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Inspection on 21/06/05 for St Augustines Court Care Home

Also see our care home review for St Augustines Court Care Home for more information

This inspection was carried out on 21st June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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.

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 home provides care for people with enduring mental illness and dementia, most residents exhibit difficult behaviours that cannot be managed in a residential environment. The care staff team have worked at the home for a long time and provide good support for the residents.

What has improved since the last inspection?

The management of personal finances is now safeguarded to ensure that abuse of people`s personal monies cannot take place. A training programme has been implemented. A policy is now in place for the use of restraint. Moving and Handling training has been undertaken. An accident audit has been completed. All residents have received a review by the Nottingham Social Services.

What the care home could do better:

The home must have a registered manager in place to ensure appropriate leadership. The standard of care planning and the actual undertaking of actions in response to risk assessments and changes in conditions needs to be improved upon, followed through by the person undertaking the assessment/review to ensure that actions necessary are undertaken in an appropriate timescale. Where qualified nursing staff fail to ensure that appropriate actions and responses to conditions are undertaken, the registered provider must take appropriate action to ensure that staff are dealt with according to the disciplinary procedure and the code of practice laid down by the Nursing and Midwifery Council. The "quick fixes" implemented at times of crises by temporary transfer of staff to the home from other homes within the group do not lend themselves to providing a long -term solution to the problems highlighted within this report. The provider must ensure that staff have the necessary skills and competencies to deliver the care that the home intends to provide. The health and personal care which the resident receives will be based on the individual`s needs. It is therefore impossible to lay down standards to cover precisely every aspect of care. Because of this the assessment process and care plan for the individual is crucial to ensure that care is delivered in accordance with the residents plan. The plan is then the yardstick for judging whether appropriate care is being delivered to the resident.

