Inspection on 10/04/08 for Wellfield House

This inspection was carried out on 10th April 2008.

CSCI found this care home to be providing an Adequate service.

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

Wellfield House 05/05/09

Wellfield House 25/03/09

Wellfield House 15/01/09

Wellfield House 14/11/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Wellfield House Manor Road Catcott Bridgwater Somerset TA7 9HT Lead Inspector Jane Poole Unannounced Inspection 10th April 2008 9:45am 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 Wellfield House DS0000065827.V361832.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. Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wellfield House Address Manor Road Catcott Bridgwater Somerset TA7 9HT 01278 722405 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) Farrington Care Homes Ltd Mrs Susan Margaret Pear Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th November 2007 Brief Description of the Service: Wellfield House is an attractive property located in the centre of Catcott village, approximately eight miles from Street and Bridgwater. The premises have been registered as a care home since 1989 and provide accommodation on two floors. There is parking for four to five cars at the front of the building. The home has a cottage annexe built in the grounds which houses a further three bedrooms. Wellfield House is registered with the Commission for Social Care Inspection to provide personal care for 21 people over 65 years of age. The home does not provide nursing care although district nurses visit the home regularly to provide treatment and advice. The home provides day care for up to two people six days a week. Farrington Care Homes Limited purchased the home in 2005. The responsible individual is Mr Kiran Nathwani. The manager Mrs Susan Pear has had many years experience of working with older people and managing care staff. There continues to be a strong commitment by the small team of established carers and support staff providing care in a relaxed family style home. Fees at the home range from £378.00 to £458.00 per week. Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. The inspection was carried out over a one-day period. During the day the inspector was able to meet with people living and working in the home and one person who was visiting. The inspector was able to tour the building and to observe care practices. Neither the registered manager or the acting manager was working at the time of the inspection although the acting manager came into the home to make some records available. The area manager and the directors of the company were visiting the home and were able to meet with the inspector. In the absence of the registered manager some records were not available. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: Wellfield House provides a comfortable homely environment. All areas seen by the inspector were warm, clean and fresh. Anyone wishing to move to the home has their needs assessed and is able to visit and spend time in the home before deciding whether or not to move in. People are able to bring personal possessions with them, which gives rooms an individual feel. People are encouraged to maintain contact with friends and family and visitors are always made welcome. People living at the home stated that routines are flexible and they are able to choose how they spend their time. Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 6 Everyone spoken to said that the food in the home was of a good quality. Mealtimes are relaxed and unhurried giving people the opportunity to socialise with each other. People living at the home stated that they would be comfortable to raise any concerns or worries with a member of staff. Staff were described as kind and always willing to assist. What has improved since the last inspection? What they could do better: When asked what the home could do better more than one person said that they would like more social activities in the home. Everyone at the home has a care plan but these are not comprehensive and do not give clear guidelines to enable staff to assist people in their chosen style. There is limited information about peoples’ social interests or hobbies. There is no evidence that people living at the home are involved in the creation, or review, of their care plan. Staff felt that they would benefit from training about care planning. Medication practices could be improved to ensure the safety of people at the home. At this inspection it was noted that all Medication Administration Records (MARs) were hand written by one person and not checked for accuracy by a second person. There are no protocols in place for the use of ‘as required’ medication and therefore no guidance for staff to tell them when this medication should be given. It was noted that some ‘as required’ medication was being given on a regular basis. Staff would benefit from comprehensive training in medication practices. Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 7 Systems for recording and retaining information is not good and does not promote transparency. In the absence of the registered or acting manager written records of staff training could not be found and there was no training matrix available to evidence that statutory training was up to date for all staff. Records to evidence that portable electrical appliances had been checked for safety were not available at this inspection. Requirements have been made at two pervious inspections to ensure that staff receive up dated training in first aid. Two senior members of staff have received training but one of these people is currently not working in the home. The home should therefore carry out a first aid risk assessment to ascertain their first aid needs and put appropriate measures in place. 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. Wellfield House DS0000065827.V361832.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 Wellfield House DS0000065827.V361832.