Inspection on 26/10/06 for Weymouth Care Home

This inspection was carried out on 26th October 2006.

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

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

Other inspections for this house

Weymouth Care Home 13/09/07

Weymouth Care Home 04/05/06

Weymouth Care Home 02/12/05

Weymouth Care Home 10/08/05

Weymouth Care Home 22/12/04

Weymouth Care Home 15/06/04

Weymouth Care Home 09/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Weymouth Care Home 21-23 Glendinning Avenue Weymouth Dorset DT4 7QF Lead Inspector Tracey Cockburn Key Unannounced Inspection 9:45 26 October & 6th November 2006 th 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 DS0000020502.V317390.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000020502.V317390.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Weymouth Care Home Address 21-23 Glendinning Avenue Weymouth Dorset DT4 7QF 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) 01305 784518 01305 206145 info@weymouthcarehome.co.uk www.altogethercare.co.uk Altogether Care LLP Mrs Jane Slater Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (10) of places DS0000020502.V317390.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th May 2006 Brief Description of the Service: Weymouth Care Home is registered as a nursing home to accommodate fortythree service users, 33 in the old age (OP) category and 10 in the Physical Disability (PD) category including younger and older persons. The home is situated in a residential area close to local amenities. The home is easily accessible by bus or taxi to the town centre of Weymouth and beaches. Altogether Care LLP owns the home and Altogether Care (Weymouth) Ltd manages the home. The designated Manager is a registered nurse and has been in post since January 2006. The Responsible Individual (RI) for the home is Mr Cotterill. The Manager is now registered with the commission. There are twenty-five single and nine sharing rooms, the majority are en-suite with a toilet and washbasin. The home is set in two wings and first floor bedrooms are accessed by two passenger lifts that can accommodate wheelchair users. Residents’ bedrooms are attractively furnished and many are highly personalised. The communal rooms include a comfortable quiet lounge/library at the front of the house, a separate open plan dining room and lounge with views of a courtyard garden at the rear of the property. There is ample off street parking at the front of the home for visitors’ convenience. The fee ranges for services at the home per week are: £595 for a shared room - £750 for a large single room with en-suite facilities. DS0000020502.V317390.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced on the first day; a further day of inspection took place the following week. Overall 9 hours and 30 minutes were spent in the home. The purpose of the inspection was to undertake a Key inspection and review 28 of the National Minimum Standards (NMS), The inspection process also included reviewing evidence from previous inspections as well as reviewing documentation relating to concerns complaints and adult protection investigations, which have taken, place since the last inspection. During the visit to the home, care records were looked at for 6 residents; this included new residents, some who had lived in the home for some time and some who were very dependant. 4 staff files were looked at as well as policy, training, recruitment and audit documentation. Residents, staff and management were spoken to as part of the process and their views and opinions are part of this report. The requirements and recommendations from the previous inspection in May 2006 were also reviewed. Prior to the visit to the home questionnaires from relatives, residents and other interested parties were reviewed and their comments are incorporated into the report, some of the comments informed the inspection. 7 comment cards were received before the inspection and help inform the inspection process. Comments included: “ It is difficult to find anyone to discuss problems” “ Most of the staff are helpful and considerate but they are struggling with too many residents” Thank you cards are kept in a file in reception and one received in August 2006 commented: “Thanks for excellent care of mother” A pharmacy inspection was completed on 11th October 2006 as part of this key inspection. The pharmacy inspection was unannounced and made 4 requirements. Most of those requirements had and were being addressed at the time of the key inspection. What the service does well: Activities in the home are varied and residents are encouraged to participate if they want to. The home provides a high standard and quality of food and recognises the importance of food in the lives of residents. The home is clean and homely and residents are able to bring personal items in to make their rooms feel very individual. DS0000020502.V317390.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: At the conclusion of this inspection there are 3 requirements and 3 recommendations. These are the requirements made at the pharmacy inspection they have been addressed and the registered provider has submitted details of the action taken to the Pharmacy Inspector. 1 of the 3 recommendations was made by the Pharmacy Inspector and action has been taken to address this. The other 2 recommendations are in relation to training in adult protection and ensuring that references are checked. Action on both these recommendations has already been taken and the Manager has tried to gain places on courses but was unlucky as the course was fully booked. Following internal disciplinary processes the Manager is already aware of the importance of ensuing that a reference is actually from a former employer. The Manager has worked hard with the staff to achieve all the outstanding requirements from previous inspections. The management and staff need to continue improving and meeting the requirements within the agreed timescales. There has been considerable improvement in this home which means residents are receiving a better quality service. DS0000020502.V317390.R01.