Inspection on 29/10/07 for Whiteacres Residential Care Home

This inspection was carried out on 29th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Whiteacres Residential Care Home 26/01/10

Whiteacres Residential Care Home 30/06/09

Whiteacres Residential Care Home 07/01/09

Whiteacres Residential Care Home 10/07/08

Whiteacres Residential Care Home 30/04/08

Whiteacres Residential Care Home 09/01/08

Whiteacres Residential Care Home 18/12/06

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

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

CARE HOMES FOR OLDER PEOPLE Whiteacres Residential Care Home 40 Whitehill Road Ellistown Leicestershire LE67 1EL Lead Inspector Keith Williamson Unannounced Inspection 29th October 2007 09:30 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 DS0000068031.V350849.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. DS0000068031.V350849.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whiteacres Residential Care Home Address 40 Whitehill Road Ellistown Leicestershire LE67 1EL 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) 01530260415 01530260415 genesishomes2003@yahoo.co.uk Genesis Homes (Essex) Ltd Mrs Melanie Partridge Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (18), Old age, not falling within any other category (18), Physical disability over 65 years of age (9) DS0000068031.V350849.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. No one in the category PD(E) may be admitted into Whiteacres Residential Care Home when there are already 9 persons of category PD(E) accommodated in the home. No one in the category OP may be admitted into Whiteacres Residential Care Home when there are already 18 persons of category OP already accommodated in this home. No one in the category DE(E) may be admitted into Whiteacres Residential Care Home when there are already 18 persons of category DE(E) already accommodated in this home. No one in the category MD(E) may be admitted into Whiteacres Residential Care Home when there are already 18 persons of category MD(E) already accommodated within this home. No person to be admitted to Whiteacres Residential Care Home in the categories OP, PD(E), DE(E), or MD(E) when18 persons in total of these categories/combined categories are already accommodated in this home. 18th December 2006 Date of last inspection Brief Description of the Service: Whiteacres is a home situated on the main road in Ellistown, a village in the North of the County of Leicestershire. The home can accommodate up to 18 people, and is registered to admit residents within the Dementia (DE) Mental Disorder (MD), Old age (OP), Physical Disability (PD) groups. The home is situated on a bus route to Leicester and Coalville, and is closely situated to shops and green areas. The home has 18 single bedrooms some having en-suite facilities. A number of bedrooms are small, and this has been recognised appropriately with information contained in the Statement of Purpose. Resident accommodation comprises of 2 lounge areas and a dining room, bedrooms are split between both floors in the home and a passenger lift services both floors of the home. The weekly fees range from £327 to £388 per week - this information was provided on the inspection day. There are additional costs for expenditure such as hairdressing, private chiropody, toiletries, newspapers, and the social fund that pays for outings, outside entertainments etc. A copy of the latest Commission for Social Care Inspection, inspection report is available in the home. DS0000068031.V350849.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspection is on outcomes for residents and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting a number of clients and tracking the care they received through looking at their records, talking with them where possible, and looking at their accommodation, in this case four residents were chosen. This inspection took place over one day, commencing at 9.30am and took six and one half hours to complete. One inspector conducted the inspection (or site visit). An opportunity was taken to look around the home, view records, policies and care plans and to talk to residents and staff. Twelve of residents and a relative were seen and five residents were spoken with during the visit process, though due to the frailty of the resident group, few comments were made. Information was gathered prior to the site visit from sources such as comment cards, completed by residents or their relatives and the Annual Quality Assurance Assessment (AQAA), which is sent to CSCI each year. The AQAA contains information relating to the running of the home, and was completed by the registered manager. What the service does well: The paperwork given to residents and their families prior to, and following admission is good. Residents and their families have the option of assisting in the care planning process. Care Plans contain the past life history of residents. Questionnaires to judge the performance of the home are issued periodically. Residents and relatives commented positively about how privacy and dignity is maintained whilst personal care tasks were being performed by staff. Residents and relatives commented that staff were friendly and helpful towards them, that staff welcomed visitors and they thought the food provided to them was of a good quality. Staff were observed to be friendly and helpful towards residents. Facilities continue to be improved and there is ongoing redecoration and replacement of furniture and fittings. Bedrooms are well decorated, and