Inspection on 06/10/05 for St Anthonys Residential Home

This inspection was carried out on 6th October 2005.

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.

Other inspections for this house

St Anthonys Residential Home 21/07/08

St Anthonys Residential Home 03/09/07

St Anthonys Residential Home 19/05/06

St Anthonys Residential Home 19/05/05

St Anthonys Residential Home 23/11/04

St Anthonys Residential Home 17/08/04

St Anthonys Residential Home 04/02/04

St Anthonys Residential Home 29/10/03

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

CARE HOMES FOR OLDER PEOPLE St Anthonys Residential Home 126 Sutton Road Erdington Birmingham B23 5TJ Lead Inspector Lisa Evitts Announced 6 October 2005 th 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 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. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Anthonys Residential Home Address 126 Sutton Road Erdington Birmingham B23 5 TJJ 0121 373 7900 0121 382 7911 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Tim Kelly Isabel Smith Care Home 18 Category(ies) of Old Age (18) registration, with number of places St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. 17 Service Users who are over 65 years of age and fall within the category of old age. 2. One named person under the age of 65 years of age at the time of admission can be accommodated and cared for in this home. Date of last inspection 19th May 2005 Brief Description of the Service: St Anthonys residential home offers residential care for eighteen older people. The home is a large detached two storey property which has been extensively renovated, extended and decorated to a high standard. The rooms are all suitably furnished and equipped to meet the needs of the occupants. The decor throughout is homely. St Anthonys provides a total of fifteen bedrooms consisting of twelve single and three double bedrooms, which are situated on both the ground and first floors. There is an attractive dining room, two lounges and a dedicated smoking area. All bedrooms and communal areas have access to a call system. Whilst none of the bedrooms have ensuite facilities there are ample assisted bathing and toilet facilities to meet the current needs of the residents. The home has vertical lift access to the first floor. The home is situated close to local amenities and public transport. There is limited parking at the front of the home. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook the announced inspection over one day; the Registered Manager and Deputy Manager assisted the inspector throughout. This was the second statutory inspection for the 2005/2006-year. There were eighteen residents living at the home on the day of the inspection. Information was gathered from speaking with residents, visitors and staff, observing the care staff performing their duties and from examining care and medication records. A partial tour of the premises was undertaken. Eighteen comments cards were received, all of which were positive in nature. What the service does well: Residents are supported by care staff to meet their health, welfare and social needs. The home encourages prospective residents to visit and spend a day at the home, to see if they would like to live there. St Anthony’s provides a homely, clean and comfortable environment in which to live where the staff aim to create “a family environment” Residents are able to exercise choice over their daily lives and this promotes their independence and individuality. Resident and relatives are invited to attend meetings to voice any concerns or suggestions. A sample of comments included: *“St Anthony’s is warm, welcoming and friendly whilst being very professionally run” *“St Anthony’s and all staff have removed all worries and left us content that our mother is safe and happy” *A visiting community healthcare professional stated, “ Two of my residents have been invited to spend one day a month at St Anthony’s and have completely lost the apprehension they had of going into a care home” *“The manager is very good, she sorts everything out for you” *“There are no problems here, everyone is very good” *“Food is very good, the menu is on the board the night before and if you don’t like it they will get you something else” St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 6 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. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 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 standard(s) 1,3 & 5 The information available and assessment processes ensure that prospective residents have enough information and confirmation that the home is able to meet their needs. EVIDENCE: The Statement of purpose had been revised since the previous inspection and included all the relevant information required by the regulations. The Service User guide was not reviewed on this occasion, but was found to contain all the relevant information at the previous inspection. Prospective residents are assessed prior to coming to live at the home using a comprehensive pre admission assessment document. The two most recent admissions files were reviewed, one had a completed pre admission assessment but the second file did not have an assessment on file. The resident had been spending one day a week at the home, while waiting for a bed to become available. One relative said, “Its lovely here, we were very fortunate to find the home” St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 9 The registration certificate for the home was clearly on display in the main reception area. The home plans to produce a photograph board of staff, so that visitors know “Who is who” and this will be displayed in the reception area. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 & 10 Resident’s health and personal needs were generally well met with the additional support of visiting Health Care Professionals and written documentation is good. Medicines are administered in a safe manner but some improvements are required for record keeping. EVIDENCE: Two recent admissions care files were reviewed. There was evidence that residents are involved in the monthly reviews of the care plans. Assessments were detailed with likes and dislikes and were personalised as to preferences. Moving and handling risk assessments are updated every six months unless there is a change, however these do not state how to get residents from the floor, should they fall. Falls risk assessments; nutritional assessments and monthly weights are in place. Records of professional visits are recorded separately and this aids with ease of monitoring information. There was evidence of pressure relieving equipment in use within the home. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 11 Residents were all observed to be dressed in clothing suitable for the time of year and general appearance was neat and tidy. Generally medications were found to have been administered correctly with the exceptions of *There is not always a clear audit trail, as some medications and all antibiotics are not always been signed in on receipt. *MAR charts reviewed were hand written. One of the charts had been destroyed as a drink had been spilt over it. Staff were requested to ask the pharmacist to supply a new chart and were informed not to dispose of any charts in future. *Ointments/creams were not dated when opened and had dispensed dates of August. Prescription creams and ointments should usually be disposed of 28 days after opening; advice should be sought from the supplying pharmacist. It is recommended that the home keep photocopies of the prescription alongside the MAR chart and that the home undertakes medication audits. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 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 standard(s) 12, 13, 14,& 15 Residents are able to exercise choice over their daily lives, community contact, and the activities, which they choose to participate in which promotes their individuality and independence. Residents receive a wholesome and varied diet that meets any special dietary requirements. EVIDENCE: There is a wide range of activities on offer for residents to participate in should they choose and one resident said “I can go out when I like, and go to bed when I want” The home has an open visiting policy and one resident said, “Visitors can come at anytime” Activities on offer include keep fit, pampering afternoons, board games, video evenings, skittles, bingo, coffee mornings and the home had held a garden tea party in the summer. One resident goes out to a day centre each week and attends church with a friend each Sunday. Some of the residents from the home had been on a day trip to Stratford recently and had a pub lunch; a resident said, “It was a really enjoyable day” On display in the main reception area where photographs from this day out. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 13 Many of the residents talked about a theatre company who had been to the home and had given a musical performance, as the residents had enjoyed this so much, the manager has booked the company again, to give another performance just before Christmas. Since the last inspection the home had implemented a record of activities, which identified which residents had participated in each activity. Further improvements are required to the documentation as it was not in line with the data protection act. The lunchtime meal was observed to be very quiet and relaxed and the residents were enjoying their meals. Tables were attractively laid and cold drinks were served with their meals. Residents wore appropriate protective clothing and staff wore protective aprons to serve the meals, staff assisted residents respectfully. Menus reviewed prior to the inspection were found to be well balanced and offered choice. Resident’s comments included: “Food is very good, menu is on the board the night before and if you don’t like it they will get you something else” “I cant grumble at the food, its alright, we have a different meal every day” A relative who was visiting the home, after travelling some distance was to have lunch at the home and said, “ I have eaten here and I am very happy with the meals” St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 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 standard(s) 16 & 18 The complaints procedure is comprehensive and is accessible to residents and representatives should they need to make a complaint. The home has robust systems in place to protect residents from abuse. EVIDENCE: The complaints procedure had been amended since the previous inspection and included relevant information should anyone wish to make a complaint. Since the previous inspection the home has implemented a complaints log. The home had recorded two “grumbles”, and these had been fully resolved and the outcome documented. Resident’s comments included: “The manager is very good, she sorts everything out for you” “The manager is very helpful” “There are no problems here, everyone is very good” A relative commented, “There is no question, that any problem would be sorted out” There was evidence on staff files that they had received recent training in the Protection of Vulnerable Adults. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 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 standard(s) 19,20,21,23,24,25 & 26 St Anthony’s provides a clean, homely and comfortable environment to live, in which residents are safe, relaxed and secure. EVIDENCE: The home was found to be clean and odour free on the day of the inspection. There are adequate assisted bathing and toilet facilities for residents use and toilets have raised frames and handrails. Some of the flooring in the ground floor bathroom was found to be raised and the manager stated that a plumber was due to come in and increase the water pressure then new flooring was to be laid. There is a call system available for residents use. The home must ensure that hygienic hand washing facilities are available at all times to reduce the risk of cross infection, including the provision of liquid soap, there was no soap available in the sluice room and a bar of soap had been left in the shower room. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 16 The dining room was decorated to a high standard and the lounges were homely with televisions, videos, radios, ornaments, pictures and books. On the mantelpiece there were a residents birthday cards and this created a homely atmosphere. A recent review of infection control procedures had been partly met, with the installation of a mechanical pot washer. A request for two fridges to be removed from the laundry area had not been actioned due to lack of space and it is recommended that this be further discussed with the Health Protection Nurse. Some bedrooms were reviewed and these were personalised with resident’s own possessions to ensure their surroundings are as comfortable as possible. One resident stated “I am very happy with my room”. A relative spoken to said that she had stayed in her moms room, when she had been admitted to hospital as she had to travel some distance. Another resident said “I would like a lamp over my bed, as it gets dark in here” This had already been discussed with the residents family, however the home manager should complete an audit of all residents to ensure residents who require bedside/overhead lighting are provided with this. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 The home has maintained core staff to offer good consistent standards of care to meet the assessed needs of the residents. Staff undertake training to improve their level of knowledge of caring for older people. Recruitment procedures require further improvements to ensure the safety of the residents. EVIDENCE: In addition to the care staff the home also employs a cook and a cleaner. A senior member of staff provides on call support to the person in charge of the shift and the person responsible for this is indicated on the staffing rota. Staffing rotas indicate that some members of staff continue to work excessive hours per week and remedial action must be taken to reduce this. Comments regarding staff included: “They bring me a nice cup of tea in the night” “Staff are very nice I’ve got no complaints” “No moans about the staff they are all ok” “Staff are very friendly and accommodating, couldn’t wish for better, nothing is too much trouble” Two staff files were reviewed. One file had only one reference on file, as the second reference requested had not yet been returned. There were some gaps in the employment history and there were no written records that these had been discussed. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 18 A POVA first check and Criminal Records Bureau check were on both files reviewed however these had been returned after the staff had commenced employment. Each member of staff is issued with a job description. One file had a completed induction checklist but the second file, although had a checklist was not signed or dated. Interview notes had been recorded for care staff and staff were asked set questions. It is recommended that interview notes are kept for ancillary staff also. There was evidence that staff had received manual handling, health and safety and protection of vulnerable adults training. Other training planned for the future includes mandatory training plus death and dying. Staff had recently completed a certificate in the Safe Handling of Medicines. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36 & 38 The Registered Manager ensures a good standard of service is provided at the home. The systems for resident consultations are good and there is evidence that resident’s views are sought and acted upon. Staff are trained in the majority of health and safety issues to ensure that the residents safety and welfare is maintained as required. EVIDENCE: The Registered manager has had much experience of working with older people and holds a NVQ Level 4 qualification in management and NVQ Assessors qualification. Recently the manager has completed a Safe Handling of Medications Course and has commenced working towards the Registered Managers Award. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 20 Minutes from a recent staff meeting were provided and a relative stated “Its good they have residents meetings so they can air their views”. This ensures that staff, residents and their representatives are given the opportunity to discuss and share any ideas or concerns about the home in an open atmosphere. The home has finished a formal quality assurance process and has been awarded the Birmingham Quality Assurance Premium Award. Health and safety maintenance checks have been undertaken all equipment used within the home including emergency lighting, gas safety certificate, fire alarm systems and electrical wiring. The portable appliance-testing certificate had run out, however the home manager stated that this was booked to be completed within the next four days. The fire risk assessment had been reviewed and updated in September. The system for staff supervision and appraisals was up to date. Health and safety training had been recently commenced for staff and this was evidenced on staff files. Fire drills were undertaken weekly and the home recorded names of staff that had attended. Bed safety rails are used with bed safety rail protectors, to prevent the risk of entrapment injuries being sustained by the residents. Accident records were reviewed and all accidents had been recorded and CSCI had been notified of these were relevant under Regulation 37. There was no evidence of auditing of accidents and it was recommended that a log is kept for ease of monitoring. The Environmental Health Service had recently undertaken an inspection and had left one recommendation to record cooking temperature checks and this had been implemented by the home. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 x 3 2 3 2 STAFFING Standard No Score 27 2 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x 3 x x 3 x 2 St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP2 Regulation 17 Requirement The room number to be occupied must be included in the residents statement of terms and conditions of residency. (Previous timescales of 23/04/05 & 19/08/05 not met) All residents must have a documented pre admission assessment. Moving and Handling risk assessments must include detail of the action to be taken should a resident fall. (Previous timescale of 19/07/05 not met) Prescription creams must be dated on opening and discarded after twenty eight days. Timescale for action 03/01/06 2. 3. OP3 OP7 14 (1) (a) (b) 13 (5) 23/12/05 23/12/05 4. OP9 13 (2) 16/12/05 5. OP9 13 (2) 6. OP12 16 (2) (m) (n) (Previous timescale of 20/05/05 not met) A written record of all medication 16/12/05 received into the home must be maintained. (Previous timescale of 01/07/05 not met) Records of activities participated 23/12/05 in by the residents must be in line with the data protection act. Version 1.40 Page 23 St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc 7. OP19 23 (2) (b) 8. OP24 23 (2) (p) 9. OP26 16 (2) (j) 10. OP27 18 (1) (a) 13 (4) (c) The manager must forward written evidence to CSCI that the flooring in the ground floor bathroom has been replaced following plumbing work. The manager must undertake an audit of all residents rooms to ensure those who require bedside lighting receive this. Bars of soap must not be used in communal areas. Liquid soap must be available in the sluice room. Remedial action must be taken to reduce the number of excessive hours worked by staff per week on a long term basis. 19/12/05 02/01/06 09/12/05 23/12/05 11. OP29 13 (6) 19 (Previous timescale of 02/06/05 not met) Two satisfactory written 06/10/05 references must be obtained in respect of all staff members prior to commencing employment at the home, one being from the current or most recent employer. (Previous immediate requirements of 30/11/04 & 02/06/05 not met) (The manager received this in the form of an immediate requirement) The manager must ensure that a 06/10/05 POVA first check is obtained prior to new staff members commencing employment at the home. (The manager received this in the form of an immediate requirement.) The manager must forward written evidence to CSCI that Portable Appliance Testing has been completed. 12. OP29 13 (6) 19 13. 38 23 (2) ( c) 19/12/05 St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard OP9 OP11 OP26 OP29 OP29 OP38 Good Practice Recommendations It is recommended that medication audits are undertaken by the manager and photocpies of current prescriptions are kept alsongside the MAR chart. Training for staff in respect of Death and dying should be arranged. It is recommended that further discussion takes place with the Health Protection Nurse regarding the removal of frideges from the laundry area. It is recommended that interview notes are recorded for ancillary staff as well as care staff. It is recommended that written records of any gaps in employment are kept. It is recommended that the home keeps an accident audit log. St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 St Anthonys Residential Home E54 S16780 StAnthonysRH V245605 061005 AI stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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