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. DS0000020502.V317390.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000020502.V317390.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good All prospective residents have their needs assessed before moving into the home, which means they can be assured their needs, can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the pre admission assessment documentation for 3 new residents was reviewed. All 3 had assessments in place, which were completed prior to admission. There was evidence of user involvement in the assessment process. The assessment covers all the points identified in the standard. The 3 new residents all had care plans, which were based on identified needs in the assessment document. DS0000020502.V317390.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate Residents have individual plans of care which means staff have the information they need to their needs well. Residents health care needs are identified which means that residents are supported and assisted when they are unwell. The homes policies and procedures for dealing with medicines should protect residents however failures have been identified which puts residents at risk. The home has systems in place to monitor working practices of staff and ensure that the dignity of residents is a priority. This judgement has been made using available evidence including a visit to this service. DS0000020502.V317390.R01.S.doc Version 5.2 Page 11 EVIDENCE: The outcome for standards 7 and 8 were good, however because of the concerns about medication errors found by the Pharmacy Inspector the overall rating is lower. Of the 5 resident files looked at all had detailed care plans which were based on the assessments: Since the last inspection the Manager has introduced a separate wound care plan where the information on daily action taken and outcomes for each wound identified are clearly recorded. There was evidence in one file that the tissue viability nurse had been consulted and action taken. Nutritional screening is done on admission and the chef is involved in the process so he is very aware of the special nutritional needs of those residents and he receive updates. Prior to the inspection the home had forwarded a detailed action plan on the action they have taken to ensure that this error did not reoccur. Some of the requirements made by the Pharmacy Inspector have been addressed already by the home. The Manager said she was confident that the audit processes she has put in place and the mechanisms for monitoring trained staff would ensure that errors do not happen again. The Manager discussed the drug training she has introduced for all trained staff in light of the immediate requirement and other requirements made by the Pharmacy Inspector. The training covers areas such as the relationship with the resident, procedure, observation and understanding of the policies and procedures. Following the pharmacy inspection a full drug audit was completed on the 23/10/06 and several issues were identified one being 2 MAR sheets not being signed, this was addressed with the individual in formal supervision and a verbal warning given. One resident said that she would like to be assisted to bed at 10pm but sometimes she doesn’t get assisted to bed until 11pm and she felt this was too late. This resident was also concerned that that there was no leg rest on the wheelchair, which she needed because of a medical problem. Other residents spoken to said that staff were kind and always respectful. One resident said that sometimes staff could be brusque and seemed very busy. During the inspection staff were observed knocking on doors to residents private space, talking to residents and wearing appropriate protective clothing when carrying out care tasks. The induction process for all staff covers how to treat residents with dignity and respect. DS0000020502.V317390.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good Resident’s social, cultural, religious and recreational interests are recorded and activities are in place daily to encourage residents to have the lifestyle they hoped for. Residents are able to have contact with family, friends and the local community if the wish. The home recognises and encourages residents to have choice and control in their lives. The chef is excellent at providing quality food, well presented and listening to resident’s preferences. This judgement has been made using available evidence including a visit to this service. DS0000020502.V317390.R01.S.doc Version 5.2 Page 13 EVIDENCE: A copy of the weekly activities programme was given to the Inspector and this demonstrates the activities on offer each day. Records of residents who have participated in activities are kept in a book and the Deputy Manager is planning to include this and more detailed information about social care into all care plans. The activities information is circulated for residents’ information and includes, reading newspapers and magazines with staff, scrap books, craftwork, being taken out by for a walk, simple gardening tasks, reading library books and listening to audio books, memory box, gentle extend exercises, aromatherapy, hairdressing and manicures, fun and games and sing- a-longs. On the second day of the inspection there was a demonstration in the afternoon on how to make a pumpkin lantern. Resident’s interests are recorded in their assessment documentation. The chef is very committed to providing a high quality service to the