Inspection on 17/01/06 for The Beeches Care Home

This inspection was carried out on 17th January 2006.

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

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

Other inspections for this house

The Beeches Care Home 04/01/10

The Beeches Care Home 29/08/07

The Beeches Care Home 30/08/06

The Beeches Care Home 18/05/05

The Beeches Care Home 26/01/05

The Beeches Care Home 11/08/04

The Beeches Care Home 09/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Beeches Luxury Nursing Home The Beeches 25 Park Road Coppull Chorley Lancashire PR7 5AH Lead Inspector Anne Taylor Unannounced Inspection 17th January 2006 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 The Beeches Luxury Nursing Home DS0000025548.V265163.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. The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Beeches Luxury Nursing Home Address The Beeches 25 Park Road Coppull Chorley Lancashire PR7 5AH 01257 792687 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) beechescarehome@tiscali.co.uk Mr Mohammed Hussain Mrs Anwar Hussain, Mr Naveed Hussain Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34), Physical disability (2) of places The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home is registered for a maximum of 34 service users to include: Up to 34 service users in the category of OP who need nursing care. Up to 27 service users in the category of OP who need personal care only. Up to 2 service users in the category of PD. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 18th May 2005 Date of last inspection Brief Description of the Service: The Beeches nursing home is situated in Coppull, approximately two miles from Chorley town centre. It is located off the main road in three acres of land with gardens to the front and rear. The home can be accessed by a regular bus service. The home is registered for 34 older people with a range of physical and personal needs, including those requiring nursing care. At the time of inspection eighteen people were living at the home. Eight were receiving nursing care and ten receiving personal care. The accommodation has both single and shared rooms. There are two floors accessed by a passenger lift. All rooms have wash hand basins and there are 16 rooms with en-suite facilities. Two of the three bathrooms have hoists for assisted bathing. There are three lounges; one is for residents who wish to smoke. In addition, there is a dining room and an activity room. The home provides a variety of social activities and events that are arranged by an activity coordinator. The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over six and a half hours In January 2006. The inspection involved discussion with the people who lived and worked at the home and visitors, examination of records, policies and procedures and a tour of the premises. As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. What the service does well: What has improved since the last inspection? What they could do better: The standard of record keeping in relation to care planning and the safe administration of medication needs to be improved to help the care process and protect the welfare of residents. Requirements have been made about The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 6 developing a written plan of care that clearly shows how a residents needs are to be met and keeping accurate records of drugs received into the home. The approach to training needs to be more positive and structured so that staff can be supported and encouraged to develop new skills and knowledge that might help them improve the service they provide. Improvements to the environment are needed so that residents continue to live in an environment that is well maintained, decorated and furnished to a satisfactory standard. The recruitment process needs to be more thorough to make sure that residents are properly protected. The home needs to show that they are carrying out all necessary checks on staff before they start work at the home. An immediate requirement notice has been issued in respect of this. More attention should be paid to the management of some health and safety issues as the home was not able to demonstrate that they are consistently protecting the safety of residents and staff. An immediate requirement notice was issued in relation to the fire risk assessment and a requirement about the control of legionella remains outstanding from the last inspection. 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 Beeches Luxury Nursing Home DS0000025548.V265163.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 The Beeches Luxury Nursing Home DS0000025548.V265163.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): EVIDENCE: Not assessed at this inspection. The Beeches does not provide intermediate care and standard 3 was considered fully met at the last inspection. The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 9 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, 9,10 The care planning process was not thorough enough to ensure that individual needs were clearly identified and properly documented. The systems in place for handling medication were not thorough enough to ensure the continued protection of residents. Staff were sensitive to the needs of residents and made sure that residents’ rights to privacy and dignity were upheld. EVIDENCE: When asked the senior sister and more junior staff said that care plans were drawn up by trained nurses after consultation with the resident or relative whenever possible. And they used information from pre admission assessments undertaken by the home, social worker or nurse from the hospital. Although staff were able to discuss individual needs and how the home met those needs this was not reflected in the care