registered person must ensure that medication requiring refrigeration is kept in a secure and covered container. The registered person must ensure that the unpainted surfaces in room 1 are treated to prevent cross-infection. The registered person must ensure that all staff receive adequate supervision. Timescale for action 01/08/06 2 OP1 5(1)(b) 01/08/06 3 OP9 13(2) 01/08/06 4 OP26 13(3) 01/08/06 5 OP36 18(2) 01/08/06 Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations The registered person should prepare an admission assessment for each new resident which brings together all identified needs, preferences and wishes of the resident as a basis for the care plan. The registered person should implement a policy of dating all medication bottles showing when they were opened. The registered person should obtain a risk assessment, regularly reviewed, from the relevant person to verify the continued competence of a resident to self-medicate. The registered person should include in their policy on adult protection how often staff should receive regular refresher training. The registered person should examine ways to permanently improve the temperature control in room 4. The registered person should follow good practice in programming a minimum of six supervisions for staff each year which are recorded. 2 3 4 5 6 OP9 OP9 OP18 OP24 OP36 Smyth House Residential Home DS0000024489.V302765.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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