Inspection on 27/09/06 for The Marguerite Centre

This inspection was carried out on 27th September 2006.

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

The Marguerite Centre 12/03/08

The Marguerite Centre 15/02/06

The Marguerite Centre 11/04/05

The Marguerite Centre 20/12/04

The Marguerite Centre 05/04/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE The Marguerite Centre The Royal Bucks Hospital Buckingham Road Aylesbury Buckinghamshire HP19 9AB Lead Inspector Joan Browne Unannounced Inspection 27th September 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 Marguerite Centre DS0000019241.V314383.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. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Marguerite Centre Address The Royal Bucks Hospital Buckingham Road Aylesbury Buckinghamshire HP19 9AB 01296 678800 01296 678800 jan@royalbucks.co.uk www.rehab@royalbucks.co.uk Mr J Clarke 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) Janet Sillitoe Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (5) of places The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That the home provides care for Physically Disabled service users over 45 years of age. That the home provides Respite Care. That the home provides Intermediate Care. Date of last inspection 15th February 2006 Brief Description of the Service: The Marguerite Centre is care home with nursing, situated within the Royal Buckinghamshire Hospital. The hospital is close to Aylesbury town centre offering level access to restaurants, a library, a shopping centre, cinema and other local amenities. The Marguerite Centre offers long-term nursing, respite and intermediate care to people over the age of forty-five, including married couples. The home is on the first floor of the Royal Buckinghamshire Hospital and is on one level, making it wheelchair accessible. Access to the home is via a service lift. There is always a registered nurse on duty supported by healthcare assistants. The current scale of weekly charges are £462.91- £850.00. Additional charges are made for Chiropody, hairdressing and newspapers. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home that took place on 27 September 2006. Prior to the fieldwork visit previous information about the home was reviewed. Comment cards were received from seven service users, fourteen relatives and seven health and social care professionals. Overall they were happy with the care provision. Residents and those family members who were visiting on the day of the fieldwork were interviewed. A tour of the premises was undertaken and care records and documentation were examined. The care of three residents was ‘case tracked’ from their original contact with the home to the care that they are now receiving. Care practices and the home’s approach to quality and diversity issues were observed. What the service does well: All residents have a plan of care, which incorporates their likes, dislikes and preferences. Healthcare needs are well met with evidence of multi-disciplinary working. Staff work towards maintaining the privacy and dignity of residents, ensuring that personal care is provided in private and ensuring that residents wear their own clothes at all times. The manager and the staff team have a good understanding of the importance of promoting equal rights for all residents in terms of choice and autonomy. Routines are kept to a minimum as a way of supporting this and care planning is, on the whole, based on the choice of residents. For example, residents are able to choose when they wish to rise and retire and choose what they wish to wear. The home has a stable staff group and are highly thought of by residents and relatives. More than 50 of the home’s staff have achieved the national vocational qualification (NVQ) in direct care at level 2 and 3. The nurse manager is very highly respected by staff and residents. Staff feel well supported and in turn say they want to support her. The home has good relationships with other health care professionals. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 Marguerite Centre DS0000019241.V314383.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 The Marguerite Centre DS0000019241.V314383.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home ensures that prospective residents’ needs are assessed and can be met before they are admitted to the home. There were no residents receiving intermediate care on the day of the inspection. EVIDENCE: It is the practice in the home that prospective residents are not admitted to the home without having his/her needs assessed to ensure that the home would be able to meet the individual’s needs. The home has eight respite beds and four of these beds are block purchased by the local county council. The unit manager explained that although beds are block purchased all residents have to undertake a pre-admission assessment. If the home were unable to meet the individual’s needs a placement would not be offered. The preadmission assessment for a particular resident who was recently admitted for respite care was examined. The assessment undertaken was detailed and The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 9 covered all aspects of health care needs. The resident was spoken to, and he confirmed that the home was meeting his needs. He said that ‘he felt free to do what he wished and that staff were promoting his independence ’. It was noted that the home had developed a pre-admission and dischargetracking book to ensure that all respite care is facilitated satisfactorily. The activity organiser was observed interacting with a resident who had arrived that morning for respite care. She was able to describe the home’s admission procedure. And the importance of ensuring that new residents are made to feel welcomed. The Marguerite Centre DS0000019241.V314383.