CARE HOMES FOR OLDER PEOPLE St Augustines Court Care Home 105-113 Wells Road Nottingham Nottinghamshire NG3 3AP Lead Inspector Mary OLoughlin Unannounced 21 & 22 June 2005 10:00 nd 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 Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Augustines Court Care Home Address 105-113 Wells Road Nottingham Nottinghamshire NG3 3AP 0115 9590473 0115 9412079 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) Highfields Care Homes No 2 Ltd Care home with nursing 40 Category(ies) of DE Dementia, x 3 registration, with number DE(E) Dementia - over 65, x 40 of places MD(E) Mental Disorder - over 65, x 40 St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within total number of 40 beds 3 beds may be used for clients under age of 65 years in the category of DE Date of last inspection 6 January 2005 Brief Description of the Service: St Augustines Care Home provides 40 places for older people with mental illness and Dementia who require nursing care. Within the total number of beds three people under the age of 65yrs may be accommodated. The registered provider Highfield Care Homes have recently merged with another care provider Southern Cross Healthcare. The companies have yet to confirm their future trading name. The home provides 14 double rooms and 11 single, there are no ensuite facilities. A passenger lift is installed to provide acess to the first floor. All areas are accessible for people in wheelchairs. Sited close to the city centre and on a regular bus route to the city of Nottingham. There are also a range of local stores close by. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and undertaken by two regulation inspectors. A regulation manager also attended for part of the inspection. The total time spent on the inspection, combining all three Commission for Social Care Inspection staff hours was 18hrs. The report indicates minimal comments from the residents, primarily due to the nature of the illness of those accommodated. Wherever possible resident’s were asked their opinion of the service provided but most were unable to give an account due to their impaired mental and physical wellbeing. Relatives were not interviewed at this inspection as none were present. Information from external professionals such as the Doctor, specialist nurses and Fire Service was considered and investigated during the inspection. The previous inspection of January 2005 and a subsequent monitoring visit undertaken in February 2005 indicated progression and compliance with action plans produced. However since this time staffing levels have fallen. Proposed training and input from the Royal College of Nursing advisor, around qualified nurse’s accountability have failed to improve the care management of the resident’s. There is a lack of ownership of the continuity of care within the home and a failure to have effective methods of communication which results in slow responses to changes in the resident’s conditions and staff that are not knowledgeable about the resident’s needs. External professionals have raised concerns to the Commission for Social Care Inspection and the local Primary Care Trust. One General Practitioner is refusing to register any more resident’s that are admitted to the home due to the poor care management and poor communication. Whilst the inspector acknowledges the progress in some areas and also that the registered provider has now merged with another provider, there are St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 6 serious concerns, which must be addressed immediately to ensure the safety of the residents. Failure to meet these immediate requirements may result in enforcement action being taken by the Commission for Social Care Inspection to ensure compliance and the safety of all those accommodated. What the service does well: What has improved since the last inspection? The management of personal finances is now safeguarded to ensure that abuse of people’s personal monies cannot take place. A training programme has been implemented. A policy is now in place for the use of restraint. Moving and Handling training has been undertaken. An accident audit has been completed. All residents have received a review by the Nottingham Social Services. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3-6 Prospective resident’s do not always receive an appropriate assessment of their needs prior to the home agreeing admission which may put them at risk if their needs are not planned for and met at the point of admission. EVIDENCE: The records of a recently admitted resident contained partially completed assessments and one care plan that did not cover the specific areas of concern or need for the individual. The documents were not signed or dated and there was no evidence of any consultation with the resident or their relative. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 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 Care practice, medicine management and the use of blood testing devices present a significant risk to the resident and does not ensure best practice in the care of the residents accommodated. The management of healthcare does not reflect best practice and may result in resident’s not receiving the care they need. EVIDENCE: One resident case tracked had received an assessment of their pressure sore risk monthly. Recent tissue damage had prompted a review of the care plan which advised referral to the tissue viability nurse for assessment-this had not been undertaken by staff at the home. The plan advised that staff should change the person’s position at regular intervals, but no record of positional changes were in place. The plan also instructed staff on the type and frequency of the dressing changes for the wound, no record of these changes was in place. The Prescription record sheet did not indicate any signatures from staff changing St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 11 dressings as prescribed. The qualified nurse spoken with during the inspection was not aware of the dressing needs of the resident. The plan advised that a prescribed cream be applied to the resident, no record of the cream being administered was in place or signed for on the prescription record sheet. The resident was weighed monthly and extreme fluctuations are noted in the weight, which may indicate that the scales are not working correctly, however the resident was underweight and the care plan advised referral to the dietician, no record of dietician referral was seen. The Dietician confirmed that they had not received a referral for the resident. The plan also advises a high protein diet to be encouraged, no evidence of this actually being undertaken was seen. A second resident with Diabetes had a care plan for the use of Hypostop in the event of