residents. He works with the management team to purchase good quality ingredients. The menu is varied and alternatives are available. Hot and cold drinks and snacks are available throughout the day and night. The chef was able to explain how pureed food is presented. The chef also has care plans for residents so he is aware of changes and can modify diets accordingly. During the inspection residents were spoken to about the meals they receive, one resident said that on the whole the food was very good her only complaint would be that there was too much on the plate. Another resident said the food was consistently good but on that day she did not like the fish, she said it was “too hard”. Several other residents were asked about the fish on the menu and there were no other comments about it being “too hard” one person said it was cooked perfectly. Food records indicate that a varied menu with seasonal options is provided. Residents were observed either eating independently in the dining room or being assisted by staff. All meals were pleasantly presented including in some cases individual pureed portions of vegetables and meat. The minority of residents choose to have their meals in their rooms. The home also has a small kitchenette where breakfast, snacks and drinks as requested can be made by support staff. This is where cups and beakers are washed; this is done by hand as there is no dishwasher. Fridge temperatures are taken and clearly recorded. DS0000020502.V317390.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good Complaints are acted upon and residents, relatives and friends should be confident that their complaints would be listened to and taken seriously. Training for staff means that residents will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the home complaints practice was examined. A record is kept of all complaints and there was a clear trail of the action taken and whether or not the complaint had been resolved. 2 recent complaints were looked at and there was evidence of an investigation and outcome and that the Provider/Manager had met with the complainants, 1 was resolved and the other ongoing. Since the last inspection the Manager has kept the Commission informed of any allegations of poor practice and has kept the Commission informed of action taken such as referring staff to the Protection of Vulnerable Adults list. The Manager has been trying to get places on an adult protection course unfortunately there were not places available on the 14/15 November course, the Manager gave a copy of the letter from the course provider as proof. The Manager will continue to seek places for staff. DS0000020502.V317390.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good Residents live in a safe, well maintained home. The home is clean, pleasant and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Communal facilities comprise of a quiet lounge/library and a more central open plan dining room and lounge, which provides a pleasant view of the home’s back garden. The home is accessible, comfortable and homely. The front entrance is level and accessible for a wheelchair. There is a passenger lift. There is one particular piece of carpet in the corridor on the ground floor, which is very worn and stained, this is due for replacement and the Manager was able to evidence this on the refurbishment plan. DS0000020502.V317390.R01.S.doc Version 5.2 Page 16 There is a programme of routine maintenance. All problems are identified and written in a small book kept in reception, which the maintenance person checks regularly and signs when completed. The patio and garden at the rear of the home are accessible for residents. The grounds are tidy. There were a number of items around the shed near the laundry room however as this was on a slope it was not accessible to most residents and someone was using the equipment on the day of the inspection. The building complies with the local fire service and environmental health department. Confirmation of this was seen on the day of inspection. The home has updated its fire risk assessment, which has included the changes outlined in the previous inspection report of May 2006. The laundry facilities in the home are sited outside the main building in small brick building. There are hand-washing facilities. The laundry floor now has a finish, which is impermeable, and the walls are readily cleanable. This work was done between the first day of inspection and the second day. The home has sluicing facilities and a sluicing disinfector. The washing machines in the laundry are able to meet disinfection standards. DS0000020502.V317390.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good The number and skill mix of staff mean that resident’s needs should be met at all times. A comprehensive training programme means that residents are in safe hands. Staff are trained and should be competent to do their jobs and care for residents properly The home’s recruitment policy and practice means that residents are supported and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Following a number of issues where poor practice has come to light with regard to the nursing staff. The Manager has introduced different questions at interview such as: ‘What do you consider the role of an RGN in a nursing home?’ The Manager is also undertaking observed practice with nursing staff and feels it is important to be clear about their abilities and not take anything for granted or assume they can complete simple procedures until they have been observed doing them. This is part of the induction for all qualified nursing staff. The Manager has also introduced audits of the qualified nurses responsibilities to check they are doing what they say they are doing. At the DS0000020502.V317390.R01.S.doc Version 5.2 Page 18 time of the inspection the Manager provided the Inspector with a rota this detailed the staff on duty and their role. On the 26th October 2006 the first day of the inspection there were 6 housekeeping staff on duty during the day. 3 qualified nurses were on duty during the day and the Manager. Two team leaders and 6 carers. 