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Inspection on 28/06/06 for St Mary`s House Residential Home

Also see our care home review for St Mary`s House Residential Home for more information

This inspection was carried out on 28th June 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 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

St Mary`s provides residents with a friendly and relaxed environment to live in. All areas of the home are nicely presented and are comfortable, clean and tidy. Residents and relatives spoke highly about the manager, the home and the staff. Interactions between residents and staff were friendly and appropriate. Visitors are encouraged to visit and made welcome. One relative commented, "my relative is very well looked after and looks well", "staff keep me informed if my relative is unwell". Residents spoken with felt they lived in a home where staff respected their dignity and privacy. One resident told the inspector "I receive care in the way I want it done", "I have lived here for over 30 years, my mother and grandmother were also here and this is my home and the staff like my own family." Staff were observed knocking on resident`s doors and waiting before entering their room.The catering arrangements within the home provide residents with a nutritious and balanced meal on a daily basis, with a good variety of choice. A resident commented, "If I do not like what is offered I can always ask for something else". Food seen on the day looked appetising and was nicely presented.

What has improved since the last inspection?

The home has a number of staff on training and effectively they are reaching levels of training that exceeds the National Minimum Standard. The home now maintains a documented programme of development and training, which is required by the National Training organisation (NTO) and was a recommendation of the last inspection.

What the care home could do better:

Medicine records must all be correctly completed. Care plans should contain strategies to address personal care giving as appropriate.

