Inspection on 30/11/06 for Westwood House

This inspection was carried out on 30th November 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 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

Westwood House 14/04/08

Westwood House 29/05/07

Westwood House 22/11/05

Westwood House 05/05/05

Westwood House 07/09/04

Westwood House 06/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Westwood House 35 Tamworth Road Ashby De La Zouch Leicestershire LE65 2PW Lead Inspector Joanna Carrington Key Unannounced Inspection 30th November 2006 10:00 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 Westwood House DS0000031586.V320446.R02.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. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westwood House Address 35 Tamworth Road Ashby De La Zouch Leicestershire LE65 2PW 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) 01530 415959 01530 415990 System Associates Ltd Vacant Care Home 16 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (16), of places Physical disability over 65 years of age (16) Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the person mentioned in application number V31066 dated 17/03/2006 who is 64 years of age be admitted to the home. 22nd November 2005 Date of last inspection Brief Description of the Service: Westwood House is a care home registered to provide personal care and accommodation for up to sixteen older people that may also have a physical disability and / or dementia. The home is owned by Systems Associates Limited operators of a number of care homes in the Midlands region. The home is located close to the town centre of Ashby De La Zouch and its shops, pubs, the post office and other amenities. It is easily accessible by private or public transport. The home is a converted house with a purpose built extension. This is a three-storey building and service users have access to all floors with the use of the passenger lift or stairs. The building has level entry access which is suitable for wheelchair users. There are eight single bedrooms without en suite facilities and four double bedrooms one with en suite and three without en suite facilities. There are gardens to the front and rear of the building, which are well maintained and accessible to all residents living in the home. The weekly fees for living at the home are based on levels of need. The minimum to maximum fee is £330 to £430 per week. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over eight hours on 30th November 2006. The main method of inspection was called ‘case tracking’ which meant selecting three residents and tracking the quality of their care by checking records, discussion with them and with staff and observation of care practices. All of the residents have some dementia and limited communication so talking with relatives was also an important part of the inspection. Altogether, two residents, two relatives and two staff members were spoken with during the course of the inspection. One of the residents spoken with was quite confused and was not able to answer all of the questions. Staff records were looked at and a partial tour of the premises also took place in order to assess environmental standards. Information gathered prior to the inspection, mainly in a tool called the ‘pre-inspection questionnaire’ has also been used to reach judgements about the quality of care. The registered manager was available throughout the inspection for discussion and feedback. This inspection also included a thematic probe. The purpose of a ‘thematic probe’ is to get information about the quality of specific aspects of social care services. This consisted of asking a series of standardised questions to residents, and their relatives that were spoken with. The results of the thematic probe are recorded under the two relevant outcome groups, Choice of Home and Complaints and Protection. The evidence nationally will be reported to the Office of Fair Trading for their market study ‘Care Homes for Older People in the UK’. What the service does well: When residents move to the home they can be assured that the home will be suitable in meeting their needs because a pre-admission assessment is carried out for all new residents. There is up to date information about the home, which enables prospective residents and their relatives to make a choice about moving there. New residents along with their relative / representative sign a contract which specifies the terms and conditions of their stay. Relatives are told when their relative in care is not very well and are consulted over the support that is given. Relatives can spend time in the home and provide care if they wish to. The staff team will help residents keep in contact with family and friends and relatives can go along on the trips out, which means they can spend valuable and meaningful time with their loved ones living at the home. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 6 Residents are treated with dignity and respect and are supported by a staff team that are well trained and get good support from their manager. The manager has an open and approachable style and relatives spoken with confirmed they feel comfortable in going to the manager with any concerns and feel confident that issues are addressed. There are regular residents meetings where any issues and ideas are shared. The environment is clean, warm and comfortable for residents. 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. The summary of this inspection report can be made available in other formats on request. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5 Quality in this outcome area is good. There is a good admissions procedure, which ensures the home is suitable in meeting the needs of prospective residents and prospective residents have enough information to help them decide whether to move there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence below is applicable to the thematic probe undertaken during this inspection. A resident spoken with reported that he has regular contact with his social worker and recalls being asked about his support before moving to the home. Relatives spoken with also recalled the manager visiting them and the resident either at hospital or at home, to assess their needs. All three residents case tracked had copies of the placing authority’s community care assessment and the home’s pre-admission assessment on their file. A senior staff member spoken with reported she has been given the opportunity to go out with the manager to assess a prospective resident’s needs, for her learning and development. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 9 Signed contracts were seen on all three files seen. Relatives spoken with remembered signing contracts, one relative said that the resident and her signed the contract together. Both relatives confirmed they are always notified in writing in advance of any changes or increases in fees. A resident and both relatives spoken with remembered being given a Service User Guide. This document and the Statement of Purpose contain up to date information about the service and what it provides, having been reviewed in September this year. A relative explained that they were also given information about the home verbally by the social worker before visiting the home. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. Care planning on the whole is satisfactory but further documentation will help ensure all identified health and personal care needs are met, and uphold residents’ rights. Better stock control will promote safer medicine management and not put residents at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: For all three residents’ case tracked there are care plans in place that cover all aspects of health, personal and social care needs. There are signatures from either residents or their relatives on some of the plans, which is evidence that they have been involved in their development and agree with them. There was evidence on all three files that care plans are reviewed on a monthly basis so that any necessary amendments are made on how support is given. A resident and both relatives spoken with know there are care plans in place and they can have access to them when they wish. A relative spoken with reported “staff will ring and let me know whenever [the resident] feels ill.” Areas of risk and how it’s managed are included in the body of care plans. It is recommended that separate risk assessments be undertaken in Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 11 accompaniment to care plans as a way to identify measures for resident’s safety but also to promote their independence and quality of life. A resident spoken with mentioned how he is can only go out with a staff member although he wishes to go out independently. There is a care plan stating “it is not at this time appropriate for [the resident] to leave the home unsupervised”. A thorough risk assessment is required for what the risks are if the resident goes out independently and what are the appropriate measures for promoting their safety and wellbeing. Daily records indicate that a social worker is involved in supporting the resident and monitoring their progress. It is important nonetheless to highlight that this limitation on their freedom of movement cannot be enforced therefore the care plan must be reviewed frequently with the resident, so they are aware of their rights. It was noted on a tour of the premises that the bedroom of a resident case tracked has a very strong malodour. There was some discussion with the manager regarding the behavioural and continence needs of this resident. The registered manager reported that a referral to the continence nurse has been made and there are daily attempts at eliminating the odour however this is not documented. There is a care plan for continence needs but it does not mention this specific problem and the action being taken. Staff were observed interacting with residents in a meaningful and respectful manner and staff spoken with gave good examples of how they ensure individuals’ dignity when assisting with intimate care. Both relatives spoken with said they are happy with how the staff team treat the residents. One relative stated “my mum trusts the staff”. There are controlled drugs kept on behalf of residents. Procedures for the administration of controlled drugs are in order. The controlled drugs register and medication administration records (MAR) are filled in appropriately. The controlled drugs are stored in a mounted wooden cupboard. It is recommended that a metal cupboard be purchased, in line with Misuse of Drugs (Safe Custody) Regulations 1973 and the National Minimum Standards. No errors were found with drugs in monitored dosage systems (MDS packs) but for drugs that are in their original boxes there is no accurate record of quantities. Any remaining medication from the previous cycle should be carried forward onto the current MAR so that there is an audit trail for checking that medicines have been given as prescribed. It was noted how on one MAR the instructions for administering a medicine have been altered but there is no record on the MAR of when the change was made and by whom. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 12 Westwood House DS0000031586.V320446.R02.