Inspection on 16/08/06 for Somerleigh Court

This inspection was carried out on 16th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Somerleigh Court 29/10/07

Somerleigh Court 30/05/07

Somerleigh Court 27/10/05

Somerleigh Court 07/04/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Somerleigh Court Somerleigh Road Dorchester Dorset DT1 1AQ Lead Inspector Gloria Ashwell Key Unannounced Inspection 11:00 16 & 22nd August 2006 th 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 DS0000062046.V308426.R02.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. DS0000062046.V308426.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Somerleigh Court Address Somerleigh Road Dorchester Dorset DT1 1AQ 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) 01305 259 882 Bentleigh Care Ltd Ms Margaret Anthea Gee Andrews Care Home 40 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (25) of places DS0000062046.V308426.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 15 service users under the category of DE(E) to be accommodated on the top floor of the building. Two named persons (as known to the CSCI) between the ages of 6065 may be accommodated to receive care. Two persons requiring palliative nursing care may be accommodated. Date of last inspection 27th October 2005 Brief Description of the Service: Somerleigh Court is a purpose built nursing care home, first registered during November 2004. It is located close to the centre of Dorchester, within walking distance of shops and other facilities including a GP practice. The home is managed by Mrs Andrews who is an experienced registered nurse. Service user accommodation is on the ground, first and second floors; each floor comprises a separate unit with a dedicated staff team, lounge/dining room, kitchenette and hygiene facilities (including assisted bathing facilities to aid safe movement of service users with impaired mobility). The second (top) floor is registered to accommodate a maximum of 15 elderly persons requiring nursing care for conditions associated with dementia; the ground and first floors are registered to accommodate up to 25 elderly persons requiring nursing care. At all times a registered nurse is on duty on each unit. All residents are accommodated in single bedrooms with en suite toilets and wash hand basins. Visitors’ cars may be parked close to the home (a permit obtained from the home MUST be displayed). Laundering of clothing and household linen is carried out at the home and arrangements are made for chiropodists, opticians and other health and social care professionals to visit individual residents. Fees are charged weekly; at present fees for permanent residents range between £650 and £770 per person. DS0000062046.V308426.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a statutory inspection required in accordance with the Care Standards Act 2000. The inspection was unannounced; the inspector arrived on 16 August 2006, toured the premises and spoke to residents and staff and registered manager Mrs Andrews to arrange the next visit which took place at 11.00 on 22 August 2006 when documentation relating to care provision and the premises was discussed and examined. The duration of the inspection (both days combined) was 6 hours. During the inspection the inspector spoke to registered manager Mrs Andrews, nursing, care and household staff, 14 residents and the visiting relatives of one resident. The inspector observed staff interaction with residents and the carrying out of routine tasks. At present 34 permanent residents are accommodated. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same resident were examined and the resident spoken with. Additional information used to inform the inspection process included the monthly reports regularly sent to the Commission by the provider and the Preinspection Questionnaire completed in advance of the inspection by Mrs Andrews. Since the previous inspection a number of completed Comment Cards were sent to the Commission: 7 from residents, 5 from the relatives of residents, 3 from local doctors and one from a care manager/placement officer. With one exception, comments indicated satisfaction with Somerleigh Court; a number were very positive and one observed “Excellent care home. The home is always calm and is caring and friendly”. (The contents of the comment card reflecting dissatisfaction were considered during the inspection and found to be unsubstantiated.) During this inspection compliance with all key standards of the National Minimum Standards was assessed. DS0000062046.V308426.R02.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000062046.V308426.R02.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 DS0000062046.V308426.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 &3 (The home does not provide intermediate care so St 6 does not apply) Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Prospective residents (or their representatives) are provided with information about Somerleigh Court and are encouraged to visit in advance of admission to establish their impressions of life at the home and the standard of available accommodation. Prior to admission the needs of each proposed resident are assessed and the home then writes to prospective residents confirming the ability to properly care for them. EVIDENCE: During the inspection the manager enquired of the inspector the alternative formats in which inspection reports can be provided and was advised these include braille, large print, audio cassette, easy read, CD, DVD and different languages. Somerleigh Court can provide the service user guide in large print. DS0000062046.V308426.R02.S.doc Version 5.2 Page 9 Comments received by the Commission in advance of the inspection about the standard of information provided to prospective residents and their families included “The home provided good information” and “very informative”. The records of a recently admitted resident included details of pre-admission assessment which had been carried out by the Registered Manager when she visited the prospective resident at her private address. A close relative of the prospective resident was already accommodated in Somerleigh Court and she had frequently visited. The initial admission was for a period of respite care during which the resident decided to remain permanently in the home. The inspector spoke to the resident who confirmed satisfaction with the home. DS0000062046.V308426.