records. There had been no The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 10 improvement in the standard of care planning since the last inspection. Care plans were too brief, and instructions for staff not specific enough to help the care process and promote the welfare of residents. The requirement about risk assessments for the safe use of bed rails, made at the last inspection had been acted upon. A detailed risk assessment based on advice from the medical devices agency was being used to make sure any risks were identified and properly managed. Polices and procedures describing the handling of medication were available within the home so staff had clear guidance to follow. Only trained nurses were authorised to administer medication and a sample list of signatures was kept at the front of the medication file so that checks for compliance could be made. A recommendation has been made in relation to the application of prescribed creams to ensure that any delegated responsibility for this is properly recorded. Records of drugs administered were generally up to date. However, drugs received were not always receipted correctly and handwritten MAR entries and amendments to the pre-printed dosage instructions were not generally signed, nor independently checked and countersigned. The medication storage was orderly and secure. The senior sister said that the refrigerator temperature was checked daily, however it was not recorded. It was noted that eye drops had not been dated on first opening, this is recommended to help ensure they are not used for extended periods. New arrangements had been made for the disposal of medicines to reflect recent changes in legislation. A revised procedure was in place and a copy attached to the front of the medication file so that staff were all aware of the new procedures. Records showed that induction training included instruction on privacy dignity and respect so that staff had knowledge and understanding of this before they started to give care to residents. Staff were observed knocking on bedroom doors before entering and providing care in a sensitive and caring manner, which promoted their dignity. People living at the home say staff maintained their dignity and treated them respectfully. They commented, “staff respect my wishes, they always ask what I want and knock on my door before they come in” and “the Dr came to see me recently, he came to my room, its always private”. The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 11 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): 14, 15 Daily routines were flexible and residents helped to exercise choice and control over their daily lives. The importance of providing a well balanced diet was recognised by the home so that residents were able to eat healthily and given some choice about what they ate. EVIDENCE: During conversations with residents and staff it was evident that residents were able to make choices about the way they lived within the home and in particular within the privacy of their own room. Rooms had been personalised by residents bringing in some of their own possessions so that they had familiar and treasured items around them. A record of all items brought into the home by residents should be kept so that staff know which items belong to each resident. Residents not able to exercise full control over their financial affairs were mainly helped by a family member. The manager and other senior staff knew how and when to access an advocate to act on behalf of a resident without a The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 12 representative to ensure that any decisions made were in the best interests of that resident. The lunchtime meal was relaxed and unhurried with staff available to assist if needed. Some residents had chosen to eat in the dining room, others in their bedroom. One resident said, “I have breakfast and tea in my room and lunch in the dining room”. The cook was able to discuss the individual dietary needs of people living at the home, including specialist diets and ways of fortifying food for residents with poor appetites or problems eating. Because of the small number of residents accommodated she knew each one and their personal likes and dislikes. This meant that even though there was a set meal at lunchtime she knew if someone would like it or not and be able to provide an alternative. At tea time residents could more or less choose what they wanted. The cook would ask each resident every day what they wanted and provide a variety of meals. Residents spoken to were generally satisfied with the range and quantity of food available to them. When asked one resident said, “we do get a choice, at tea time every day, they come round and ask what you want, if you don’t like it they will get you something else”.” The Beeches Luxury Nursing Home DS0000025548.V265163.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): 16,18 The approach to the management of complaints made sure that there was an accessible complaints procedure and that residents felt they would be listened to if they made a complaint. Management processes in relation to the protection of vulnerable adults were not thorough enough to ensure the continued protection of any vulnerable residents. EVIDENCE: A complaints procedure was in place. The procedure was included in the service user guide and on display in the home so residents and visitors had access to information about how and who to complain to. Residents spoken to know whom to contact if they had cause for concern and felt that the staff would listen to them and action would be taken if they made a complaint. Staff were able to discuss how they would respond if a resident complained to them and realised how important it was to make sure residents felt able to raise concerns and be sure they were listened to. An