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Inspection on 19/04/06 for West Lodge Care Home

Also see our care home review for West Lodge Care Home for more information

This inspection was carried out on 19th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents spoken with stated they are being well cared for and their privacy and dignity is respected. Two visiting relatives expressed confidence with the level of care being received by their relatives at the home. They also stated staff are friendly and helpful. Residents were observed to be relaxed and appropriately dressed. On the day of the inspection the home was clean and free from mal-odour. Two residents spoken with stated the food is very good and plentiful.

What has improved since the last inspection?

Following the last inspection the home has taken action to meet some of the requirements set. The bay window in the lounge has had its curtain refitted. The manager advised the inspector that the carpet in the lounge area has been replaced and the trip hazard leading to the dining area has bee replaced due to new carpets.

What the care home could do better:

There was no evidence of systems in place to prevent legionella. The Registered Person to seek advice from the Health and safety officer. The statement of purpose continues to require further amendments to include all elements in schedule 1 of the care homes regulation 2001. The training provision needs to be improved to ensure that the mandatory topics including adult protection are taken by staff. Practice around medication administration requires further improvement to ensure no prescribed medication is left out and unattended. Requirements are set in relation to staff files, amendments to the statement of purpose and all staff to receive training in mandatory area`s.

CARE HOMES FOR OLDER PEOPLE West Lodge Care Home 238 Hucknall Road Sherwood Nottingham NG5 1FB Lead Inspector Rehana Rashid Unannounced Inspection 19th April 2006 09:50 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 West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 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. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service West Lodge Care Home Address 238 Hucknall Road Sherwood Nottingham NG5 1FB 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) 0115 9606075 0115 9606075 Ms Razma Vanessa Alishan Ms Razma Vanessa Alishan Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (21), Physical disability (4), Terminally ill (2) of places West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the total number of beds a maximum of 4 bed maybe used for the category PD Within the total number of beds a maximum of 2 bed maybe used for the category TI 9th November 2005 Date of last inspection Brief Description of the Service: West Lodge Care Home was established in 1987. It now provides nursing and personal care for 27 residents. Within this number, the registration allows admission for up to 4 people who have a Physical Disability and 2 people who are terminally ill. The home is privately owned by Ms Razma Vanessa Alishan. Located on a main road in Sherwood, it is on a main bus route into Nottingham city centre. The home consists of a large converted house, with a purpose built conservatory. There are 6 double bedrooms and 13 single rooms 4 of which have en-suite facilities. There is ramped access to the building and a passenger list serves all three floors. The homes grounds are mainly to the front of the building and are well maintained although there is open access to the road. There is car parking space at the front of the home. The registered manager stated that the current weekly fee range is approximately £262 to £410. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out on 19th April 2006 for duration of six and half hours. The main method of inspection was case tracking, which involved randomly selecting three residents and examining the care plans. Case tracking is used to establish if the needs of the residents are being appropriately assessed by the home and their needs are being catered for. Indirect and direct observation of practice and interaction between staff and residents was also carried out as part of the inspection methodology. The manager gave the inspector a partial tour of the building. Which included the communal areas, 1 bathroom (ground floor), kitchen and three bedrooms. Residents were briefly observed during lunchtime. Other documentation including health and safety records were also examined. The management of medication was partly assessed. During the course of the inspection the Inspector spoke with two residents, the feedback was positive about the level of care received. These residents spoke positively about the care staff and about the service provided by the home. Two relatives were interviewed during the inspection both praised the home and the level of care provided by the staff. The Registered Manager assisted in the inspection process. Three members of staff were spoken with to obtain their views on the home. Staff files What the service does well: The residents spoken with stated they are being well cared for and their privacy and dignity is respected. Two visiting relatives expressed confidence with the level of care being received by their relatives at the home. They also stated staff are friendly and helpful. Residents were observed to be relaxed and appropriately dressed. On the day of the inspection the home was clean and free from mal-odour. Two residents spoken with stated the food is very good and plentiful. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 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 West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 Quality in this outcome area is adequate this judgement has been made using available evidence including a visit to the service. The statement of purpose needs to be amended to meet legal requirements. EVIDENCE: The Statement of Purpose was viewed which has been produced by the registered manager, which does not fully meet the elements as identified in schedule 1 of the regulation. For instance it did not contain information regarding the background and qualifications of the Registered Manager. One residents care record viewed showed evidence that a prospective residents enquiry assessment had been completed, by a staff member who assessed the resident in the residents home environment. This was completed prior to the commencement of the placement. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 9 West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to the service. Resident’s health, personal and social care needs are generally set out in individual care plans. The management of medication continues to need to be improved to ensure residents are protected by the home policies and procedures for dealing with medication. Residents feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Three residents care plans were examined. The files contained no photographs of the residents. Daily communication sheets are signed and dated by the author. Significant events are recorded however some of the entries were illegible. There was no evidence on the care plans regarding resident’s oral health needs, but there was evidence that some residents had received input from the dentist. One resident with diabetes his risk assessment does not provide action that staff should follow if he experiences a diabetic hypo. Care plans included information on resident’s health, personal and social care needs. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 11 The care plans did not contain information regarding resident’s preferred daily living routine. Care plans viewed indicated residents at the home receive input from health care professionals as and when required this included GP, Chiropodist and dentist. There was evidence on the files, which showed residents receive follow up hospital appointments. Medication was observed to be stored securely in the treatment room in a lockable trolley. The inspector directly observed a member of staff dispensing and administering medication. The inspector observed the appropriate practice of signing the medication administration record (MAR – Chart) after the staff member visibly observed the resident take the medication. She also checked the medication administration record prior to administrating the medication. The temperature of the medicine fridge is taken daily. Medication from the blister pack was being popped into plastic pots for administration. One resident required assistance to take some of his medication, an individual spoon was used. During the drug round the member of staff left the monitored dosage system on top of the trolley. She also left a container with eye drops whilst she went to administrate medication. This was immediately raised with the staff member who locked the medication into the trolley; the risks about leaving medication unattended were raised with the staff member. This was also discussed with the manager advising her under no circumstance should prescribed medication be left unsupervised. Photographs of residents should be placed with individual medication records to assist with identification. Residents spoken with during the inspection confirmed that they are happy with the arrangements made to promote privacy and dignity. Whilst the inspector was being shown around the home, staff knocked on the door and waited for permission before entering resident’s rooms. Both residents spoken with stated this was standard practice at the home and staff mostly knocks on the door prior to entering. There is a pay phone available in the conservatory; one resident stated he receives calls from family members who reside abroad. The resident also stated he receives his mail unopened. The inspector observed a good rapport between staff and residents. One resident stated overall staff are friendly and polite. One resident stated there relationship with some staff is better than others and finds some staff members more approachable. Relatives spoken with stated staff are very welcoming towards them and there are no restrictions as to when they can visit. During the inspection relatives were observed coming and going as they pleased. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to the service. Service users find the lifestyle experienced in the home matches their expectations, preferences and their cultural and religious needs. The home arranges social activities for the service users. They maintain contact with family, friends and exercise control over their lives. Residents receive a wholesome appealing diet. EVIDENCE: Residents spoken with during the inspection process confirmed routines at West Lodge Care Home are flexible to meet their individual needs and preferences. One resident stated she has her own happy memories and prefers to spend her time in her own private room. The staff at the home carried out social activities with the residents; on the day of the inspection a member of staff was playing a ball game with some off the residents. Another resident stated he did not wish to participate in social activated, however he would like to read books around history. With his agreement this was raised with the manager she agreed to look into this. During the inspection the inspector observed residents snoozing, reading the newspaper, watching television. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 13 Residents spoken with at the inspection confirmed there are no restrictions around visiting times. One resident relative stated he is able to take his relative out. Visitors reported that they are made very welcome in the home. One resident stated she is able to decide what she wants to wear and that the staff assist her. She also informed the inspector through choice she prefers to spend time on her own. The same resident stated she is confident the home are able to meet her needs, however she is not happy that the hair dresser has not been for sometime. This was raised the manager who stated the current hairdresser has been unavailable due to this she has agreed to contact another hairdresser. Both of the residents spoken with stated the meals are very nice and portion sizes are good. During the inspection the inspector observed lunchtime, some residents were assisted with their meal in a sensitive manner. Staff interacted well with residents and encouraging them to eat. Diabetic and soft diet is provided for. One resident stated he would occasionally like to have culturally appropriate meals. However during a discussion with the manager and the staff they sated residents do receive culturally appropriate meals. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good this judgement has been made using available evidence including a visit to the service. Service users and their relatives are confident that their complaints will be listened to and acted upon by the home. Adult protection is in place, all staff to receive adequate training with regards to adult protection. EVIDENCE: Residents and relatives spoken with at the inspection stated they are aware of the complaints procedure. One relative stated he would directly raise any concerns with the manager and is confident they will be taken seriously. A complaints policy is on display in the reception area. Since the last inspection a complaint was received by CSCI, this has been resolved by the home satisfactorily. The homes complaints records document complaints clearly. Information regarding complaints is kept with the complaints record. Three staff members spoken with were confident about the action they would take if they witnessed possible adult protection issue. Staff training records showed no evidence staff have received training in this area. This was discussed with the manager who stated training in this area was ongoing; there was evidence on the staff-training file about an enquiry about adult protection training. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good this judgement has been made using available evidence including a visit to the service. Residents live in a comfortable and homely environment. The home is clean, pleasant and hygienic. EVIDENCE: Residents spoken with stated they are happy with the standard of their accommodation and with their bedrooms. One resident stated she has everything in her room, which she needs and is comfortable in her private accommodation. A limited tour of the premises was conducted; radiators, which were seen, were fitted with radiator cover. Four bedrooms were viewed, they were personalised with photographs and other personal belongings. Windows in these rooms were fitted with restrictors. Lighting in the main communal areas appeared to be in good order and there was a Varity of appropriate seating. The communal areas were bright and generally well West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 16 maintained. The layout is open plan consisting of a lounge and dining room. From the lounge there is access to the conservatory, on the day of the inspection the temperature was adequate. The conservatory leads onto a patio area. Residents spoken with stated the temperature around the home was adequate. There is a passenger lift. A Residents relative spoken to confirmed West Lodge Care Home is generally well maintained and free from offensive odours. There is a domestic staff employed by the home to maintain a standard of cleanliness throughout the home. The home was clean and free from mal odours on the day of the inspection. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate this judgement has been made using available evidence including a visit to the service. Resident’s needs are met by the numbers and skill mix of staff. There is some evidence on staff files indicating staff receive training to do their jobs, but further evidence is needed to ensure this is fully up to date in mandatory areas. EVIDENCE: The staff rota was examined which indicated that there are adequate staffing levels to meet the resident’s needs. There is a skill mix of staff on duty to include domestic staff, cook and care assistant. During every shift there is trained nurse on duty. Three staff files were viewed; the files contained no photographic evidence and failed to show proof of identification. Schedule 2 of the Care Home Regulations lists the requirements for documentation to be included in staff files. One staff file contained a training certificate belonging to another member of Staff. One staff file contained one reference. Satisfactory CRB disclosures were held in separate files. The three members of staff spoken with stated they have received training. One person stated she had completed training in health and safety but as yet had not received her certificate. One staff file contained a West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 18 certificate to confirm they had completed food hygiene training, however this has now expired. Two files contained certificates confirming that Fire Training has been completed. During discussions with the manager she stated staff had received training in the area of manual handling, however there was no documentary evidence of this. In order to develop staff skills further all staff should receive training in the mandatory areas. Residents and relatives spoken with during the inspection stated they felt staff at the home are competent in their jobs. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate this judgement has been made using available evidence including a visit to the service. The manager is registered with CSCI. The home is run in the best interest of the residents. Resident’s financial interests are safeguarded. The health, safety and welfare of residents is generally promoted and protected. EVIDENCE: The manager is registered with CSCI. Staff members spoken with during the inspection stated the registered manager is supportive. Relatives and two residents stated the manager is approachable and listens to them. The manager showed the inspector evidence that she had recently started the certificate in coaching and mentoring. The manager verbally confirmed she is Working towards the registered managers award. West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 20 The manager showed the inspector evidence of feedback from relatives and residents. She stated she was still in the process of developing a quality assurance system. The manager stated she has an open door policy where relatives and residents are able to talk to her about the service provided. One relative confirmed he is able to speak to manager if there are any concerns. The manager informed the Inspector at the moment she has 18 residents and has 9 current bed vacancies, which she is concerned about. A sample of resident’s financial records were examined during the inspection and found to be satisfactory. Two residents financial records were examined and found to be satisfactory containing receipts. The expenses money is mainly used for the hairdresser and chiropodist receipting for this practice was included with records. The manager stated the home only keep allowances for a few residents and other resident’s relatives or representatives manage all finances. Staff spoken with stated they have been receiving supervision from the deputy manager, however they are able to discuss issues with the person in charge. The three staff files examined only contained supervision notes in one file. The inspector viewed a range of records relating to health and safety. During the inspection the Employers Liability Insurance Certificate was displayed in the reception area this is due to expire 11th September 2006. Fire system testing including door closure tests, emergency lighting takes places weekly as logged in the fire book. During the inspection the manager was unable to locate PAT testing, and hoist servicing details. The passenger lift was serviced March 2006. The gas service was maintained 15th June 2005. The Environmental Health Officer visited the home on 7th April 2006 and left some recommendations. The manager stated the fire officer carried out a fire risk assessment during November 2005, however there no evidence was seen to confirm this. Water outlet temperatures have not taken place since 18th January 2006. There was no evidence of systems in place to prevent legionella. The manager has agreed to contact the Environmental Health officer to seek information regarding legionella control measures During April 2006 CSCI received Regulation 37 notifications of incidents affecting the well being of residents with nursing needs. During the inspection a discussion with the manager took place she stated CSCI have been notified about incidents regarding nursing residents and Social Services about residential care residents. She was advised that in accordance with Regulation 37 of the Care Home Regulation 2001 care homes to notify CSCI of any death, West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 21 illness or significant event of all residents. A copy of a template for Regulation 37 notification was left with the manager, which she has agreed to use in future to notify CSCI. There was no evidence of systems in place to prevent legionella. This was discussed with the manager who will look into contacting the Environmental Health officer to seek information regarding legionella control measures West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 22 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 1 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 23 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 OP1 Regulation 4, 5 Requirement The statement of purpose and service user guide must be updated to include all of the elements in Schedule 1 of the Care Homes Regulations 2001. (This requirement remains outstanding from the last inspection) The statement of purpose must include the arrangements for providing day care at the home. (This requirement remains outstanding from the last inspection) Individual assessments must include how the residents oral health needs are to be met. (This requirement remains outstanding from the last inspection) Timescale for action 19/05/06 2. OP1 4, 5 19/05/06 3. OP3 14, 15 19/05/06 4. OP9 13, The registered manager shall 19/05/06 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines and other prescriptions. DS0000026478.V289600.R01.S.doc Version 5.1 Page 24 West Lodge Care Home 6. OP18 13,18 The registered manager must ensure that staff are confident in their knowledge of abuse and of adult protection procedures and receive training in mandatory areas. Ensure all staff files contain the documentation required by schedule 2 of the regulations. (This requirement remains outstanding from the last inspection). 19/06/06 7. OP29 18 19/05/06 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 OP19 Good Practice Recommendations Seek advice from the Health and Safety Executive regarding Legionella prevention measures Include further information regarding residents daily routines in the care plan i.e. personal care preferences (bath/shower) bedtimes etc 2. OP14 West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI West Lodge Care Home DS0000026478.V289600.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!