Inspection on 02/05/07 for The Gables Care Home

This inspection was carried out on 2nd May 2007.

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 Gables Care Home 15/10/08

The Gables Care Home 30/10/07

The Gables Care Home 02/05/06

The Gables Care Home 05/12/05

The Gables Care Home 20/07/05

The Gables Care Home 02/11/04

The Gables Care Home 08/04/04

The Gables Care Home 17/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Gables (The) 37 Manchester Road Buxton Derbyshire SK17 6TD Lead Inspector Rose Veale Key Unannounced Inspection 2nd May 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 Gables (The) DS0000019989.V335555.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. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gables (The) Address 37 Manchester Road Buxton Derbyshire SK17 6TD 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) (01298) 70567 Mrs Teresa Alice Rzepa Mr Jaroslaw Antoni Rzepa Vacancy Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To admit into The Gables 1 LD place under 65 years for a service user named in the Notice of Proposal letter dated 30th June 2006 The maximum number of persons to be accommodated at The Gables is 23 2nd May 2006 Date of last inspection Brief Description of the Service: The Gables is a care home registered to provide personal care and accommodation for up to 23 older people. The home is located on the outskirts of Buxton in the Derbyshire Peak District. Local amenities include an opera house, leisure complex, park and shops. Accommodation is provided on 2 floors with a passenger lift and stair lift accessing the upper floor. There is a large communal lounge and separate dining room. 15 of the bedrooms are single accommodation and 4 are double. There are no bedrooms with en-suite facilities. There is a garden accessible to residents. Car parking is available at the bottom of the steep drive. Information about the service, including CSCI inspection reports, is available in the entrance area of the home and on request from the provider or acting manager. The fees at the home range from £311 to £380 per week. This information was provided by the provider in the pre-inspection questionnaire received on 18th April 2007. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and took place over 6 hours. The inspection visit focused on assessing compliance to requirements made at the previous inspection and on assessing all the key standards. There were 15 residents accommodated in the home on the day of the inspection. Residents, visitors and staff were spoken with during the visit. The owner and acting manager were available and helpful throughout the inspection visit. Most residents were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Records were examined, including care records, staff records, maintenance, and health and safety records. A tour of the building was carried out. A questionnaire and surveys had been completed and returned prior to the inspection and information from this has been included in the body of this report. There was an unannounced random inspection visit to the home in November 2006. The purpose of the random inspection was to assess compliance to requirements made at the inspection of 2nd May 2006. Information from the random inspection has been included in the body of this report. What the service does well: What has improved since the last inspection? Some requirements from previous inspections had been met, resulting in improvements to the environment of the home, quality assurance measures, and staff training. The home had recently produced a newsletter for residents and their representatives. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There was a satisfactory assessment system in place so that residents were confident that their needs could be met. EVIDENCE: The Statement of Purpose for the home was seen. There were some minor details not included, such as the address of the proprietors, the size of rooms, and the age range and gender of residents who could be accommodated at the home. The acting manager said that she was careful to explain to prospective residents that, although their primary care needs were due to the effects of aging, most residents in the home had dementia and consequent difficulties with communication. This was not made clear in the home’s Statement of Purpose. The care records of 4 residents were examined and each included a range of assessment information. All of the records had an assessment of the residents Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 9 needs by Social Services and / or hospital staff. 3 records had an assessment carried out by the acting manager prior to the resident’s admission, and a letter to inform the resident that their needs could be met at the home. (The other record was of a resident who had lived in the home for many years). There were records of assessments carried out on admission to the home, such as assessments of the resident’s mental and physical health, and of continence and nutritional needs. There were details of the resident’s social and family circumstances, and of their preferences regarding personal care and daily routines. The responses to the surveys indicated that residents felt they usually received the care and support they needed. One relative spoken with was satisfied that the home was able to meet the needs of the resident. There was one comment received that the resident’s needs were not always fully met. It was observed that residents’ needs generally appeared to be met. Standard 6 did not apply to this home. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ personal and healthcare needs appeared generally to be met. However, there were gaps in care plans and some problems with effective communication that could prevent residents receiving consistent person centred care. EVIDENCE: The care records of 4 residents were examined and each included a care plan produced from the assessment information. Three of the care plans seen had been revised to include more detail than at previous inspections. One care plan included only brief details of the care and support needed. The acting manager said that this care plan was being developed as the resident was recently admitted to the home. The care plans had all been reviewed regularly, mostly every month. There were some gaps in the care plans seen. For example, for one resident, there was no manual handling assessment in place and no clear directions for Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 11 staff about the resident’s preferences and needs when assisting to change position. For another resident, the care plan did not include enough detail in the care plan of how staff should assist with maintaining continence. There was no evidence that residents or their representatives had been involved in devising care plans. A comment was received that the resident’s relative was unaware of the care plan. It was commented that staff were knowledgeable about the care needs and preferences of residents, and that staff showed “a real interest” in residents. It was observed that staff were aware of the needs and preferences of residents. Staff were observed to have an appropriate and sensitive approach to residents. The survey responses showed that all those who responded felt that staff listened to and acted on the wishes of residents/their representatives. There were comments received at the random inspection in November 2006 and at this inspection that there were communication difficulties between residents and some of the Polish staff. The acting manager said that staff who were not fluent in English were always on duty with staff who were fluent. The proprietors of the home are fluent in Polish and English and were able to translate for the Polish staff. It was observed that a resident was assisted to shave in the utility area next to the kitchen, rather than in their own bedroom. There was no privacy for the resident as other residents and staff were walking through this area. The care records included the input of other healthcare professionals, such as GPs, District Nurses, chiropodist, optician and dentist. It was seen that health issues were followed up promptly. For example, a resident whose condition had recently changed had been seen promptly by the GP and referred for further assessment. The survey responses indicated that residents felt they usually received the medical attention they required. Medication at the home was stored securely and was administered by staff who had received appropriate training. The Medication Administration Records, (MARs), were generally correctly completed. Each MAR had a photograph of the resident and brief details of relevant information, such as allergies or any difficulties the resident may have in taking medication. Handwritten entries had not been signed by the person making them or countersigned by another person checking the entry as correct. This was a recommendation at the inspection in May 2006. The medication policy included incorrect information regarding the procedure for staff to follow when a resident needed to take medication out of the home, (for instance, if going out for the day). It was seen that correct procedures were followed by staff when a resident was going out for the day. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 12 The care records of one resident included consent from a relative that medication could be disguised in food. There was no evidence that the GP or pharmacist had been involved in the decision, and there were no clear directions for staff as to when and how medication should be given in this way. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities was provided and residents’ choices were respected so that the lifestyle in the home generally met the expectations and preferences of residents. EVIDENCE: There were details in the care records seen of residents’ past and present interests and lifestyle, and of their religious and social needs. There were records of activities provided for residents. On the day of the inspection visit residents were enjoying sitting and walking in the gardens, having manicures, singing along to music, and sitting chatting to staff. The survey responses indicated that most residents were satisfied with the activities offered. There was one comment received that there should be more activities. There was evidence that residents’ preferences were respected regarding daily routines. For example, there were residents who regularly went out during the day with relatives. Staff were clear that residents’ choices should be respected and this was referred to in the care records. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 14 Visitors spoken with and those commenting on the surveys said that they were able to visit at any reasonable time and were always made welcome. The dining room at the home was pleasant and spacious with a view of the gardens. The proprietor said that replacement of the dining chairs and tables was planned. Residents were encouraged to eat lunch in the dining room. Staff sat with residents to assist those who needed help with eating. The lunchtime meal on the day of the inspection visit appeared appetising and well presented. The survey responses indicated that most residents were satisfied with the food provided, although there was a comment that the menu lacked variety, particularly at teatime. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints system was not sufficiently robust to ensure residents’ concerns were effectively dealt with. Residents were put at risk by staff recruitment practices at the home. EVIDENCE: The acting manager said that there had been no formal complaints received at the home, and none had been received by CSCI. There were no records available of complaints or concerns raised verbally. It was found at the random inspection in November 2006 that a resident had complained about a problem that was not satisfactorily resolved – no records were available of the complaint or of the action taken. The survey responses indicated that most residents or their representatives knew how to make a complaint and who to speak to if they were not happy. There was one comment that the resident’s representative was unaware of the complaints procedure. Since the inspection in May 2006, most staff had received training in safeguarding vulnerable adults. There were satisfactory policies and procedures in place and staff spoken with were aware of the correct procedures to follow if abuse was suspected. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 16 It was found at the random inspection in November 2006 and at this inspection that recruitment practices at the home put residents at risk. (See Staffing section of this report). Gables (The) DS0000019989.V335555.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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was generally well maintained, clean and comfortable so that residents lived in a pleasant and homely environment. EVIDENCE: At the random inspection in November 2006 it was found that work had been carried out to meet the requirements made at the inspection in May 2006. There was a plan of refurbishment and redecoration for the home. On the day of this inspection visit the outside window frames were being painted and the utility area next to the kitchen was being redecorated. Several areas in the home had been redecorated. One resident commented that they had been involved in the choice of décor for their room and they were pleased about this. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 18 It was noted that a bathroom on the first floor had cracked tiles to the bath surround. The home was clean and free from offensive odours on the day of the inspection visit. The bedrooms seen were personalised with residents’ own furniture and belongings. The lounge was comfortably furnished. The laundry was suitably equipped. Gables (The) DS0000019989.V335555.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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were sufficient staff on duty to meet the needs of residents, but there were gaps in training and staff records so that residents were not supported by competent staff and fully protected. EVIDENCE: The staff rota was seen and showed that there were usually 2 care staff working the morning shift with assistance from 6am to 8am of the care assistant who had been ‘sleeping-in’ the night before. In the afternoon, there were usually 2 care staff on duty until 9pm. At night there was 1 waking care staff and 1 ‘sleeping-in’. In addition, there was a cook working every day and domestic assistance on most days. The proprietor assisted at the home during the day on 3 or 4 days each week. The acting manager had some supernumerary time allowed for management responsibilities. The staffing levels appeared satisfactory for the assessed dependency of the residents accommodated. The survey responses indicated that there were usually staff available when needed. There were comments received that staff were sometimes not immediately available, particularly in the afternoon or early evening. Staff spoken with said that staffing levels were satisfactory to meet the needs of the residents. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 20 It was commented that there was a small number of staff in total so that some staff worked a high number of hours per week, and staff often worked extra shifts to cover for sickness and holidays. The acting manager said that the home was actively trying to recruit staff and had recently employed 2 full time care assistants. It was found at the random inspection in November 2006 that there were 5 members of staff who had started work without a Criminal Records Bureau, (CRB), disclosure or POVA First check in place. An Immediate Requirement was made for evidence to be provided to CSCI that CRB application had been made and POVA First checks were in place. The proprietors complied with the Immediate Requirement. At this inspection the files for 3 staff were examined. 1 file had a CRB disclosure, the other 2 had evidence of application for CRB disclosures and satisfactory POVA First checks in place. 1 file was for a recently recruited member of staff and included most of the required information, except that there were unexplained gaps in the employment history on the application form. 1 file for another member of staff recruited since the last inspection did not have an application form with full employment history or 2 written references. When brought to the attention of the proprietor, documentation was produced that was in Polish with no English translation. An Immediate Requirement was made to provide evidence of a full employment history and 2 written references for the member of staff. The Immediate Requirement was complied with by the proprietors. There were individual staff training records for each member of staff. Most staff had received training in manual handling and safeguarding vulnerable adults. Senior care assistants had received training in safe-handling of medication. Most staff had not received training in first aid. Some staff had received training in the care of people with dementia. 