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): 3 & 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Anyone wishing to move into Wellfield House has their needs assessed to ensure that the home is able to meet their needs. There are opportunities for people to spend time in the home before deciding to move in. Intermediate care is not provided. EVIDENCE: Staff on duty at the time of the inspection stated that anyone thinking about moving into Wellfield House is seen and assessed by a senior member of staff. Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 10 One new person has moved into the home since the last inspection. Their personal file showed that the home had obtained a copy of a full assessment completed by professionals outside the home. People asked stated that they or their representative had been able to visit the home before deciding to move in. This ensures that people have an opportunity to meet other people living at the home and ensure that it will be able to meet their expectations. In addition to full residential care the home also offers day care to a small group of people, which is another opportunity for people to spend time in the home before deciding to move in. One person spoken to stated that they had originally stayed at the home for a period of respite before becoming a permanent resident. Wellfield House DS0000065827.V361832.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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home have access to healthcare professionals in line with their individual needs. Medication practices in the home need to be improved to ensure that they promote safe practice and minimise the risk of errors occurring. Care plans do not give clear guidelines for staff to follow and are not created in consultation with people living at the home. EVIDENCE: Everyone living at the home has a care plan. The inspector viewed 3 care plans in detail and sampled a further three. All were personal to the individual but were not comprehensive and did not give clear guidelines for staff. For example one plan of care stated ‘needs help with showering’ but gave no Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 12 further information of the type of help required. There was limited information about peoples’ mental health or social needs. However staff spoken to during the inspection demonstrated a good knowledge of the people living at the home and their individual needs and personalities. Two staff spoken to stated that they felt that they needed further guidance on completing care plans. There was no evidence that people living at the home were fully involved in the creation, or review, of their care plans and no documentation to state why they had not been involved. Care plans seen gave evidence that people have access to healthcare professionals in line with their individual needs. All appointments are recorded. People living at the home were generally happy with the support they received with healthcare and many said that the district nurse visited them at the home. People said that they felt that their privacy was respected. The inspector noted that people were free to spend time in the communal areas or in the privacy of their rooms. Staff interacted with people living at the home in a friendly polite manner. Medication is supplied by the surgery and is dispensed from its original packaging. All medication is kept securely in the office and then placed on an open trolley and taken to a communal area to be dispensed to individuals. Since the last inspection the home have carried out a risk assessment on the use of the open trolley. Staff stated that they never leave the trolley unattended. All Medication Administration Records (MARs) are hand written and signed by one person. The inspector noted that these were not being checked by a second person to ensure their accuracy and minimise the risk of errors occurring. All medication is signed into the home and signed for when administered to provide a clear audit trail. There were no protocols for medication, which is prescribed on a PRN (as required) basis meaning that there were no guidelines for staff to state in what circumstances these medicines should be given. In once instance it was noted that PRN medication was being given on a regular basis but there was no rationale for this in the care plan or on the MAR chart. Staff asked stated that they had received training on the administration of medication from the registered manager. Training described by the staff did not appear to be in line with standard 9.7 of the National Minimum Standards for Older People. Wellfield House DS0000065827.V361832.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. Routines in the home are flexible in line with peoples’ wishes and choices. Visitors are encouraged to ensure that people maintain contact with family and friends. There are some organised activities but some people living at the home would like to see this expanded upon. EVIDENCE: People living at the home stated that routines were flexible. People were able to choose what time they got up, when they went to bed and how they spent their day. Staff stated that since the last inspection staffing levels in the home have increased in the morning, which has meant that they now have more time to assist people to get up and to spend time with individuals. Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 14 There are some organised activities in the home. Some entertainers have been booked for the coming months and care staff are responsible for assisting people to occupy themselves on a daily basis. It was noted that in the afternoon of the inspection a carer spent time in the lounge playing games and chatting to people. There is a large TV in the main lounge that was on throughout the day although when the inspector spent time in the lounge everyone said that they were not watching it and did not know why it was on. The majority of people at the home have TVs and radios in their room and some people have personal phones. People are able to bring small items of furniture and other possessions to personalise their rooms. There is a monthly church service held at the home and people said that they could go to the local church if they wished to. The hairdresser visits on a weekly basis. One person said that they played scrabble and other board games. More than one person spoken to said that they would like to have more social activities and that they spent a lot of the day sat in the lounge with the TV in the background. One relative spoken to stated that they were able to visit at anytime and that they were always made welcome. Many people living at the home stated that they enjoyed visits and trips out with family and friends. There is a notice board in the dining room stating what the meals for the day are and people are able to request an alternative if they wish to. Everyone asked stated that the quality of the food was good. The inspector was invited to have lunch with people living at the home. The meal was well presented and cooked. The lunchtime was sociable and unhurried giving people the opportunity to chat and relax. Wellfield House DS0000065827.V361832.