Inspection on 10/01/06 for St Mark`s Road Care Home - Block B

This inspection was carried out on 10th January 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Mark`s Road Care Home - Block... 10/06/09

St Mark`s Road Care Home - Block... 06/10/08

St Mark`s Road Care Home - Block... 28/08/07

St Mark`s Road Care Home - Block... 31/10/06

St Mark`s Road Care Home - Block... 17/08/06

St Mark`s Road Care Home - Block... 20/07/05

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Beech Lodge

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Hunter`s Lodge

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

CARE HOME ADULTS 18-65 26 St Mark`s Road Care Home - Block B 24 St Mark`s Road Derby DE21 6AH Lead Inspector Claire Williams Unannounced Inspection 10th January 2006 09:30 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 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 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 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. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 26 St Mark`s Road Care Home - Block B Address 24 St Mark`s Road Derby DE21 6AH 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) 01225 444 596 The Robinia Group PLC Karen Mary Bridge Care Home 8 Category(ies) of Learning disability (8) registration, with number of places 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2005 Brief Description of the Service: The Robinia Care group is the responsible provider for St Marks Care Home. The home is purpose built and is spacious and creates a homely environment. The home has two floors; the ground floor is used for accommodation, and the first floor is used for the staff team. The home is registered to provide personal care and accommodation for 8 people within the category of Learning Disabilities between the ages of 18- 65 years old. The home is situated just on the edge of Derby and is close to local amenities. The home has all single bedrooms with en-suite facilities. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 9.30am. The visit lasted 7 hours, and was the second inspection of the home this year. The inspector checked the previous requirements and recommendations made in the previous inspection report, and checked the key areas that were required to be assessed in a 12-month period. She examined care files and associated documents, and spent time speaking with staff members. A brief tour of the building was undertaken and the health and safety records and checks of the building were examined. Time was spent observing staff interaction with the people that live in this home. The Manager and the new deputy both assisted the inspector with the inspection. What the service does well: What has improved since the last inspection? The Registered Manager now ensures that all potential individuals that move into the home have been assessed prior to the admission and appropriate assessments completed and forwarded to the home to enable the staff to meet individual needs. The completion of healthcare monitoring forms has improved. Staff are aware of the purpose of using behaviour management forms. An Activities co-ordinator spends time within the home and competes a weekly structured activity planner for all the individuals residing in the home. The observations made by the inspector confirmed that the staff practices have 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 6 improved in relation to working with individuals and creating an inclusive environment. 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. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 7 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 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 4 Pre-admission assessments are obtained before individuals move into the home; this enables the staff team to provide appropriate support to individuals based on their needs and aspirations. EVIDENCE: Improvements have been made in response to the previous inspection report to the admission processes within the home. The inspector examined two files for individuals that have recently moved into the home. Both files contained comprehensive Community Care assessments, which have been completed by the sponsoring Local Authority. A delegate from Robinia had also completed a pre-placement assessment for one of the individuals, but this assessment was not dated or signed and contained brief information of the required support needs. The Registered Manager informed the inspector that work is currently underway to develop these assessments. The inspector examined another pre-placement assessment, which was in the second file. This was completed by the Registered Manager from the visits made to the individual’s previous placement. This assessment was completed in full detailing the holistic needs of the individual enabling the home to be make a professional judgement on whether they can meet the individuals needs and aspirations. There was evidence in the files of trial visits that have been undertaken and a transition programme was in place to support the move for one individual. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Care files reflect individual aspirations and needs and detail how these should be supported. Systems are in place to manage risks and decision-making processes. EVIDENCE: The files examined by the inspector contained personal service plans, which are written from the individual’s perspective. The areas covered within these plans were varied but included aspects of personal and health care specific to the individual. These plans were developed from the pre- admission information and there was evidence to support that they were completed following their admission. This is an improvement from the previous inspection visit. The personal service plan links in with the Aims and Objectives, which are compiled based on the individuals needs, and aspirations. The individual’s keyworker are responsible for completing progress reports on a monthly basis for each objective identified, but at the time of the inspection only a couple of objectives had been reviewed. Each file contained a generic risk assessment, which identified all of the risks associated with the individual, linking in with the objectives recorded. However these assessments contained a lot of information and only a small brief 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 10 statement was made in relation to the Moving and Handling needs of the individuals. The files when first examined did not contain an information sheet with all of the individual’s details and contact numbers as required by the regulations. The inspector was informed that this sheet had been archived, but following a discussion with the Registered Manager all of these sheets have been replaced back in individuals care plan files. Some of the individual’s that live in this home have limited verbal communication. Each person has a Keyworker and a core staff team. Each month this group of staff meet and discuss the needs of the individual and collective make decisions on behalf of this individual. Records are maintained of these meetings and any decisions made. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 14 and 15. Service users have access to varied opportunities, and life experiences in order to develop independent living skills. Opportunities were tailored to individual interests and abilities. EVIDENCE: An activities co-ordinator is employed and divides her time between this home and another home that is situated at the same location. The inspector spent time discussing her role. Each individual now has a list of likes and dislikes in relation to activities, hobbies, areas of personal development and the community facilities they enjoy. The activities co-ordinator completes a weekly activity planner for all individuals, which incorporates internal and external activities, and includes small group and individual activities. She is also responsible for ensuring that the staff team facilitate these activities and record how individuals respond to them. Observations at the time of the inspection confirmed that activities both internal and external were taking place and staff members were observed interacting with individuals rather than exclusive with each other. This is an improvement from the previous inspection visit. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 12 Each individual now have a record of any contact made with their friends and family, and this in incorporated within their personal service plan. The records confirm the support given to maintain contact with families and representatives these individuals, and the contact made by staff in order to keep people informed about their relative’s well being. The home has made arrangements to enable a relative to visit the home twice a week in order to spend time with his son. The staff members collect and take him home following the visit. The relative spoke with the inspector and stated how grateful he was for this arrangement, and commented on how “highly satisfied” he was with the care his son received. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Service users receive support in personal care tasks in a manner, which promotes their dignity and in accordance with individual support plans. Service users are monitored and access to healthcare facilities is supported to maintain service users health. EVIDENCE: Each individual has a medical file, which is separate from his or her care plan file. The two files examined contained evidence of contact made with healthcare professionals and records were completed of any visits made providing feedback of the outcomes. There was evidence to support that improvements have been made in the completion of healthcare monitoring forms in response to the previous inspection visit. The forms that were in place were completed in full and were signed and dated. The Registered Manager informed the inspector that accessible scales for wheelchair users were still on order. The inspector and the Registered Manager had another discussion concerning the use of tissue viability forms, as a monitoring tool to identify any pressure areas due to individuals who use wheelchairs sitting in one position for long periods of time. The inspector examined the medication practices and storage. The Team leaders are responsible for the administration of medicines and some have now 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 14 undertaken a day course delivered by boots in “Safe handling of medicines”. Staff members are only allowed to administer medication following this training. The Registered Manager informed the inspector that she has started undertaking medication competency assessments on the team leaders to assess their practices. The inspector identified that two people do not countersign handwritten medical instructions. The dose for one individual was amended and increased for a short period of time, however it was difficult to ascertain when this was implemented and subsequently stopped from the examination of the Mar charts. The staff team were not using the codes identified on the MAR chart for the purpose of recording why medication was not administered, they was using their signatures instead, but explanations were recorded on the back of the individuals Mar chart. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Satisfactory complaints and adult protection procedures are in place in order to safeguard service users. EVIDENCE: A complaints procedure and recording system is in place. The previous inspection visit was undertaken in response to a complaint received by the Commission for Social Care Inspection. This complaint has now been concluded and the organisation has sent in an action plan in response to the findings. The home have in addition to this received 4 complaints, but these have been in relation to staffing issues from staff members, and the Registered Manager has addressed all of these issues. The recording system for the complaints needs to be reviewed, as currently information is not recorded concerning the timescales or outcomes of complaints investigated. A Vulnerable Adults policy was in place, that’s refers to the local authority procedures. At the time of the inspection a copy of the local procedures was not available. The inspector agreed to send a copy of these to the home. From discussions with both the management of the home and the staff it was evident that those spoken with had satisfactory knowledge of the procedures and what action should be taken in the event of an incident occurring. The Registered Manager has arranged adult protection training for the 8 staff that has not undertaken this training; all other staff have undertaken some form of abuse training either by attending courses or through their NVQ training. The inspector was informed that there have been no incidents at the home this year. The inspector checked the management of individual’s finances. All money was held separately in individual’s bags. The amount held cross-referenced to the 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 16 transaction sheets and there was evidence of receipts for purchases made on behalf of individuals living in the home. A financial management procedure is in place but was not examined on this occasion. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 The recruitment procedures do not fully safeguard residents from potential risk. An experienced and trained staff team supports the service users. EVIDENCE: There has been an improvement in the staff practices and attitudes since the previous inspection visit. The inspector was informed that some staff have left since the previous visit and have been replaced. A lot of work has been undertaken in order to support the staff members new to this client group and with the team has a whole in order to improve the practices so that staff work in a positive way with individuals living at the home. The inspector spoke with several staff members who were clear about their roles and responsibilities. Staff had knowledge of individuals support needs and their aspirations. The staff work as a team and in accordance with the homes ethos, which is to encourage individuality and ensure individuals have fulfilling lives. The staff commented that they have access to good training opportunities and feel that their induction equipped them with the knowledge and skills for their roles. The relative who visited the home spoke positively about his interactions with the staff team and his observations of them with his son. The home have received a letter of compliment about the “good work” they have done with another individual who has recently moved into the home. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 19 In response to some of the staff issues, the management structure of the home has been reviewed and changed. Interviews are taking place this week for a Team leaders position, increasing the numbers in this role to three enabling one team leader to be responsible for each shift. In addition to this a deputy has recently started who used to work at another home in the position of a Registered Manager, this will provide support to the current Registered Manager who has responsibility for another home on the same site. The inspector examined three staff files, one of which was for a staff member from overseas. Majority of the required information and recruitment checks have been completed. All files contained the required references, work permits, and criminal checks. Although application forms were completed not all staff have provided a full employment history, which is required by the regulations. There is evidence in the files of training undertaken but certificates were not available as evidence to support the attendance to all of the required mandatory training. The training matrix confirmed that majority of the staff team have attended the required mandatory training and for the newly appointed staff member’s dates have been arranged. The files confirmed that staff supervision is being undertaken. The inspector and the Registered Manager discussed the status of the staff team in relation to achieving National Vocational Qualification (NVQ). The inspector was informed that currently there are 5 staff members who are working towards an NVQ level 2 and above and 1 member of staff who has completed this award. The home has employed some staff members from overseas who hold medical qualifications undertaken in their country of origin. These staff members confirmed to the inspector that they are supported by the Registered Manager and the staff team and commented that they have “settled in well”. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, and 42. The Registered Manager is now supported by deputy and senior staff in providing leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: As previously mentioned the home has a new-experienced deputy who used to work in the capacity as a Registered Manager working at the home. This will be beneficial to the Registered Manager and provide support to her in her role of managing two homes located on the same site. The inspector received positive feedback from staff on how supportive and approachable the Registered Manager is. She is committed to ensuring the home is managed in accordance with the best interests of the individuals living there. The Registered Manager is currently undertaking the NVQ level 4 in management. Not all of the individuals living at this home can verbalise their opinions about the quality of the services they receive. At the time of the inspection a survey 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 21 or questionnaire had not been distributed to individuals and their representatives in order to obtain feedback about the home and its provisions. Although informal feedback has been obtained from families through regular contact and the reviews held. There was evidence to support that a representative from the organisation regularly undertakes visits to the home in accordance with the requirements of regulation 26. The inspector checked some of the health and safety systems in place at the home. The staff team had received updated Fire training, but at the time of the inspection there was no evidence to support that night staff receive this twice a year. All the gas and electrical installations certificates are still in date and all equipment was PAT tested when the home initially opened. Regular Fire checks and tests are undertaken and records maintained. The home has many Health and Safety audit checklists that are completed on a weekly and monthly basis and records are maintained. 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 22 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 2 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 3 12 X 13 3 14 3 15 3 16 X 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 2 X X 2 x 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 23 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 YA2 Regulation 14 (1) (a) Requirement The Registered Persons must ensure that when pre-placement assessments are undertaken, they are completed in full, dated and signed. The Registered Persons must ensure that appropriate consultation regarding the care plan and pre-admission assessments with the service user or a representative are undertaken and records maintained. The Registered Persons must complete a separate Moving and Handling Risk Assessment in order to make it clear what support needs individuals require in their files. The Registered Persons must ensure that two people countersign handwritten medical instructions. The Registered Persons must ensure that when medical instructions are amended this is clearly recorded on the Mar chart The Registered Persons must ensure that the staff team use the appropriate codes to record DS0000063062.V275844.R01.S.doc Timescale for action 01/04/06 2 YA6 14 (1) (d) 01/05/06 3 YA9 12 (1) (a) 01/04/06 4 YA20 13 (2) 01/04/06 5 YA20 13 (2) 01/04/06 6 YA20 13 (2) 01/04/06 26 St Mark`s Road Care Home - Block B Version 5.1 Page 24 7 YA22 22 (3) 8 YA34 19 (b) (i) 9 YA35 19 (5) (b) 10 YA39 24 (3) 11 YA42 23 (d) why medication has not been administered. The Registered Manager must ensure that the complaint record includes the timescales and outcome following the investigation of the complaint. The Registered Persons must ensure a full employment history is obtained for all applicants and newly appointed staff The Registered Persons must ensure that copies of certificates are available on staff files of the training undertaken. The Registered Persons must develop and implement a system for reviewing and obtaining feedback from service users and their representatives. The Registered Persons must ensure that all night staff receives Fire training twice a year. 01/04/06 01/04/06 01/04/06 01/05/06 01/04/06 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 25 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 Refer to Standard YA6YA9 YA13 Good Practice Recommendations The Registered Persons should ensure that all documentation completed for services users is signed and dated and completed in full. The Registered Manager should ensure that indivduals likes, dislikes, and hobbies are reflected in individual personal service plans in addition to the sheet in their diary. The Registered Persons should contact a District Nurse to discuss the possible use of Tissue Viability assessments in order to monitor service users pressure areas. The Registered Manager should ensure the medication signature sample sheet is replaced. The Registered Persons should consider putting a number on the front door to enable external people to be able to identify the home. 3 4 5 YA19 YA20 YA24 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 26 St Mark`s Road Care Home - Block B DS0000063062.V275844.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!