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is generally good although some improvements must be made with regard to the management of accidents and medicine handling. This judgment has been made using available evidence including a visit to the service. The standard of care is good and in accordance with a written plan of care for each resident ensuring that staff have sufficient information upon which to base their care practice. Residents health needs are fully met and periodic audit of accidents is recorded to minimise risks of recurrence. Records of medicines prescribed by doctors must be improved to ensure the correct administration of medicines. Residents wishing to do so can manage their own medicines. Residents are treated with respect and their privacy and dignity is protected at all times. DS0000062046.V308426.R02.S.doc Version 5.2 Page 11 EVIDENCE: Residents believe they are properly cared for; comments made during the inspection included “I love it here…been here since it opened…it’s very good…I haven’t got any complaints of any kind”. Care records of 4 residents were examined and contained risk assessments forming the basis for care plans and daily records describing the care of each resident. To ensure correct identification of residents, records contain a recent photograph of each resident. Some care records were vague e.g. “screaming and shouting” without stating what the person was shouting and why. Some conflicting statements were made in care plans e.g. one recently reviewed document stated that for a particular resident bed rails were to be used, another similarly recent document stated they were not to be used. (The inspector gave to the manager a document regarding the safe use of bedrails, produced by www.mhra.gov.uk.) The care plan of another resident stated that because of perceived overuse the call bell was to be removed from this person (and gave no guidance on alternative means of summoning staff), and another document stated the resident was to have a “call bell in reach at all times”. It is required that care plans and other care records be improved to ensure provision of accurate information to staff to enable them to properly care for residents. Records are kept of all accidents and periodically audited but it is recommended that the records be expanded to include details of investigation. Residents wishing to do so can manage their own medicines; it is required that the findings of the associated risk assessment process be recorded to provide robust evidence of the assessment and findings, including safe storage of the medicines to be self-administered. Medicine handling is carried out by registered nurses and medication administration records were in general properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts but on the second day of inspection a nurse had instead of signing the chart recorded ticks against administered medicines. Other improvements to be made to the recording systems include signing, dating and countersigning all handwritten instructions and stating the actual dose administered on each occasion when a variable dose is prescribed. DS0000062046.V308426.R02.S.doc Version 5.2 Page 12 Residents expressed satisfaction with Somerleigh Court and in the presence of staff appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and considerate manner. Comments received from the visiting relative of a resident during the inspection included “I try to spend 2 hours every afternoon with X and the staff always come if necessary; they are friendly and very competent”. Comments received by the Commission in advance of the inspection included those from a resident’s relative who is not satisfied with aspects of care and activity provision; the manager explained that the resident is presenting many management problems and following recent review by a team of health and social care professionals the family have been requested to find alternative accommodation for this resident whose needs can no longer be met by Somerleigh Court. DS0000062046.V308426.R02.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected 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 adequate. This judgment has been made using available evidence including a visit to the service. The quality of daily life in the home is good with residents assisted to maintain as much independence as possible. Social and leisure activities are suited to the preference and ability of each resident. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals are of good quantity and quality but a number of residents commented upon the frequently poor choice of menu. Most residents take meals in the Unit dining rooms; others receive them in their bedrooms. EVIDENCE: The home provides for two care staff to work a combined total of 24 hours each week to arrange local excursions, visiting entertainers, one-to-one and small group social and recreational activities. DS0000062046.V308426.R02.S.doc Version 5.2 Page 14 Residents select their chosen meals from a daily menu; most eat in the dining room of the Unit on which they are accommodated, meals are provided to the bedrooms of those who prefer to eat in private or are too frail to visit the dining room. Residents and their visitors may prepare beverages and snacks in the kitchenettes adjoining the dining rooms on each Unit. On the first visit of the inspection the serving of supper in the dining room of the top floor was observed; there was little variety and no apparent alternative to sandwiches although the quantity and quality of food appeared good. All residents able to express an opinion indicated satisfaction with the range of activities but a number made adverse comments about the meal provision, noting the frequently poor choice e.g. lamb or vegetable hotpot, chicken or vegetable curry. Residents said “too much sausage and mash – sometimes twice a week…meat too tough to eat - today’s pork”, “not too bad; I don’t think there’s a lot of imagination – for instance today when they brought the menu I guessed there’d be sausages on it…it was ages before we had new potatoes and I haven’t had a fresh runner bean yet”. Another resident described the food as “quite good…often more than you can eat”. The home carries out a daily food audit involving the chef speaking to all residents able to express an opinion. These verbal responses recorded on each day did not seem entirely plausible because for every day, for every resident the only findings recorded were “all very good” or “all very nice” – these comments were also recorded on 16 August 2006; the day on which the residents made adverse comments about the food. These matters were discussed with the manager at the close of the visit on 16 August 2006; by the date of the second visit of inspection (22 August 2006) the manager was arranging the necessary improvements to the menu variety and meat quality, including the introduction of ‘finger food’ to encourage residents with only small appetites to eat light but nutritious food. Visitors are welcome at any time and those the inspector spoke to said they are always made to feel welcome and placed at ease by the staff. There is a ‘close care’ apartment suite which when not in use in this capacity is occasionally available to accommodate the relatives of residents who live a long distance from the home. DS0000062046.V308426.R02.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be 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. This judgment has been made using available evidence including a visit to the service. The complaints procedure provides information on the procedure to follow to persons wishing to make complaint; all complaints are recorded and properly investigated. The home protects residents from harm and abuse. EVIDENCE: To ensure residents and their representatives have access to the complaints procedure it is included in the service user guide to the home and a copy is provided to each resident. Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously; one said that if she had a complaint she would take it “right to the top, to the matron, to Maggie and she’s very good”. The home keeps records of all complaints received and investigated. Since the last inspection two complaints have been received; a person living nearby complained about the noise nuisance caused by a kitchen extractor fan, a resident believed staff had bruised her. The extractor fan noise has been reduced and the care manager and family of the resident understand her to be DS0000062046.V308426.R02.S.doc Version 5.2 Page 16 suffering from dementia and frequently muddled – they do not believe she has been mistreated. The home adheres to a policy/procedure for the prevention of abuse and all staff have received training in this subject to ensure that they remain vigilant to protect vulnerable residents from risks of abuse and know how to properly manage any allegation or suspicion of abuse. DS0000062046.V308426.R02.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 & 26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Somerleigh Court is a well-appointed and comfortable home. On the days of inspection the home was clean, pleasant and hygienic and there was evidence indicating that this is the usual standard of provision. EVIDENCE: Somerleigh Court is a spacious home, with good-sized bedrooms, bathrooms equipped for the use of persons requiring assistance and attractive communal rooms. The home is clean, tidy and comfortable throughout; there were no unpleasant odours. DS0000062046.V308426.R02.S.doc Version 5.2 Page 18 Residents said this was the usual high standard; one described it as “A lovely place”. To ensure the comfort of residents during the recent heat wave the home obtained portable air conditioning machines. DS0000062046.V308426.R02.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 good with regard to the number of staff and their competency but improvements must be made to employment processes to ensure the protection of residents against the employment of unsuitable staff who may place them at risk of harm. The overall rating for this outcome group is adequate; this judgment has been made using available evidence including a visit to the service. EVIDENCE: Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. All staff spoken to during the inspection were enthusiastic about their work and felt that they provided a good standard of care to residents. Employment records of five recently employed staff were examined; two of these persons had not yet commenced work in the home because their CRB (Criminal Record Bureau) disclosures have been applied for but not yet received, the other three staff were originally in the home as student nurses on work experience placement from Bournemouth University. In their capacity as student nurses the university had obtained and shown to the home manager CRB disclosures. However, they are now working in the home as bank staff and in this regard the manager was unaware that new CRBs should