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Arrangements are in place to ensure that residents’ health and personal care were being met. However, inconsistency in staff’s practice in the administration and recording of medication has the potential to put residents at risk. EVIDENCE: Three residents’ care plans were looked at in detail. Plans contained waterlow, manual handling and nutritional risk assessments and covered the following core areas of needs: hygiene, dressing, bowel management, bladder, catheter, dietary, pressure sore prevention, rehabilitation, social interaction, activity interests, sight, hearing, breathing and sleeping. Plans seen were concise and easy to follow and reflected the plan of care in place to ensure that needs were being met. Daily records referred to physical care provided and included reference to the implementation of the care plan, which is a good practice. The unit manager was able to describe the care plan process for the three residents whose care was case tracked. The frequency of the review of care plans was also discussed. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 11 During the site visit three relatives were spoken to. Overall they were very happy with the care that the home was providing to their relatives. The following comments were noted from surveys: “our family could not ask for better care for our mother. She is loved and care for like a member of the family.” “Care provided is excellent, staff are very professional.” “We are both very satisfied with the level of care received.” All permanent residents are registered with a general practitioner (GP) of their choice wherever possible. Arrangements are in place to ensure that the home is visited by a GP weekly to provide medical treatment to residents if required and to offer advice and support to nursing staff. Professional advice about the promotion of continence is sought and acted upon and aids and equipment needed are provided. The community physiotherapy and dietician visit the home when required. The home deserves particular credit for the care they have been providing to residents who have had to be nursed in bed. None were suffering with tissue damage. The chiropodist visits the home on a regular basis. On the day of the site visit the optician was visiting a particular resident. Residents have access to dental facilities as and when needed. Surveys completed by health care professionals were confident with the provision of care that staff were providing to residents. The following comments were noted: “The staff are all very caring and helpful. I am confident that they are providing an excellent quality care.” “I am always impressed with the care and professionalism of all staff I come into contact with.” The medication administration record (MAR) sheets were examined and unexplained gaps were noted. Inconsistent practice in staff’s recording practice was noted. The administration records are pre-printed. Where handwritten entries had been made they were not signed checked or countersigned to make sure that they were correct. Some opened boxes of eye drops did not have the date of opening recorded. This practice and the lack of adequate recording have the potential to put residents at risk. It was noted that some medication recorded on MAR sheets did not specify the strength, dosage timing and frequency of how the medication should be administered. This was discussed with the nurse manager during the inspection. Controlled drugs were safely stored and recorded correctly. Staff were observed interacting with residents in a kind and sensitive manner. Residents’ appearance and attire were clean and tidy with attention to detail. Residents spoken to said that personal care is provided in private and that staff respected their privacy and dignity. All residents have access to a telephone in private in their bedrooms. Residents’ preferred term of address is recorded in their care plans. Medical examination and treatment are provided in residents’ bedrooms. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home’s daily routine ensures that it matches residents’ expectations. Family contact and links with the local community are encouraged. The dietary needs of residents are catered for with a balanced and varied selection of food available that meets residents’ taste and choice. EVIDENCE: Residents spoken to confirmed that the home’s daily routine was flexible and they were able to choose how they wished to spend their day. The home has an activity organiser who provides one to one activities and group activities such as bingos, quizzes, exercises, and board games. Entertainers are brought into the home periodically and residents are escorted to family functions such as weddings. On the day of the site visit a particular resident spoken to, was looking forward to having a pub lunch and some one to one time with the activity organiser. Staff support residents to maintain contact with family and friends and in turn they become well known to family members and friends. Relatives spoken to felt that ‘staff cared for residents like family members’. All residents