Inspection on 17/01/07 for Tealbeck House

This inspection was carried out on 17th January 2007.

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

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

Other inspections for this house

Tealbeck House 09/03/06

Tealbeck House 01/12/05

Tealbeck House 15/12/04

Tealbeck House 22/06/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Tealbeck House Tealbeck Approach, Crow Lane Otley Leeds West Yorkshire LS21 1RJ Lead Inspector Ann Stoner Key Unannounced Inspection 17th January 2007 09:30 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 Tealbeck House DS0000001514.V325127.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. Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tealbeck House Address Tealbeck Approach, Crow Lane Otley Leeds West Yorkshire LS21 1RJ 01943 850821 01943 461 018 barbara.thomson@anchor.org.uk www.anchor.org.uk Anchor Trust 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) Mrs Barbara Thomson Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2006. Brief Description of the Service: Tealbeck House provides personal care, without nursing, for 50 residents in a purpose built two-storey building, on the outskirts of Otley town centre. The home is centrally situated within a sheltered housing complex, and although this complex is not part of Anchor Trust, some of the tenants occasionally visit the home to make use of facilities such as the bar. Accommodation for residents is in single rooms, which have a fridge, kettle, toaster and all are well stocked with tea, coffee, milk, snacks, bread, butter pats, marmalades, jams, and cereals. Some rooms have en-suite facilities. There is a lift giving access to the second floor. Communal accommodation includes an attractive dining room, 1 large and 1 small lounge, and a conservatory. The home is within walking distance of Otley town centre, and public transport to Leeds, Skipton, Harrogate and Ilkley is within easy reach of the home. Fees that applied at the time of this inspection were stated in the preinspection questionnaire as ranging from £500 - £570. More up to date information may be obtained from the home. Copies of previous inspection reports are available in the home. Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk The last inspection was unannounced and took place on the 3rd March 2006. There have been no further visits until this unannounced key inspection, which took place between 9.30am and 6.00pm on the 17th January 2007. The purpose of this visit was to monitor standards of care in the home and to look at progress in meeting the requirements and recommendations made at the last visit. Before the inspection a pre-inspection questionnaire was sent out to the home, this provided some information for this report. The people who live in the home prefer the term ‘resident’ and this will be used throughout this report. Before the inspection I sent out survey cards to residents, relatives and health care professionals and had a telephone conversation with three relatives. I received sixteen completed survey cards from residents, nine from relatives and two from GPs. Comments from the survey cards and telephone conversations can be found throughout this report. During the inspection I spoke to residents, visitors, staff on duty and the manager, I looked at records, made a tour of the building and watched staff working with residents. Feedback at the end of this inspection was given to the manager. I would like to extend my thanks to everyone who contributed to the inspection and for the hospitality during the visit. Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The home has maintained a good standard of care to residents. Some rooms have been decorated, and some lounge furniture has been replaced. Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 8 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 Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 4 & 5. Standard 6 does not apply to this home. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are able to visit the home and have access to written information so that they can make an informed choice about moving in, but they do not always have detailed information about the range of additional charges. The home’s pre-admission assessment information does not provide detailed information about the precise needs of the resident, in all aspects of their care, which means that on admission some needs may be overlooked. EVIDENCE: During a telephone conversation with relatives of two residents admitted since the last inspection, both said that they had looked at other homes before visiting Tealbeck House, and were given written information about the home and the facilities provided. One person said he had spoken to other relatives Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 10 and had received good feedback about the home, the other person said that during the pre-admission visit she thought the manager was ‘absolutely marvellous and so helpful’. Three care plans were looked at in detail and in all three there was a signed contract showing the terms and conditions of residency. Although the contract specifies the standard fee, it does not specify the range of additional charges for example, washing up liquid and other items such as tea towels and dishcloths that residents are expected to provide for their rooms. This information was not specified in any of the written information given to residents and relatives before admission. There were assessment details in the three records sampled, but the home’s pre-admission assessment did not provide sufficient information about the person’s needs and strengths in all aspects of their care, and there was not enough information to form the basis of a care plan. During the inspection the home was preparing for the admission of a married couple the following day. Two rooms had been prepared to a high standard, one as a small private sitting room, and the other as a bedroom. The home had made arrangements for the couple’s double bed to be delivered to the home, so that everything would be in place for their arrival. This is good practice. Recommendations have been made to address some of these issues. Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 11 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. This judgement has been made using available evidence including a visit to this service. Staff are aware of the specific needs of residents but because this is not recorded, there is always the possibility that some care may not always be delivered according to the resident’s needs and wishes. Resident’s privacy and dignity is respected. People’s health care needs are met, and overall medication practices are safe but there are no safeguards in place to make sure that people who are self medicating are still able and safe to do so. EVIDENCE: From discussions with staff it was clear that they knew the precise needs of residents and provided care based on individual needs and preferences, but none of this was recorded within care plans. The current care plans are based around a ‘Lifestyle Agreement’ where the resident states his/her perception of Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 12 needs, but this is not followed by clear and precise instructions for staff about how to deliver care according to needs. There were no specific care plans for pressure area care, particularly when pressure relieving equipment was being used. There was no insulin care plan for one person who was a diabetic and there were no care plans giving instructions for staff on how to manage people that have short-term memory loss. There were no falls risk assessments completed on admission and nutritional assessments were not always fully completed. Resident’s care plans are reviewed monthly but some information in the review records conflicted with information in other records. The home arranges a sixmonth review of the person’s care and residents and their relatives are, wherever possible, involved in this, which is good practice. The manager was aware of the shortfalls in care plans, and said that the organisation is introducing a new style format. These should be introduced in the home by the end of March 2007. During telephone conversations with relatives one person said that he had no concerns about his mother’s health care needs, and that the home responded to any changes in her condition. Another person said that she was confident that her father’s health care needs were met at the home. Two GPs who returned survey cards did not make any adverse comments about the home and one resident surveyed said, “Doctors and ambulances are called immediately.” A GP and a Community Nurse both visited during the inspection visit and residents were seen in private. Records sampled showed that residents have chiropody and optical treatment. The home has a good system of ordering and disposing of used medication, and correct administration procedures are followed. Medication keys are not kept separate from other keys in the home, which means that there is the possibility of unauthorised access to medication. Because the home does not have a homely remedy policy there is the possibility that a resident may not have access to a simple dose of medication such as a Paracetamol or cough linctus on a short term basis. Medication Administration Records were sampled and were in order. Some residents manage their own medication, but the home does not have a formal system of assessing whether a resident has capacity to manage their medication safely. There is also no formal way of monitoring compliance when residents self medicate, therefore, the home has no way of knowing that the resident is taking their medication in the correct dose at the right time. From discussions with residents during the inspection and from their returned cards it is clear that they feel that their dignity and privacy is respected. Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 13 Requirements and recommendations have been made to address some of these issues. Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 14 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. This judgement has been made using available evidence including a visit to this service. The level of activities provided on a day-to day basis, do always meet residents’ needs, which means that some people are left with little stimulation. Visitors are made to feel welcome. A good and varied diet is provided and residents can choose to eat in the attractive dining room or in the privacy of their room. EVIDENCE: The home organises bingo sessions, entertainment evenings, film evenings, and various other activities including church services, but comments from residents on survey cards indicated that these did not meet the needs and expectations of residents. Comments included, “There are activities but they don’t always appeal”, “My disabilities restrict me”, “There is not much on offer and nothing suitable for me to take part in”, “Very few activities, e.g. no handicrafts”, “Would like more activities e.g. regular dominoes, word games if possible”, “I’d like some activities which stretched the brain more, e.g. quizzes, Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 15 book club. I would also like to be taken out (in a wheelchair) to do shopping”. One relative said that there is bingo, occasional concerts and entertainment, but