Inspection on 09/06/05 for St Raphael`s Integrity Care Home

This inspection was carried out on 9th June 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Raphael`s Integrity Care Home 24/11/08

St Raphael`s Integrity Care Home 08/08/06

St Raphael`s Integrity Care Home 26/09/05

St Raphael`s Integrity Care Home 02/11/04

St Raphael`s Integrity Care Home 15/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 St Raphael`s Integrity Care Home 93-95 Stanhope Gardens Haringey London N4 1HZ Lead Inspector Susan Shamash Unannounced 9 June 2005 @ 11.15 a.m. The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service St Raphael`s Integrity Care Home Address 93-95 Stanhope Gardens, Haringey, London, N4 1HZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8800 0429 Mrs Eftychia Joannides Mrs Eftychia Joannides PC Care Home 8 Category(ies) of LD(E), LD registration, with number of places St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1 Limited to 7 adults of either gender with a learning disability (LD) and one female over the age of 65 years who has a learning disability (LD(E)). Date of last inspection 2nd November 2004 Brief Description of the Service: St. Raphael’s Integrity Care Home is a care home registered to provide personal care for a maximum of eight residents between the ages of 18 to 64 years who have learning disabilities. One specified resident may be over the age of 65 years. The stated aim of the home is to provide a high quality of care within a comfortable and homely environment and to enable residents to lead as independent a life as possible.The home consists of two adjoining two storey terrace houses which have been converted to become a single home. There are eight single bedrooms located on both the ground floor and the first floor. None of the bedrooms have en-suite facilities although each bedroom has it’s own sink. The two kitchens, dining room and lounge are on the ground floor.The front of the building is primarily paved. The back garden is partly paved and accessible to residents. It is attractively arranged and contains a variety of fruit trees and flowers.The home is situated in a residential area of Haringey and close to a large selection of Mediterranean restaurants, shops and community facilities located along Green Lanes and in Wood Green. St. Ann’s Hospital is about half a mile away. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection lasted approximately six hours. The inspector was assisted throughout by the registered manager (Mrs Eftychia Joannides) and her son (who covers some night shifts at the home as well as managing another care home nearby). The inspection took place as one of the two routine annual visits to the home. At the start of the inspection two residents were in the home, whilst the other four were out at day services, returning later in the day. The inspector had the opportunity to speak to four residents and one staff member independently. Three residents’ care plans, staff records and maintenance records for the home were examined and an inspection of the premises was carried out. What the service does well: What has improved since the last inspection? What they could do better: St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 6 It remains required, from the previous inspection, that risk assessments and care plans for all residents must be reviewed at least six-monthly and that the temperature of refrigerators and freezers be recorded on a daily basis to ensure safe storage of food at the home. It also remains required that residents’ choices in terms of furniture in their rooms be recorded to evidence that they have had the choice of items not currently provided in their rooms. New requirements are made regarding the need for risk assessments and agreements to be recorded for all residents who have had the water disconnected to the sinks in their bedrooms. A requirement is made that there be an increase in the choices available to residents of leisure activities outside of the home and that the possibility of a holiday for residents be researched. Although there had been an improvement in the recording of medicine administration in the home, it is required that the number of tablets to be administered be recorded on the medicine charts and that records are not discarded and rewritten when a mistake is made in the recording. A requirement is also made regarding the need for recording of all residents’ diagnosed medical conditions and treatment to be provided. A number of identified minor repairs or replacements are required in residents’ rooms to ensure their comfort and it is required that more regular meetings be held for residents at the home. The manager was reminded that the home must send off for their own criminal records bureau checks on behalf of any new staff member recruited to the home, to ensure the protection of residents. Finally it is recommended that records prior to 2003 be removed from residents’ files and stored in an archive to ensure easier access to current records. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 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 standard(s) 2. An adequate system is in place to assess service users’ needs and goals effectively and ensure that these are met. EVIDENCE: Three service user files were inspected and each included detailed assessments of service user’s needs and aspirations, prior to their admission to the home. No new service users had been admitted to the home since the previous inspection. Discussion with the manager and staff in the home indicated that the staff team is knowledgeable regarding the needs of users. Service users spoken to indicated that the home had the capacity to meet their needs effectively. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 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 standard(s) 6, 7 and 9. Insufficiently frequent review of service users’ care plans and risk assessments places service users at risk of not receiving appropriately responsive care to meet their changing needs. Whilst the majority of risks are recorded appropriately with strategies in place to ensure the protection of service users, insufficient recording of their choices and preventative measures taken compromises their independence. EVIDENCE: Three service user plans were examined in detail, and there was evidence to indicate that the individual choices of service users were respected and their care plans had been prepared in consultation with them or their representatives. However care plans had not been reviewed for over six months, and a requirement is restated accordingly. The manager advised that she was in the process of collecting information for the reviews. A requirement that service users’ wishes with regard to furniture and equipment provision in their rooms be recorded, is also restated. Discussion with management indicated that the precise nature of what was required in terms of the above requirement was misunderstood. The wording of the requirement is therefore altered to ensure clarity. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 10 At the previous inspection it was required that a risk assessment be undertaken with regard to the service user at risk of causing flooding in the home. This had been undertaken as required, however on this occasion it was noted that several other service users were deemed at risk of causing flooding, and had had the water supply to their bedroom sinks cut off. It is required that risk assessments be undertaken for all such service users and that agreement forms including the signatures of service users and relatives/advocates (when appropriate) and service users’ care managers should be completed, and reviewed regularly. The majority of risk assessments recorded within service user files had not been reviewed within the last six months. This requirement is therefore restated. Service users spoken to indicated that they were satisfied with the ways in which their needs were met at the home, and were encouraged to make their own decisions. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 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 standard(s) 12, 13, 14, 15, 16 and 17. Service users have access to meaningful activities both in the community and in the home and are supported to maintain links with their friends and families. However an inadequate variety of leisure activities available to service users outside of the home may result in their receiving insufficient social and therapeutic stimulation. Service users are encouraged to be involved in the running of the home and to develop independent living skills. Dietary needs of service users are catered for, with a varied selection of food available that meets their nutritional and cultural needs. EVIDENCE: St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 12 A selection of photographs were available of service users involved in various recreational activities, and these activities were recorded within service user files. On the day of the inspection, the majority of service users were out attending day activities (including attendance at local day centres). Most service users attend day centres on a full or part-time basis. Service user plans and staff spoken to indicated that service users are encouraged to maintain contact with friends and family members and to utilise independence skills at the home. The majority of service users spoken to, said they were satisfied with the activities arranged for, or available to them both inside and outside of the home. Until recently a student psychologist had been undertaking voluntary work with service users on a regular basis assisting them with various activities including baking and arts and crafts. The manager advised that service users had been on a trip to South End in April 2005, but that no other trips out of the home had yet been planned for the rest of the year. It was noted that the number of recreational activities available to service users had decreased in the last few months and there were few leisure activities arranged outside of the home. It was also noted that service users had not had the opportunity to go on a holiday for a number of years. A requirement is made accordingly. A requirement that was restated at the previous inspection had been met, regarding the recording of food served in the home. Records indicated that a varied and nutritious diet is available to service users, and those interviewed spoke highly of the food served in the home. Greek cultural dishes are also available for the Greek service users in the home or other service users who wish to try these. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 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 standard(s) 18, 19 and 20. Service users receive appropriate physical and emotional support, and their medication needs are met. However inadequate recording of health conditions and insufficiently precise medication procedures may place service users at risk of harm. EVIDENCE: St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 14 The service user plans examined indicated that in general, the personal and healthcare needs of users had been assessed and responded to. Service users spoken to advised that their needs were met sensitively according to their preferences. They confirmed that their privacy was respected and that staff spoke to them appropriately at all times. However it was noted that although one service user had been diagnosed with osteoporosis and was receiving appropriate treatment for the condition, there was no mention of this in their care plan. A requirement is made accordingly. As required at the previous inspection, a record was maintained of all medicines dispensed into dosett boxes, for administration to service users by staff members. The signatures of at least two staff members were recorded for all medicines thus dispensed. Other records of the storage, administration and disposal of medication were generally found to be satisfactory. However a requirement is made that the number of tablets of each dosage of medicine, administered at any time be specified on the medication administration sheets to further safeguard service users from error. The inspector noted that one medical administration record that had included an error had been removed, and a new medical administration record had been copied out based on the correct information available on the previous record, in order that the error should not appear. It is required that where a mistake is made in recording the administration of medicines, the error should be clearly crossed through, corrected and initialled by the staff member involved. In no circumstances should the administration form be destroyed and entries be rewritten. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 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 standard(s) 22 and 23. The home has adequate complaints and adult protection procedures to ensure that the concerns of service users are acted upon effectively. EVIDENCE: Service users informed the inspector that they were well treated by staff. No complaints had been made to the home since the previous inspection, and none were received from service users by the inspector. The home had the required policies and procedures for safeguarding users, including a complaints recording format and an adequate adult protection procedure. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 16 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 standard(s) 24, 25, 26 and 30. The home is sufficiently comfortable to meet service users’ needs safely with adequate private and communal space. The general cleanliness of the home is satisfactory, however service user’s comfort may be compromised by the need for a number of minor repairs in their individual rooms. EVIDENCE: St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 17 Lockable storage facilities had been provided in the bedrooms inspected, and each was individualised with personal possessions as appropriate. Service user rooms, the exterior of the home and both kitchens and bathrooms had been painted prior to the last inspection. As required at the previous inspection all potentially hazardous chemical substances (COSHH materials) were now being stored appropriately, and COSHH hazard analysis sheets had been obtained for the materials used within the home. The home was clean and was generally well maintained. Service users spoken to advised that they were happy with their accommodation, and that they had the opportunity to personalise their own rooms according to their wishes. Inspection of individual rooms indicated that some minor repairs/replacements were required. The management advised that the carpets in all of the house were due to be replaced this year. Requirements are made regarding fixing a headboard on the bed of one service user, replacing the chair in one service user’s room and fixing the curtain and replacing the carpet in another service user’s room. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 35. The home is adequately staffed and staff members are well trained to meet the needs of service users at the home. There is evidence that an adequate recruitment procedure is in place to safeguard service users, however confusion over the need for the home to undertake its own enhanced CRB disclosures for any new staff, may place service user’s at risk. EVIDENCE: Service users who were interviewed spoke positively about staff, and the manager and staff member were knowledgeable regarding their roles and responsibilities. Training and supervision records for staff members were satisfactory and up to date. At the previous inspection requirements were made regarding the need for up to date CRB disclosures and POVA checks, two references and identity documents to be available for the most recently appointed staff members. These were available as required. A further requirement was made regarding the accuracy and currency of the staffing rota for the home, which was also found to be satisfactory. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 19 Discussion with the manager and her son indicated that there was some confusion with regard to enhanced CRB disclosure requirements. It was clarified that the home must undertake its own CRB disclosures for any new recruits, even if they have recently undertaken CRB disclosures through another organisation. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42. The home is managed appropriately with the needs of service users in mind, however insufficient consultation with service users may mean their wishes are not always respected. Health and safety checks within the home are generally adequate to safeguard service users from harm, however inadequate recording of refrigerator and freezer temperatures may place service users at risk. EVIDENCE: Service users and staff interviewed indicated that they were happy with the way the home was managed. At the previous inspection it was noted that a quality assurance audit had recently been undertaken and was due to be undertaken annually. There was also evidence that service users are consulted regarding the management of the home in the form of service user meeting minutes. However it was noted that these were not occurring on a regular basis (with only two meetings in the last year). A requirement regarding the frequency of meetings is therefore made. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 21 As required all serious incidents affecting the wellbeing of service users were being reported to the local CSCI area office. Maintenance records checked were generally satisfactory, with recent gas, electricity and portable appliances test certificates available. Major work had been undertaken to upgrade the home’s plumbing systems in line with work specified by Thames Water following an inspection. Fire safety procedures were also found to be satisfactory. However it remains required (from the previous inspection) that the daily temperatures of the refrigerators’ and freezers’ must be recorded. SCORING OF OUTCOMES St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 22 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 2 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 6 Regulation 15(2)(b) Requirement The registered person must ensure that all service user plans are reviewed at least sixmonthly. (Previous timescale of 31/12/04 not met). The registered person must ensure that when individual service users choose not to have an item of furniture/equipment specified under Standard 26 of the national minimum standards e.g. a second chair for their bedroom, this must be recorded within their service user plan including the signature of that service user or an advocate to indicate that this is their choice. (Previous timescale of 17/12/04 not met). The registered person must ensure that all risk assessments are updated at least six-monthly. (Previous timescale of 17/12/04 not met). The registered person must ensure that risk assessments are drawn up with regard to all service users whose taps have been disconnected in their individual rooms, due to a risk of flooding. The assessments Timescale for action 2nd September 2005 5th August 2005 2. 7, 26 15(2)(c) (d) 23(2)(e) (f) 3. 9 13(4) 15(2)(b) 5th August 2005 4. 9 13(4)(c) 15(2)(c) (d) 5th August 2005 St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 24 5. 14 16(2)(m) (n) 6. 19 12(1)(2) (3) 7. 20 13(2) should include the signature of the service user or advocate (who has agreed to this measure being taken) and their social worker, at their next review visit to the home. The registered person must ensure that an increased variety of leisure activities is available to service users, including more activities arranged outside of the home. The possibility of a holiday for service users who are interested, must also be researched. The registered person must ensure that up to date health care information, including details of any medical conditions diagnosed, is recorded on each service users plan. The registered person must ensure that the number of tablets of each dosage of medicine administered at any time is specified on the medication administration sheets. 2nd September 2005 5th August 2005 8th July 2005 8. 26 23(2)(b) (d) 9. 39 18(2) When a mistake is made in recording the administration of medicines, the error should be clearly crossed through, corrected and initialled by the staff member involved. In no circumstances should the administration form be destroyed and entries be rewritten. The registered person must 19th August ensure that the headboard on 2005 one identified service users bed is fixed, the chair in one identified service user’s room is replaced and the curtains are rehanged and the carpet is replaced in another identified service user’s room. The registered person must 5th August Version 1.20 Page 25 St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc 10. 42 13(4)(c), 16(2)(j) ensure that the frequency of service user meetings within the home is increased, so that regular meetings are held at least six times a year. The registered person must ensure that the temperature of every fridge and freezer, used for the storage of communal food, is maintained up to date. (Previous timescale of 19/11/04 not met). 2005 5th August 2005 11. 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 6 34 Good Practice Recommendations It is recommended that material prior to 2003 should be archived so that current information in service user plans can be more easily accessed. The registered person is reminded that the home must undertake its own CRB disclosures for any new staff recruits, even if they have recently undertaken CRB disclosures through another organisation. St Raphael`s Integrity Care Home G59 S10719 St Raphaels V223679 09.06.05 Stage 4.doc Version 1.20 Page 26 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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. 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