4 care staff had achieved National Vocational Qualification, (NVQ), at level 2 or 3. The acting manager said that another 2 staff were due to start working towards NVQ. The Polish staff who were not fluent in English were assisted in training by the proprietor who translated for them. Gables (The) DS0000019989.V335555.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 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There were significant lapses in ensuring health and safety, and a lack of robust recruitment procedures so that residents were put at risk. EVIDENCE: The acting manager had been in post since February 2006 and had not applied for registration with CSCI. She had commenced NVQ Level 4 in care and hoped to achieve this by the end of 2007. Staff spoken with said the acting manager was well organised and “very hands-on”. Relatives commenting in the surveys said they thought the acting manager was approachable. Some progress had been made in developing a quality assurance system for the home. Surveys had been sent out to residents’ representatives. No Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 22 analysis had been made of the responses. The proprietor continued to make Regulation 26 reports. The home had started a newsletter for residents and their relatives. Satisfactory records were seen of residents’ personal money held by the home. The money was securely kept and access was limited to the acting manager and a senior care assistant. Records relating to health and safety were sampled. The fire log book was seen and had up to date records of fire drills and weekly checks. There were up to date records of water temperatures tested at the home. There was no Landlord’s Gas Safety Certificate or electrical installation certificate available for inspection. The lifting hoist and bath hoist had not been maintained and serviced as required. The wheelchairs had not been checked or serviced. Gables (The) DS0000019989.V335555.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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 1 Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4(1) Requirement The Statement of Purpose must include all the required information. This will ensure that residents / their representatives are able to make an informed choice about living in the home. Each resident must have a written care plan detailing how their needs are to be met. This will ensure that residents receive consistent, person centred care. Original timescale 30/06/06 There must be a written policy in place for the covert administration of medication. This will ensure protection of residents rights and choices. Residents must be allowed privacy when being assisted with personal care to ensure their dignity is maintained. A record must be kept of all complaints made by residents / their representatives, and of the action taken in response. This will ensure that residents complaints are taken seriously and acted upon. DS0000019989.V335555.R01.S.doc Timescale for action 31/05/07 2. OP7 15(1) 30/06/07 3. OP9 13(2) 31/05/07 4. OP10 12(4)(a) 31/05/07 5. OP16 17(2) Schedule 4 30/06/07 Gables (The) Version 5.2 Page 25 6. OP19 23(2)(b) 7. OP29 19(1)(b) 8. OP38 13(4) 9. OP38 13(4) The cracked tiles in the identified bathroom must be repaired or replaced to ensure the health and safety of residents. New staff must have a full employment history and 2 satisfactory written references in place before commencing employment. This will protect residents. The lifting hoist, bath hoist and wheelchairs in the home must be maintained in accordance with current health and safety legislation to ensure the health and safety of residents and staff. The current gas and electrical safety certificates must be available for inspection. Copies must be provided to CSCI. This will ensure the health and safety of residents and staff is promoted and protected. 30/06/07 31/05/07 31/05/07 31/05/07 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 OP9 Good Practice Recommendations Handwritten entries on medication records should be signed by the member of staff writing them and countersigned by another member of staff who has checked the entry is correct. This will ensure medication is given as prescribed. The medication policy should be amended to ensure staff have the correct information about providing medication for residents going out of the home. This will ensure residents have the correct medication as prescribed. All staff should have first aid training and training in the care of people with dementia to ensure residents needs can be fully met. There should be an annual report available to residents DS0000019989.V335555.R01.S.doc Version 5.2 Page 26 2. OP9 3. 4. OP30 OP33 Gables (The) and their representatives detailing the results of quality assurance surveys and the action taken in response to issues raised and comments made. This will ensure that the home is run in the best interests of the residents. Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Gables (The) DS0000019989.V335555.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!