Inspection on 10/11/06 for Upper Lattimore Road (2)

This inspection was carried out on 10th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Upper Lattimore Road (2) 21/01/06

Upper Lattimore Road (2) 06/05/05

Upper Lattimore Road (2) 05/10/04

Upper Lattimore Road (2) 22/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Upper Lattimore Road (2) Kyros House 2 Upper Lattimore Road St Albans Hertfordshire AL1 3TU Lead Inspector Claire Farrier Unannounced Inspection 10 and 13 November 2006 2:45 th th Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 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 Upper Lattimore Road (2) DS0000019599.V321341.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 Adults 18-65. 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. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Upper Lattimore Road (2) Address Kyros House 2 Upper Lattimore Road St Albans Hertfordshire AL1 3TU 01727 858 783 01727 858 783 kyroshse@walsingham.com 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) Walsingham Mr Jose Arlindo Vasconcelos Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st January 2006 Brief Description of the Service: Kyros House is a home for six adults who have a learning disability. The homes purpose is to support Service Users towards greater independence, to be part of and participate in community life, to promote rights and accountability, to support achievement of goals and aspirations within a supported environment and to provide for the health, social and personal care needs. Kyros House operates activities within a risk management framework. The accommodation comprises a six bed roomed detached house with front and rear gardens. The front garden is given over to parking the service users vehicle and up to three other cars. There is limited other parking close by. The home is situated close to local shops and the main town of St Albans is a short car journey away. The town centre is popular to tourists world wide, being an old Roman town, and offers many restaurants and other amenities. The statement of purpose and service users’ guide provide information about the services provided by the home for prospective residents and social workers. Information on the fees charged was not available on this occasion. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector over two days, and including preparation time a total of eight hours was allocated to it. This was the first key inspection for the year, and all the key standards were inspected. The majority of time was spent talking to residents and staff, and discussions were held with the home’s manager. Some time was also spent in the office looking at records, care plans and staff files, and the inspector made a tour of the premises What the service does well: What has improved since the last inspection? What they could do better: The residents’ files contain some aspects of person centred planning, with a personal planning book, but the care plans do not appear to have been written with or by the residents. There is inconsistent recording of the residents’ health needs. One person has epilepsy. There is a record of the seizures, but the format for recording is confusing. Another resident has mental health needs and regular input and reviews from the Herts Partnership Trust. But there is no mention of this, or of any special needs or management plans, on the care plan. Some old residents files were seen in an unlocked filing cabinet in the lounge. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 6 PRN medications are not recorded effectively, and there was an overstock of one medication. The temperature of the medication cupboard was observed to be too high for the medication stored there. The staff spoken to were very happy to work in the home, but the staffing rotas show that many staff work long shifts without a break. Two health and safety concerns were observed, concerning the recording of fire drills and fridge temperatures. 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. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has sufficient information on residents’ needs and access to appropriate services to enable their needs to be met. EVIDENCE: No new residents have been admitted to the home since the last inspection. On that occasion it was found that a rigorous process of assessment was undertaken for all prospective service users. The assessments involved the input of all significant others and the service user was the centre point of the assessment process; being fully involved in the process. As part of the assessment process the service user was also very involved with considering risks, assessing risks and agreement to the risk management strategies, which were to be included in the care plan, to minimise risks. The care plans that were seen during this inspection contain information and procedures drawn from these assessments. The staff said that they have sufficient information and training to enable them to meet the residents’ needs. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents’ care plans contain information on all their personal care and health care needs, and the residents spoken to say that they feel involved in decision making in the home. However there is little indication that the residents are involved in writing and reviewing their care plans, in line with the principles of person centred planning (PCP). Some assessed needs are not addressed in the care plans. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 10 EVIDENCE: Detailed case tracking was carried out through the files of two residents, which showed what care is provided for the residents and how it is recorded. The care plans include personal profiles, personal and health care needs and likes and dislikes. Referrals to and contacts with outside professionals are also recorded. Appropriate risk assessments are in place for each person. The file includes a personal planning book that has been produced in a “person centred planning” format. Entries are written in the first person and describe the person’s personal preferences, methods of decision making and assistance required from staff. In both the files seen the personal planning book was not fully completed. The care plans are clearly written, but they do not include all the needs assessed in whole life reviews. One person has decreasing mobility. A physiotherapy assessment in July2006 recommended that this person should be encouraged by the home staff to wear a special shoe in order to prevent further deterioration. “This will require determination and patience but would be very rewarding.” The whole life review for 2006 states that the person needs more help and asks the staff for help. A risk assessment was written in June 2006 for the risk of falling, and specified that rails should be put in place indoors, two members of staff should support the person when out, and a wheelchair should be used when out. The hand rails have been put in place outside the person’s bedroom, but there are no care plans to address the needs for extra help, wearing the special shoe and using a wheelchair with two members of staff when out. Many of the residents of Upper Lattimore Road are capable of being fully involved in writing and monitoring their own care plans. The personal planning book is produced in a person centred format, but the care plans do not appear to have been written with or by the residents. The care staff write a daily record for each person in a separate book, and the comments are frequently “X is fine”. This form of daily recording seems to serve no purpose, and may be better completed by or with the resident as a record of how they are addressing their personal objectives. Self-advocacy is promoted by the home, and advocacy is available when needed from the advocacy group PowHer. The residents stated that they know their rights and that staff also know about residents’ rights and respect them. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff assist and encourage the residents to make decisions for themselves and choose their activities. The residents use community services and amenities. Residents have appropriate relationships with each other, with relatives and with others outside the home. Staff respect and promote individual rights and encourage the residents to take responsibilities in many areas. EVIDENCE: The staff support and encourage the residents to develop and maintain independence. Each resident has a weekly programme of meaningful activities, all attending day centres during weekdays. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 12 The residents act as members of the community using amenities and facilities in the ordinary way with staff support as necessary, including local shops, pubs, clubs, cinema, and public transport. They also access community health services such as GPs, dentists, opticians, chiropodists and so on. All the residents asked said that they were happy with their activities and lifestyles. The residents confirmed that the staff treat them with respect and said they generally enjoy very positive relationships. Interaction between staff and residents was noted to be natural and relaxed, with a good level of mutual respect and trust. The residents take part in a number of household chores including shopping, cooking, housework and laundry. The residents discuss their food preferences with staff and help them plan the menu for each week. They also participate in meal preparation. The residents spoken with said that they enjoyed their meals and mealtimes. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff provide a good standard of personal care support and treat residents with sensitivity and respect. There is insufficient recording of the residents’ healthcare needs to ensure that the staff have appropriate information to meet them effectively. The home has appropriate procedures for ensuring the safe handling, storage and recording of medication that protect service users’ interests. However PRN medications are not recorded effectively, and the temperature of the storage cupboard is too high for some medications. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 14 EVIDENCE: Most of the residents look after their own personal care, and the care plans contain good details of the care needs of those that need some assistance. The healthcare records seen included references to hospital visits, and contact with GPs and other health professionals. Some of the older residents have health problems associated with increasing age, and the staff spoken to showed good understanding of each resident’s personal and healthcare needs. However there is inconsistent recording of the residents’ health needs. One person has epilepsy. There is a record of the seizures, but the format for recording is confusing. There are two forms in different places in the person’s file, and some incidents are recorded on each one, so that there is no clear record of the occurrence of seizures. Another resident has mental health needs and regular input and reviews from the Herts Partnership Trust. But there is no mention of this, or of any special needs or management plans, on the care plan. The home has sound systems in place for the safe management of medication. The residents who are able to do so look after and administer their own medication. Storage is secure in the office and administration records checked were error-free, with no signature gaps found on the MAR (medication administration record) charts. However PRN (when required) medications are not recorded effectively, so that an audit can be carried out to ensure that the medication has been administered appropriately. Two residents have Chlorpromazine PRN. For one this is supplied in monitored dosage blister packs, but for the other the medication is supplies in bottles, and there are two bottles in the medication cupboard, which is more than is required. One person has rectal diazepam PRN that is very rarely needed. If it were needed, it would be difficult to record it, as it is not listed on the MAR chart. Medication is stored in a cupboard in the office, which is also used as the staff sleeping in room. The thermometer in the cupboard showed a temperature of 23°C, but the temperature is not recorded to ensure that it does not go above the recommended maximum of 25°C. There were three bottles of lactulose in the medication cupboard that should be stored at below 20°C. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and enabled to make their views and concerns known. Policies and procedures are in place to ensure that service users are protected from abuse and neglect. EVIDENCE: The ethos of the home is to empower the residents to express their opinions, including concerns and complaints about the service provided. In support of this ideal the home has a satisfactory complaints procedure in place that is available to all residents and their relatives. No complaints have been recorded since the last inspection. The home has up to date policies concerning adult protection that follow the Hertfordshire inter-agency guidelines and a copy of the guidelines is kept in the office. All staff have had training in the prevention of abuse. Staff spoken with were aware of the general principles involved including the company’s whistle-blowing policy. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and well maintained environment for the residents, and the staff maintain a good standard of cleanliness. EVIDENCE: The building is an ordinary detached house, furnished and decorated in domestic styles that produce a homely, comfortable environment, which allows the residents to relax and feel very much at home. The residents all have their own rooms, arranged and decorated to reflect their particular interests and tastes. The lounge, dining room and kitchen are domestic in style and are comfortably furnished and well equipped. The ground floor shower room was in the process of being refurbished and retiled at the time of the inspection. The home appeared to be clean and generally well maintained, and the staff follow appropriate procedures to maintain hygiene and prevent the risk of infection. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is (excellent, good, adequate or poor) This judgement has been made using available evidence including a visit to this service. The home is staffed by experienced support workers who are appropriately trained to meet the needs of the residents. The staff spoken to are confident of their knowledge of the needs of the residents and feel well supported in their work. EVIDENCE: Staff rotas show that two members of staff are on duty from 8 am to 9 pm. Night staffing is by one person sleeping in. These levels are adequate to meet the needs of the current group of residents. The staff spoken to said that they have sufficient experience to feel confident about being alone in the home during the night, and they have access to duty managers in case of emergency. The member of staff who sleeps over during the night frequently works a total of 24 hours without a break, from 2pm to 11.00pm, followed by the sleepover, then from 6.00am to 2pm. This schedule does not comply with the Working Time Regulations. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 18 Walsingham provides comprehensive training for staff that covers all mandatory training in first aid, moving and handling, fire safety, food hygiene, etc, and training to meet special needs the residents have such as epilepsy, and behavioural problems. The staff spoken to said that the training and support provided for them is very good. One member of staff said that it is much better at Upper Lattimore Road than at their previous place of employment. The staff files of two members of staff were inspected. They contained all the required information to show that they are fit to work in the home. The references, CRB (Criminal Record Bureau) disclosures, evidence of identity and full employment history are stored at Walsingham headquarters, and a record sheet in each person’s file confirms that these are satisfactory. The manager confirmed that the recruitment procedures followed by the company are robust and that he sees all the information on each applicant during the recruitment process. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management within the home is secure and effective ensuring that changing needs of service users are met and that the home is meeting its aims and objectives. The quality assurance system ensures that views of the residents and their families underpin all self-monitoring, review and development of the home. The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. Two health and safety concerns were raised during the inspection. Residents’ records need to be maintained in good order and stored securely. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 20 EVIDENCE: The home is well run in accordance with the principles set out in the statement of purpose. The manager is experienced in social care and is taking the Registered Manager’s Award course. The manager sets the tone for the home, provides strong leadership to the team and enjoys good relationships with the residents. Walsingham has a comprehensive system for quality assurance in its homes, which includes annual surveys of residents and their families. The company carries out regular service audits of the home and monthly Regulation 26 monitoring visits, and reports of the visits are sent to CSCI. There are regular residents’ meetings on the home, and several issues raised by the residents have been acted on. These include a shed in the garden this year, and garden furniture and a barbecue last year. The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. All the staff have training in moving and handling, fire safety, food hygiene and infection control as part of their induction. Two issues were noticed that need to be addressed. 1. Regular fire drills are held, which include the evacuation of the residents. All the staff have appropriate fire training. The fire drill log records the residents who take part, but not the staff. All members of staff must take part in at least one fire drill a year, and the fire log should record that they do so. 2. The fridge and freezer temperatures are recorded every day. For the three days before the inspection the temperature of the fridge was above the maximum temperature of 5°C that is recommended for food storage The residents’ files include appropriate risk assessments, but it was not clear whether some were still needed. For example one was dated 27.5.03, with a review dated 12.9.04 and nothing since, and the actions for managing the risk were not in the current care plan. Some old residents files were seen in an unlocked filing cabinet in the lounge. Upper Lattimore Road (2) DS0000019599.V321341.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 Adults 18-65 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 X 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 3 X 2 2 X Upper Lattimore Road (2) DS0000019599.V321341.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 YA6 Regulation 12(2) & (3) Requirement The care plans and risk assessments contain clearly written information on personal and health care needs, but there is little indication of the involvement of the resident in setting up and reviewing their care plan in accordance with the principles and practice of PCP. Timescale for action 13/02/07 2. YA19 12(1)(a) Measures must be put in place to ensure that residents are enabled to provide a realistic input into their care plans and risk assessments. There is inconsistent recording of 13/01/07 the residents’ health needs, including monitoring of epilepsy and mental health needs. All health care needs must be recorded appropriately in order to prevent any avoidable risks to the resident’s health. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 23 3. YA20 13(2) PRN medications are not recorded effectively. There was an overstock of one medication. All medication must be stored, administered and recorded in accordance with the Royal Pharmaceutical Society guidelines and the home’s policy and procedures. The temperature of the medication cupboard was observed to be too high for the medication stored there. The temperature of all rooms used to store medication must be regulated to the temperature required for the medications stored there. The staffing rotas show that many staff work long shifts without a break. 13/01/07 4. YA20 13(2) 13/01/07 5. YA33 18(1)(a) 13/02/07 6. YA41 17(1)(b) The registered person must ensure that sufficient staff are employed in the home in order to comply with the Working Time Regulations and to meet the needs of the residents. Some old residents files were 13/01/07 seen in an unlocked filing cabinet in the lounge. Personal records, including care plans that contain personal information, must be stored securely. There is no record to show that all staff take part in fire drills. The registered person must ensure that every member of staff take part in at one fire drill a year. 7. YA42 23(4)(e) 13/02/07 Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 24 8. YA42 13(4)(c) The fridge temperatures were too high for the safe storage of food. The registered person must ensure that food is stored at the correct temperatures to avoid any risk to the residents. 13/01/07 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 YA41 Good Practice Recommendations Some out of date information and risk assessments was seen in residents’ files. The residents’ files should be audited to ensure that information that is no longer relevant is not presented as current information. Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Upper Lattimore Road (2) DS0000019599.V321341.R01.S.doc Version 5.2 Page 26 - 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. 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