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Inspection on 14/10/05 for Sycamore Court

Also see our care home review for Sycamore Court for more information

This inspection was carried out on 14th October 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.

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

One of the best things about Sycamore Court is that all residents have their own bedroom and ensuite toilet and wash hand basin. The home is situated in lovely grounds and so many of the rooms give residents a very pleasant view. The residents spoken with said that the staff at Sycamore Court are very nice and are helpful and friendly. Residents also said that the food was good and that they enjoyed it. Different residents had different views about the activities offered but mostly they seem to have been enjoyed and appreciated.

What has improved since the last inspection?

Although the care plans did not meet national minimum standards, they were noted to have been improved. There were less residents at the home at the time of this inspection and so the dining room seemed to have more space and not be so crowded. Two residents bedrooms have been carpeted and the new bath hoist had been fitted. Staff were being provided with more regular supervision.

What the care home could do better:

It was disappointing to again see that there were a number of things that need to be done better at Sycamore Court. Residents and staff explained that they found the management team didn`t get on with things and sometimes gave information that was opposite to each other. Some staff said they didn`t feel very valued and some residents spoken with said that they had noticed the problems that this caused. The monthly reports that somebody from the company has to do and send it to the commission have not been received every month as required. There were concerns regarding the medication system. A resident had been without an important medication for some days and nobody seemed to know or have done anything about it. There was limited evidence to show that very many staff had been given training on the things that were shown at the last inspection needed to be done.