felt that residents are not offered stimulation on a day-to- day basis. In a returned survey card another relative said, “We are happy with the care provided, but think there could be more social activities organised and encouraged”. During the inspection, those residents in the lounge, who were unable to occupy themselves, had little stimulation, other than at times when care was delivered. The manager said that she is trying to recruit an activity organiser but has had little interest in the post. A requirement has been made. Staff described the level of choice available to residents and were knowledgeable about the importance of residents’ retaining as much independence as possible. Throughout the inspection staff were seen to respond to the individual choices of residents. During telephone conversations with relatives they said that they can visit any time and are always made welcome. On the day of the inspection visit several people visited the home, and they appeared to have a good rapport with staff. One person was offered a tray of tea and home made biscuits. There is a notice board outside the office that gives visitors and residents good information that includes how to access advocacy services. As part of the pre-inspection material requested of the home, a 4-week menu cycle was supplied. This showed that there is plenty of choice and variety. During the inspection residents had the opportunity to enjoy a complimentary glass of wine with their meal. Relatives confirmed that this is standard practice. The mealtime was relaxed, and residents were able to eat in comfortable surroundings. Tureens and gravy boats were placed on each table, encouraging people to be as independent as possible, but support and help was given as needed. The cook said that all biscuits, cakes and pastries are home baked. One relative described the food as being ‘excellent’. Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 16 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 good. This judgement has been made using available evidence including a visit to this service. There is a robust complaints procedure and residents are confident that complaints will be taken seriously. Residents are protected by the existence of a vulnerable adults procedure and by a staff team that are aware of what to do if abuse is suspected or reported. EVIDENCE: The complaints procedure is displayed in the home, and during a telephone conversation with two relatives both said that information on how to make a complaint was included in the introductory welcome pack given to the resident on admission. Returned residents’ survey forms showed that residents know how to make a complaint. The home has a comprehensive policy and procedure on the action staff should take if abuse is suspected or reported. When asked, staff were clear about the different types of abuse, including the more subtle types of abuse. They were also confident about the reporting methods depending on the status of the abuser. Tealbeck House DS0000001514.V325127.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, 24 & 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is clean and tidy throughout and offers a safe environment in which the residents are able to live in comfort. EVIDENCE: The home is very well maintained. On the day of this inspection the home had just taken delivery of new lounge chairs and coffee tables. Resident’s bedrooms are like small flats; some have en-suite facilities that are spacious enough for people who use walking frames and the newer bedrooms have an en-suite shower. All rooms have a domestic type fridge, toaster and kettle so that the more able residents are able to make snacks. Fridges are replenished on a daily basis with cereals, milk, bread, butter pats, jams and marmalade and fruit. Staff assist those residents not wishing to go to the dining room for Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 18 breakfast, to have a continental style breakfast in their room. This is good practice. Many residents prefer to spend their time in their room. On the ground floor there is a lounge and conservatory, but this would be crowded if all the residents chose to sit there. There is however a small lounge with seating for 5 – 6 people on the first floor. There is a bar area on the ground floor. Staff said that this was a facility enjoyed by a number of residents and on occasions by people from the adjoining sheltered housing complex. The hospitality manager said that the bar area gave residents the chance to mix with people of a similar age group living in a different care environment. All residents have their own laundry basket, and their personal laundry is done on an individual basis. This is good practice. Staff described the measures they take to prevent the spread of infection in the home and during the inspection they wore protective clothing when assisting people to the toilet. In returned survey cards from residents, all said the home was clean and free from offensive odours. Tealbeck House DS0000001514.V325127.