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Inspection on 15/05/08 for Swallows Residential Home

Also see our care home review for Swallows Residential Home for more information

This inspection was carried out on 15th May 2008.

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.

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 service offers homely and comfortable accommodation to a small number of residents. Bedrooms have been personalised and cleanliness and hygiene was generally good. Staff make efforts to make meal times into a pleasant social experience. Residents sit together in small friendship groups and vegetables are served in dishes from which residents are able to serve themselves. There was a good range of condiments provided and the meals served on the day of the inspection looked appetizing and nutritious. People living in the home identified the quality of the food as good.

What has improved since the last inspection?

The home has appointed a manager on a full time basis. There are better auditing arrangements in place for the management of resident`s moneys. The systems in place for ordering medication is improved and residents have an adequate supply of medication.

CARE HOMES FOR OLDER PEOPLE Swallows Residential Home Helions Bumpstead Road Haverhill Suffolk CB9 7AA Lead Inspector Cecilia McKillop Unannounced Inspection 15th May 2008 11:30 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 Swallows Residential Home DS0000063929.V364808.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. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Swallows Residential Home Address Helions Bumpstead Road Haverhill Suffolk CB9 7AA 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) 01440 714745 01440 761315 Burrows Care Homes Miss Annmarie Burrows, Mr Harold Burrows, Mrs Donna Burrows Manager post vacant Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th June 2007 Brief Description of the Service: The Swallows Residential Home offers care and accommodation for up to sixteen older people, in single storey accommodation situated on the outskirts of the town of Haverhill in a rural position. The home was first registered in 1995 and the building adapted to provide appropriate accommodation for seven residents. In February 2000 an extension was completed, providing good quality and pleasant additional communal and bedroom accommodation and increasing the registration of the home to fifteen. In November 2000 a previous office was converted into an additional resident bedroom and the total increased to sixteen residents. All resident bedrooms are for single occupancy with one room having an en-suite toilet facility. The home came under new ownership and management in June 2005 and the new owners have already made changes to improve and upgrade the environment. The fees range between £331.00 and £375.00 per week. The cost of newspapers, chiropody, hairdressing and some transport is not included in the fees. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is zero star. This means the people who use this service experience poor outcomes. This report includes information gathered from a visit to the home on 15th May 2008. During this inspection time was spent with people who live and work in the home as well as the inspection of records and documents relating to the provision of care. A tour of the home was also undertaken. Information received by the Commission for Social Care Inspection since the last inspection was taken into account. This includes information contained in the Annual Quality Assurance Assessment, completed by the manager of the home. What the service does well: What has improved since the last inspection? What they could do better: At the last inspection requirements were made in relation to care planning, medication, safeguarding and staff recruitment. It is of concern that a year later shortfalls remain in these key areas, which could place people living in the home at risk. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 6 One of the proprietors who is managing the service said that it had been assumed that the previous manager had addressed these areas but this was found not to be the case on the day of the inspection. The new manager has a kind and caring approach and while it is positive that she is working at the home on a fulltime basis, her ability to drive improvement is as yet untested. The manager gave assurances that matters of concern would be addressed as a matter of urgency. However there is a need for more robust management and for matters to be managed in a more proactive way. The homes management has been asked to prepare an improvement plan as to how they will take the matters concern forward. The Commission will undertake an inspection to follow up the requirements and should they remain outstanding statutory notices may be served. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Swallows Residential Home DS0000063929.V364808.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 Swallows Residential Home DS0000063929.V364808.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6.Quality in this outcome area is adequate. People who use this service can expect to receive an assessment of their needs prior to their admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In the AQAA the proprietor stated “Before a client is admitted to the home a needs assessment has to be carried out” Two newly admitted resident’s files were seen. Both contained a pre-admission assessment completed by the service. The pre admission documents were not signed or dated, so it was difficult to ascertain when they had been completed but the manager said that the previous manager had undertaken these. Signed copies of contracts were on file. People living in the home said that their admission had been planned and they had the chance to visit the home before moving in. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 9 The Statement of Purpose and the Service User Guide was on display in the entrance to the home and were dated May 2007 The home does not offer intermediate care. Swallows Residential Home DS0000063929.V364808.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. 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 a care plan in place, but cannot be assured that risks to their health will always be managed proactively. Medication practices do not offer sufficient levels of protection to people living in the home and staff do not always treat people as individuals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each resident had a record containing health care information and there was evidence of people accessing health care services in the local community. People interviewed confirmed that the home made arrangements for them to seek the GP if this was required and medical staff visited the home on the day of the inspection at the request of the a resident. The care plans for two residents were seen and covered areas of care such as personal hygiene, continence, diet and mobility. In addition there were risk Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 11 assessments in place for nutrition and moving and handling. Information was recorded on a number of separate documents, which made it difficult to clearly identify care needs. Staff maintain daily records and monthly summaries were being undertaken to identity any changes in care needs. Records however were not very detailed but the manager had asked staff to expand their recording to ensure that the records better reflected the care being undertaken. In one set of records, which were examined, there was evidence of the home working with the GP to monitor medication and nutritional intake. It was recorded that there had been some improvements to the residents overall health and they were feeling “less tired” Overall however, the care planning and risk assessment systems were more reactive than proactive. One resident for example had a number of recent falls but the home did not have a clear documented plan in place as to how the home intended to manage these risks. During the course of the inspection one resident was observed making very unpleasant and bullying comments to another very vulnerable resident. The homes records indicated that the manager had made some previous effort in conjunction with the resident’s family to resolve the issues between the two residents however this had been unsuccessful. There was a written plan in place but it lacked detail and did not sufficiently outline the risks and identify the role of safeguarding. The inspector was subsequently informed by the Deputy manager that the situation was much improved but the home have been asked under separate cover to outline how they intend to manage these issues should they reoccur. The home uses a monitored dosage system to manage its medication. During the inspection staff were observed administering medication and a sample of records were examined. Staff reported that the issues identified at the last inspection regarding the stock of medication had been resolved and residents were not missing doses because the home did not have medication on site. There has however been two occasions over the last few months were medication has been incorrectly administered to the wrong resident. Staff however quickly realised the error and sought medical attention on both occasions. The manager had asked staff to document the most recent error but had not fully established the sequence of events and no changes had been made to administration practices. Discussions with staff about the systems in place for administering medication in the evening indicated that they were not safe. Medication was being given to residents by staff who had been given the medication by another member of staff. In addition staff were administering Temazepam into medication pots, which at a later point was given to residents. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 12 In the AQAA the home stated that they were intending to introduce competency testing for staff administering controlled drugs, but there was no evidence that this had taken place at the time of the inspection. People living in the home said that they were cared for “all right” and that they could talk with the new manager. Feedback from relatives was positive. In one questionnaire, which was returned, a relative commented that their relative only had one bath each week and sometimes there were gender issues due to the lack of same sex staff at bath times. The interaction between staff and residents was observed on the day of the inspection. Staff were generally helpful and well meaning and there was some examples of good practice with staff getting down to face residents and speaking with them gently. However some residents were observed being spoken to in a patronising manner. A resident indicated that they wished to leave the table but a member of staff told them that they could only get down from the table when “you eat this.” Staff were observed being very directive and the resident’s opinions or wishes were not respected. Another member of staff was observed giving residents their medication without any communication or interaction. Medication was simply placed in the table in front of the resident before the staff member moved away. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. People who use this service can expect to be provided with a range of activities and freshly prepared meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Resident’s files contained details of family contacts and their relationship to the resident. Daily records had entries about visits from family and friends. Residents said that staff welcome visitors to the home and some residents had their own telephone in their room. The home is located in a rural position and the inspector was informed that residents can order a taxi if they wish to travel to nearby Haverhill. There is a trolley located in the dining area, which contains items such as cards, sweets and toiletries, which residents can purchase. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 14 On the day of the inspection residents were observed watching television and talking together. There were no formal activities but the residents interviewed were generally satisfied and did not identify boredom as an issue. The inspector was informed that there are fortnightly craft sessions, bingo games and sing-alongs organised. Details of the May activities were displayed and contained details of a day trip to Clacton. At previous inspections the food provided has been identified as good. Residents are offered a choice for lunch and tea and the staff ask residents for their preferences each morning. On the day of the unannounced there was a menu board on display setting out what was on offer. The cook had planned a barbeque however there had been a change in the weather, which had led to a change in the menu. The cook had prepared Shepard’s pie with carrots and cauliflower. Residents commented positively on the meal and the food generally. The tables were nicely laid and residents were offered a good range of condiments. Homemade chicken soup was served for the evening meal and there were fresh cakes available. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. People who use this service can expect to have complaints taken seriously but they cannot be assured that staff are clear about what to do in the event of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Safeguarding systems were examined at this inspection as part of the thematic probe being undertaken in all registered service in May 2008. As part of the probe specific questions were asked of the manager, staff and residents. The Home has copies of the protection of vulnerable adults guidance issued by the interagency committee of Suffolk. However the manager was not able to locate the homes in house policy on the day of the inspection. This had been the subject of a requirement at the last inspection and it is of concern that this had not been actioned. Staff interviewed had some understanding of safeguarding systems and what abuse meant. One member of staff said that they had watched a video on vulnerable adults and two staff said that they completed a questionnaire however they were not clear as to the procedure for making a referral. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 16 The manager reported that staff would be expected to report matters of concern to one of the senior staff who would be aware of the local authorities role and how to make a referral. The home has a whistle blowing policy and the manager said that safeguarding is discussed generally at staff meetings. The manager said that as a result of the discussions they had recently reviewed their policy on visitors coming into the home and were considering purchasing name badges for staff. There was an issue identified at the inspection regarding bullying which has been referred to earlier in the report and while there was a plan in place it did not refer to safeguarding and what the triggers might be for making a referral. The complaints policy was on display in the entrance to the home. The Commission has received two complaints since the last inspection and these were both investigated by one of the proprietors, within the timescales. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. People who use this service can expect to find accommodation that is comfortable, generally clean and homely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home was undertaken as part of the inspection. The home was tidy and looked well maintained. There were no unpleasant odours or hazards noted during the inspection. In the AQAA completed by the home prior to the inspection, the manager outlined a number of items that have been purchased and areas that have been redecorated over the last year. Security has been tightened with the fitting of gates. A sample of residents bedrooms were visited as part of the inspection and these were very comfortable and had been personalised by residents. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 18 Resident’s names were on the doors and keys were available. The inspector noted liquid soap, gloves and aprons at key locations around the home. One member of staff was observed with an individual hand wash. The laundry was visited as part of the inspection and this was clean, tidy and well maintained. Water temperatures were tested as part of the inspection and were within the recommended levels. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is poor. People who use this service can expect to be cared for by adequate numbers of staff. Training is provided but is not being fully implemented. The recruitment of staff does not offer protection to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing rota was examined on the day of the inspection. One member of staff was unwell and cover was being provided from within the staff team. Levels of staffing were adequate on the day of the inspection, with sufficient staff on duty to meet resident’s needs. One member of care staff provides night cover with a second carer on sleep in duties. In the AQAA competed by the home prior to the inspection the manager stated that 75 of the current staff have achieved NVQ2. Staff interviewed as part of the inspection reported that they were provided with updating training. Issues have however been identified in earlier sections of the report which highlight training shortfalls particularly in the area of medication, care planning and how staff relate to people living in the home. The inspector was informed that newly appointed staff shadow more experienced staff as part of their induction. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 20 The recruitment records for a newly appointed member of staff were examined as part of the inspection. The file contained a range of documentation including an application form, copies of certificates, an ID check and two references. The application form does not ask the applicant for a reference from their current employer. In the file examined neither of the two references were from the applicants previous employer, one of which was a health care provider. The homes manager said that they had tried unsuccessfully to get a reference from the employer but there was no evidence on file to substantiate this. A POVA first check was on file but this was not dated. The inspector was shown a list of dates on which other staff had obtained a criminal record bureau check. The home were waiting on the results of one check, but had a POVA first check. Shortfalls in the recruitment processes had been identified at the last inspection and a requirement was made. It is of concern that issues remain unresolved. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35. Quality in this outcome area is poor. The homes operation is generally adequate however there have been issues, which have not been managed well over the last year, which have placed people living in the service at risk of harm. The new management team have indicated that they have the capacity to improve the service but as yet have not delivered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been a change in the management arrangements at the home since the last inspection, with the registered manager and another senior member of staff leaving. At the time of the inspection the home was being managed by one of the proprietors who indicated that they intended to make an application for registration. The manager has experience of working directly with older Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 22 people and presented as kind and helpful. The manager has a NVQ2 and was in the process of undertaking the registered managers award. The manager is assisted in the day to day management of the home by a deputy manager and an assistant manager. The proprietors had an independent person conducting their Regulation 26 visits on their behalf but this arrangement has come to an end and the manager had prepared recent reports. Two of the three proprietors work at the home on a full time basis. Concern was expressed to the manager that a number of the requirements, which had been made at the last inspection, had not been fully addressed. The manager said that it had been assumed that the previous manager had addressed these matters and gave an assurance that they would have her full attention. Issues have also been raised earlier in the report about staff communication with residents and medication practices, which would indicate the need for a tighter and more proactive management style. The home has issued questionnaires to relatives and residents in the past to formally ascertain their view on the care provided but the last occasion was in February 2006. There was evidence in resident’s files that they are consulted about their needs at reviews and minutes of a recent resident meetings was on display. The systems in place for managing resident’s personal moneys were examined as there had been issues at the last inspection. In the sample examined the records corresponded with the amounts being held on residents behalf. Receipts were available and had been separated from the homes main shopping. In the AQAA the home’s management provided the Commission with the dates of the testing of the electrical circuits, portable electrical equipment, hoists and fire detection equipment. They confirmed that 13 staff had undertaken training on infection control. An award for food hygiene dated 2008 was on display. Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 23 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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 2 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X X 3 Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? yes 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 OP7 Regulation 15 Requirement All people using the service must have an up to date detailed care plan, which includes details of their care needs and how risks to their health and welfare will be managed. This will ensure that they receive person centred support that meets their needs. Where care plans are not working successfully advice should be sought from other professionals and a new plan put in place to ensure that people living in the service are safeguarded The registered persons must undertake, and retain evidence of, all the recruitment checks required in Schedule 2 of the Care Homes Regulations 2001, to protect people living in the home. This requirement has been repeated from previous inspections. Further failure to comply may result in enforcement action. Timescale for action 01/08/08 2. OP7 12 13 15 01/08/08 3. OP29 19 (1) (b) (i) Sch 2 01/08/08 Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 25 4. OP9 13 The systems in place for administering medication must be reviewed in the light of medication errors to protect people living in the home. Staff responsible for the ordering and administration of medication must receive training to ensure that they are administering medication safely. Staff must be encouraged and assisted to interact with people living in the home in a way that enables them to make decisions about their care and respects their dignity. The registered persons must compile a safeguarding policy for staff guidance based on the guidelines set out in the Suffolk interagency procedures. This requirement has been repeated from previous inspections. Further failure to comply may result in enforcement action. 01/08/08 5. OP9 13 01/09/08 6. OP10 12 01/08/08 7. OP18 13(6) 01/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Swallows Residential Home DS0000063929.V364808.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!