CARE HOMES FOR OLDER PEOPLE St Mary`s House Residential Home Earsham Street Bungay Suffolk NR35 1AQ Lead Inspector Jan Davies Key Unannounced Inspection 28th June 2006 12:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Mary`s House Residential Home Address Earsham Street Bungay Suffolk NR35 1AQ 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) 01986 892444 01986 895708 Mr Christopher Albert Farrer Mrs W Farrer Mrs W Farrer Care Home 28 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (19), Old age, not falling within any other of places category (9) St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 The home may accommodate up to one person, aged 60 and over, who require care and accommodate by reason of dementia. 1st March 2006 Date of last inspection Brief Description of the Service: St. Mary’s House Residential Home is registered to provide care for 28 older people. Of these, up to 19 places are for older people with dementia, and 1 place for a person aged between 60 to 65 years of age. The home is situated in the market town of Bungay, close to shops, Post Office, public houses, Hotel, Library, Doctors surgery, Dentist, Optician, and restaurants. A bus service links it to the main towns, including Norwich and Lowestoft. St Mary’s House is a large adapted Georgian property. Residents’ bedrooms, toilets and bathrooms are located across all 3 floors. Communal rooms lounges/dinning rooms are on ground level, and have doors leading out to the patio and mature gardens. Residents can move around the home by using the passenger lift, platform lift, stair lift, stairs or ramp. A ramp is located to the rear of the home, to enable disabled, or wheelchair users access. There are 7 car-parking bays at the rear of the home. There is also off-street parking, and Pay & Display car park within walking distance. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place one afternoon and evening in June and lasted approximately six hours. The two owners were out at the time of the inspection and the inspector was assisted by a senior carer. At the end of the inspection Mr Farrer, the owner, came into the home to see to a matter unrelated to the inspection. He was unwell and said that the senior carer would pass on any inspection issues to the manager who is also joint owner and that any issues arising from the inspection would be followed up on. This report assesses the key standards for older people that were not covered on the inspection from December 2005 when there were no requirements nor recommendations made from those standards assessed at that time. Three residents were met with and they discussed the care they received at the home. One relative, one member of staff and two professionals were also spoken with. Records either sampled or audited included risk assessments, care plans and associated records, medication, staff roster, and recruitment of one new member of staff. A tour of the communal areas was undertaken and three bedrooms were visited. What the service does well: St Mary’s provides residents with a friendly and relaxed environment to live in. All areas of the home are nicely presented and are comfortable, clean and tidy. Residents and relatives spoke highly about the manager, the home and the staff. Interactions between residents and staff were friendly and appropriate. Visitors are encouraged to visit and made welcome. One relative commented, “my relative is very well looked after and looks well”, “staff keep me informed if my relative is unwell”. Residents spoken with felt they lived in a home where staff respected their dignity and privacy. One resident told the inspector “I receive care in the way I want it done”, “I have lived here for over 30 years, my mother and grandmother were also here and this is my home and the staff like my own family.” Staff were observed knocking on resident’s doors and waiting before entering their room. The catering arrangements within the home provide residents with a nutritious and balanced meal on a daily basis, with a good variety of choice. A resident St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 6 commented, “If I do not like what is offered I can always ask for something else”. Food seen on the day looked appetising and was nicely presented. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5,6 Quality in this outcome area is good. Prospective residents and their relatives can expect the opportunity, prior to admission, to visit the home to assess for suitability. People who use this service can expect to have their needs assessed before moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a written contract agreed with each resident which is kept filed in the main office, and the contracts for residents that are funded by social services are signed and returned and the home keeps copies. Evidence of contracts was available on residents’ file. One resident informed the inspector that their relative had assisted them to view the home prior to moving in. The inspector was able to talk with relatives of a resident who had been admitted since the last inspection. The relative confirmed that the manager and staff were very helpful in assisting the admission and making the transition from the resident’s own home a smooth one. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 9 The resident’s relative said the home had been chosen after viewing others and that this home offered the appropriate care to meet their needs and that the information provided to them was very useful. They said they would rate the home as being ‘10 out of 10’. The care plans of three residents were inspected. All three care plans had a pre admission assessment. These assessments included information about the resident’s physical and mental health, recreation and social care, safety, communication, falls, personal hygiene and the reason for their admission. The home was not providing intermediate care at the time of the inspection. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. People who use this service can expect to have most of their health needs met and have an individual plan of care drawn up, however not all care plans reflect the needs of residents. Residents can be assured that they are protected by the home’s polices and practices around medication storage and administration but can not always expect that medicine will be correctly recorded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans and associated records, such as the daily statements, relating to three residents were examined. These were discussed with a senior staff member. Three residents were also spoken with about their care at the home. Each of the residents had a care plan in place; these had been revised on to a new format designed by the manager. Each plan had several elements to it including communication, being safe, personal care, dressing, eating and drinking, sleeping, mobility and recreation needs. On the whole these care plans were clear and easily understood. There was evidence of monthly review. There was evidence of accessing health care from the chiropodist and the optician. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 11 The plans all contained an assessment of mobility, as appropriate, and use of a frame/wheelchair. There were clear instructions to staff on how to move and handle the individual resident. During the inspection one resident was observed to be unsettled and was constantly calling out for help and the need to visit the toilet. There were no members of staff in the lounge area where they were sitting at the time and three staff undertaking duties around administering medication were in the other lounge of the home. The inspector went to find staff and all were busy caring for residents. Their attention was drawn to the resident calling out for assistance. One staff member said ‘ that will be – she calls out like that all the time whether she needs assistance or not’ and promptly went to see what the resident wanted. However it was too late to assist the resident with toileting and two staff then tended to the resident with bathing and changing them into nightwear. The time was 5pm and there was no detail in the resident’s care plan to address this situation if, as stated by staff, it was a constant care need of that resident. The medication protocol was examined. Senior members of staff have access to the medication keys and the medication was kept secure. The home operates a monitored dosage system. There was a record of all medication coming into the home, a record of medication administered and a record of medication returned, therefore it was possible to audit medication at random. Whilst auditing medication it was observed that there were gaps in the medicine administration record for two residents in April and June and no explanation written or offered for why this was the case. All the liquid medication and medication not in the bubble packs are kept in sections in the cupboard. The senior staff said that Medicine Administration Record (MAR) sheets are checked and the medication is put in the medication trolley. The liquids and other medication is put in little cups or dishes with the residents name on and then put in the medication trolley. The member of staff then takes the locked medication trolley around the home with the Medicine Administration Record (MAR) sheet. The Medicine Administration Record (MAR) sheets were looked at and all had the name of the resident, date of birth, photo and were completed appropriately. The inspector observed this process during the course of the inspection. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. The home provides a range of interesting and stimulating activities for service users. Friends and families are encouraged to visit and routines within the home are flexible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: it was evident that quite a number of visitors to the home come to provide the residents with entertainment and activities. The home does take residents out to quite a few community activities and social events locally like the village fair. The home is right in the centre of the village of Bungay and every year the village hold a fair and close the road, all the residents able go out and one resident used to run their own stall at the fair. The senior carer indicated that in good weather two residents go out regularly. On the day of the inspection the weather was very warm and the lounge doors were open onto the home’s very pleasant garden. Carers were observed to encourage residents to get some fresh air but in reality very few residents will sit in the garden. Those that do told the inspector how much they appreciated such a lovely spot. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 13 The home encourages relatives and friends to visit and the senior carer said that one family member comes every afternoon. Relatives were visiting at the tine of the inspection and were spoken with. The home supplied refreshment for them. Another resident has their family member visits very often. Another resident spoken with had been at the home for a few years and told the inspector “ I spend my time socialising with others in the lounge or sitting in my room watching television or reading” They considered that the interaction between residents and care staff, catering and management was very good. Residents spoken to described the food as “appetising and with plenty of choice”. A resident commented, “If I do not like what is offered I can always ask for something else”. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. People who use this service can expect that any complaint will be taken seriously and investigated and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection two residents and two members of staff were spoken with individually. The resident was asked about complaints, concerns and if they felt safe living in the home. One resident said their grandmother used to be in the home and so did their mother and they felt very safe living in what they feel is a real home for them. They said that they would be able to tell any member of staff about any concern and had done so. Another resident confirmed how safe they felt also. One member of staff said that they had worked in the home for some sixteen years and this was because they felt the home was so good. When asked about residents being safe, they were very clear that any kind of problem would be dealt with straight away. Another staff member said that staff had had updated training about what to do if any abuse was suspected or reported. They were unsure where the complaints file could be located and contacted the manager by phone. She said there was no record of complaints because none had been received. Appropriate information was available in the home informing residents and relatives how make a complaint if they were unhappy. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23,24,25,26 Quality in this outcome area is good. People who use this service can expect to live in a clean, well-maintained home, in personalised rooms. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is in the centre of the village of Bungay; and is a beautiful old building, which has been modified to meet the needs of the residents. The home had a homely feel and was clean, without being clinical. Residents spoken with during the inspection referred to the ‘homely feel’. Residents who were agreeable accompanied the inspector to visit their rooms. All were found to be individually personalized and included hoists and bed-rails in line with residents’ care plan information. The home has a variety of lifts, ramps and chairlifts that gives access to all areas of the home. There are two separate lounges, with dining room areas and a quiet area where residents can sit or take visitors. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 16 All the bathrooms looked at had equipment to give access to a bath and all of them were warm and well ventilated. One of the bathrooms had a specialized overhead hoist to allow access to a bath for the most disabled resident. The home spans three floors. All communal rooms are on the ground floor. Communal areas consist of a television lounge, a smaller quiet lounge and a dining room including a sitting area for meeting with visitors. As previously referred to the home has a beautiful garden where residents can choose to sit. Appropriate garden furniture was provided and residents were seen to enjoy using the garden with their relatives on the day of inspection. There is a passenger lift providing access to the upper floors. The home has the majority occupancy of single bedrooms and twin rooms are also available for residents who have actively chosen to share. Additionally there are assisted toilets and assisted bathrooms fitted with Arjo baths. All the bathrooms looked at had equipment to give access to a bath and all of them were warm and well ventilated. One of the bathrooms had a specialized overhead hoist to allow access to a bath for the most disabled resident. Evidence was seen that hoists were being serviced on a regular basis. Care plans seen had risk assessments in place to assess the risks to the residents in relation to premises and mobility. The home was clean and hygienic throughout. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Residents can expect to be supported by a staff team, who receive ongoing training to obtain the skills and knowledge to care for them. Residents can expect to be cared for by a team who are available in sufficient numbers to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection, the newest members of staffs’ files were looked at. These were for two staff from Eastern Europe whose files contained appropriate corresponding qualifications from their country of origin in relation to nursing and caring roles. Their files contained their applications for Criminal Record Bureau (CRB) checks, which had not been returned. Information was available from their country of origin to provide an equivalent police/character check in addition to staff supervision forms completed, job application form, two references, job description, copy of the birth certificate and the Protection of Vulnerable Adult (POVA) first check. However the provider should record on their files occasions when CRB is contacted to expedite this. Also on the file was an assessment question paper, health declaration form, terms and conditions, staff training. Staff rotas were looked at and demonstrated an appropriate level of staffing in accordance with the current dependency levels of residents. Staff spoken with said that there were sufficient staff at all times of day to meet residents assessed needs. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 18 One carer said that they had made a positive choice to work in this home because they considered it to be a good place to work and providing quality care. Displayed in the home were lots of training certificates and since the recommendation of the last inspection a staff development programme that meets National Training Organisation (NTO) has been devised. The home’s staff training was discussed and ten staff have the National Vocational training (NVQ) level three and three staff are in the process of doing the qualification. Eleven staff have achieved National Vocational Training (NVQ) level two and two staff are National Vocational Training (NVQ) assessors. The home has more than 50 of its staff attaining the necessary qualification and exceeds the National Minimum Standard. There are only a few staff not currently on a National Vocational Training (NVQ) course, and those who do not want to do the training. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This home is well managed and there are clear systems in place to protect service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mr and Mrs Farrer owners and registered providers for the home are both very involved in the running of the home, with Mrs Farrer being the registered manager for sometime. Residents’ personal finances are not dealt with by the home and, as appropriate their families or a representative deals with any issues around money. One resident who manages their own personal finances, goes with Mr Farrer the Registered provider once a fortnight and gets what money they need. This is in line with their care plan arrangements. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 20 At a previous inspection there was a requirement around the fire doors being wedged open. During the tour of the home there were no fire doors wedged or propped open. All the doors were either held open by appropriate equipment or they were shut. During a tour of the premises it was recommended that the home provide a handrail to the stairs in the bedroom with stairs leading up to the fire exit for safe access in an emergency. The accident book was seen and evidence was seen that incidents and accidents were being reported and recorded. From comments received from residents and from daily records in their files there was evidence to confirm that the home is run in the best interests of residents. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 X 3 X X 2 St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 22 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. 1. Standard OP9 Regulation 13(2) Requirement All staff who administer medication must adhere to the procedures for the recording of medicines. All residents health and care needs must be set out in a plan that must have clear instructions to care staff on individual requirements for personal care needs. Timescale for action 20/08/06 2. OP7 13(5) 14 15 20/08/06 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. OP29 2. OP38 Refer to Standard Good Practice Recommendations The registered provider should record on staff files occasions when CRB is contacted to expedite the application process. The home should provide a handrail to the stairs in the bedroom with stairs leading up to the fire exit for safe access in an emergency. St Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Mary`s House Residential Home DS0000024499.V298710.R01.S.doc Version 5.2 Page 24 - 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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