Inspection on 27/11/07 for Westminster House Care Ltd

This inspection was carried out on 27th November 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Westminster House Care Ltd 18/12/06

Westminster House Care Ltd 06/12/05

Westminster House Care Ltd 18/07/05

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOMES FOR OLDER PEOPLE Westminster House Care Ltd 41 Westminster Drive Westcliff On Sea Essex SS0 9SJ Lead Inspector Michelle Love Unannounced Inspection 27th November 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Westminster House Care Ltd DS0000062663.V353681.R03.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. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westminster House Care Ltd Address 41 Westminster Drive Westcliff On Sea Essex SS0 9SJ 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) 01702 333034 01702 333034 Westminster House Care Ltd Manager post vacant Care Home 12 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (12) Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th December 2006 Brief Description of the Service: Westminster House is a care home offering care and accommodation for up to twelve older people who have dementia or a mental health disorder. The cost of care at this home is from £73.00 - £80.00 per day. Westminster House is situated in a residential area of Westcliff-on-Sea and the premises are in keeping with the houses in the locality. Accommodation comprises of a large lounge with dining area. There are twelve single bedrooms situated on the ground and first floor. There is a five person passenger lift. The home has a non-smoking policy and staff and residents who wish to smoke make use of a cabin in the garden. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection visit. The inspection was undertaken over a seven hour period. At this inspection all the key standards and the management teams progress against their previous agenda for action were assessed. Prior to this inspection, the registered provider had submitted an Annual Quality Assurance Assessment, detailing what they do well, what could be done better and what needs improving. At this inspection visit, a tour of the premises was undertaken, residents and members of staff were spoken with and their comments are used throughout the main text of the report. Following the inspection, relatives were contacted so as to seek their views about the services provided. The inspector was assisted by the deputy manager registered provider and other members of the staff team. Feedback on the inspection findings were given throughout the day and summarised at the end of the day. The opportunity for discussion and/or clarification was given. What the service does well: Feedback from residents, relatives and staff about the home were positive. Comments such as “I like it here” and “Nice homely place to work in and the residents are well looked after and kept active” were made. Relatives were positive about the care their relatives received. Information relating to the services and facilities provided were seen to be good. The management team are good at ensuring that prospective residents are assessed prior to admission so that they are able to meet the individual’s needs. Where appropriate more than one visit is planned/undertaken so as to enable the prospective resident to visit Westminster House so as to meet existing residents and staff. Residents are actively encouraged and enabled to participate in a range of activities, which meet their social care needs. Relatives felt that they were always made to feel welcome in the home and this was observed by the inspector on the day of inspection. Staff working within the home, were observed to have a good relationship with residents and were able to demonstrate a good knowledge and understanding of individual needs. The ambience of the home is inviting and warm. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 6 Resident’s needs are met by the right numbers and skill mix of staff. The management team are proactive in ensuring that new staff members are appointed in line with robust and safe recruitment procedures. Team work and staff morale at the care home are good. Staff were observed to be friendly and helpful and made positive comments about the home and the management team. Management of the home is proactive, not complacent and seeks ways of improving the service for residents. What has improved since the last inspection? What they could do better: Care planning at Westminster House has improved and is generally good, however further development and attention to detail is required, to ensure that all residents’ needs are identified and planned for. Information should also include clear guidelines identifying staff interventions and strategies. Some procedures for the safe management of medication need to be reviewed to ensure that outcomes for residents are positive and that their healthcare needs are met. Although it is recognised that staff have received a range of training since the last inspection, further development is required to ensure that staff receive training pertaining to those conditions associated with mental disorder. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 7 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. Westminster House Care Ltd DS0000062663.V353681.R03.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 Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their families are given sufficient information about the services and facilities at Westminster House before they decide to move into the home, so they are well informed and can decide as to whether or not the care home is the right one for them. Prospective residents have their needs assessed prior to admission so that the management team know that they are able to meet individuals care needs. EVIDENCE: Since the last inspection the registered provider has reviewed and updated both the Statement of Purpose and Service Users Guide. The Service Users Guide has been compiled in both a written and pictorial format and these were available for residents and other interested parties. Both documents were observed to contain information as required by regulation. The Annual Quality Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 10 Assurance Assessment, details that is planned for the future to produce a DVD and development of the Statement of Purpose in pictorial format. The care file for the most recent person admitted to the care home since the last inspection showed that a pre admission assessment, to ensure that the management team are able to meet the prospective resident’s needs, had been completed over a period of time. Information recorded was sufficient so that the management team could make an informed decision about whether or not they could meet the individual’s needs. Additional information had been provided by the resident’s placing authority and there was evidence to indicate that the resident had visited Westminster House prior to admission and that their family had been invited to visit the care home. Additionally there was evidence depicting that a multi-disciplinary meeting had been facilitated to discuss the transitional steps undertaken for the resident and to confirm that the placement was deemed suitable. Intermediate care is not provided at Westminster House. Westminster House Care Ltd DS0000062663.V353681.R03.