CARE HOMES FOR OLDER PEOPLE Sycamore Court Magpie Lane Little Warley Brentwood Essex CM13 3DT Lead Inspector Mrs Bernadette Little Unannounced Inspection 14th October 2005 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 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. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sycamore Court Address Magpie Lane Little Warley Brentwood Essex CM13 3DT 01277 261680 01277 202028 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) Southern Cross Healthcare (West) Limited Mr Peter Edward Watchorn Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th May 2005 Brief Description of the Service: Sycamore Court is a purpose built, elegant two storey building situated in a rural location outside Brentwood/Warley and within easy access of A127 and M25. The home provides accommodation for 39 older people on two floors, in 39 single ensuite rooms. Other facilities include 4 lounges, 1 of which is a smoking lounge, and separate dining areas. In addition the home benefits from a specially equipped hairdressing salon. A passenger lift provides access to all levels within the home. There are large open grounds with excellent views across the local countryside and a patio area with seating. Car parking facilities are available to the side of the property. The home is not serviced by any public transport. Brentwood station is approximately 3 miles away and the nearest bus stop is advised as approximately 40 minutes walk. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection that took place over a nine hour period from 11:45 am to 8:45 pm. There were 29 people living at the home at the time of the inspection. One of them was away on holiday with their family. The registered manager was on annual leave at the time of the inspection. The deputy manager was off shift but came in to assist with the inspection. This inspection took into account the views of five residents who were talked with individually, other residents who were chatted with generally, five staff who were spoken with individually, general discussion with other staff and discussion with the deputy manager and the administrator. Most areas of the home were inspected and time was spent sitting with residents and looking at the everyday routines and practices in the home. Records and documents were also inspected. What the service does well: What has improved since the last inspection? Although the care plans did not meet national minimum standards, they were noted to have been improved. There were less residents at the home at the time of this inspection and so the dining room seemed to have more space and not be so crowded. Two residents bedrooms have been carpeted and the new bath hoist had been fitted. Staff were being provided with more regular supervision. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 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 Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 Some residents’ contracts/statement of terms and conditions provided better detailed than others The admission procedure included a sufficiently adequate assessment that ensured that the person’s needs could be met. EVIDENCE: The types of contract or statement of terms and conditions available for residents varied depending on their type of funding, and how old the contract was. Some resident’s statements of terms and conditions did not include detail on who was responsible for payment of the fees and one was also seen not to identify the number of the room the resident was to occupy. A record was not available of the fees charged to residents and the charges for any additional services. The preadmission assessments sampled contained adequate basic detail. They continued to be no evidence on the file that, having assessed the resident’s needs, the registered person had confirmed in writing to the person they could meet those needs, as is required. Staff files sampled did not evidence that all staff had had training on conditions associated with older people. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 9 Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9, 11 Care plans provided a basic level of detail to assist staff to meet residents’ needs, but overall were improving. EVIDENCE: A new care plan format had been introduced and some care plans had been partly rewritten. One resident advised that they had been involved in their new plan of care, but only to request a signature after it had been written. Another newly written care plan did not evidence the residents’ involvement. Some care plans remained in the old format although in at least one case, the resident was a recent admission. This care plan contained no information on the resident’s oral or optical care, although these were relevant issues. Where risk assessment tools were available, some had been completed without follow-up care plans or additional supporting assessments that they should have been connected to, for example to nutritional risk assessment. Where a resident’s need had changed due to a current infection and prescription of antibiotics, the care plan had not been reviewed and updated to reflect this. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 11 Staff were advised that care plans should not include instructions such as ‘regular’, but that this should be specified. It was noted positively that staff were interested and open to suggestions and advice on writing the care plans. Care notes in the main were noted to be of good quality and written regularly. Medication Administration records (MAR) demonstrated appropriate recording and stock of controlled drugs. The signatory list/list of staff signatures was incomplete. A risk assessment was not in place for self-medication of eye drops. Staff advised that the care plan was used as the protocol for as required(PRN), and it was recommended that a copy of this be kept with the medication records. Several omissions on the MAR sheets had been highlighted. The deputy manager confirmed they had been completed at a later date than the time of administration following monitoring of the sheets. The MAR sheet for one resident demonstrated that the resident’s morning medication, for their Parkinsons disease, was recorded as out of stock on one day and had not been recorded as administered the three subsequent mornings. The deputy manager and a senior had said that they were unaware of this until it was identified during the inspection. They advised that no one person has responsibility for managing and ordering medication. The home had a copy of a current medications directory. A copy of the Royal Pharmaceutical Society guidelines for medication in care homes was eventually found on request. It is recommended that all staff, particularly those involved in medication system, update their knowledge on these guidelines. On one file sampled, it was noted positively that that was very clear information about the residents wishes at the end of their life. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 Sycamore Court provided residents with a good range of social and leisure activities, and welcomed visitors. Residents were provided with a range of foods that met their individual needs. EVIDENCE: The home employed two activity co-ordinators, one for six hours at the weekend, and the other for varied hours on weekdays. Residents spoken with said that the approaches of the co-ordinators and the type of activities provided varied, so providing something for everyone. This included individual time for residents who may not be able to join in a group activity. This was confirmed with the activity coordinator on duty at the time of the inspection. Residents were made aware of the planned activities by having them displayed on the notice board. Residents also said that they enjoyed a visit to the homes hairdressing salon and going on the outings. Residents spoken with also said that their visitors were welcomed at Sycamore Court. All residents spoken with said they were satisfied with meals provided. Some residents preferred to eat in their room and this was accommodated. There were less residents living at the home on this occasion and the dining room presented therefore as more spacious. Staff confirmed that some residents now also ate in the small lounge /diners, providing more space. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 The home had a satisfactory complaints procedure that was readily available and accessed. Training for staff in appropriate areas would better protect residents. EVIDENCE: Residents have spoken with confirmed that they would feel confident to raise any concerns with staff. Access was available on this inspection to the records of complaints. This was noted to have improved and details were available of complaints and their investigation. Two compliments were displayed on the notice-board in the hall, which complemented the care provided at Sycamore Court. Staff confirmed that residents would have access to postal voting if this was their wish. The last inspection required that staff were provided on training on the protection of vulnerable adults. A training session was recently made available but only the deputy manager attended. Staff confirmed that they had had workbooks but not all staff had completed these. More effective management of this issue needs to be demonstrated. Staff stated that they had not had trading on the management of aggression and that residents who had demonstrated this behaviour had been moved on to more appropriate placements. Staff confirmed that some residents did become agitated and they had not had training on how to manage behaviour that challenges. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 25, 26 Sycamore Court provided a safe environment for residents. Better attention was needed to the décor to provide residents with a more pleasant living environment. EVIDENCE: All residents spoken with said they were satisfied with the comfort offered in their own bedrooms and with the facilities of the premises in general. Many bedrooms were attractively personalised. Staff confirmed that two bedrooms had had new carpet fitted and one new hoist had been installed, but apart from this there had been no changes to the premises. The decoration of the premises looked tired in several places and some carpets remained badly stained. This is particularly noted, as at the last inspection, in the small lounge used for smoking. There were no residents living at Sycamore Court who smoked at the time of this inspection. Curtains in some areas needed attention either by replacement or by being hung properly at the windows. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 15 Bolts were seen to still remain on some residents’ bedroom doors. As locks were fitted to all bedroom doors, the last inspection recommended that the bolts to be removed and an effective system be put in place for residents to use the keys to their rooms to protect their privacy. While the laundry was generally clean, areas visible behind the machines were in need of a thorough cleaning. The attention of the laundress and the handyman was drawn to the small black objects seen on a shelf. The handyman confirmed that appropriate action to ascertain what they were. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Care staffing levels were, in the main, considered adequate. Staff recruitment procedures were generally robust and protected residents. EVIDENCE: All residents spoken with complemented the care provided by the staff. Some staff were clearly feeling demoralised and devalued and were aware that this is not in residents’ best interests. The deputy manager advised that the original agreed minimum staffing levels were being met even though resident numbers had decreased. Inspection of the rotas however indicated occasions where this had not been met on a regular basis, on some day for shifts and occasionally at night. Additionally there was now no domestic cover on Sundays. The majority of staff were working 12 hour shifts, which is not considered best practice. Staff spoken with were happy with the system and advice of the difficulty of transport to the home. Advice was provided to the deputy manager that a member of staffs visas that stated they were only allowed to work 20 hours a week during term time.. This was being exceeded in some cases and needed to be addressed. Staff were advised as currently undertaking NVQ level 2 in care. Certificates were seen to confirm that three staff had had achieved this level of training. The deputy manager confirmed that she has achieved D32 and D33 and NVQ 4 in management. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 17 Recently appointed staff confirmed that they had been provided with appropriate induction and basic mandatory training. In record sampled indicated that staff have not had up-to-date moving and handling training. The recruitment files for three staff were sampled. In the main, appropriate references to checks had been taken up prior to employment commencing. Photographs were not available on to of the three files. Original records of criminal record bureau checks were not available for inspection. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37, 38 Sycamore Court was not effectively managed. The leadership approaches in operation failed to demonstrate that the home was run in the best interests of the residents or supported staff. EVIDENCE: The registered manager was not on duty at the time of this inspection and so could not contribute their view. However, staff and residents spoken with advised of a clear lack of effective management, as well as different and confusing/conflicting approaches within the management team. Sycamore Court does undertake routine questionnaires from a sample of their residents as part of the quality assurance approach. It was clear however from this inspection that either residents’ views had not been effectively sought or else they had not been addressed effectively. This could include the routine regulation 26 reports that were required to have been undertaken on behalf of the organisation. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 19 Access to the records and money looked after for residents was available at this inspection and those sampled were found to be satisfactory. Records of residents’ personal possessions were also noted to be included on the care files. Staff supervision had taken place. There were clearly different styles in supervision taking place and some conflict regarding this and the appropriateness of the role and approach of the supervisor. The format should allow for the staff member to have input to the agenda. Better access was available to records on this occasion as the inspection was undertaken during office hours. Records sampled included accidents, rosters, residents’ finances, visitors and other records identified throughout this inspection. Safety inspection certificates requested for sampling were satisfactory in relation to the electrical fixed wiring and the gas supply. The passenger lift certificate expired on the day prior to the inspection. A current controlled waste disposal contract was seen to be in place. The new handyman confirmed that he does the water and fire checks and that this is monitored by the registered manager. It was not positively that bed rails and wheelchairs had now been numbered, recorded and regularly monitored and checked for safety. Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 20 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 x 2 3 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 1 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 2 X X 3 X 3 X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 X 3 2 3 3 Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 21 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 OP2 Regulation 5(1)b Requirement Timescale for action 01/12/05 2. OP2 17(2) Schedule 4 (8) 3. OP3 14 4. OP7 15(1) The person registered must ensure that the rights and obligations of the resident and the person registered are included in their terms and conditions. (Previous timescale of 30.06.2004 and 13.09.04 and 01/07/05 not evidenced as met) A record of the care homes 01/12/05 charges to service uses must be kept including any extra amounts payable for any additional services not covered by those charges And the amounts paid by or in respect of each service user. The person registered must 01/12/05 confirm in writing to the service user that, based on detailed assessment, the care home is suitable to meet the service users needs.( Previous timescale of 13.09.04 and 01/07/05 not evidenced as met) A written service user plan must 01/12/05 be prepared, based on the assessment, to identify how each service user needs, in all aspects of their health and welfare, are DS0000018123.V258804.R01.S.doc Version 5.0 Sycamore Court Page 22 5. OP7 15 6 OP8 13(4) 7 OP9 13(2) 8 OP18 13(6) 9 OP19 23(2)(d) 10 OP26 23(2)d 11. OP27 18(1)a to be met. This includes detailed risk assessments.(Previous timescales dating back from 15.08.03 to 01/07/05 not met) The person registered must evidence that the service user is involved and consulted regarding their care plan. (Previous timescale of 13.09.04 and 01/07/05 not met) Risk assessments must include appropriate detail to ensure the health and safety of service users. This includes bed rails. Not assessed on this occasion, carried forward to the next inspection. The person registered must ensure that there are safe arrangements for the handling, recording and safe administration of medication for residents at the care home. The person registered must ensure the safety and protection of residents and provide all staff with training on Protection from abuse and management of behaviour that challenges. (Previous timescale of 01/07/05 not met). The person registered must ensure that all parts of the care home are kept reasonably decorated The person registered must ensure that all parts of the home are kept clean. This refers to the cleaning of the carpets to remove stains and to ensuring adequate domestic staffing hours.(Previous timescale 01/06/05 not met). The person registered must maintain adequate minimum staffing levels at all times. (Previous timescale of 13.09.04 and 07/05/05 not met) DS0000018123.V258804.R01.S.doc 01/12/05 15/06/05 14/10/05 01/12/05 01/12/05 01/12/05 01/11/05 Sycamore Court Version 5.0 Page 23 12. OP27 13. OP27 14. OP27 15. OP29 14. OP30OP4 15. OP31 16. OP31 17(2)Sch4 The person registered must (6) ensure that staff do not exceed the hours there are legally allowed to work.. 37(1)e The person registered must notify the Commission for Social Care Inspection of any event that adversely affects the well being of service users, this refers to minimum staffing levels not being met at Sycamore Court.(Previous timescale of 13.09.04 and 07/05/05 not met) 18(1) The person registered must ensure that competent staff are on duty at all times. This refers to staff working excessive hours (Previous timescale of 13.09.04 not met) and to having evidence of training and conditions associated with older people 19 & The person registered must Schedule ensure all records relating to 2 staff required by regulation are available. This refers to photographs 18( c ) The person registered must ensure that staff at the care home undertake appropriate training to the work they perform to ensure the safety of service users and have the necessary skills and expertise to meet the specialist needs of service users. (Previous timescale of 13.09.04 and 01/07/05 not met). 8(1)&9(b) The person registered must evidence effective management of the home.(Previous timescale of 13.09.04 have 07/05/05 not met) 26 Monthly reports must be undertaken by the registered provider, as required by Regulation. Copies must be sent to the Commission for Social Care Inspection DS0000018123.V258804.R01.S.doc 01/11/05 01/11/05 01/12/05 01/11/05 01/12/05 01/12/05 01/11/05 Sycamore Court Version 5.0 Page 24 18. OP36 18(2) The person registered must ensure that staff are provided with appropriate supervision 01/06/05 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 2. Refer to Standard OP9 OP9 OP24 Good Practice Recommendations A copy of the protocol for As Required (PRN) should be kept with each persons medication administration records All staff involved in medication practices should read the Royal Pharmaceutical Society guidelines for medication in care homes. u Bolts should not be used on residents bedroom doors. Keys to the existing locks should be readily available and accessible to residents able to use them, and to staff to use for residents where needed. Staff should have opportunity to participate in the timing of planning of the agenda for supervision. 4 OP36 Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sycamore Court DS0000018123.V258804.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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