personalised to residents tastes. DS0000068031.V350849.R01.S.doc Version 5.2 Page 6 The majority of the staff have been trained to National Vocational Qualification Level two or above, the remaining staff are only waiting for a suitable course. Residents’ finances are kept appropriately with accurate accounting on the accounts seen. Comments received from residents and their relatives included “Whiteacres consult with a family member as agreed i.e. regarding medication; and always contact to inform of any situation”. Meals are usually very good, especially ay Christmas” “Staff have taken me to church when able” What has improved since the last inspection? What they could do better: Some of the information around residents’ safety could be improved with more detailed risk assessments, and instruction on how staff should manage those risks. Information around administering medication, and how individual prescriptions are checked throughout the medication “month” could be tightened, to ensure residents receive their appropriate doses. Information from the quality assurance questionnaires could be used in the development of the home, and to inform prospective residents and their families about how the home operates. Daily life, social activities and mealtimes could be improved with better staffing numbers and staff deployment at busy times. Staff training and their perception around protecting residents must be enhanced to ensure residents are safe in the home. Information required during the recruitment process, must be complete prior to staff being allowed to work unsupervised in the home Comments received from residents and their relatives regarding improvements in the home, “More staff as there are many different levels of care at Whiteacres and some residents consume more time than others” DS0000068031.V350849.R01.S.doc Version 5.2 Page 7 “Could there be more stimulation through activities”? 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. DS0000068031.V350849.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 DS0000068031.V350849.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): 1, 2, 3 & 6. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The assessment process is detailed and effective resulting in accurate and detailed information for staff to ensure care needs are met. EVIDENCE: The Statement of Purpose, which sets out the latest aims, objectives and philosophy of the home and gives information about services, facilities and current staffing, was available for inspection. This document has been updated to include the new Registered Person details but does not include the feedback of the annual quality assurance questionnaires sent to residents, relatives and supporters. The Service User Guide has also yet to be updated. Of the residents’ files that were seen, all had a contract or statement of terms and conditions in place. These were signed by the resident or a relative. DS0000068031.V350849.R01.S.doc Version 5.2 Page 10 Assessment information for the residents was viewed; the information gathered by the staff prior to any stay commencing was produced with good detail from which a plan of care could be derived. Most residents’ assessments are backed up with additional assessment information from Social Services. A relative who spoke to the Inspector confirmed the home supplied a wealth of information prior to the resident moving in, this included the Service User Guide or brochure. The home does not provide facilities for intermediate care. DS0000068031.V350849.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. Residents’ physical health and personal care is not managed adequately, with dangerous moving and handling practices putting residents at risk. Improvements to the medication system are needed to ensure that residents are given the prescribed medication, and accurate records are kept of the medication administered. EVIDENCE: Care plans were viewed for a number of residents in the home; these were produced from the information in the pre-assesments. There was written evidence that residents or their representative were given the choice to be involved in the setting up and reviewing of the plan of care. Care plans have individual detail of residents’ personal care and past life history. DS0000068031.V350849.R01.S.doc Version 5.2 Page 12 Risk assessments were evident and set out within a risk assessment framework, though these were not detailed enough to be fully understood by staff and state specific risks and how they need to be managed. This was evident when the Inspector observed Moving and Handling practices whereby a resident was being inappropriately lifted by staff. This was also evident at the last visit to the service. Care Plans now clearly set out routine medical checks, with evidence of dental and chiropodist visits. There continues to be some gaps in medication administration records (mar charts), where medication had been given but not signed for by staff. Mid term medication audits, must be increased to include bulk medications; the inspector found an incidence of poor practice where one box of medication had medication missing yet the same drug prescribed for another resident had too much medication, this would indicate medication prescribed for one resident was being used for another. There was evidence that the privacy and dignity of residents was respected at all times. Staff were seen to relate well to residents, to knock and awaiting permission to enter prior to entering their private accommodation. A relative confirmed personal care and consultations with medical staff were conducted in private. Bedroom, bathroom and toilets lock appropriately, so ensuring resident choice for privacy. Comments received from residents and their relatives included “Whiteacres consult with a family member as agreed i.e. regarding medication; and always contact to inform of any situation”. DS0000068031.V350849.