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Inspection on 20/07/06 for Southminster Residential Home

Also see our care home review for Southminster Residential Home for more information

This inspection was carried out on 20th July 2006.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service offers care to older people, some with high dependency needs, in a sensitive way, in homely surroundings. The staff team is stable with a number of staff members having worked there for some years. There is a commitment to staff training for the job.

What has improved since the last inspection?

Since the last inspection most of the staff have had protection of vulnerable adults (POVA) training and are clear about their duty of care and the referral route if there are concerns. Results of quality assurance surveys are available for inspection. The programme of internal decoration has continued.

What the care home could do better:

Evidence needs to be available of the checks undertaken during the recruitment of new staff. MAR sheets are not always completed correctly with initials or a code to indicate medication has been administered or a reason why it has not. Medication offering a choice of dose i.e. one tablet or two, does not have the number of tablets administered recorded for audit purposes. Medication requiring lower temperatures is stored in the domestic refrigerator in the kitchen. One resident`s room had an unpleasant odour on the day of inspection and there were a number of curtains lacking curtain hooks around the home. Obsolete furniture was stored in two of the bathrooms and the fire door to the laundry was wedged open with a chair and a pile of clothing. The clinical waste bin in the clinic room had no lid to it.

CARE HOMES FOR OLDER PEOPLE Southminster Residential Home Station Road Southminster Essex CM0 7EW Lead Inspector Jane Offord Unannounced Inspection 20th July 2006 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Southminster Residential Home DS0000063215.V305025.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. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southminster Residential Home Address Station Road Southminster Essex CM0 7EW 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) 01621 773462 Top Care Homes Ltd Mrs Elizabeth Wynn Care Home 29 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (29) of places Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 29 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 15 persons) The total number of service users accommodated in the home must not exceed 29 persons Minimum daytime staffing to include five carers on duty Date of last inspection 29th September 2005 Brief Description of the Service: Southminster Residential Home provides residential and personal care for up to 29 older people, fifteen of who may have a diagnosis of dementia. The home has changed owners since the last inspection and is now run by an organisation named Top Care Homes Ltd. Southminster R.H. is located in the rural village of Southminster a few miles from Maldon, Essex. The premises were originally built as the village Manor House. There are two floors to the home, accessed by stairs and a passenger lift. In total there are thirteen single bedrooms and eight double bedrooms between the two floors, with two lounge/dining rooms on the ground floor. There are gardens to the front and side of the property that are attractive and accessible. Southminster is accessible by road and rail. The nearest station is in the village, approximately 300 metres away from the home. Visitors’ car parking is available to the front, side and rear of the property. The fees for the home range between £366.97 and £614.40 depending on the accommodation provided, who is funding the care and the level of dependency of the resident. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection that looked at the core standards for care of Older People. It took place on a weekday between 10.30 and 15.30. The registered manager was on annual leave but the deputy manager was available throughout the day to assist with the inspection process. One of the directors of Top Care Homes Ltd was also in the home from mid-day and was helpful in locating files and providing information. The files, care plans and daily records for two new residents were seen, as were two new staff files, the policy folder, some menus, the duty rotas, the activities record and the results of quality assurance (QA) questionnaires. Part of a medication administration round was followed and the medication administration records (MAR sheets) were inspected. A tour of the building was undertaken and a number of residents, staff and visitors were spoken with. In addition minutes of staff meetings, fire drill records and maintenance check records were all seen. The day of inspection was extremely hot and staff had taken care to ensure that residents had cool air around them with the use of fans or open windows and doors. Residents were appropriately dressed for the unusual weather and looked comfortable. Staff were overheard offering residents choice about where they wanted to be or what they wanted to do. Interactions were respectful and friendly. What the service does well: What has improved since the last inspection? Since the last inspection most of the staff have had protection of vulnerable adults (POVA) training and are clear about their duty of care and the referral route if there are concerns. Results of quality assurance surveys are available for inspection. The programme of internal decoration has continued. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 6 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. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6. Quality for this outcome area is good. People who use this service can expect to have their needs assessed and assurance that they can be met given prior to admission to the home. This judgement was made using information available including a visit to the home. The home does not offer intermediate care. EVIDENCE: The admission policy and the Statement of Purpose both offer a pre-admission assessment. Two new residents’ files were seen and both contained a preadmission assessment that had been completed by a senior member of the home’s staff. The assessment covered areas of care need such as mobility, continence, personal hygiene including dressing and undressing, communication and nutrition. Also assessed were memory, orientation, comprehension, awareness and social activities. Other information was the person’s preferred name, their next of kin, their past medical history and the medication regime they were currently on. Any dressings required or any pressure area damage was also noted. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 9 The manager was spoken with after the inspection and said that at times they were reliant on other professionals for information and there had been occasions when they had not been given accurate details. One distressing occasion, recorded in one of the files inspected, had meant the resident had been returned to hospital, on the day of admission to the home, after the community nurses had made an assessment of their pressure area needs. The manager had accepted this resident on the assurance of the ward staff that their pressure areas were intact. When the resident arrived at the home the staff found that they had a number of broken areas of skin that the hospital staff had not mentioned. When the resident was discharged from hospital a second time the home, with the help of the community nurses, had prepared for the resident with appropriate pressure relieving equipment. The resident’s file had documented evidence of this. Southminster Residential Home DS0000063215.V305025.R01.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 for this outcome area is adequate. People who use this service can expect that they will have a care plan to help meet their health needs and that they will be treated with respect, however, they cannot be assured that some present medication recording practice and storage will protect them. This judgement was made using information available including a visit to the home. EVIDENCE: Both residents’ files seen included a care plan to help meet their needs in a way that was acceptable to the resident. There were interventions for mobility, personal hygiene, night needs, nutrition and the resident’s preferred daily routine. Particular areas of individual care were addressed such as deafness and pressure area care. One intervention recorded, ‘XXXX is profoundly deaf. Write things down in large letters or use the whiteboard’. Included in the files were records of any known allergy, a life history, assessments for moving and handling and tissue viability, likes and dislikes, general health and preferred activities, (‘likes Shirley Bassey tapes’). There were records of visits to and from health professionals such as the GP, community nurse, optician and chiropodist. Residents’ final wishes were recorded. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 11 Staff were observed knocking on doors before entering residents’ rooms. They spent time interacting with residents in a friendly way giving the residents choice about what they wanted to do or where they wanted to be. Help with meals was offered sensitively. Part of a medication administration round was observed. The senior carer said they had received in-house training and competency assessment before being allowed to administer medication alone. The medication is supplied to the home by the local pharmacy in prepared blister packs, a system known as monitored dose system (MDS). It was noted that the carer signed for medication as it was dispensed not after it was administered. Some gaps were seen on the MAR sheets where neither a signature nor a code had been used to denote that medication had or had not been given. Prescriptions that had a choice of dose i.e. one tablet or two, 10-20 mls, did not always have the actual dose administered recorded. Medication requiring a low temperature for storage is kept in the domestic refrigerator in the kitchen. It is not in a sealed container and as such is available to anyone with access to the kitchen and the refrigerator. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality for this outcome area is good. People who use this service can expect to be encouraged to maintain contact with family and friends, be offered meaningful activities and have a well balanced diet. This judgement has been made using available information including a visit to the home. EVIDENCE: The home employs an activities co-ordinator who works fifteen hours a week. They said they try to come into the home each weekday for some time. When they arrive they visit all the residents briefly to see that they are alright and if there is anything special they would like to do that day. Individual records are kept for the activities that each resident participates in, such as playing ball, having a sing-along, going for a walk or being visited by animals. The record includes whether the resident is happy with the activity that day. The co-ordinator said they have 1:1 sessions with residents if they want that and they play cards, do jigsaws and take people out to the village in wheelchairs when the weather is good. They are hoping to hire a minibus to take some residents further afield to Southend or Burnham. A representative of the local church holds a service in the home once a month. Two residents are Jehovah’s witnesses and staff said their families and their church are supportive and help them attend their meetings. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 13 The home’s Statement of Purpose says there is no restriction on visiting and that visitors are welcomed. Visitors seen on the day agreed that that was the case. They said staff always made them feel welcome. Staff said that animals are welcome and one member of staff brings their dog to visit the residents. One resident had some lovely photographs of their dogs in their room and said all three dogs regularly visit them. The kitchen was seen after lunch and was clean and tidy. On the day of inspection the director could not locate the temperature records for the refrigerators and freezers but the manager has since faxed them to CSCI and they show that the refrigerators and freezers all function within safe limits for food storage. Food stored in the refrigerator was covered and labelled correctly. The dry goods store had a wide range of foods most of them of quality brand names. The fresh fruit and vegetables are delivered from a local greengrocer every two days. The menus were seen and showed that lunchtime is when the main meal of the day is served. There was a choice of two cooked dishes and two desserts for example, bacon and onion rolls or beef stew, herb and tomato pasta or lamb casserole. Sunday and Wednesday had a roast meal and there was fish on Fridays. Desserts had favourites such as sponge pudding and custard or milk puddings. Teatime and breakfast offered a cooked dish if requested. The meal served on the day of inspection looked appetising and was clearly enjoyed by the residents. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality for this outcome area is good. People who use this service can expect to be protected from abuse and have any concern taken seriously. This judgement has been made using available information including a visit to the home. EVIDENCE: Neither the home nor CSCI have received a complaint about the service since before the last inspection. The complaints policy was seen displayed in the entrance hall and offered in-depth investigation in an effort to resolve any issues. Staff spoken with said they had had regular Protection of Vulnerable Adults (POVA) instruction, either in-house or during NVQ training or both. Training records confirmed this with over half the staff, including some ancillary staff having had a recent update in May 2006. Staff spoken with were clear about their duty of care and the process to follow if they had any concerns that a resident was potentially being abused. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 15 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, 22, 26. Quality for this outcome group is adequate. People who use this service can expect to live in a comfortable home with specialist equipment available if required, but they cannot be assured that all areas of day-to-day maintenance will be addressed, that the home will be free of odours or that regulations in respect of fire doors will be observed. This judgement was made using information available including a visit to the home. EVIDENCE: A tour of the home was undertaken with the director. A number of residents’ rooms were seen. As the building is so old the rooms vary in size and shape but all had large windows and a pleasant outlook. Shared rooms all had curtains for privacy. It was noted that some window curtains and some dividing curtains were lacking curtain hooks and did not hang properly as a result. The two lounge/dining rooms are large and light, furnished with seating suitable for the client group. On the day of inspection the visiting hairdresser was using the smaller of the rooms to see residents. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 16 There was evidence in some rooms that pressure-relieving mattresses were being used for residents and some residents were sitting in specially adapted armchairs in the lounge. One resident who was unwell, and had remained in bed, had been provided by the community nurses with an adjustable height bed, a large hoist and an extra large commode so the carers could manage their needs in comfort. The bathrooms and toilets seen all had liquid soap and paper towels available for hand washing. Two bathrooms had obsolete furniture stored in them; one had a mattress and the other an armchair. The director said both pieces of furniture were to be disposed of. Generally the home was clean and tidy throughout. Staff spoken with said there is a domestic staff member on duty every day including the weekends. One resident’s room smelt of urine. When this was discussed with the deputy manager they agreed that steps needed to be taken to negotiate with the resident to allow cleaning to take place. The resident does not like leaving their room for any length of time. The laundry is in a central part of the house and can be accessed by two doors. Both doors are fire doors and on the day of inspection one of them was propped open with a chair that had a pile of clothing on it. The laundry was clean and the washing machine has a sluicing programme. The laundry worker said that soiled linen was sent to the laundry in alginate bags that went straight into a machine and the seams dissolved during the cycle. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 17 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 for this outcome area is adequate. People who use this service can expect to be cared for by sufficient numbers of well trained staff but they cannot be assured that all the required recruitment checks are carried out prior to employment. This judgement was made using information available including a visit to the home. EVIDENCE: The duty rotas were seen and showed that on an early shift there was a senior carer supported by four care staff and the same on a late shift. Night duty was covered by two or three carers. The deputy manager said they tried to have three carers on at night but they had a vacancy in the team that they were trying to recruit to. The manager or deputy manager were always on call and lived very close to the home so could respond to a call if help was needed during the night. The home employs a maintenance person and an administrator but the proposed hours of work were not on the duty rotas. The director said that time sheets were completed that showed the actual hours worked. The home employs twenty one care staff, including the manager, and of these twelve have achieved an NVQ level 2 qualification or above. Fourteen care staff have attended a Positive Dementia Care course run through Chelmsford college over a year. Each student has a comprehensive folder that they work through and outcomes are measured by questions and responses. Staff said they had found the course extremely interesting and helpful in their work. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 18 The training matrix showed that staff had received regular updates in training on POVA, moving and handling, fire awareness, infection control and first aid. Kitchen staff had had a training update in safe food handling in June 2006. Staff spoken with confirmed they had regular training organised for them to attend. Two new staff files were seen and both contained two references and a job application. One file had evidence if identification checks but the criminal record bureau (CRB) check was relating to a previous job. The other file had no CRB or evidence of any identification checks. Neither file had a recent photograph of the member of staff. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 19 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, 36, 38. Quality for this outcome area is adequate. People who use this service can expect to live in a home managed by a competent person, that their opinion will be sought and that the home’s policies will protect their finances and their welfare, the home’s equipment is regularly maintained but some aspects of infection control are not complied with. This judgement was made using information available including a visit to the home. EVIDENCE: The manager is a registered nurse and has many years experience in caring for older people. They have achieved an NVQ level 4 in management. The deputy manager has been at the home for fifteen years in a variety of posts. Together with the director they form a well-motivated and committed management team. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 20 There is a supervision programme in place and staff spoken with felt it was supportive. They were able to raise any matter at supervision and training needs were identified. Supervision records were seen in staff files. The director explained the system used to manage residents’ personal monies. There is a safe in the office and the director and manager hold keys to it. Individual records of transactions and receipts are kept for each resident whose money is managed by the home. The balance is retained in a named wallet. Two wallets, at random, were checked and their contents tallied with the records. The results of some resident and relatives satisfaction surveys were seen. Most people who had responded were satisfied with the level of care being offered. One commented, ‘The care is exemplary – 1st class’. Minutes of staff meetings were also seen and it was evident that a wide range of subjects was discussed from care practice to the environment. Records of regular maintenance checks were seen for washing machines, the lift, the assisted baths and hoists. An environmental health officer’s inspection done in November 2005 commented, ‘Very good standards noted at the time of inspection’. As the building is old and has been adapted over the years the present owners had an asbestos survey done in May 2006. The survey concluded the building had no asbestos present. Records were seen for checks made on fire alarms and fire extinguishers and a fire risk assessment was done in August 2005. Evidence was recorded of weekly fire alarm testing and fire drills that were carried out. The fire door to the laundry was propped open with a chair, as noted earlier in the report. The bin for clinical waste in the clinic room did not have a lid so used gloves, aprons and other products were not sealed away when they were discarded. Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 3 X X X 2 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 1 Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Requirement Medication requiring low temperature storage must be stored in a locked container in a domestic refrigerator or a dedicated medicine refrigerator. MAR sheets must be signed to indicate administration of medication not dispensing. MAR sheets must be completed to record whether medication has been taken and the amount administered. A system for disposing of obsolete equipment rapidly must be implemented so the bathrooms are kept free for their purpose and day-to-day maintenance of furnishings must take place. A cleaning regime must be developed to eliminate unpleasant odours from all parts of the home. All the recruitment checks required in schedule 2 must be undertaken for prospective members of staff and documentary evidence kept in their files. DS0000063215.V305025.R01.S.doc Timescale for action 31/07/06 2. OP9 13 (2) 20/07/06 3. OP19 23 (2) (b) 31/07/06 4. OP26 13 (4) (c) 23 (2) (d) 19 (1) (b) (i) Sch. 2 20/07/06 5. OP29 20/07/06 Southminster Residential Home Version 5.2 Page 23 6. OP38 13 (3) 13 (4) (c) 23 (4) (c) (i) Fire doors that are required to be 20/07/06 open during the day must be fitted with self-closure devices and all clinical waste bins must be suitable for the purpose. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Southminster Residential Home DS0000063215.V305025.R01.S.doc Version 5.2 Page 25 - 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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