have been obtained. This report contains an associated requirement to ensure that no DS0000062046.V308426.R02.S.doc Version 5.2 Page 20 new staff commence work in the home prior to receipt of a CRB accurately reflecting their current role. At present 58 care staff currently employed by the home hold a National Vocational Qualification in care; the home thereby exceeds the standard for at least 50 of the care staff to hold an NVQ in care. Notwithstanding the weaknesses in their employment records, the staff whose records were examined had received induction training and had attended training in fire safety. An external training provider is engaged by the home to supply training to staff in a variety of relevant subjects. To further assist the training of care staff there is available a range of opportunities including www.picbdp.co.uk (the Partners in Care web site), www.skillsforcare.org.uk (the Skills for Care web site), www.traintogain.gov.uk (a programme and funding stream supported by the Learning and Skills Council and Business Link) and www.lsc.gov.uk/bdp/employer/eggt_intro.htm (the Employer Guide to Training website, which is aimed at assisting employers to choose the most suitable training provider to meet their workforce needs by the use of a search facility). DS0000062046.V308426.R02.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, 33, 35 & 38 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The home is well managed and staff understand their work and receive training appropriate to their needs. Residents and their representatives are satisfied with the home and feel staff care for them well and put them at their ease. The home is developing a quality assurance system to ensure that residents remain satisfied with all aspects of the home. The home does not manage the finances of residents. The premises and equipment are properly maintained in good condition. DS0000062046.V308426.R02.S.doc Version 5.2 Page 22 EVIDENCE: Somerleigh Court commenced operation during November 2004 with Mrs Andrews as the registered manager. She is an experienced nurse and manager and demonstrated high degrees of competency in both aspects throughout the inspection. Systems for quality assurance are under development. One resident thinks that call bells take a long time to be answered (“you have to wait such a long time for answering the bell”); it is recommended that a survey of call bell response times and of satisfaction with meal provision be conducted by the home. To date there have been no arranged general meetings for residents or their relatives to give feedback on the standard of service provision; a newsletter was produced during 2005 and future more frequent issues are under consideration to keep residents and their representatives up to date with changes and innovations at Somerleigh Court. To ensure continuity of approach the home operates in accord with an extensive selection of clear and appropriate policy and procedure documents, including those for care provision, management and the premises. The home does not manage the finances of residents; residents who are unable to undertake this responsibility personally have nominated relatives, friends or other representatives to do this on their behalf. Staff trained in First Aid and health care are on duty in the home at all times. The premises are well maintained and there are regular checks/tests of all equipment. Details of equipment servicing and maintenance were provided to the Commission in a questionnaire. The inspector examined some records to verify this information including records of regular checks/tests of fire safety equipment. At present the home is not connected to a telephone landline service because the telephone service provider inadvertently discontinued the service and is proving slow to recommence it; during the interim mobile telephones are in use. DS0000062046.V308426.R02.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X 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 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 DS0000062046.V308426.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Care plans and other care records must be improved to ensure provision of accurate information to staff to enable them to properly care for residents. Records of self administration of medicines (by a particular resident) must be improved to provide robust evidence of the assessment and findings. Handwritten entries in medication instructions must be signed and dated by the writer and countersigned by a member of care staff who has checked the entry for accuracy. A record must be kept of the actual dose administered on each occasion when a variable dose is prescribed. This was included in the report of the previous inspection as a recommendation but remains unmet so is now stated as a requirement. DS0000062046.V308426.R02.S.doc Timescale for action 22/09/06 2. OP9 13 22/09/06 3. OP9 13 22/09/06 4. OP9 13 22/09/06 Version 5.2 Page 25 5. OP29 19 & Schedule 2 There must be evidence that the home operates a robust recruitment procedure. New staff must not commence work in the home without evidence of suitable CRB and POVA disclosure. 22/08/06 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 OP15 Good Practice Recommendations The opinions of residents and their relatives should be reliably obtained with regard to food provision, and remedial action should be promptly taken if shortcomings in this essential area are identified. It is recommended that a survey of call bell response times and of resident’s satisfaction with meal provision be conducted by the home. 2. OP33 DS0000062046.V308426.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 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 DS0000062046.V308426.R02.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!