hypoglycaemia, there was no evidence that this was in stock and it was not recorded onto the medicine record sheet. The resident had numerous care plans for managing diabetes that prove to be confusing and provide no comprehensive action plan to address the risks to the individual and safe management of their condition. Care plans were very difficult to read, handwriting was poor. The second resident had been referred to the district dietician who had advised upon diet supplements but this had not been followed up and implemented by the staff at the home. Lancet devices in use for people with Diabetes to monitor their blood sugar levels were not being used as per the manufacturers instructions and the guidance from the medical devices agency. The practice of using individual use devices for multiple residents poses a serious risk of cross infection. The testing monitor had areas of dried blood encrusted to the machine. The Commission for Social Care Inspection have received concerns from one G.P. practice around the management of the care at the home, they have subsequently refused any further registrations from residents admitted to the home. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 12 External professionals raise concerns that staff are not always able to confirm the condition of the resident when they visit the home as staff comment that they have not been on duty recently and have no knowledge of significant changes in people’s condition. Throughout this inspection the inspector met with the same responses to questions about the condition of some resident’s, staff referring to them not being responsible for that resident or not being on duty that day. The Nottingham Tissue Viability Team were working closely with the home during 2004 and set action plans for the manager to improve practice in areas related to Tissue Viability. Concerns raised during this inspection and from external professionals all indicate that the home are not working towards achieving the set action plans. To ensure that practice is up to date the manager should request a further audit from the Tissue Viability Service. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 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 standard(s) 12 The lack of organised activities or social and recreational activities does not provide residents with the opportunities or stimulation they require. EVIDENCE: There are no structured activities in place. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 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 management of complaints was disorganised which may result in complaints not being addressed in a reasonable time or followed through to conclusion. EVIDENCE: The home’s record of complaints was not located and the acting manager has commenced a new record as a result. Information required on the outcome of previous investigations could not be evidenced as records were missing and the new manager was not able to furnish the inspector of progress. The multi agency investigation into financial abuse of the resident’s personal finances at the home has concluded. The Crown Prosecution Service will not be pursuing a case. However it was established that two members of staff may be considered for entry onto the Protection of Vulnerable Adults list as a result of the investigation. The provider must inform the Commission for Social Care Inspection and Social Services of the evidence that the POVA procedures are applied. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 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 The environmental upgrades and general repairs are not addressed promptly and may not ensure a safe well maintained home. EVIDENCE: The inspector was shown a record of a submitted report to the registered provider from January 26th 2005, which listed all the required environmental upgrades to ensure the health and safety of the premise. Staff spoken with and an inspection of the premises show that these upgrades have not been undertaken. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 16 One service user has a broken window that will not close and expressed concerns that if the weather changed the rain would come through the window directly onto his bed. There was no maintenance person employed at the home, during the inspection a maintenance worker from another home in the group was asked to attend the home and provide the necessary support. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 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 number of staff in place do not meet the minimum level required and may present an increased risk to the health and safety of the resident’s. EVIDENCE: There were 39 residents in the home at this inspection. There are two qualified nurses on duty throughout the day and one at night. The management hours are not included in the qualified nurse numbers. 5 care staff are provided during the day hours and 3 at night. Duty records show that sickness and absenteeism can leave the home on extremely low staff numbers when agency workers have not previously been arranged. The present numbers of staff do not reflect the staffing notices as agreed prior to 2002, and do not reflect the action plan received by the Commission for Social Care Inspection on 24/01/05 from the registered provider following the immediate requirement set at the inspection of 06/01/05. Staff spoken with expressed concerns that the named nurses/ key workers written on documents or rooms were no longer employed by the home and did not reflect the true allocation of staff. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 18 One staff file examined shows gaps in employment history were not explored and references that were not supplied by the most recent employer as the company policy requests. A second staff file did not contain an application form, no copy of induction and no supervision records. The audit recently undertaken on 02/06/05 by the operations manager for Highfield Care confirms the lack of recorded supervision, training and induction. The audit also records the poor management of accident recording and notification to relatives following accidents. Staff receiving training did not have a clear record within their files, the “Highfield “audit highlighted the lack of mandatory training in the two cases examined. An action plan is in place for the new acting manager to achieve compliance within the areas highlighted in the provider’s own audit. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 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) 31-35-36-38 The recently appointed manager is not registered with the Commission for Social Care Inspection, appropriate notification must be undertaken within 28days. Personal monies of resident’s unable to manage their own financial affairs are now safely managed and monitored to ensure there is no financial abuse. The management of the health and safety of the building does not safeguard the residents. EVIDENCE: The acting manager had been in post for 4 weeks. An application to register with the Commission for Social Care Inspection has not been requested at the time of the inspection. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 20 Following the previous inspection a temporary manager has been in post until the appointment of the present acting manager four weeks ago. The fire service undertook an inspection of the home in March 2005, their report was examined against the actions that the provider has since taken. The home has failed to undertake the appropriate action necessary to address the risks identified at the fire inspection of March 2005. The Fire Service have been notified by the inspector of the non compliance with the outcome of the fire safety audit and a further inspection will be undertaken to ensure compliance is achieved by the registered provider. The office area and main lounge have adapter sockets that are overloaded with plugs from various appliances and pose a risk of fire and injury to residents and staff. The main lighting in most communal areas are without covers. Portable appliance testing is required. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 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 x x 1 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 x 15 x COMPLAINTS AND PROTECTION 1 x x x x x x x STAFFING Standard No Score 27 1 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 3 1 x x x 3 x x 1 St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 22 No 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 3 Regulation 14 Requirement The registered person must ensure that a suitably qualified nurse from the home is involved in the pre-admission assessment of prospective service users and that written confirmation is provided to the prospective resident that the home are able to meet the persons needs. A care plan should then be drawn up with the involvement of the service user and their relative at the point of admission. The registered person must ensure that where assessment of the residents condition indicates referral to specialists that this referral is undertaken. The registered person must ensure that records are kept of (a) positional changes (b) special diets and administration of diet supplements provided (c) Application of creams and lotions (d) Treatment of pressure sores The registered person must ensure that the management of medicines which includes the records of administration, supply C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Timescale for action Immediate 2. 7&8 13 Immediate 3. 8 17 Immediate 4. 8 13 Immediate St Augustines Court Care Home Version 1.30 Page 23 5. 8 13 6. 7. 8 8 CSA 13 8. 8 14 9. 12 16 10. 16 17 11. 18 17 12. 19 23(2)(b) and storage are managed in accordance with the Medicines Act. The registered person must ensure that medicines required and prescribed to control medical conditions are obtained and held in the home. The registered person must ensure that all records are legible. The registered person must ensure that medical devices intended for individual use are provided as required. Each device must have a cleaning and maintenance schedule to ensure appropriate control of infection. The registered person must ensure that care plans are comprehensively completed and updated as conditions change to ensure that there is clarity and continuity regardless of which staff are on duty. The registered person must consult with residents about a programme of activities and provide the necessary provision for recreation within the building including staff to undertake the programme. The registered person must ensure that complaint records are held and are able to be accessed during inspections. The registered person must notify the Commission of staff referred to the Protection of Vulnerable Adults Register. The registered person must supply to the Commission an action plan outlining the necessary building and maintenance work to be undertaken as recorded in the report provided to the inspector dated 26th January 2005. Immediate Immediate Immediate Immediate October 31st 2005 Immediate Immediate August 1st 2005 St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 24 13. 14. 19 27 23 18 The registered person must ensure that broken windows are repaired. The registered person must ensure that at all times suitably qualified and competent staff are employed in such numbers as are appropriate for the health and welfare of the service users. The registered person must ensure that the staff recruitment practice meets the NMS and staff files contain all the required documents as included in Schedule 2 CSA. The registered person must ensure staff receive induction training. The registered person must confirm in writing the management arrangements within the home. An application to register the proposed manager must be requested. The registered person must ensure that actions are taken to address the Fire Inspection requirements of March 2005. The registered person must ensure that electricity at work regulations are followed and that unecessary risks to the health and safety of all people on the premises are as far as possible eliminated. This includes the use of multi plug adapters, uncovered lighting and portable appliance testing. Immediate Immediate 15. 29 19 Immediate 16. 17. 30 31 18 8 Immediate Immediate 18. 38 13 Immediate 19. 38 13 Immediate RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 25 No. 1. Refer to Standard 8 Good Practice Recommendations The registered person should ensure that the person appointed to manage medicines within the home are instructed on the local arrangements and protocols in place. The registered person should ensure that the scales are serviced to ensure accuracy. The registered person should request an audit by the Tissue Viability staff to assess the progress of the home in the previous action plans prepared by the Tissue Viability Service. The registered person should ensure that staff no longer employed at the home have their names removed from care plans and doors. The registered person should supply the Commission with a record of training undertaken during 2005 including the numbers of staff attending training. The registered person should ensure that staff receive supervision as required within the minimum standard. 2. 3. 8 8 4. 5. 6. 7. 27 30 36 St Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Augustines Court Care Home C53 C03 S58342 St Augustines Court V234307 210605 Stage 4.doc Version 1.30 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. 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