Inspection on 09/07/07 for Viera Gray House

This inspection was carried out on 9th July 2007.

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

Other inspections for this house

Viera Gray House 08/10/08

Viera Gray House 12/07/06

Viera Gray House 23/01/06

Viera Gray House 26/07/05

Viera Gray House 24/02/05

Viera Gray House 25/08/04

Viera Gray House 17/02/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Viera Gray House 27 Ferry Road Barnes London SW13 9PP Lead Inspector Sharon Newman Unannounced Inspection 10:00 9th July 2007 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 Viera Gray House DS0000017396.V342894.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. Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Viera Gray House Address 27 Ferry Road Barnes London SW13 9PP 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) 020 8748 4563 020 8748 4580 betty.wright@rutcht.com Richmond upon Thames Churches Housing Trust Ms Elizabeth Wright Care Home 38 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (20), of places Physical disability over 65 years of age (20) Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th July 2006 Brief Description of the Service: Viera Gray is a purpose built care home accommodating up thirty-eight older people, including up to eighteen residents with dementia. The home opened in 1992. The home is owned and managed by Richmond upon Thames Churches Housing Trust. The home is divided into four units, each with a sitting and dining area and a small kitchenette. All bedrooms are for single occupancy and have en suite facilities. Each unit has their own bathroom, equipped with specialist mobility baths. There is an attractive and well maintained garden. The home is situated close to local shops and transport links. The Registered Persons have produced a Service User Guide, which includes information on the aims and objectives of the service. The fees for Viera Gray House are between £547 - 577 per week. Viera Gray House DS0000017396.V342894.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 regulation inspector and took place over one day. The manager was present throughout the inspection and the inspector spoke to her at length, some residents were also spoken to. Documentation looked at included medication records, staff recruitment information, residents care plans and health and safety documentation. A tour was also taken of the premises. The manager has also completed an Annual Quality Assurance Assessment (AQAA) which is a self assessment survey. This contains detailed and comprehensive information about the home. Surveys were left at the home for residents, staff, relatives and health professionals to complete. Two were returned from relatives thirteen from staff and one from a health professional before this report was completed. The responses were positive about the home. What the service does well: What has improved since the last inspection? There has been an improvement in the way that residents are supported at mealtimes. From observations at lunchtime the staff were conscientious in supporting residents to eat in a kind and dignified manner. A quarterly activity forum has now commenced for residents. Staff were observed to follow safe moving and handling practice. Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 6 A new shower/wet room has been installed, the kitchen in the tea bar area has been refurbished as has the main kitchen. Staff training is improving and the manager is arranging for ongoing staff training in many mandatory areas such as food hygiene, health and safety, first aid and moving and handling to ensure the safety of the residents and staff. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Viera Gray House DS0000017396.V342894.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 Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are assessed prior to coming to live at the home. This helps to make sure that the home can meet their needs. EVIDENCE: The home provides a Statement of Purpose and Service User Guide to prospective residents and these have been updated. It contains information about the home, including details about the complaints procedure and the aims and objectives of the home. The manager reported that senior staff assess residents before they move to the home. Assessments of need were seen to be kept in the resident’s files. As stated in the previous inspection report prospective residents are invited to visit the home and spend time there before making a decision about whether they wish to move to the home. All residents are admitted for a trial stay. Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 9 Residents spoken to during the inspection reported that they liked living at the home and two said that they ‘had no complaints at all.’ A relative said that they felt the care given at the home was ‘good.’ One relative wrote that ‘differences are respected and catered for, whether it is in respect of behaviour food or religion.’ They also commented that the home tries to ‘create a communal atmosphere.’ Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use this service have access to a range of health and social care services. Residents are treated with respect by staff. No issues were seen regarding the storage or administration of medication. However, the allergies sections in the medication administration records are not always fully completed to help ensure that residents are not placed at risk. EVIDENCE: Some issues remain with the care plans. Whereas some have been completed well with good detail others did not contain as much attention to detail. Some entries were meaningless. A bathing sheet was found that contained only one entry that stated ‘resident been weight.’ In relation to dietary needs another stated ‘eats a stable diet’ – but did not explain what was meant be ‘stable diet’. In relation to night care another entry stated ‘yes’ but did again not elaborate on this. One stated that a resident ‘feels insecure and might be Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 11 confused of place.’ Again there is no suggestion about what they mean by this and what action is to be taken. Not all care plans contained information about the residents life, likes or dislikes. It is important that this information is fully recorded and then used to help plan their care and activities. One residents name was spelt wrong throughout her care plan which does not show sufficient attention to detail. It is recognised that the manager acknowledges in the annual quality assessment (AQAA) that the home needs to ‘further improve the quality of our care plans’ and that it is addressing this. As stated in the previous inspection report the format used for recording risk assessments is basic and does not allow for adequate information. This was discussed with the manager at the time of inspection who reported that she is addressing this. Risk assessments for different, unrelated activities were recorded on the same sheet. These would benefit from being on separate sheets and in more detail. Some of the information in the risk assessments was meaningless and did not contain enough detail. A risk assessment for someone with behavioural issues just stated ‘try to calm (them) down or walk away. Remove resident that is in immediate danger.’ Risk assessments need to contain more detail about the issue and exactly what action is required. A risk assessment for bathing did not stated what the actual risk was or clear guidelines as to the action that needs to be taken. There was evidence of input from a wide range of health and social care professionals in the resident’s care plans. The manager said that District Nurses visit the home every Tuesday and Thursday and provide advice and support. They chiropodist visits three monthly and GP’s visit regularly and when required. Dentists and opticians also visit the home. A health professional wrote about staff that ‘they always attempt to do their best.’ The manager reported that there are three local GP surgeries that provide care to the home and residents may choose their GP. She said that the home has a very good relationship with one local GP surgery in particular who are happy to visit the home at short notice. One health professional was visiting the home during the inspection and was given a survey to complete about the home. They commented that ‘this is a very good home.’ Much of the recording on the MAR sheets has improved since the previous inspection. However, although the majority of the medication administration records (MAR) had been fully completed, one did not have the allergies section completed. All allergies sections on the MAR sheets need to be complete to Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 12 ensure that residents are not placed at risk. Where there are no allergies known then this needs to be documented. Entries recorded on one MAR sheet indicated that medication had not been given to one resident as it was ‘not available’ at the home. This was discussed with the manager at the time of the inspection. She reported that a health professional had been due to come to review the medication but had not arrived before the supply of medication ran out. It was discussed that the home must find a way to address this issue, as medication must not be stopped without authorisation of the relevant healthcare professional. The manager reported that she would take this issue up with the health care professionals concerned. The self assessment of the home (AQAA) completed by the manager reports that sixteen care staff have attended training in the safe handling of medication at a local college. Staff were observed to treat residents with respect throughout the visit and to have a good rapport with them. Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service have the opportunity to develop and maintain important personal and family relationships. Staff are sensitive to the needs of those residents who find it difficult to eat and give assistance at mealtimes. Meals are taken in a relaxed and unhurried environment ensuring that it is a pleasant experience for residents. EVIDENCE: The manager reported that there are a range of activities on offer for residents. The home shares a minibus with another home owned by the organisation. She said that residents recently went on a trip to Windsor and that they are planning another trip soon to the local Wetlands centre. A resident remarked that they had enjoyed the visit to Windsor and looked forward to these outings. Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 14 Residents spoken to during the visit reported that they were happy with the activities on offer. A residents activities group was taking place during the inspection. One resident reported that they had been due to take part in a quiz but they had all decided on this occasion that they would all rather have a chat which they had preferred. Residents were seen to be watching television, engaged in conversation with staff or other residents, reading or resting in their rooms. Residents’ choice was seen to be respected regarding their chosen activities. If residents wish to remain in their rooms they may do so. One resident said that they did not like to do much and preferred to sit and watch television or read. A hairdresser visits the home regularly. Regular residents meetings are held and the manager reported that she is introducing a quarterly residents forum for residents. She said she would like to support the residents to chair this meeting themselves. In the annual quality assessment (AQAA), the manager reported that the home promotes equality and diversity at the home through a variety of measures. She wrote that residents can choose to have male or female care staff to attend to them, arrangements can be made for specialist staff to visit the home for those with sight difficulties and a loop system has been installed for those with hearing difficulties. Also, there are a range of specially adapted baths and showers within the home. The Alzheimers Disease Society have recommended the Spice up Your Life training for staff to assist them in caring for people with this condition. Lunch was observed to be taken in a relaxed and unhurried atmosphere. Residents needing help were supported to eat their lunch in a dignified manner by staff members who sat beside them to offer assistance. Lunch portions were a good size and residents were offered a choice of meal by staff. Residents were complimentary about the food, one said ‘it is delicious’ another said ‘it is lovely.’ The manager said that the home is in consultation with the residents about introducing new menus. There are two cats that live at the home and help to create a homely atmosphere for the people who live here. A staff member wrote that the home ‘has a very homely feel and is very relaxed.’ Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Policies and procedures for safeguarding adults are available at the home and staff are aware of the procedures to follow. EVIDENCE: The Commission for Social Care Inspection (CSCI) have not received any complaints since the previous inspection. A record of complaints and compliments is kept at the home. The annual quality assessment (AQAA) reports that the home would ‘act immediately on receipt of any form of complaint.’ The home follows the London Borough of Richmonds’ Adult Protection Procedures (POVA) and a copy of these procedures was available at the home. A potential POVA issue has been referred to the London Borough of Richmond and the home is awaiting their decision. Richmond Upon Thames Churches Housing Trust have their own procedures on abuse and whistle blowing. The manager reported that the organisation has introduced the first Safeguarding Adults Champion project and a senior staff member is going to undertake this responsibility. They will receive training for this role. There was evidence that staff attend training in abuse awareness and the protection of vulnerable adults and this helps to maintain the safety of the residents. Staff are also to receive training about the Mental Capacity Act, to Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 16 ensure they are aware of the important issues that this legislation encompasses. Viera Gray House DS0000017396.V342894.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, 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. This home is comfortable and homely and residents comment that they like to live here. There is an effective ongoing programme of maintenance and decoration. The home is clean and hygienic. EVIDENCE: The home is set out over two floors, has a very comfortable and homely atmosphere and is built around a pleasant courtyard garden. This garden is well maintained and contains an attractive fishpond and many plants. Some resident’s were seen to be sitting out in the garden enjoying their surroundings. Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 18 The annual quality assessment (AQAA) states that the home has made improvements by replacing some communal carpets and chairs, refurbishing two unit kitchens, the kitchen by the communal lounge and the main kitchen and installing the wet room. This was observed on the inspection visit. The building is well maintained and decorated. The maintenance person was spoken to and they reported that they ‘really enjoy working at this home.’ Bedrooms all have en suite facilities and those seen had been personalised by residents. Residents are able to bring their own furniture and equipment to make the environment more homely. There is a range of equipment available to help meet the needs of residents this includes assisted baths and showers, wheelchairs and toilet rails. There is a bathroom, with a specialist mobility bath, available in each unit at the home. A new adapted shower has been installed at the home. The manager reported that a new loop system has been installed at the home to help those with hearing difficulties. From observations at the home it is clear that a high standard of cleanliness is maintained and there were no unpleasant odours. Viera Gray House DS0000017396.V342894.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 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are appropriately trained to help ensure that they can carry out their roles. Residents are protected from harm by a good recruitment procedure. EVIDENCE: Sufficient numbers of staff were observed at the home on the day of inspection. The manager reported that there were enough members of staff to meet the needs of the residents. The duty rota was clear and easy to follow. The home does have permanent staff vacancies at present and is using regular agency staff to cover these hours. Some comments from residents, relatives and staff indicate that they would appreciate more continuity of care from regular permanent staff employed by the home. One relative wrote that improvements could be made by ‘increasing the number of staff.’ A relative said ‘staff are never constant so you don’t get used to the same faces but they are very nice.’ Additionally a health professional wrote that ‘less agency’ staff would be beneficial. There was evidence of a staff training programme and most staff are up-todate in mandatory areas including: moving and handling, first aid, health and safety and food hygiene. Most staff have completed or are undertaking NVQ Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 20 training. The induction programme at the home is in line with current Skills for Care guidelines. Staff spoke highly of the training programme in the surveys that were returned. One said that it was ‘excellent,’ another said ‘the organisation is very good at this.’ Four staff recruitment files were looked at and there was evidence that all necessary pre-employment checks are carried out. This helps to ensure the safety of the residents. Regular staff meetings are held and minuted. Issues discussed at the last one included the residents, staff issues, the introduction of the new loop system, training and care plans. Staff survey responses confirmed that staff regularly attend meetings. One wrote ‘new ideas and input are listened too’ and ‘we have a staff suggestion box in the lounge.’ In the annual quality assessment (AQAA) the manager writes that this was in response to ideas raised at the organisations staff conference. Staff at the home were observed to behave in a courteous and professional manner. They help to create a cheerful and friendly atmosphere at the home. One staff member was observed to tactfully and discreetly intervene in an incident between two residents. They quickly and professionally resolved the situation to the satisfaction of the residents involved. Residents spoke highly of the staff, one said ‘the staff are lovely and helpful.’ Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service is well managed, staff have a professional attitude and are knowledgeable about the residents in their care. One- to one staff supervision takes place to help ensure that staff receive the support they require to carry out their duties. Quality assurance systems are in place so that residents and relatives views are taken into consideration regarding the running of the home. EVIDENCE: The manager is very experienced and has undertaken the Registered Managers Award. She is also a National Vocational Qualification (NVQ) assessor. Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 22 Residents spoke highly of the manager and one said that she was ‘lovely.’ A staff member reported that she was ‘approachable.’ A staff member wrote ‘the manager is excellent.’ As stated in the previous inspection report the organisation conducts monthly quality inspections of the home and reports of these are sent to the Commission for Social Care Inspection (CSCI). A local advocacy group visit the home annually to conduct a quality audit. They meet with all residents and prepare a report of their findings with recommendations. A copy of the latest report was available at this inspection. The manager reported that she welcomes the observations made in the report as they are a method of improving quality at the home. Staff one-to-one supervision is taking place and helps to ensure that staff have the direction and support that they need to carry out their roles. The manager reported that the home’s finance policies and procedures have recently been updated. Residents make their own arrangements for the management of their finances. The home does hold small amounts of cash for the purchase of small items, the hairdresser and any additional expenditure. Checks relating to safety including: gas safety, legionella, electrical installations and portable appliance testing were up-to-date. An external company conducts a full health and safety audit of the home each year. The last one was conducted in February 2007. CCTV has been installed for the residents safety. A relative commented ‘ Viera Gray is a very open home in every way.’ A resident said ‘I am very happy here.’ Viera Gray House DS0000017396.V342894.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 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 Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Timescale for action 01/08/07 2 OP7 13(4) 3 OP9 13(2) Care plans must contain sufficient detail, including social, cultural, religious and health information. To ensure that residents needs can be met. Clear and detailed assessments 01/08/07 of risk must be in place wherever there is an identified risk or restriction. Risk assessments must give information on actions to minimise risks. Previous requirement of 30/09/06 not met. 1. The allergy section on records 09/07/07 must be completed and accurate. (Previous requirements of 01/03/06 and 31/08/06 not met) 2. Medication must be given as prescribed Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 25 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 OP27 Good Practice Recommendations The organisation should consider ways to increase the number of permanent staff at the home. Viera Gray House DS0000017396.V342894.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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. 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