CARE HOME ADULTS 18-65
St James` House Danes Road Rusholme Manchester M14 5JT Lead Inspector
Val Bell Unannounced Inspection 3rd May 2007 10:00 St James` House DS0000021626.V337568.R01.S.doc Version 5.2 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 St James` House DS0000021626.V337568.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 Adults 18-65. 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 James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service St James` House Address Danes Road Rusholme Manchester M14 5JT 0161 225 6999 0161 224 9355 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) Standwalk Limited Wendy Ramsdale Care Home 14 Category(ies) of Learning disability (14) registration, with number of places St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. A maximum of 14 service users will be accommodated. The home will only provide a service to people whose primary need for care arises from a learning disability with associated challenging behaviour. Accommodation will be provided in three separate units. The home will not accommodate:(i) people who have a criminal conviction, (ii) those people whose risk assessment inidcates that they are likely to pose a risk to the general public (iii) sexual Offenders, (iv) people with a history of sexualised behaviour, unless a full risk assessment has been carried out and it is clear that the behaviour is either situation speficic or can be controlled in other ways A manager with qualifications, agreed as appropriate by the Commission for Social Care Inspection, will be employed to manage the day to day running of the home at all times. In the absence of the manager, day to day running of the home will be the responsibility of a senior member of staff who has substantial experience at a senior level and/or qualifications relating to care of people with a learning disability and associated challenging behaviour. Staffing levels must be commensurate with the needs of the services users and must be sufficient to allow for them to be escorted outside the building on a one:one or two:two:one basis, as per their assessment. Night care provision will consist of a member of staff on waking duty per unit. 26th June 2006 5. 6. 7. Date of last inspection Brief Description of the Service: St James House is a registered home providing 24-hour care and accommodation for 14 persons with a learning disability and associated challenging behaviours. The home is situated in the Rusholme area of South Manchester, close to local amenities and transport routes. The home is a converted church sited in a residential area within its own grounds. It is accessed directly from a
St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 5 residential street and has adequate parking and an extensive and wellmanaged garden. The home is divided into three separate areas, offering a range of facilities to cater for people with varying levels of support needs. Bedroom accommodation is provided on the ground, first and second floors. The ground and second floor bedrooms are single with en-suite facilities and a self-contained flat. The first floor contains three self-contained flats and three single rooms. The building is fully accessible and there is lift access to all floors. There are a variety of communal areas on each floor including lounges, kitchens, laundry facilities, a well-equipped sensory room, and hydrotherapy pool and gym room. The fees charged by this home are calculated according to the assessed needs of people using the service. St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This report is based on information gathered by the Commission for Social Care Inspection (CSCI) since the last inspection on 26th June 2006 and supporting information provided by the manager prior to a visit to the home. Additionally, the relatives of two people staying in the home provided information by completing satisfaction surveys. Site visits to the home form part of the overall inspection process and the lead inspector conducted this visit during daytime hours on Thursday 3rd May 2007. The opportunity was taken to look at the core standards of the National Minimum Standards (NMS) This inspection will also be used to decide how often the home needs to be visited to make sure that the required standards are being met. During the visit time was spent with people living in the home and discussions were held with a senior member of staff on duty, the manager and the homeowner. Relevant documents, systems and procedures were assessed and a tour of the home was undertaken. No issues were outstanding from the last inspection. What the service does well:
The home was commended for best practice in five of the eight sections contained in this report. People who are referred to this home receive a thorough assessment of their needs so that the individual and the home can decide if it will be the right place for them to live. Following admission peoples needs are monitored and reviewed regularly in consultation with the individual and their representative. People are respected as individuals and are encouraged to make decisions that affect their lives. Person-centred plans are drawn up from the assessments of need and these detail a person’s likes, dislikes, wishes and personal goals. Importance is placed on helping people to reach their potential and follow their chosen lifestyle. This is achieved by providing the right level of support for people to make choices in what they would like to do during the day. Risks involved with this are assessed and clear guidelines are written down for staff on how to keep people safe. Varied opportunities for personal growth are provided, such as keeping pets, developing and maintaining personal relationships and trying out new experiences with support as needed. Two people that were looking after pets said that they enjoyed doing this. Healthy lifestyles are promoted through nutritional screening and people living in the home regularly access the full range of healthcare services. An occupational therapist said that staff were very good at following the
St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 7 instructions that she had written down and this had resulted in positive outcomes for her client’s development. Daily routines in the home such as times for getting up or going to bed and mealtimes are flexible and people are encouraged to make choices in these areas. Robust policies and procedures keep people living in the home safe and any suggestions or concerns that people have are listened to and prompt action is taken to make improvements wherever possible. Similarly, health and safety procedures are given priority to ensure that hazards in the home do not cause risks to peoples welfare. Excellent standards are maintained in the home’s environment and the facilities provided, particularly for people with sensory impairments, exceed the national minimum standards. This service has achieved the Investor’s in People award and the system of quality assurance in place makes sure that records, policies and procedures are up to date. The manager recognises the importance of staff training and development and this makes sure that staff understand individual’s needs and know how to provide the right kind of support to meet them. What has improved since the last inspection? What they could do better:
Six good practice recommendations were made during the visit to this home. Four of these related to the administration of medication. Medication added to the administration records should be handwritten in ink and countersigned by a second member of staff as this provides a permanent record of the medication that people are taking. Additionally, records of medication received into the home should be signed by staff to verify that people have been supplied with the correct amount as prescribed by their general practitioners. The manager said that she had asked the pharmacist to supply her with a different recording system so that this could be done. The manager should also review the way in which the pharmacy supplies some of the medication to the home to ensure that the manufacturers instructions on dispensing are followed. The inspector was told that the room where medication is stored could become hot during the summer months. The temperature in this room should be monitored to ensure that it does not exceed 25 degrees Celsius as this may adversely affect the way in which the medication works. The homes training records did not confirm that staff had received regular refresher training in some areas of health and safety. This should be reviewed
St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 8 and an action plan be developed to ensure that all staff are following current good practice in health and safety. 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. The summary of this inspection report can be made available in other formats on request. St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 10 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People admitted to the home can be confident that the right level of support will be available as determined by their current needs assessments. EVIDENCE: The files belonging to four people living in the home were examined for evidence that their needs had been assessed prior to admission. Care manager assessments of need and in-house assessments had been undertaken. This provided evidence that people were only offered a place in the home if their support needs could be met. Following admission the assessments of need were reviewed regularly to ensure that changes to the support required were updated in individual care plans. Records provided evidence that people using the service and their representatives had been consulted throughout the assessment process. St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living in the home are enabled to take control of their own lives by making informed decisions that improve the quality of their chosen lifestyles. EVIDENCE: Four files examined contained person-centred care plans, which had been developed from the assessments of need. Care plans set out how a person’s needs would be met and this was reviewed every month. Individual preferences, likes and dislikes were recorded in detail along with evidence that people were enabled and supported to make decisions. Care plans identified individual’s aspirations, hopes and their personal goals. These goals were realistic and it was particularly pleasing to note that the support provided to enable people to reach their goals had been achieved by agreeing target dates in small steps that suited the pace of the individual. For example, one of the care plans stated that the person would like to go swimming. As this was a new experience staff had taken the person to visit the swimming baths on four
St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 12 occasions so that he could develop self-confidence in a new environment before attempting to go into the water. This provides the right kind of support for people to make decisions and take control of how they want to lead their lives and is commended as an area of best practice. Risks identified during the assessment process had been assessed and clear guidelines were in place to inform staff how to provide support in a safe way. When accidents had happened, staff had been very careful to record the details of the accident and what action had been taken to minimise the risk of further incidents. St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People using this service are respected as individuals and are supported and enabled to develop their potential through engaging in activities and relationships of their choice. EVIDENCE: The person-centred approach adopted by this service had provided people living in the home with a wide range of opportunities for personal growth through educational, leisure and occupational activities both within the home and in the surrounding community. Personal interests and individual choices were given priority in determining what people wanted to do during the day. It was pleasing that people were enabled to keep pets. Two people spoken to said they enjoyed looking after their pets (a guinea pig and an aquarium) This encouraged personal development and provided evidence that people were enabled to pursue their own interests.
St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 14 An occupational therapist visited one of her clients at the home during the site visit. She was pleased with her client’s progress and commented that staff at the home had been very good at continuing this person’s therapy by following her guidelines. It was evident that people living in the home were encouraged to develop and maintain personal and family relationships and staff worked very hard to involve people that were important to individuals. Daily records detailed the outcomes of individual’s interactions with family and friends. Religious, cultural and gender needs were respected and it was evident that people had received support in these areas. For example, one of the people living in the home had a copy of the Koran in her bedroom and her mother was receiving staff support to attend to her daughter’s religious and cultural needs. During the site visit people were observed to move freely about the home and two people chose to go out for the day. One person was playing football with a member of staff in the grounds. The atmosphere in the home was relaxed and routines were flexible according to an individual’s needs and preferences. Mealtimes were also flexible according to personal choice and people could choose from three-weekly menus. A three-week vegetarian menu was also available. Peoples dietary needs were assessed on admission and any special dietary needs relevant to a person’s health, culture or religion were available. People with communication needs were enabled to make choices from a range of photographed dishes. The required records relating to safe food hygiene were up to date. St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living in the home can be confident that they will receive the right level of support to stay healthy. EVIDENCE: People using the service had received in depth assessments of their health needs and the information had been developed into health action plans that determined the health services people would need to stay healthy. Records demonstrated that people had access to the full range of primary and specialist healthcare services. The outcomes of health appointments were very detailed and professional health guidance had been followed consistently. The way in which the service promotes healthy lifestyles was commended as an area of best practice. The blister pack system of administration of medication was being used by the home and the supplying pharmacist had trained staff in how to operate the system safely. Medication records were legible, accurate and up to date and all medication had been stored securely. The inspector did not check balances
