Inspection on 20/08/07 for Trevarna

This inspection was carried out on 20th August 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 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

Trevarna 03/07/06

Trevarna 11/10/05

Trevarna 16/05/05

Trevarna 16/11/04

Trevarna 19/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Trevarna 4 Carlyon Road St Austell Cornwall PL25 4LD Lead Inspector Mike Dennis Unannounced Inspection 20th August 2007 10:00 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 Trevarna DS0000009242.V347039.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. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Trevarna Address 4 Carlyon Road St Austell Cornwall PL25 4LD 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) 01726 75066 mail@cornwallcare.org Cornwall Care Limited Vacant Care Home 54 Category(ies) of Dementia - over 65 years of age (46), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (46), Old age, not falling within any other category (8) Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To include two service users under the age of 65 yrs for respite care only Total number of service users not to exceed a maximum of 54 Date of last inspection 24th October 2006 Brief Description of the Service: Trevarna is a purpose built care home situated close to the residential centre of St. Austell with the local library next door. The home provides residential care for up to 54 elderly people, including up to thirty with a dementia. Accommodation is provided on one floor and service users can access all areas` easily. The building consists of five wings, each having a sitting room, dining room, kitchenette and bedrooms. Meals are prepared in a large kitchen and served in the dining rooms of each wing. Assisted bathing facilities are provided and all rooms have call bells. The home has a hairdressing salon, which is well utilised by service users. There is also a day care facility at the home providing a service for up to twelve elderly people with a dementia. The grounds are kept tidy and there are patios with bench seating. Ramps provide easy access for service users. There is adequate car parking space at the front of the home. There are opportunities for socialising and visitors are openly encouraged. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was conducted as follows. At 2300 hrs. on the 16th. August 2007, two inspectors, Mr. Michael Dennis and Mrs Melanie Hutton visited the home, spending just over two hours on the premises. The purpose of this visit was to take the opportunity to meet with the night staff on duty, observe routines and assess workload. Mr. Dennis returned to Trevarna on the 20th. August 2007 and the 21st. August 2007 to conduct the main part of the inspection. The total amount of inspector time allocated was approximately 18 hours. The purpose of the inspection was to follow up the provider’s compliance with the requirements and recommendations set in the last inspection report dated 3rd. July 2006, and two Random Inspections conducted since that date. We focused on the key national minimum standards as identified by the commission. The methods used were discussion with the manager, staff, residents, and their relatives and visitors, inspection of records and documents, observation of the daily life of the home and inspection of the premises. A Short Observational Framework of Inspection tool was also used to enable us to observe resident interactions with staff. We are grateful to the Management team, staff and residents for their assistance in completing the inspection. There has been a significant change in the management structure of the home recently to include the resignation of the registered manager. Cornwall Care Ltd. Have appointed a new manager who will take up her post in September. In the mean time a senior manager from Head Office has been drafted in on a temporary basis. Two acting deputy managers have also been appointed for this interim period. The home has undergone a period of disruption due to senior staff leaving and also due to a high turnover of care staff. A result of this is that standards have slipped, particular details of which are highlighted in this report. Based on discussions with the current management team, they are aware of what needs to be achieved in order to bring this home back up to standard. What the service does well: Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 6 Cornwall Care as a company have established sound and comprehensive policies and procedures which aim to ensure those in their care are fully protected with their needs being met. Dementia Care training is given high priority. Recruitment procedures are robustly adhered to with all the required checks being made. We wish to commend the night staff who greeted us on our night visit. They were most professional and thoroughly checked identification before allowing entry. What has improved since the last inspection? What they could do better: A review of documentation is needed to ensure that all records are kept up to date. This includes the Statement of Purpose and Service User Guide, Care Plans, fire records, supervision records, and general training records. The continuity records will benefit from better inclusion of detail concerning the social and emotional side of residents life at the home. Night staff need to be increased in numbers to meet the care needs of residents proportionate to the assessments documented in the care plans. Night staff require further training in the administration of medicines. Secondary dispensing of medication must cease at night. A uniform call bell system should be in place so that all staff are alerted immediately a call bell is activated. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 7 A permanent, competent and stable management need to be employed as soon as possible and be committed to improving standards. 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. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5, People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents receive, the information they require in order to make an informed choice about residing at Trevarna although some of this information now requires updating. Their needs are assessed so that they can be assured that the home can provide the care required. EVIDENCE: A comprehensive Statement of Purpose and Service User Guide is available. These documents are now in need of review. The staff team has changed and is changing which needs to be reflected. All references to the CSCI eg. Complaint policy should note the local CSCI office as now being at Ashburton and not St.Austell. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 10 Residents informed the inspector that they had knowledge of these documents. A copy of these documents is to be found in each service user’s bedroom. Four service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment. The information provided included :- continence assessment, pain assessment, risk assessments and general details of daily care requirements, medication and health care requirements. Residents files contained signed contracts/ terms and conditions of the home. Service users and relatives confirmed they had knowledge of these documents and processes. Relatives informed the inspector they were able to visit the home prior to admission of their relative. The home caters for those suffering from dementia and staff receive relevant training to a good standard. Intermediate Care is not provided at this home. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health, personal and social care needs are not being met due to the fact that care plans are not up to date. Medication practices have improved to an acceptable standard except for night staff routines. Residents are treated with respect and dignity. EVIDENCE: Four Individual Plans of Care were inspected. They were seen to contain full and relevant information, to include Risk Assessments, pertaining to the health, personal and social care needs of that individual. In addition information is gathered regarding the service users past life experiences and interests. This information will be used to promote an Active Care programme for that individual. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 12 It was noted however that all of these care plans had not been reviewed at monthly intervals as required. In fact a general scan through these and other care plans showed that many had not been updated for 12 months. Perceived problems and resident needs were documented along with the action or interventions needed for improvements that would benefit the individual resident. The records did not show whether or not such action plans had been carried out and therefore no evidence was available to judge progress, success or failure. The daily continuity records contain information concerning personal care, accidents, state of mood and other general comments. They do not paint a picture of the lifestyle of the resident as information pertaining to activities, interests, outings and other social events is lacking in many cases. Continence assessments are out of date. A stock of continence pads were available but they did not correspond to individual residents and in many cases the wrong size were being used. This situation has caused unnecessary discomfort to residents and night staff informed us that it could result in an extra 20 bed changes a night. We are satisfied that steps are being taken to remedy the situation as all residents are currently being re-assessed by the continence nurses. Appropriate professionals from other disciplines frequently visit the home to provide for general health care, ie. G.P’s, Community Nurses, Opticians, Dentists etc. Residents have the opportunity to receive aromatherapy and massage. This service is offered on a regular basis. A random inspection took place on the 7th. June to look specifically at medication administration practices in the home. The outcome was less than positive. During the course of this inspection we observed part of a drugs round. An experienced and trained member of staff was monitoring a recently trained staff member to determine her competence and confidence levels. This was seen as good practice. All day staff now involved in the administration of medicines have received training from an external accredited provider and also via Cornwall Care’s training program. This is not the case with night staff. In the main they are experienced carers and were able to explain the processes followed. We evidenced that medication is removed from the blister packs during the day and placed in containers, from which night staff administer to the resident. This practice amounts to secondary dispensing and cannot be condoned. Night staff must be trained in this area to the same standard as the day staff. We inspected the medication records and procedures and are pleased to note that improvements have been made. The requirements made as a result of the random inspection have been complied with. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 13 We observed staff treating residents with respect, addressing them in a polite and friendly way whilst respecting dignity and privacy. Residents and relatives confirmed that this was the case. Following analysis of the Short Observation Framework for Inspection exercise, we are able to report positive results. All staff contact with residents was seen as positive. The state of being of those residents observed showed that none were asleep or withdrawn and 60 of the time there was positive interactions. This exercise was conducted from mid to late afternoon. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and relatives confirmed that the lifestyle they experience in the home meets their expectations and preferences. Visitors are welcome at all times and a steady flow of visitors were observed to be in the home during the course of the inspection. Residents are helped to exercise choice and control over their lives. The food prepared was varied, wholesome and well received. EVIDENCE: The residents individual care plan has a detailed section regarding their interests and choice, and activities are planned to encompass these interests. The home arranges and facilitates visiting entertainment and in-house activities. Life story books are being collated to enable social profiling and active care. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 15 Planned activities are displayed on a notice board. Flexibility is achieved throughout all aspects of daily living. The management ‘buy in’ facilitators for aromatherapy, hand massage, drama therapy, ‘pat a dog’ etc. Residents are given the opportunity to vote at elections and evidence was presented to demonstrate that some residents had had contact with solicitors and advocates. Relatives, residents and staff gave examples of the lifestyle, interests etc. relating to individual residents. We spoke with one of the two cooks and evidenced that they were well experienced and qualified. A variety of choices and menus are available on a day to day basis and in some cases special/individualised diets are catered for. Residents confirmed that the food presented was to a high standard and that it met with their approval. Night staff informed us that they had better access to the kitchen than before and could now be more flexible in providing food to residents at night. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure is well publicised and used when required. with staff having knowledge through training of Adult Protection issues which helps to protect service users EVIDENCE: A comprehensive complaints policy and procedure is kept within the home. This procedure includes timescales and who will deal with the complaint. The home also keeps a complaints log for ease of reference. Residents indicated that they were aware of the procedures. The home has a comprehensive policy and procedure in place to protect residents from abuse. Policies are also available in regard to physical and / or verbal aggression from residents, physical intervention and restraint. Staff are made aware of these procedures during the induction period. The manager is also aware of the local social services procedure within “No Secrets” to investigate any complaints regarding the suspected abuse of any service user. CRB and POVA checks are undertaken, with Cornwall Care being the umbrella body to obtain these checks. Trevarna DS0000009242.V347039.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, 20, 21, 23, 24 and 26 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The location and layout of the home is suitable for it’s stated purpose and provides a safe and well maintained environment. The home was clean, hygienic and generally free from offensive odours providing an attractive and homely place to live. EVIDENCE: Residents have access to safe and comfortable communal facilities. A program of redecoration and refurbishment is ongoing. This is currently active with partitions in lounge areas being removed. Sufficient and suitable lavatories and washing facilities are provided in each area. Sluicing facilities are available. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 18 Bedrooms are suitable for purpose and all individually personalised by the occupant. Residents expressed satisfaction with their living accommodation. Some staff were enthusiastic with the improvements already made and those planned. The home was generally free from offensive odours, clean and hygienic. Seating areas are arranged in the gardens with one area designated to become a sensory garden. Some areas present as a little tired, of which the manager is well aware but overall the premises present to a good standard. The call bell system in Wing one is not satisfactory. When a call bell is operated in this area it only alerts staff actually working on the wing. There is a five minute delay before staff elsewhere in the building are alerted. Given that wing one is staffed by a single staff member at night, this situation is deemed unsafe. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The temporary management team are working hard to improve deficiencies in staff training, supervision and the skill mix and numbers of staff on waking night duty. EVIDENCE: We conducted a night visit to this home and spent time with the three night staff on duty at that time. On arrival at the home we were greeted with professional courtesy and we commend the night staff for their vigilance in checking our identification. During the course of the visit we observed the staff to be busy attending to residents’ needs. Several residents were not in bed asleep and therefore required similar care to that which day staff would provide. Staff told us that in addition to caring for residents they were expected to complete other household chores, cleaning, ironing etc. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 20 We consider that insufficient staff are employed over night! The three waking night staff are deployed as follows :- Two staff cover all areas except wing 1 which only has a single staff presence. Wing 1 houses those residents with the greatest needs. The majority of the residents in this area were awake and solely for that reason alone were more demanding. We read the care plans for several of the residents in wing one. They stated that various individuals needed 24 hour care from 2 carers. We also contend that a single carer in this area is at risk without adequate support from colleagues. Training for night staff is also an issue. There was no evidence to indicate that night staff have received, supervision, fire training, medication administration training within required time limits. We consider that Cornwall Care need to urgently review night cover at this home in respect of numbers of staff and training given. The duty rota indicates that 8/9 care staff are on duty during the mornings, 8 throughout the afternoon and evenings. Waking night staff number 3. In addition managers, domestic and catering staff are on duty Staff recruitment is conducted in line with the home’s policies and procedures. Evidence obtained from staff files indicates that references, CRB and POVA checks are taken up prior to interview. All staff undertake Induction Training. . NVQ training is encouraged. At present the number of staff holding NVQ certificates has dropped below 50 due to recent staff changes. Individual training profiles for staff are kept. Staff are not receiving supervision at regular intervals as required. Trevarna DS0000009242.V347039.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, 36, 37, People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of this service has failed to promote sound and safe practices to ensure the welfare of the people who use the service. To their credit they have recognised the shortfalls and are now working hard to redress the balance and improve services. EVIDENCE: There has been a significant change in the staffing arrangements at this home during the past six months resulting in the departure of the registered manager, other senior staff as well as a number of care staff. Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 22 Cornwall Care Ltd. Have drafted in a temporary management team whose role it is to improve standards and act on deficits identified in the course of this inspection. The management team currently in place consists of :- Mr. G. Cantwell, acting Manager, two acting deputy managers who are supported by two assistant managers, a care co-ordinator and a training manager. A permanent manager has been appointed to take up her duties in September. She will subsequently be applying to the CSCI to be the Registered Manager. The requirements and recommendations listed in this report are not to be attributed to this current management team. Based on our discussions with staff and residents, inspection of records and observations it is apparent that the past management structure of this home has failed to promote satisfactory care for those people who use the service. Staff training has fallen below par in core areas such as Fire prevention, moving and handling, medication administration and the use of correct size incontinent pads. This has been compounded by a lack of staff supervision. Records in respect of the above are not up to date and shortfalls have been noted in other areas too. The main areas which require urgent improvement are noted elsewhere in this report and in the Statutory Requirements section. We acknowledge that Cornwall Care Ltd. Are acting positively to put matters right. A follow up inspection will be held to assess the progress made. Trevarna DS0000009242.V347039.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 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 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 3 3 X 3 3 2 3 STAFFING Standard No Score 27 1 28 1 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 1 1 X Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4@5 Requirement The Statement of Purpose and Service User Guide must contain all the information as listed in Schedule 1 of the Care Standards Regulations to include up to date lists of all staff and their qualifications. The current address of the CSCI must also be included Care plans must be reviewed at monthly intervals and updated accordingly. Evidence that action plans and required interventions are followed must be recorded. Continence assessments on all residents to be undertaken and a correct supply of pads for each person needing them retained. The practice and procedures followed by night staff amounts to secondary dispensing of medication. This must stop and the laid down procedures by Cornwall Care Ltd to be followed All night staff involved in the administration of medication to have accredited training. The call bell system must alert DS0000009242.V347039.R01.S.doc Timescale for action 01/11/07 2 OP7 15 01/12/07 3 OP8 13 01/11/07 4 OP9 13 01/11/07 5 6 Trevarna OP9 OP19 13 13 01/01/08 01/01/08 Page 25 Version 5.2 7 OP27 18 8 OP36 18 9 OP37 17 all staff on duty immediately and requires improvement. Night staff cover must be 01/12/07 reviewed and increased to take into consideration the care needs of residents as listed in care plans and to ensure the safety of both residents and staff. ALL staff must receive training 01/12/07 appropriate to the work they are to perform and receive regular supervision This to include, fire training, moving and handling All records required by the Care 01/12/07 Homes Regulations must be kept up to date in a concise and meaningful manner RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Trevarna DS0000009242.V347039.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!