spoken to The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 13 during the inspection said that staff always made their visitors feel welcome and offered them tea and biscuits. Residents’ individual choices and needs are reflected in their care plans. Residents choose what clothes they wish to wear and if they wish to spend time alone. There were no residents using the services of an advocate on the day of the inspection. Some residents’ bedrooms had personal items of furniture such as chairs and chest of drawers, which confirmed that residents are made aware that they are entitled to bring personal possessions with them if they wished to. Residents who are able to are encouraged to handle their own financial affairs for as long as they are able to and have the capacity to do so. Menus submitted with the pre-inspection questionnaire appeared varied and nutritionally balanced. Residents spoken to said that there was always a good selection of choices to choose from at mealtimes and that lunch was tasty and the portions were adequate. Snacks and tea and coffee are on offer throughout the day. Special diets such as diabetic or soft can be catered for. The inspector participated in the midday meal. Choices on offer were roast chicken and bread sauce, roast potatoes, carrots and peas, creamed pasta bake and cheese salad. Dessert choices were plum and almond crumble, strawberry yoghurt or fresh fruit. Lunch was tasty and seemed to be a relaxed and social activity. There were sufficient cutlery and condiments for residents to use and a selection of fruit juices to choose from. Staff assisted those residents who needed assistance with feeding and prompting in a sensitive and discreet manner. Staff interaction with residents was positive and were observed offering words of encouragement to residents such as, ‘well done’. ‘Can I help you?’ The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has systems in place to ensure that residents and relatives are confident that their complaints will be listened and to protect residents from any potential harm. EVIDENCE: No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. Information on the pre-inspection questionnaire indicated that the home had not received any complaints about the service. Residents and relatives spoken to said that they were aware who to speak to if they wished to raise a concern. The Commission has not received any information concerning any suspicion or evidence of abuse or neglect made to the service since the last inspection. Information submitted on the pre-inspection questionnaire in section D6 indicated that some staff had undertaken training in the protection of vulnerable adult. The nurse manager and unit manager confirmed that all staff are offered updated training in the protection of vulnerable adults and that training is provided on a rolling programme. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 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): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The building is maintained to ensure that residents live in a homely environment. However, in some areas of the building radiators would need to be fitted with covers to protect residents from the potential risk of burns. EVIDENCE: The home is situated on the first floor of the old Royal Buckinghamshire Hospital and has been adapted for its present use as a nursing home. All rooms are single occupancy. The home was clean and tidy on the day of the inspection and there were no offensive odours. There is a passenger lift with wheelchair access. There is a planned maintenance programme in place and the home was in a good state of decorative order. The home has been inspected by the local fire service and all matters of safety were found to be satisfactory. It was noted that radiators in the lounge and dining areas and residents’ bedrooms were not fitted with covers. This was discussed with the nurse manager during the inspection. A requirement is being made in this report for radiators to be fitted with covers. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 16 The unit has infection control policies and procedures in place. Appropriate hand washing facilities were available. There is a well-organised laundry in the basement of the building and washing machines are equipped with the specified programming ability to meet disinfection standards. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home ensures that there are adequate staff on duty who are trained with the appropriate skill mix to meet residents’ needs. The home’s recruitment procedures ensure that residents are protected from potentially unsuitable staff. EVIDENCE: Information submitted on the pre-inspection questionnaire under section D2 indicated that the home employs fourteen registered nurses, fifteen carers and three ancillary staff. The staff group is multi-cultural. There is a rota in place, which indicated that seven staff are rostered to work in the morning. This number is reduced to five in the afternoon and two at night. Residents’ dependency levels are high and are kept under review to ensure that there are sufficient staff to meet their needs. Comments in surveys suggested that residents, relatives and other professionals had confidence in the care that staff were providing to residents. The following comments were noted: “The staff are all very caring and helpful. I am confident that they are providing excellent care”. “Great team work, excellent level of caring, very knowledgeable nurses.” Information submitted on the pre-inspection questionnaire indicated that fourteen of the fifteen carers have achieved the national vocational qualification (NVQ) in direct care at level 2. The home’s commitment to training care staff to meet residents’ needs is to be commended. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 18 The recruitment files of two new members of staff were examined. Both files had the required information although up to date photographs of staff members were not available. This was discussed during the inspection and the nurse manager confirmed that arrangements were being made to ensure that up to date photographs are in all staff members’ files. The home ensures that all new staff receive induction training to assist them in understanding their roles and responsibilities. There is a training programme in place to ensure that mandatory training for all staff is regularly updated. On the day of the inspection some staff were participating in moving and handling updated training in-house. It was noted that some nurses have been trained as moving and handling trainers and have been assisting with facilitating the in-house training. Further training for staff in the administration of medication, syringe driver, protection of vulnerable adults, death dying, bereavement and loss and managing challenging behaviour and NVQ 3 in direct care had been booked. It was noted that the home provides placements for student nurses. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 19 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is well managed thus ensuring that residents are consulted in all aspects of their care. Health and safety records are maintained, which should indicate that residents’ health and safety are protected. EVIDENCE: The manager is a registered general nurse and has ten years experience of managing a care home. She also has a post-graduate qualification in elderly care and is undertaking the National Vocational Qualification (NVQ) in level 4. She also has management responsibilities for the Royal Buckinghamshire Rehabilitation unit. She and her senior team are experienced in caring for the elderly and those with physical disabilities. Staff spoken to said that they were able to discuss any concerns with her and that they had confidence in her leadership skills and professionalism. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 20 The manager said that the home had recently carried out a survey to seek residents and relatives’ views. The outcome of the survey was satisfactory and there were no suggestions made on areas for improvement. There is also a customer service and audit group, which is made up from staff in other departments in the home that meet monthly. The aim is to enhance on the service delivery. Twenty-eight comment cards were received in connection with this inspection. Seven from residents, fourteen from relatives and seven from health and social care professionals including four general practitioners. All resident respondents said that they liked living in the home. Felt well cared for, felt well treated by staff, and knew who to complain to if they were unhappy. All liked the food as well. Relatives were equally positive in their views and were overall satisfied with the care provision. Additional comments from residents and relatives have been incorporated in the narrative of this report. Comment cards demonstrated a high level of satisfaction with the home. Residents’ financial affairs are managed by their families. Where residents choose to leave a small amount of money with the home, for expenditure such as hairdressing and chiropody, this is banked in a treasurer’s account and records are kept detailing expenditure made on behalf of residents. The unit manager said that residents’ finances were recently audited and were found to be satisfactory. The home has systems in place for the regular maintenance of equipment. Information submitted on the pre-inspection questionnaire under section A5 indicated that the fire officer visited the home on 24 March 2006 and requirements made had been acted on. Fire training for staff was held on 8 May 2006. The fire alarm panel is checked weekly and regular fire drills are carried out. Yearly checks are carried out on the central heating system. The lift was serviced in April 2006. The mobile and bath hoists were service in July 2006. The yearly Legionella check was carried out in July 2006. Records are kept of all accidents sustained by residents and risk assessments are updated when necessary. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 21 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 22 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 OP9 Regulation 13(2) Requirement The registered manager must ensure that medication is administered in accordance the Nursing and Midwifery Guidelines. The registered manager must ensure that radiator in the dining and lounge areas and in residents’ bedrooms are fitted with covers. Timescale for action 20/11/06 2 OP19 13(4)(b) 04/04/07 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 It is recommended that the registered manager should ensure that the date of opening is recorded on opened boxes of eye drops. The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Marguerite Centre DS0000019241.V314383.R01.S.doc Version 5.2 Page 24 - 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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