1 team leader covers each side of the home. Staff spoken to on the day said that they were busy but organised. Several comment cards were received where concerns were expressed about the numbers of staff on duty particularly at the weekend. One person commented “they could never find anybody in charge”. The Manager is not normally in the home at the weekend however she does undertake spot checks at different times including weekends and nights. Another comment received stated that “staff were helpful depending on who you asked” during the inspection several residents were very positive about the staff and the care and attention they provide. Care staff spoken to on the day of the inspection felt that they were receiving more training opportunities and they said they felt more supported. The Manager is a qualified assessor and works with her deputy to ensure that training needs are identified and courses offered. Records showed that all staff are on a matrix, which highlights when a refresher course is due. All training is ongoing. Following the pharmacy inspection the Manager has sought out medication training for staff an order confirmation slip evidenced this. DS0000020502.V317390.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good The Manager understands her responsibilities and how to implement them in order to improve the quality of care for residents. The Manager is developing systems to demonstrate that the home is run in the best interests of residents. There are policies in place to safeguard the financial interests of residents. Policies and practice within the home ensure that the health, welfare and safety of residents and staff are promoted and protected. This judgement has been made using available evidence including a visit to this service. DS0000020502.V317390.R01.S.doc Version 5.2 Page 20 EVIDENCE: At the time of the inspection the Manager had not received confirmation of registration this has since been confirmed. During the inspection the Manager was very helpful, open and willing to discuss the changes implemented and the expected outcomes. The Manager demonstrated during the inspection her commitment to continuing the improvement of the service. The Manager is only responsible for one service; she evidenced her professional development and continuing training. There are lines of accountability within the home and the Manager sees herself as part of a management team working together to improve. The home has a quality assurance process in place. The home needs to ensure that the outcome of the process is feedback to all interested parties on a regular basis. Excellent progress has been made to address the outstanding requirements since the last inspection. Evidence of all mandatory training taking place for staff on a rolling programme. Evidence seen of regular servicing of equipment, water system, and electrical system. All accidents are audited monthly and the Manager produces a bar chart detailing the number and type of accidents and any action, which needs to be taken. Fire records for the home were up to date. DS0000020502.V317390.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 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 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000020502.V317390.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received in the care home including: Ensuring that medicines are offered as prescribed and the administration or reason for nonadministration accurately recorded at the time they are given. Ensuring that medicines received are checked carefully and accurately recorded. Nurses are working to improve the records and some progress has been made. (Previous timescale of 31/01/06 and 04/05/06 not met). At the time of the inspection management had submitted information on the action they have taken to meet the standard There must be a system for providing an audit trail for medicines not in the monitored dosage system (e.g. recording the date a new pack is started on the pack or on the MAR chart). DS0000020502.V317390.R01.S.doc Timescale for action 1. OP9 13(2) 30/11/06 2. OP9 13(2) 30/11/06 Version 5.2 Page 23 4. OP9 17(i)(a) The date of opening medicines with a limited life must be recorded so that they are not used beyond the expiry date. Nurses are working to improve this and some progress has been made. (Previous timescale of 04/05/06 not met). Since the inspection further information has been received from the Manager about action taken to meet this requirement Nurses must record the dose given if a choice is prescribed so that all medicines can be accounted for. 30/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard OP9 Good Practice Recommendations The doctor should be asked to include full dose directions on prescriptions, rather than as directed, so that they can be included on the medicine label. When medicine details are added to the MAR chart dose directions should be written in full and not abbreviated. The registered Manager should continue to seek places on adult protection courses for both management and staff. The registered Manager should check references to ensure that if a reference is from a previous employer, it is the employer who has given the reference. 1. 2. 3. OP18 OP29 DS0000020502.V317390.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stanford Road Poole BH17 0NF 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 DS0000020502.V317390.R01.S.doc Version 5.2 Page 25 - 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. 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