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Inspection on 04/02/09 for St Thomas Rest Home

Also see our care home review for St Thomas Rest Home for more information

This inspection was carried out on 4th February 2009.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a good range of information to people thinking of coming to the home, so they can make an informed decision. The home makes a full assessment of a person`s needs before deciding if it can meet all those needs. The home draws up plans to meet the care needs of its service users. Service users health care needs are also fully assessed and properly met. Service users say that staff treat them well and always with respect. The staff are working hard to provide a stimulating atmosphere in the home, with appropriate social activities for service users. Service users are encouraged to keep in regular contact with family and friends, who say they are always made welcome in the home. Service users are also encouraged to take as much control over their own lives as they are able, and make their own decisions. Service users were very complimentary about the food, and there is a balanced diet, with service users choice included. Complaints and concerns are taken seriously and are responded to properly. The home is kept clean and hygienic and free from odours. The home has enough staff to meet the needs of service users. The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is experienced and is providing positive leadership to the home. The home is being run in the best interests of the service users. Service users finances are protected by the home`s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home`s policies and systems.

What has improved since the last inspection?

The home now has a registered manager, she has been in post for 10 months, she has ensured that the requirements identified at the last inspection have been addressed.

What the care home could do better:

To safeguard the service users health and wellbeing, it is important that the correct code is always used when completing the medication records.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Thomas Rest Home Belgrave Terrace South Shields Tyne And Wear NE33 2RX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jim Lamb     Date: 0 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: St Thomas Rest Home Belgrave Terrace South Shields Tyne And Wear NE33 2RX 01914546662 01914975811 stthomascomplex@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Khalid Hamodi care home 52 Number of places (if applicable): Under 65 Over 65 0 0 52 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 21 16 0 The maximum number of service users who can be accommodated is: 52 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 52 Dementia - Code DE, maximum number of places: 21 Mental Disorder, excluding learning disability or dementia - Code MD, maximum number of places: 16 Date of last inspection Brief description of the care home St Thomas Complex comprises of two large converted houses that have been recently upgraded with a purpose built extension added to the main building. The main entrance is to the front of the building in Belgrave terrace. A lift is available within the Home to take people to the first and second floors. The Home provides personal care for up to 55 older people that includes an area of the home for 21 people with Care Homes for Older People Page 4 of 28 Brief description of the care home dementia care and the home also has an identified bedroom for service users requiring respite care. All the bedrooms within the building are single rooms and all have ensuite facilities. The Home cannot provide nursing care. The Home is located on the outskirts of the town centre, close to the park and sea front. There are many community amenities in close proximity including shops, churches, park and medical centres, and a frequent bus service is available outside the Home. Fees for the home range from 427.00 to 437.00 per week. Additional charges are made for hairdressing, chiropody, newspapers and personal toiletries. Copies of the most recent inspection report, the service users guide and statement of purpose are available in the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out. Care Homes for Older People Page 6 of 28 Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run. The providers view of how well they care for people, and the views of people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, relatives, staff, the manager and visitors, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable,and checked what improvements had been made since the last visit. An expert by experience visited the home as part of the inspection, her views have been included in this reort, - see standards 12-15. We told the manager/provider what we found. What the care home does well: What has improved since the last inspection? The home now has a registered manager, she has been in post for 10 months, she has ensured that the requirements identified at the last inspection have been addressed. Care Homes for Older People Page 8 of 28 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users are provided with enough information about the service to enable them to make a choice about where they want to live. Evidence: The care records for four service users were examined. These showed that the manager makes sure that a full assessment of a new service users needs is carried out by the persons social worker before they come into the home. The manager also carries out her own assessment, to be doubly sure that the home can meet all of the new persons needs. More detailed assessments are carried out once the new service user has come into the home. These include assessments of risk, of nutritional needs, social needs, moving and handling needs and of behavioral needs. Skin care assessments are also Care Homes for Older People Page 11 of 28 Evidence: carried for those at risk of developing pressure sores. The manager also intends to introduce formal nutritional assessments, and a recognised dependency assessment. As a result of all these levels of assessment, the manager can clearly demonstrate that all the service users are in a home that can give them the care that they need. The homes service users guide is available,information will soon be available on compact disc and large print. All are provided with a contract explaining the homes terms and conditions, and fees. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Evidence: People using the service are given sensitive personal support by the staff, who promote each individuals independence, dignity, privacy and choice. Each person has an individual assessment of his or her personal needs, and has a care plan in place to meet those needs. Plans are person-centred, sensitive and thoughtful. They stress the strengths of the individual, and are positive in terms of seeking to develop the skills and abilities of the person. Privacy is given a high priority. Plans are reviewed every month, and amended as necessary, to reflect the progress made by the individual. Some of the monthly evaluations were rather repetitive, such as, no change for several months. The manager said that she will address this issue. Care Homes for Older People Page 13 of 28 Evidence: Each person has his or her own personal health information file. This contains professional health assessments, correspondence, and records of contacts with health professionals. It demonstrated that all aspects of a persons physical and mental health are taken seriously and are properly met. The manager also intends to introduce a recognised dependency assessment tool, and this will help to determine each individuals dependency level. Medicines are ordered monthly, and these are delivered in blister packs. This is said to be working well, and to minimise any risk of a medication error. The Medication Administration Records were checked. These were found to completed to a good standard, although there were three gaps found where the correct codes had not been entered properly.The manager will ensure that the correct codes are used at all times. Medicines are safely stored. All staff have had training on how to use the medication system. They have also had external Safe Handling of Medicines training. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users are offered a good quality lifestyle, which includes varied social contact and activities. Evidence: Each service user has a social skills assessment carried out. This is reviewed and updated on a regular basis. All service users participate in this process. The manager also intends to create life story books for each service user. Service users are supported and encouraged to be in control of their own lives, to enjoy their own interests and hobbies. There are daily activities available, and service users have a choice of activities they want to do. There is a full time activities co-ordinator, and she keeps a record of activities that service users participate in. The home has a new mini bus that is frequently used for outings. Outings and activities are planned. There are meals out, visits to cafes, shops, pubs, and trips to local theaters, etc. Care Homes for Older People Page 15 of 28 Evidence: All service users are supported to maintain very close links with their families and friends. They can choose who they want to see and when. The Homes menus are based on the known likes and dislikes of the service users. At least three hot meals are provided each day. Special diets are catered for when needed. The menus are varied and well balanced. The service users said that the meals were very good and that they were always offered a choice. An expert by experience who attended the inspection said: I arrived at the home at 11am, i was introduced to the deputy manager and offered a cup of tea. I was invited to have lunch and given a choice of meals. The deputy manager then showed me around the home and introduced me to many of the staff and residents. The hairdresser was in attendance - she comes every Wednesday, and sometimes on a Thursday if required. All the ladies were very chatty, enjoying being titivated. I was then taken down to the ground floor where the residents with dementia reside. I was introduced to the activities worker who works full-time 5 days per week. Some of the ladies were playing cards, and continued to do so while the activities worker was chatting to me. On this floor there is a reminiscence room with old fashioned furniture, radios, and other memorabilia. There were lots of old photographs around and pieces of old music. A programme of activities is on the notice board with the weeks plans clearly seen. These included, exercises, quizs, jigsaws, cooking and bingo. Bingo is so popular that it has been increased to three times per week. Other events are also organised such as outings in the homes own mini bus, concert parties and pub outings in the summer. There are also singers and fashion events put on in the home. The deputy manager showed me a an album of photos of last years Halloween party which looked lovely, with walls and tables decorated beautifully. I then had lunch and was seated with a lady and two gentlemen. The lady had been a resident for 12 years and was very content. One gentlemen had been a resident for 10 months and the other for 4 months, both were quite happy. The dining room was very pleasant and bright with tables set with coloured place-mats. The meal i had chosen was roast lamb as had the other lady. The gents both had braised liver. The vegetables were served in a separate tureen - turnip, cabbage and peas. Everything was very tasty. The sweet was semolina or fruit and jelly. Before lunch tea was served and all during lunch top ups were offered, which i found rather strange. There was no water or other cold drinks on the tables. The residents chose their meal for the following day, and a print out is kept. Breakfast is served from 8.30-9.30 fruit and cereal is offered and also something cooked every day. Supper is also a small meal such as quiche or cauliflower cheese. If residents want something different, it isnt a problem, the chef is happy to cook alternatives. There is someone on duty in the Care Homes for Older People Page 16 of 28 Evidence: kitchen from 8am-8pm. The staff were very helpful and kind to all the residents during lunch, treating everyone with respect and dignity. While i was having my lunch i asked my companions about the complaints procedure. The lady was very positive and knew exactly what to do and how to follow it up. The gentlemen agreed with her, although i am not entirely sure if they really understood the procedure. A priest attends every Wednesday to see the residents who would like to speak to him. A vicar comes in on a Friday to do the same. At present there are no residents of any other faith, but i was assured that arrangements would be made for them if required. The outside area has many seating areas which i am sure will be used in the warmer weather. At all times i observed staff treating the residents with kindness and respect, whether it was taking them to the toilet, or walking to the dining room. I was very impressed by the atmosphere of peace and quiet during my visit which i very much enjoyed. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints management is effective, and this results in service users being protected from harm and abuse. Evidence: There is a complaints procedure. The procedure is written in a way that ensures service users fully understand its contents. Copies are available in service users bedrooms. Four service users said that they had been given copies of the procedure and that staff listened to their concerns and always dealt with them fairly. The home keeps a record of complaints. During the last twelve months there has been one complaint received, and four protection of adult procedure referrals, all were appropriately investigated and resolved. The home has a Whistle Blowing policy, a copy of the Local Authorities Vulnerable Adults procedures. Staff are aware of these procedures and have easy access to them. Safeguarding adults training is ongoing for all staff. Facilities are available to look after small amounts of service users cash, and records are kept of accounts. A sample of personal finances records was examined. Care Homes for Older People Page 18 of 28 Evidence: Transactions were appropriately recorded and had two signatures for each entry. There was plenty of evidence of personal spending. Receipts are obtained for purchases and numbered and cross-referenced to the transaction. Weekly checks of balances and cash are carried out. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a very comfortable and safe environment for those living there. Evidence: The premises maintain a pleasant and homely atmosphere. The home is set out into two self-contained units and a variety of communal areas, all of which are accessible by service users. All parts of the building seen were exceptionally clean, suitably equipped and have good quality decoration and furnishings. There is an ongoing programme of decoration and refurbishment. The manager has created colour and fabric boards, and these enable service users to choose a colour scheme for their bedrooms. The dementia care unit is an attractive area, however the walls are rather bland, adding additional colours will make this unit, and other areas of the home look much more homely. The manager has also agreed to have an orientation board located in this area, and this will help those service users with memory problems to become more aware of their surroundings, and showing what day of the week it is, month, season, and the names of the staff on duty. This unit also has a reminiscence lounge that the service users enjoy. Care Homes for Older People Page 20 of 28 Evidence: All bedrooms have en-suite facilities, they are spacious and well furnished. All toilets and bathrooms were appropriately equipped and nicely decorated. The kitchen was very well organised, and stock levels were good. The home employs a laundry assistant, and the laundry was also well organised and well equipped. The grounds have all been professionally landscaped and there is a full time gardener. There is a conservatory that leads out onto a large deck area, the dementia care unit has an attractive enclosed garden, to the side of the home there is a large fountain and waterfall. The service users and their visitors have access to the grounds, and there are various seating areas for them to use. A number of service users spoke positively about their bedrooms and the accommodation in general. One service user said, The gardens here are magnificent, and i love to sit out there when the weather is fine. The home has policies and procedures on hygiene and control of infection. Staff receive infection control training. There is suitable hand washing facilities throughout the building. Disposable gloves and aprons are provided for staff use. Arrangements are in place to dispose of clinical waste. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good match of well-qualified staff, who are apporpriately recruited and supervised. Evidence: Staff levels on the day of the inspection met the agreed level for the number of service users. On the day of the inspection there were 51 service users. In addition to the manager, the required numbers of staff were on duty: 8 staff between 8am and 10pm with 4 staff between 10pm and 8am. The latter will shortly increase to 5. There are ample kitchen, domestic and laundry staff. There is also a full time activities co-ordinator. All staff were over 18 years of age and those left in charge were at least 21. The training needs of the staff are identified in supervision and appraisal sessions. The homes training programme meets the National Training Organisation requirements for the first six months. Staff receive at least three days paid training each year. Care Homes for Older People Page 22 of 28 Evidence: The service has a good staff training and development programme in place. All statutory training was up to date and 90 of the staff team has completed NVQ level 2/3. All those who have attained level 2 have progressed to level 3. Arrangements are in place to ensure that new staff are subject to robust preemployment checks. Personnel records confirm that staff have undergone Criminal Records Bureau disclosure checks. Two written references have been obtained for each member of staff. Each member of staff has completed an application form and provided a full employment history. Verification of identity has been obtained. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is supported by the proprietor in providing good leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The manager has been in post for 10 months. She had extensive experience and displayed the professional competence required to manage the home. There was evidence that the staff team worked hard to improve the lives of the people living at the home. Staff and service users felt that the managers style of leadership was fair, supportive and understanding. Staff also said they were clear about the standards of care which they were expected to achieve, and they had good knowledge about the service users care needs. The majority of service users had requested that the home take on day-to-day responsibility for overseeing their money. A safe was available to ensure that their Care Homes for Older People Page 24 of 28 Evidence: money could be kept secure. Staff signitures had been obtained for all money spent on behalf of service users and receipts had been obtained and attached to their financial balance sheets. Financial records showed evidence of regular audits. The home was not acting as an appointee for any of the service users. A quality assurance system had been developed to monitor the quality of care provided in the home. For example, quality surveys had been sent to people living at that the home their relatives and professionals involved with the home. An annual development plan will also be completed. The manager will ensure that prospective service users will have access to the results of the service users surveys. All staff working at the home had received supervision at least six times during the last 12 months. Supervision sessions are used to provide staff with feedback on their performance, and training needs. A range of health and safety records were examined and found to be up to date. A tour of the premises identified no health and safety concerns. An audit of the homes fire records confirmed that the required fire prevention checks had been completed. For example, the homes emergency lighting and fire extinguishers had received monthly visual checks. An up to date fire risk assessment was in place. The homes accident records contained the required details. The homes lift and hoisting equipment had been serviced. All gas and electrical appliances had been subject to the required safety checks. A range of workplace risk assessments had been completed. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 To safeguard the wellbeing of the service users, staff must record the correct code in the medication administration records when the prescribed medication has not been given. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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