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 adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels have affected the time that staff spend with residents, but the recruitment of additional staff should address this. Residents are protected by a robust recruitment procedure and staff receive training relevant to their job. EVIDENCE: In returned survey cards from residents many made reference to inadequate staffing levels, and made additional comments such as, “Things would be better if there were more staff,” “There are not enough staff at night time and at weekends, “I think the carers are helpful, sympathetic and caring, but sometimes they don’t have time to stop and chat because the ratio of carers to residents is not enough”. During the inspection the only staff interaction with residents was at times when personal care was given. The manager was aware of the shortfalls in staffing levels, and during the inspection she received CRB (Criminal Record Bureau) clearance for four new staff to start work the following week. A team leader, with responsibility for induction training, immediately started to arrange an induction programme for these four people. The recruitment files of two members of staff, appointed since the last inspection, were sampled and found to contain all the necessary checks to Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 20 make sure that the person was safe and suitable to work with vulnerable people. From information supplied in the pre-inspection questionnaire staff have received training in fire awareness, back care, protection of vulnerable adults, first aid, cross infection, nutrition and medication. 70 of the care staff team have achieved a National Vocational Qualification (NVQ) at level 2 or above. Tealbeck House DS0000001514.V325127.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, 37 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the health and safety of residents is safeguarded. EVIDENCE: There is a clear commitment by the manager and staff to safeguarding the best interests of the residents. This is evident from discussions with staff and residents, and that they hold her in high esteem. Staff described an open and transparent management team who are always willing to help and support. As a result of the staffing levels, the manager and other members of the management team have worked alongside carers, thus limiting the time available for management issues. Hence, the shortfalls in care records. Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 22 Quality assurance systems are in place with questionnaires being sent out to relatives on an annual basis, and residents’ and staff meetings are held regularly. There are arrangements in place for the monthly provider visits, as required, and reports of these visits are forwarded to the CSCI (Commission for Social Care Inspection). There are lockable facilities in the bedrooms for the safe keeping of valuables. Some residents hand small amounts of money to staff to keep in the safe. There are clear records of all residents’ money and the home has clear policies and procedures about handling resident’s monies. The fire alarm system is checked weekly with a different actuation point tested each time. There is a fire risk assessment in place and records are kept of fire drills. Records are kept of accidents occurring to residents and the manager keeps a weekly log of accidents to try to identify any trends. However, when an accident is not witnessed records do not state when the person was last seen and by whom. The home is working in partnership with Bradford PCT (Primary Care Trust) to reduce the number of falls in the home. This is good practice. Information supplied with the pre-inspection questionnaire shows that all servicing and maintenance of equipment takes place as necessary. One recommendation has been made. Tealbeck House DS0000001514.V325127.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 2 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 4 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 3 Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 (1) Requirement To make sure that care is delivered according to individual needs care plans must specify the precise care needed. Timescale for action 30/04/07 2 OP9 13 (2) Care plans must be in place for those people who are at risk of developing pressure sores and for those people who have diabetes. To make sure that residents who 01/03/07 manage their own medication are safe to do so, the home must develop a formal system of assessing capacity to self medicate. A similar system must be developed to monitor compliance. To make sure that residents can access a range of activities, suitable to their needs and abilities on a regular basis, a full and varied activity programme must be developed. This includes day-to-day activities. 3 OP12 16 (n) 01/03/07 Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 25 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. Refer to Standard OP2 Good Practice Recommendations So that people have correct information about the amount of fees payable at the point of admission, the contract of terms and conditions should specify the range of additional charges. To make sure that staff have precise and detailed information about resident’s strengths and needs at the point of admission, the pre-admission assessment should include specific information about all aspects of the resident’s care needs. To make sure that those people at risk of falling are identified, a falls assessment should be completed at the point of admission and updated as and when necessary. The home should consider developing a homely remedy policy so that residents have access to medication such as Paracetamol and cough linctus on a short-term basis, without prescription. To prevent unauthorised access to medication storage areas, medication keys should be kept separate from other keys in use in the home. To guarantee information at a future date, where an accident occurs that is not witnessed by staff, a record should be kept of when the person was last seen, and by whom. 2. OP3 3 4 OP7 OP9 5 OP38 Tealbeck House DS0000001514.V325127.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Tealbeck House DS0000001514.V325127.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. 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