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 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In general residents health and care needs are well identified, however further development is required so as to ensure that residents receive a standard of care that meet their needs and provides positive outcomes. Further development is required pertaining to the management of medication so as to ensure that individuals healthcare needs are met. EVIDENCE: As part of this inspection a random sample of care files were examined. It was evident from discussions with both the deputy manager and the registered provider that since the last inspection, care documentation had been reviewed and updated and includes reference to daily routines. Care files in general, provided a good basis for care to be delivered to residents and there was evidence to indicate that resident’s had been consulted in relation to their personal preferences, strengths and areas of Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 12 need. Observations and discussion with care staff demonstrated a good understanding and knowledge of individual resident’s care needs. Identified shortfalls in care planning were discussed with both the deputy manager and registered provider and related to care plans not reflecting in sufficient detail individual resident’s behavioural care needs e.g. known triggers and management strategies depicting how care staff are to deal effectively with individual’s inappropriate behaviours. This could leave staff unaware of residents needs and could lead to an inconsistent approach being adopted by some staff members, resulting in residents not receiving the most appropriate delivery of care. Additional information is also required detailing how some individual’s poor mental health care needs and their dementia impact on their every day life. Records and observations showed that resident’s have access to a range of healthcare services and professionals as and when required, and that the management team and care staff provide an appropriate level of healthcare to residents. Residents can access professional services such as GP, chiropody, care manager, community psychiatric nurse, optician etc. Relatives spoken with advised that they were happy with the care provided at the care home for their member of family and that outcomes of GP/hospital appointments are conveyed by staff to them, so as to keep them informed. Of those care files examined risk assessments were completed for all assessed areas of risk. The deputy manager and registered provider were advised to ensure that where staff interventions are required, information is clearly recorded. Daily care records were observed in general to be informative, however further development is required to ensure that records include staff’s interventions so as to evidence actual care delivery provided by staff to individual resident’s. Medication at the home is generally well maintained and managed. The medication round was observed and staff practices were seen to be in line with regulation. The majority of records were seen to be satisfactory, however both the deputy manager and registered provider were advised to ensure that where the Medication Administration Record (MAR) states the dose to be administered can be variable, the specific dose administered should be recorded. Additionally where the MAR sheet is handwritten, this should be double signed/witnessed so as to ensure that the information detailed has been recorded accurately. MAR sheets evidenced that medication relating to pain relief had been out of stock and unavailable for some residents. This must be monitored to enable all residents to receive their prescribed medication and to have their healthcare needs met. A list of staff deemed competent to administer medication to residents was evident and from inspection of staff training records, these confirm that all Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 13 staff detailed had received training/up to date training relating to medication. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The social care needs of residents, are met and ensures that residents receive stimulation and appropriate activities. Meals provided to residents are of a satisfactory quality and promote a healthy diet and wellbeing for people at the home. EVIDENCE: Residents are actively encouraged and enabled to participate in a range of activities, which provide stimulation and occupation. Records evidenced activities such as card games, dominoes, ball games, hand massage, sing-along, reminiscence, arts and crafts and access to external venues e.g. local bingo hall, church club and shopping. Records indicated that activities are undertaken on both a group and one to one basis and where appropriate, individual residents are enabled and/or supported to participate in day-to-day tasks within the home. Visiting at the home is open and one visitor advised the inspector that they were always made to feel welcome and that staff were helpful and kind. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 15 Lunch on the day of inspection looked appetising and those resident’s who required assistance with their meal were supported by staff with care and sensitivity. Those residents who required a meal that was pureed/soft were observed to have individual food items portioned separately so that they looked appealing and inviting. The management of the home had devised a two-week rolling menu and on inspection this indicated that residents are provided with `good home cooking` e.g. toad in the hole, fish and chips, roast dinner, sausages and mash, shepherds pie etc. A choice of hot and cold snacks, were available at teatime. Individual residents made comments such as “the food is lovely and this is nice”. The management of the home were advised to consider devising and implementing a larger print and/or pictorial menu board so as to enable residents to make an informed choice. Following discussions with the registered provider, this is planned for the future. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of complaints is satisfactory. Developments in adult protection policies and related staff training would further improve outcomes for residents. EVIDENCE: The home has a clear complaints procedure in place, which is on display for residents, visitors and other interested parties. Since the last inspection, the management team at Westminster House have not received any complaints. The record of compliments was also examined and indicated that none have been received since the last inspection. Relatives spoken with confirmed that they are aware of the home’s complaint procedure and felt assured that should any issues be raised, that they would be dealt with by the management of the home. At the last inspection, the inspector requested that the policy on safeguarding be reviewed. The registered provider advised the inspector that the procedure for staff has been updated and is simple and easy to read. Both the deputy manager and registered provider were spoken with at the inspection and demonstrated a good awareness of safeguarding and whistleblowing procedures. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 17 Staff training records indicated that the majority of staff had received training relating to safeguarding. The Commission for Social Care Inspection recognises that several members of staff have received training relating to dementia awareness and that within this there is an element devoted to challenging behaviour, however further development of this particular area needs to be considered to ensure that staff have the skills, confidence and competency to deal with individual resident’s needs. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 18 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Westminster House provides a clean, comfortable and safe environment for residents. EVIDENCE: As part of this inspection, a tour of the premises was undertaken with the assistance of the registered provider. The care home was observed to be homely and had a nice ambience. All areas of the home were well decorated and individual resident’s bedrooms were observed to be personalised and individualised to suit individual’s preferences. Two residents spoken with confirmed that they were happy with their room. Following the last inspection one bathroom on the ground floor has been turned into a wet room. This is seen as a positive move to enhance the home’s environment and in meeting resident’s needs. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 19 For those people who wish to smoke, the registered provider has provided an external room/cabin which has heating and lighting. During the inspection, individual residents were seen to be accompanied by staff to access this area. One resident spoken with confirmed they were happy with the current smoking arrangements. No unpleasant odours were noted on the day of inspection and the laundry facility was tidy. Training records indicated that some staff had received training relating to infection control. The Annual Quality Assurance Assessment details that further improvement is to be carried out to enhance the home environment e.g. new carpet in the hallway, additional double glazing and redecorating of resident’s bedroom doors. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 20 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at Westminster House can feel assured that the numbers of staff, training undertaken by care staff and the management’s recruitment procedures will ensure that their needs can be met. EVIDENCE: The deputy manager advised the inspector that the current staffing levels remain at 3 staff between 09.00 a.m. and 18.00 p.m., 2 staff between 18.00 p.m. and 21.00 p.m., 2/3 members of staff between 21.00 p.m. and 22.00 p.m. and 2 waking night members of staff between 22.00 p.m. and 09.00 a.m. each day. On inspection of four weeks staff rosters, it was evident that staffing levels as detailed above are being maintained. The registered provider must ensure that the reduction between 21.00 p.m. and 22.00 p.m. is appropriate and continues to meet individual resident’s needs. The deputy manager and registered provider advised the inspector that one person has been newly recruited since the last inspection. On inspection of this employment file, the majority of records as required by regulation were in place. Gaps were noted in relation to no recent photograph, no health declaration and no copy of the person’s job description. A record of induction was available and indicated that some elements of skills for care had been considered. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 21 On inspection of training records, these evidence that since the last inspection, some staff have received a variety of training relating to safeguarding, food hygiene, dementia awareness, medication administration, moving and handling, emergency first aid, health and safety, fire awareness, respiratory conditions and preventing falls. Records also indicate that one member of staff undertook training relating to communication. The registered provider was advised that further training needs should be considered for those conditions associated with people who have a mental disorder. This will ensure that staff working at the care home, are able to meet and understand the specialist needs of residents. The registered provider advised that 6 members of staff have attained NVQ Level 2 (4 staff members awaiting certificates) and 3 staff, are currently undertaking NVQ Level 2. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 22 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, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and provides positive outcomes for those people residing at the care home. EVIDENCE: Westminster House benefits from having a proactive and competent management team in place. At the time of the inspection, the inspector was made aware that following the last inspection a manager was appointed, however at present they are undertaking a period of absence/extended leave from the home. The care home is being managed by the deputy manager and is supported by the registered provider. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 23 Staff and residents spoke well of the deputy manager and the registered provider. Quality Assurance surveys have been completed by outside agencies and resident’s representatives. Although outcomes/analysis of these surveys has not been undertaken by the registered provider one questionnaire recorded positively “Just a few lines to say thank you to all of you for the kind care you have given my relative over the years. I am very grateful to you all for allowing me to phone or visit whenever I want to and for letting me have an input with regards to my relatives care”. In addition to the surveys the registered provider advised that internal checks are also completed. Evidence was available to indicate that resident and staff meetings are undertaken. The deputy manager advised the inspector that supervision sessions for staff are conducted on average 6-8 weekly. Records are held securely and only the supervisor has access to the records. The registered provider advised that no monies for residents are managed. Currently one resident accesses their own bank account and it is envisaged that this will be increased for other residents who are assessed as able to look after their own financial affairs and/or require limited support from staff to manage their personal monies. A random sample of records relating to fire equipment, fire drills, the fire plan for the home, fire risk assessments and hot water temperatures were inspected and observed to be satisfactory. Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 24 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 3 X 3 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X N/A 3 X 3 Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 15 Requirement Ensure that individual plans of care are detailed and contain sufficient information for staff relating to how individual’s challenging behaviour are to be managed and how their mental health care needs and/or dementia affect their everyday life. Ensure that all residents receive their prescribed medication, so that their health and wellbeing can be maintained at all times. Ensure that all staff receive training, especially for those conditions associated with mental disorder. This will ensure that staff, have the competency and skills to meet residents care needs. Timescale for action 21/01/08 2. OP9 13(2) 27/11/07 3. OP30 18 01/04/08 Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 26 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. 2. Refer to Standard OP7 OP9 Good Practice Recommendations Daily care records should include information relating to staff’s interventions/actual delivery of care. MAR records to detail the variable dose of medication actually administered to individual residents and where handwritten MAR sheets are in use, these are to be witnessed/signed by two members of staff to ensure accuracy. Ensure on each staff recruitment file that this includes a recent photograph, health declaration and copy of their job description. 3. OP30 Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Westminster House Care Ltd DS0000062663.V353681.R03.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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