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 adequate. This judgement has been made using available evidence including a visit to this service. The recruitment practises are now more robust and minimise the risks of abuse to people living in the home. The home should ensure that all staff are aware of the local policy and procedure on Safeguarding Vulnerable Adults to ensure that staff are able to respond appropriately to any allegations or concerns. EVIDENCE: The home has policies and procedures in respect of recognising and reporting abuse, making a complaint and whistle blowing. Staff spoken to stated that they felt well supported and were aware of the ability to take serious concerns outside the home. People living at the home said that they would be comfortable to discuss any worries or concerns with a member of staff. There is information on the notice board on making a complaint and how to contact outside advocacy agencies. There is evidence that the owners of the home, Farrington Care Homes Ltd, take all allegations seriously and are aware of their responsibilities in respect of the protection of vulnerable adults. Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 16 There are no records that staff have received training in issues of abuse or the protection of vulnerable adults but some people stated that it had been covered in the National Vocational Qualification (NVQ.) Staff are not familiar with the Somerset policy – ‘Safeguarding Vulnerable Adults.’ A complaints log is maintained which showed no complaints have been received since the last inspection. The inspector observed that people moved freely around the home and had unrestricted access to communal areas and their personal rooms. Recruitment procedures have improved since the last inspection and now minimise the risks of abuse to service users. Wellfield House DS0000065827.V361832.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, 24 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Wellfield House provides a comfortable homely environment. EVIDENCE: The home is an attractive building located in the village of Catcott. There are public transport links to larger towns. All areas are fitted with a fire detection and call bell system. Accommodation is located over two floors with a stair lift between. All communal seating areas are on the ground floor and are accessible to people Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 18 with all levels of mobility. There is a large lounge/diner and a smaller quiet lounge. In addition to the main house there is an annexe with three bedrooms and a lounge area. Outside the home there is an attractive courtyard with a summer house and seating which people living at the home have unrestricted access to. People are able to bring small items of furniture and other personal possessions with them, which gives bedrooms an individual homely feel. The inspector toured the building and noted that all areas were clean and fresh. There is a laundry that is appropriate to the size of the home. Since the last inspection a hand-washing sink has been fitted in the laundry to promote good infection control practices. All areas seen were warm and comfortably furnished. Wellfield House DS0000065827.V361832.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, 29 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is adequately staffed. The home needs to have a training programme in place to ensure that staff have the skills to meet the needs of people living in the home and are aware of current up to date best practice. EVIDENCE: Since the last inspection the home has increased the level of care staff in the morning. This means that there is now three care staff on duty each morning and two in the afternoons. Overnight there are two staff on duty. All staff asked felt that this was a great benefit to the home. In addition to care staff there is a cook and domestic on duty each day. Staff are based in the main house and regularly go to the annexe during the day and night. On the day of this inspection neither the registered manager nor the acting manager was working in the home, therefore records of staff training were not available. Staff spoken to stated that they had recently completed training in health and hygiene and fire safety. One member of staff said that recent staff training was video training with questionnaires. They felt this was a very good Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 20 way of learning because it enabled the staff team to be together to discuss issues raised. A requirement has been made at the previous two inspections for the home to ensure that staff receive up dated training in first aid. Two senior members of staff have received first aid training but one of these people is currently not working in the home. The home should therefore carry out a risk assessment to ascertain their first aid needs and put appropriate measures in place. One new member of staff was spoken to they said that they had been welcomed into the team and felt well supported by all staff. The staff recruitment records for the two most recently appointed members of staff were viewed by the inspector. These contained application forms, written references and enhanced Criminal Records Bureau checks. There was no evidence of an induction programme in the files seen. One member of staff said that they had had a basic induction with the registered manager and were aware that there was a more comprehensive induction programme, but had not been asked to complete it. People living at the home said that staff were kind and always willing to assist them if they requested help. Wellfield House DS0000065827.V361832.