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. Daily life and social activities are poorly managed; an increase in staffing would allow all residents to benefit socially, both within and out of the home. EVIDENCE: A resident and a relative confirmed that visiting is unrestricted and residents are able to receive their chosen visitors in private should they wish. Relatives were seen coming and going throughout the day. Residents confirmed that they are supported to maintain choice and autonomy in their daily lives. Bedrooms seen offer a high level of personal items, again this was confirmed by a relative visiting the home. Lunchtime service was viewed and seen to comprise beef stew. The choice of puddings comprised home made pear crumble with custard, yoghourt, and fresh fruit. A variety of fresh fruit juice was also available. A relative confirmed their satisfaction with the food provided by the home adding how much they had enjoyed the meals when offered. Staff serving lunch were appropriately attired for food hygiene purposes. DS0000068031.V350849.R01.S.doc Version 5.2 Page 14 One resident was served their meal in the dining room prior to 12.00 mid day, those residents confined to bed were still being assisted with their lunch at 2.00 pm, this is an unreasonable timescale and staff numbers could be increased to provide adequate numbers of staff to assist residents at busy times. The meals offered suit the ethnicity of the current resident group Entertainment is provided on a regular basis, with various people coming into the home, a particular favourite was “Graham” the organist, who has visited frequently enough to know some of the residents by name. Activities and trips out provided by the staff have almost ceased. The staff that spoke to the Inspector indicated they could not provide activities on a regular basis due to there “not being enough staff”, and the “high staff turnover” in the home. A relative who spoke with the Inspector indicated he was pleased with the staff, and the home and stated, “the staff are lovely”. The relative went on to explain he visited most days of the week, and indicated he was always made welcome. Other comments were received from the comment cards returned to the inspector, these included: “Could there be more stimulation through activities”? “Meals are usually very good, especially ay Christmas” “Staff have taken me to church when able” DS0000068031.V350849.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. The lack of staff knowledge and training on Safeguarding Adults puts residents at risk. EVIDENCE: The complaints procedure is available in the foyer of the home, as well as in the Service User Guide (or brochure) for the home. There have been no complaints recorded by the staff, since 2002. The Deputy Manager and Inspector discussed the level of complaints and the process to follow in the recording of complaints information. Risk assessments were seen in the plans of care; these were not detailed enough to be understood by staff, and state specific risks, and how they need to be managed. This was evident when the Inspector observed Moving and Handling practices whereby a resident was being inappropriately lifted by a member of staff. This practice was also evident at the last visit to the service, and presents an ongoing physical danger to residents and staff. The requirement set at the last visit where staff were required to have undertaken Vulnerable adults training by February 2007, has not been complied with, and staff lack specific knowledge in safeguarding adults, and this was evident by the practices witnessed by the inspector during the visit. DS0000068031.V350849.R01.S.doc Version 5.2 Page 16 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, 22 & 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The premises are suitable for the stated purpose, being well maintained and offering a good standard of accommodation. EVIDENCE: A number of improvements have been made in the home with carpets being replaced throughout the home; and dining chairs being replaced. There is an ongoing plan of refurbishment for the home this enables the tracking of the improvements made in the home. Residents’ personal bedroom space, and public areas of the home were pleasantly decorated, and contained personal items such as photos and ornaments. DS0000068031.V350849.R01.S.doc Version 5.2 Page 17 Adaptations and specialist equipment such as hoists and raised toilet seats were seen in place throughout the home, the first floor bathroom is currently being refurbished and improved. Staff showed an awareness of cross contamination and cross infection issues. The laundry area has been recently refurbished and re-tiled. DS0000068031.V350849.R01.S.doc Version 5.2 Page 18 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 poor This judgement has been made using available evidence including a visit to this service. Poor recruitment practices and low staffing numbers put residents in danger in the home. EVIDENCE: On the day of the visit there were three care staff on duty as well as the cook, domestic staff, handy person and Deputy Manager. The inspector observed four residents in bed, all on periodic monitoring charts, turning