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 and 15 Quality in this outcome area is excellent. Meeting residents’ recreational needs and maintaining contact with family and friends is managed well in accordance with residents’ wishes. There are good arrangements in place for providing wholesome appealing meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff spoken with confirmed that spending time with residents chatting and playing games is an important element of their role. There is a file dedicated to recording what recreational activities have been provided to residents and this record shows that meaningful time is spent with residents’ everyday. On the morning of the inspection some residents were taken out for coffee and in the previous few days some of the other activities have been making Christmas cards for families, connect 4, karaoke, recreational exercises to music, pamper sessions and dominoes. Relatives spoken with confirmed they are always made to feel welcome when they visit and are invited along to activities including going for walks in the country. A staff member explained how sometimes staff facilitate phone calls between residents and their relatives or friends. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 14 There are residents meetings held monthly, and minutes of the last meeting show that residents are consulted over what activities they enjoy doing and a permanent agenda item is the opportunity for any questions or concerns to be raised. Sunday hymns is a favourite and plans are currently in progress for the Christmas party and musical entertainment. The menu records show that there are always two choices of meals and that meals are nutritiously balanced and appealing. On the day of the inspection the mealtime was observed to be a relaxed affair with residents enjoying savoury mince, mashed potatoes, sprouts and green beans followed by chocolate mousse or fruit. Westwood House DS0000031586.V320446.R02.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): Quality in this outcome area is adequate. Residents can be assured their concerns and complaints are taken seriously and acted on. Following relevant procedures in the event of any form of abuse will help ensure residents are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence below is applicable to the thematic probe undertaken during this inspection. A resident and both relatives spoken with remember being given information in the Service User Guide on how to make a complaint. Both relatives also confirmed they feel comfortable going to the manager with their concerns and that their concerns will be listened to. The registered manager reported that there have been no complaints made since the last inspection. A discussion about what should be recorded in the Complaints file took place. It is recommended that minor as well as major complaints be recorded as a way of monitoring any issues and to prevent what could potentially turn into a major complaint. The training records seen indicate that training on adult abuse is attended by staff. Staff members spoken with were asked how they would respond in certain scenarios. Staff demonstrated an understanding of confidentiality and their responsibilities to whistle-blow and alert the manager of any allegations of abuse disclosed to them. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 16 A resident that was case tracked has a care plan in place for how staff respond to aggressive outbursts and staff spoken with demonstrated they are fully aware of this care plan and what steps they have to take. A very serious incident was seen in the incident records that involved this resident verbally abusing a resident whilst waving a knife at the resident. There was no evidence that any action in relation to this specific incident was taken. There are local procedures to be followed when an incident of abuse occurs. In partnership with Social Services, who are the lead agency in adult protection, attempts to identify strategies / risk assessments should have been made to minimise the risk of such an incident occurring again, and to ultimately protect all residents living in the home. Westwood House DS0000031586.V320446.R02.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, 24 and 26 Quality in this outcome area is good. On the whole, the environment is homely, clean and hygienic and well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection some bedrooms and communal areas including the dining room and hallway have been redecorated. The lounges are homely and comfortable, with one lounge looking out onto the patio and well-maintained garden. On a partial tour of the premises the environment appeared clean and hygienic. The laundry and sluicing facilities are appropriate to the needs of residents. The bedrooms seen are personalised with individuals’ own furniture and personal items such as ornaments and pictures. It is recommended that the screen in the shared bedroom be brought back to the room ready for immediate use, to maximise the residents’ privacy and dignity. If this Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 18 particular screen is more user friendly for district nurses that visit then another screen should be purchased. A strong smell of urine was noted in one of the bedrooms. The registered manager reported that the carpet is washed on a daily basis in order to eliminate the odour but so far this action has been unsuccessful. (Please refer to the outcome area, Health and Personal Care.) Further action is required to make this room comfortable and fresh again. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. Residents’ needs are well met by sufficient numbers of trained staff. Recruitment practices fail to protect the safety of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All people spoken with during the course of the inspection confirmed that staffing numbers are not a problem. Staff members spoken with commented on having time to talk with residents as part of their duties. A relative spoken with said “staff are brilliant with [the resident]” and that “[the resident] trusts the staff.” Four staff files were selected for inspection. Three of these files were for staff members that have commenced employment since the last inspection. No evidence of a criminal record bureau check or POVA first check was available for one of these staff and the other two staff commenced their employment before the return of their criminal record bureau check. Some of the references are also dated after these staff members commenced their employment. This is of serious concern and an immediate requirement was issued in respect of the staff member with no CRB. When new staff commence employment on a POVA First check then there are induction and supervision provisos as specified under the Care Home Regulations amendments 2004, which must be adhered to. The immediate requirement was responded to immediately, with evidence of a POVA First Check supplied to the Commission. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 20 A training matrix and the four staff files seen indicate that all the necessary mandatory training, such as food hygiene, moving and handling and first aid are attended and there are other essential training programmes accessed, to enable staff to carry out their role and meet the needs of residents. Courses include Dementia Awareness, Wound Management, Risk Assessment and Protection of Vulnerable Adults. Training records also indicate that more than fifty percent of the care staff either already have or are in the process of training for their national vocational qualification level 2. Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. Health and safety and the home in general are managed well and there are good systems in place for monitoring quality underpinned by the views of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The support from the manager was described as “excellent”. Staff spoken with confirmed that both the manager and deputy manager are approached at any time if there is a problem. There are records of regular supervision sessions held with individual staff. The registered person visits the home unannounced every month to monitor the running of the home. Reports of these visits were seen and show that documents are inspected and staff and residents are spoken with. There are Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 22 monthly residents meetings where residents have the opportunity to share any issues and to make suggestions on certain aspects of the home, for example, activities. The fire log indicates that all the necessary fire system tests are carried out and there is an up to date fire risk assessment for the home, which is important for promoting and protecting the health and safety of residents. It was noted how one resident case tracked has bed rails. There is a generic care plan in place but to ensure their safe use a thorough individual risk assessment must be carried out. Residents spoken with confirmed that their relatives help them in managing their money and have access to their money when they require it. The manager and an administrator that visits the home audit all residents’ monies held by the home on at least a monthly basis. Westwood House DS0000031586.V320446.R02.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 3 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 X X X X X 3 2 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Ensure all care plans include necessary information about residents’ needs and the support required. This refers to the resident with behavioural and continence needs at night. Ensure appropriate action is taken, in line with adult abuse procedures, and that measures are put in place for the protection of all residents. Further action is identified and taken to eliminate the malodour in the named resident’s bedroom. Provide evidence of a CRB and POVA first check for the named staff member. If there is neither identify what measures will be put in place for the safety and protection of residents until the return of a satisfactory criminal record bureau disclosure. An immediate requirement was issued in respect of this. Ensure staff do not commence employment until the return of a satisfactory Criminal Record Bureau check and two written DS0000031586.V320446.R02.S.doc Timescale for action 30/12/06 2. OP18 13 30/12/06 3. OP26 16 01/03/07 4. OP29 19 01/12/06 5. OP29 19 01/12/06 Westwood House Version 5.2 Page 25 references. 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 Carry out risk assessment for the resident that is vulnerable when out in the community and ensure this risk assessment is regularly reviewed with the resident. Ensure when there are any changes to administration of medication that the medication administration record is clearly amended along with the date amendment, and by whom. Cross-reference with daily records. Ensure all stocks of medication are accounted for in the home. Carry over left over medicines from previous cycle onto the current medication administration record. Ensure screening is available in the shared bedrooms at all times. Ensure action is taken, and records kept of this action, to eliminate any malodour in the home. Ensure individual risk assessments are carried out for residents that use bed rails. 3. 4. 5. 6. OP9 OP24 OP26 OP38 Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 Westwood House DS0000031586.V320446.R02.S.doc Version 5.2 Page 27 - 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!