St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 16 of liquid medication stock, as the staff had not signed to verify that the amount of medication received from the pharmacist was correct. Records did however provide evidence that staff were checking incoming medication as they had ‘phoned the pharmacist to check the accuracy of some medication received into the home. The manager said that she had requested amended medication charts from the pharmacy to include enlarged spaces where staff could sign to demonstrate that they had completed this task. Further good practice recommendations in relation to medication administration were made as follows: • Medication administration records contained printed pharmacy labels for medication that had been added following receipt of the monthly stock from the pharmacy. The manager said that the pharmacist had advised staff to do it that way. Changes or additions to medication records should be handwritten and verified by a second member of staff, as labels that may peel off do not provide a permanent record. The manager said that the room where the medication was stored had the potential to become warm in the summer months. It was recommended that a thermometer be situated in the medication cupboard so that the temperature is monitored to ensure it does not exceed 25 degrees Celsius. Epilim, which had been prescribed for a person who suffered from epilepsy, had been removed from the manufacturers foil packaging and placed in the blister packs by the pharmacist. This is contrary to the manufacturer’s instructions. The manager should review this with the pharmacist to ensure that the efficacy of this medication is not reduced by prolonged exposure to air. • • St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service can be confident that staff have the relevant knowledge and skills to keep them safe and to deal with any concerns or complaints they might have. EVIDENCE: A suitable complaints procedure was in place and people spoken to during the site visit knew who to talk to if they had any concerns or complaints. One person living in the home said that staff always listen to and take action to resolve her concerns. She confirmed that she felt safe in the home. No complaints had been received about this home. Policies and procedures were in place to safeguard people living in the home from abuse and staff had received training in the procedures to follow if abuse was suspected or alleged. St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care has been taken to provide a safe and comfortable environment that has been designed to meet the specific needs of people that live there. EVIDENCE: On a tour of the premises the environment was found to be clean and hygienic and no unpleasant odours were present. The home’s boiler had been replaced and a major re-decoration programme had been undertaken since the last inspection. This had provided a well-maintained, pleasant and comfortable environment for people living in the home. During the visit to this home, work was underway to provide a quiet lounge so that people would have a choice of communal areas in which they could relax. People had personalised their bedrooms to reflect their personalities, hobbies and interests and individual preferences. One of the people spoken to said
St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 19 that she had been asked to choose a colour scheme for her bedroom, which was due to be redecorated. The in-house standard of facilities was excellent and this was commended. Facilities included a hydrotherapy pool, sensory garden and sensory room where people could relax to soothing music and subtle lighting. No health and safety issues were found during this visit. St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have opportunities to attend regular training sessions and this equips them with the knowledge and skills needed to meet the assessed needs of people living in the home. EVIDENCE: The manager said that fourteen staff had achieved recognised qualifications, such as National Vocational Qualifications (levels 2, 3 and 4) and six qualified nurses were also employed at the home. A sample of personnel files contained evidence that the required preemployment checks had been undertaken prior to confirming staff in post. Additionally, staff employed had undertaken induction training. A training matrix was provided and this showed that staff had undertaken the following training in the previous twelve months, health and safety, moving and handling (including the use of hoists), medication administration, safeguarding adults from abuse, epilepsy, autism and communication. Staff spoken to were able to demonstrate that they understood the assessed needs
St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 21 of people living in the home. The training matrix did not contain evidence that staff had received regular refresher training in mandatory health and safety such as food hygiene, first aid, fire-safety and infection control. It is recommended that staff development be reviewed in this area and an action plan put into place to ensure that staff receive the necessary refresher training on a regular basis. This is needed to ensure that staff have up to date knowledge of current practice in order to keep people safe and well. St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is managed well and people living there receive a person centred service designed to meet their assessed and changing needs. EVIDENCE: This home was managed well, lines of responsibility were clear and it was evident that there was good communication within the staff team. This provided an excellent standard of person-centred care for people living in the home. The certificate of public liability insurance was current and on display in the entrance hall along with the home’s registration certificate. The Investors in People Award had been achieved and audits of systems, records and procedures were taking place at monthly intervals. The views of
St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 23 people using the service and their representatives were regularly listened to and suggestions for improvements had been evaluated and incorporated into the home’s business and development plan. This type of quality assurance programme ensured that action was taken to consistently meet the changing needs of people living in the home. Health and safety records were not examined during this site visit as the environmental health department had inspected the home some ten days previously and no shortfalls had been identified. St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 3 X X 3 X St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations The manager should ensure that staff sign to verify that they have checked that medication received from the pharmacy is correct. This will provide evidence that people are receiving the correct levels of prescribed medication. Changes or additions to medication records should be handwritten and verified by a second member of staff. This will provide a permanent record of the prescribed medication that people have taken. A thermometer should be situated in the medication cupboard so that the temperature can be monitored to ensure it does not exceed 25 degrees Celsius. The manager should review the way anti-convulsant medication is dispensed by the pharmacist to ensure that the efficacy of this medication is not reduced by prolonged exposure to air. The manager should ensure that staff have up to date knowledge of mandatory health and safety practice in first
DS0000021626.V337568.R01.S.doc Version 5.2 Page 26 2. YA20 3. 4. YA20 YA20 5. YA35 St James` House aid, fire safety and food hygiene to ensure that people living in the home are kept safe and well. St James` House DS0000021626.V337568.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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