and requiring a high degree of assistance with personal care, drinks and assisted to eat there food. The current resident group need a high degree of input and monitoring, and the current staffing levels are not adequate enough to achieve this. The recruitment process has been developed with all staff now having an appropriate Protection of Vulnerable Adults pova(first) check in place. One member of staff was employed without an appropriate Criminal Record Bureau clearance; an immediate requirement was left regarding this breach in regulations. Twelve of the current care staff are qualified to National Vocational Qualification level two or above, this equates to 85 of the total group. DS0000068031.V350849.R01.S.doc Version 5.2 Page 19 Staff training has taken place since the last visit, though not all courses have taken place within the required timescale and in line with the last report. Comments received from residents and their relatives included “More staff as there are many different levels of care at Whiteacres and some residents consume more time than others” DS0000068031.V350849.R01.S.doc Version 5.2 Page 20 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 & 38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The service is adequately managed; however improvements to the quality assurance system would enhance the information of residents and their relatives enabling them to make an informed choice about any stay in the home. EVIDENCE: The registered manager has many years experience of working and managing Whiteacres, and is qualified having passed the National Vocational Qualification Level four and the Registered Managers award. The registered manager is aware of the categories under which residents can be admitted into the home. DS0000068031.V350849.R01.S.doc Version 5.2 Page 21 Quality assurance questionnaires have been distributed to residents and their relatives, though not since the last visit to the home. No quality assurance information has been added to the Service User Guide, the deputy manager is aware of the need to include this in the future. The Responsible Individual visits regularly and produces a report on at least one occasion of each visit. Resident finances are kept appropriately; of three records seen all were up to date and accurate. Staff supervision is currently undertaken in the home. Staff spoken with confirmed the “one to one” meetings. A sample of accident reports were viewed and found to be completed appropriately, and there is accuracy between these and the residents’ individual daily records. Fire records including the weekly fire alarm tests, emergency lighting tests, and the servicing of fire appliances were all found to be up to date. The fire risk assessment was also seen this has also been updated. Other records viewed included the record of hot water tests in the home; again these were up to date. DS0000068031.V350849.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable DS0000068031.V350849.R01.S.doc Version 5.2 Page 23 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 X X 3 X X X 3 STAFFING Standard No Score 27 1 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 3 DS0000068031.V350849.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 13 (4) c 18 (1) a Requirement Timescale for action 19/11/07 2 OP9 13 (2) 3 OP18 13 The Health and Safety systems in the home must protect the welfare of residents from harm. This includes protection from unsafe Moving and Handling practices. This is to protect residents and staff in the home. 19/11/07 There must be an accurate record of all medication received, administered and disposed of by the service including: Defined codes for any nonadministration. Quantities received and balances carried forward from the previous month. This to ensure accurate records are kept of medications administered. 17/12/07 All staff must receive refresher Safeguarding Adults Training and be made fully aware of this procedure. This is to ensure residents are safe in the home. This requirement with an original timescale for action of 19/02/07 remains unmet). DS0000068031.V350849.R01.S.doc Version 5.2 Page 25 4 OP27 18 5 OP29 19 6 OP33 24 Staffing levels need to be reviewed periodically to ensure that residents needs are met, with adequate staffing to ensure residents are safe. This is to ensure residents are safe in the home, and staffing numbers are sufficient to provide a prompt service. This requirement with an original timescale for action of 19/02/07 remains unmet) Statutory staffing checks must be in place before staff commence employment. This is to ensure the safety of residents and staff. This requirement with an original timescale for action of 19/12/06 remains unmet) The outcome of any quality assurance exercise is used to inform any prospective residents coming into the home, and the homes’ development. This would provide prospective residents with the information to make an informed choice regarding a stay in the home. 19/11/07 29/10/07 17/12/07 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 The risk assesments within the Care Plans need to be more thorough regarding clearly explaining risks and how staff can minimise these. A more rigorous audit trial for medication should be introduced, to ensure that gaps in recording and accurate administration of prescribed medication are swiftly followed up. DS0000068031.V350849.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 DS0000068031.V350849.R01.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. 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