adult abuse policy was in place, however it was not up to date so staff were not familiar with the process for referring allegations of abuse to the appropriate authority. A copy of the “no secrets in Lancashire” document was in the policy manual as a point of reference for staff. The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 14 The manager was aware of her responsibilities in relation to protecting people living at the home and making sure staff were appropriately trained to recognise and act upon any signs of possible abuse. Staff who had completed national vocational training had covered the subject of abuse during the course. Discussion with staff showed that all staff had to watch a training video about abuse and then had to complete a short written questionnaire, to test their understanding and knowledge. Training was not updated so staff might not be familiar with any new legislation or changes to best practice. The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 15 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): EVIDENCE: The key environmental standards were not fully assessed at this inspection. However, progress in meeting the requirements and recommendations made at the last inspection was monitored. A tour of the premises showed that improvements were still needed to the environment to make sure residents continue to live in comfortable, safe and well-maintained surroundings. Requirements were made at the last inspection about the environment that had not been fully addressed. They have been included in this report along with additional requirements identified at this inspection about the supply of pillows and lighting on the first floor corridor. The Beeches Luxury Nursing Home DS0000025548.V265163.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): 28,29,30, The approach to training was not proactive and further work is needed to make sure that staff are kept up to date and continue to be competent to do their jobs and practice safely. The recruitment process was not thorough enough to ensure the continued protection of residents. EVIDENCE: Training records showed that new staff received induction and some ongoing training that provided them with the basic skills needed to carry out tasks allocated to them. The training matrix only recorded completed training and covered just 4 topics. A training and development plan needs to be in place to make sure staff receive appropriate training that gives them the knowledge and skills to deal with a range of care practices and keeps them up to date. Staff spoken to were generally disappointed with the home’s approach to training. National Vocational training at level 3 was not available to them unless they paid themselves and did the work in their own time. One member of staff was leaving because of this. Staff doing NVQ level 2 did get time off to attend sessions with their assessor. Staff said that each year they receive moving and handling and fire safety training and some staff had done other courses such as food hygiene and infection control. However, they do not get any time of for this and for some training courses they have to pay half of the The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 17 cost. This puts people off attending courses and may prevent them from developing their knowledge and skills. National vocational training (NVQ) at level 2 was available to care staff and some care staff had already achieved this. The manager was aware of the need to have fifty per cent of care staff trained to NVQ level 2 or above in order to meet the national minimum standard. The files of two new members of staff were examined. A recruitment checklist had been introduced to assist the recruitment process. Head office processed applications and then sent copies of documents and information obtained to the home. Some of the documentation relating to “fitness” was missing and head office was unable to provide it. An immediate requirement was made at the last inspection about making sure all necessary checks and documentation relating to recruitment and “fitness” were obtained before an employee started work. In order to protect residents all necessary checks need to be carried out before an employee starts work and an immediate requirement notice was issued to this effect. The Beeches Luxury Nursing Home DS0000025548.V265163.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, 33,35 The quality assurance systems in place at the home were not thorough enough to show that the home was being run in the best interests of residents. The arrangements for handling money on behalf of residents were not thorough enough to ensure their financial interests were consistently safeguarded. EVIDENCE: The key standard relating to the registered manager could not be assessed as the manager is new in post and is not yet registered with the Commission. She said that she would submit her application as soon as possible. The registered person had carried out regular monitoring visits to the home and submitted a report to the Commission. This provided an overview of the The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 19 management of the home and showed that residents had an opportunity to comment on the running of the home. Some work was still needed around the quality assurance systems in place at the home. The last resident and relatives survey had been carried out in 2004 and the information obtained was out of date and new residents had come to live at the home who had not had the benefit of being involved in a review of the quality of service provided. A structured system was not in place to monitor the quality of service delivered so that the home could be made aware of their strengths, weaknesses and whether residents were satisfied with the service they received or not An annual