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): 33, 35, 37 & 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The company has been pro-active in ensuring the smooth day-to-day running of the home in the absence of the registered manager. Systems in relation to the recording and retaining of information are not transparent. EVIDENCE: The registered manager is Sue Pear who is currently away from the home. In the absence of the registered manager the company have appointed an acting manager to maintain the smooth running of the home. The acting manager Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 22 was not working on the day of the inspection but came into the home to make some records available for the inspection. On the day of the inspection there was a relaxed atmosphere in the home and all staff said that they were being well supported by the acting manager and the area manager. The area manager and the directors of the company visited the home on the day of the inspection. The company carries out quality assurance audits, which includes sending out questionnaires to interested parties on a regular basis. The area manager visits the home regularly. Staff stated that there are staff meetings in the home, which are an opportunity to share information and ideas. Minutes of staff meetings could not be found during this inspection. In the absence of the registered or acting manager many items requested could not be found by staff which shows that systems in place for the recording and retaining of information are not good and do not always provide transparency. The home does not act as a financial appointee or power of attorney for any person living at the home. The inspector viewed the fire log, which showed that alarms, door releases and detectors are tested weekly. The homes policy is to test emergency lighting on a monthly basis but records show that this was last tested in January of this year. Since the last inspection the home has set up a contract to ensure that the fire detection and alarm system is serviced twice a year by outside contractors. All lifting equipment in the home is regularly serviced by outside contractors and was last tested on the 3rd March 2008. There was no evidence that portable electrical appliances had been tested in the last 12 months. As previously stated staff said that they had recently received training in health and hygiene and fire safety. No training matrix was available to evidence that all statutory training for staff was up to date. There is an up date certificate of insurance displayed in the home. Wellfield House DS0000065827.V361832.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 3 N/A 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 3 x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x 1 2 Wellfield House DS0000065827.V361832.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(2) Requirement Care plans must be drawn up in consultation with service users where appropriate. All care plans must be kept up to date to ensure that they give clear guidance for staff. Requirement made at previous inspection date for compliance 30/01/08 not met. The manager must ensure that service users are consulted about their social interests and provide appropriate activities and social stimulation for all. Requirement made at previous inspection date for compliance 28/02/08 not met. The manager must ensure that all staff receive training appropriate to work that they do and records are kept of training undertaken. Requirement made at previous inspection date for compliance 28/02/08 not met. DS0000065827.V361832.R01.S.doc Timescale for action 30/05/08 2 OP12 16(2) mn 30/05/08 3 OP30 18 (1)c19 (1)bSch 2 30/05/08 Wellfield House Version 5.2 Page 25 4 OP9 13 (2) 5 OP30 18 (1) [a] 6 OP37 17 7 OP38 13 (4) The registered person must ensure that medication practices are safe and procedures are in place to minimise the risk of errors. The registered person must forward to the Commission for Social Care Inspection details of all staff training undertaken and planned. The registered person must ensure that records in the home are well maintained and up to date. The registered person must carry out a risk assessment in relation to their first aid needs and put appropriate measures in place. 30/04/08 16/05/08 16/05/08 16/05/08 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 OP18 Good Practice Recommendations The manager should ensure the Abuse and Whistleblowing policy make clear that informants are able to contact Local Authority, Social Services and Commission for Social Care Inspection. Recommendation made at previous inspection. The manager should ensure that alternative meals are written on the menu to enable service users to make a choice about the food they eat. Recommendation made at previous inspection. The manager should ensure that all staff undertake an induction programme in line with the ‘skills for care’ 12 week programme. Recommendation made at previous inspection. The manager should ensure that: Emergency lighting is tested on a monthly basis. Portable electrical appliances are tested annually. Recommendation made at previous inspection. Staff should receive training in care planning. DS0000065827.V361832.R01.S.doc Version 5.2 Page 26 2. OP15 3 OP30 4 OP38 5 OP7 Wellfield House 6 OP7 7 OP18 All hand written entries on medication records should be signed and witnessed to minimise the risk of errors. There should be clear individual protocols in place for the use of ‘as required’ medication. All staff should receive training in abuse issues and be made familiar with the local policy on recognising and reporting abuse. Wellfield House DS0000065827.V361832.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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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