development plan for the forthcoming year was not available. The senior sister said that there might be a more current one but she was not aware of it. It was agreed that a copy of an up to date business plan would be submitted to the Commission. The home handled few personal allowances for residents. Any personal allowances and money brought in by relatives for residents was stored in a safe that only two members of staff had access to. This meant that residents’ money was appropriately safe guarded. Records were kept of any money handed in for safekeeping and receipts kept for most purchases made on behalf of residents. The system needs to be improved so that so a clear audit trail of income and expenditure is available if needed. When asked about access to their money residents said, “my daughter looks after my money” and “I have some money but my family do everything now”. Standard 38 was not fully assessed. Progress in meeting the requirements made at the last inspection regarding health and safety issues was monitored. Since the last inspection the gas system and appliances have been tested to show that they are safe to use and the risk assessments for safe working practices had improved. However, two requirements remain outstanding and they have been included in this report. One relates to the home’s fire risk assessment and an immediate requirement notice was issued in respect of this. The other relates to the control of legionella and the systems in place to manage any risk. The Beeches Luxury Nursing Home DS0000025548.V265163.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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 x X X X X X x x STAFFING Standard No Score 27 X 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 2 x X x The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 21 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(1) Requirement A written plan of care that clearly shows how a residents needs in respect of his health and welfare are to be met must be in place. The plan should give clear instructions for staff to follow and be specific to individual needs. (Timescale of 31.08.05 not met) All medication administration records must be complete, clear, accurate and up-to-date. Drugs received must be receipted correctly. Policies and procedures relating to the protection of vulnerable adults must be reviewed and updated to reflect any changes. Arrangements must be made to ensure that all staff receive updated training about the protection of vulnerable adults. Worn furniture and fittings must be replaced. Stained carpets must be cleaned and if cleaning is unsuccessful replaced. A programme of maintenance and refurbishment must be produced to show how and when this will DS0000025548.V265163.R01.S.doc Timescale for action 30/04/06 2 OP9 13(2) 31/03/06 3. OP18 13(6) 30/04/06 4. OP18 13(6) 31/05/06 5. OP19 23(b)(d) 31/03/06 The Beeches Luxury Nursing Home Version 5.0 Page 22 6. OP19 13(4)(c) 7. 8. OP19 OP19 16(2)(c) 23(2)(p) 16(2)(c) 9. OP30 18(1)(c) 10. OP29 17(2) Schedule4 be achieved. (Timescale of 31/12/05 not met). Pipe work in bathrooms and toilets must be appropriately covered. (Timescale of 30.09.05 not met) The registered person must make sure that the home has an adequate supply of pillows. Missing lampshades in the bedrooms identified at inspection must be replaced and the faulty strip lighting on the first floor corridor repaired or replaced. The registered person must ensure that staff receive training appropriate to the work they perform. They must also ensure that staff receive suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. A training and development programme must be developed that shows how the home is going to achieve this. All checks relating to the fitness of prospective employees must be obtained prior to the start of employment. (Timescale of 31.07.05 not met). Immediate requirement notice issued. 31/03/06 28/02/06 31/03/06 30/04/06 01/02/06 11. OP38 23(2)(c) 13(3) 12. OP38 13(4) Systems and equipment used at the home must be properly maintained. A risk assessment regarding the control of the risk of legionella must be in place. Following consultation with the fire authority a fire risk assessment must be carried out and properly recorded. (Timescale of 31/07/05 not met). Immediate requirement notice issued. 31/03/06 08/02/06 The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 23 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. 3. 4. 5. 6. 7. 8. 9. Refer to Standard OP7 OP9 OP9 OP9 OP9 OP14 OP19 OP33 OP33 Good Practice Recommendations Trained nurses should be aware of the guidelines for record and record keeping produced by the Nursing and Midwifery Council. It is recommended that eye drops are dated when first opened to help ensure they are not used for extended periods. The refrigerator temperature should be recorded. Nurse delegation to competent staff in relation to the application of prescribed creams should be evidenced and their responsibilities be recorded. Handwritten additions or alterations to the MAR should be signed, independently checked and countersigned. A record of all items brought into the home by residents should be kept. A formal planned programme for maintenance and refurbishment should be developed. A copy of an up to date business plan should be submitted to the Commission. The quality monitoring system of sending out satisfaction questionnaires to residents and relatives should be done annually. The result should be collated and made available to interested parties. Records of payments made for hairdressing need to be receipted properly. 10. OP34 The Beeches Luxury Nursing Home DS0000025548.V265163.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Chorley Local Office Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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