CARE HOMES FOR OLDER PEOPLE
Wren House 32 Vicarage Street Warminster Wiltshire BA12 8JF Lead Inspector
Thomas Webber Announced 1 September 2005
st 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 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. Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Wren House Address 32 Vicarage Street Warminster Wiltshire BA12 8JF 01985 212578 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Wren House Ltd, Mr Roger Twinn Mrs Anne Elizabeth Anderson Care Home 13 Category(ies) of OP Old Age registration, with number of places Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 9th March 2005 Brief Description of the Service: Wren House is a private residential home offering accommodation and personal care to a total of 13 residents over the age of 65 who require care primarily through old age. Short-term care places can also be offered. In addition, there are also two sheltered flats in an adjacent building with a further number of sheltered flats having been built to the rear of the home. However, these do not form part of the registered accommodation although the people here may have the opportunity to move into the care home at a later time, should their needs change. The home is situated close to the centre of Warminster, which offers a full range of amenities. The service is privately owned and registered as Wren House Limited. Mr Twinn and Mrs Anderson, the registered persons, who have constant involvement with all aspects of the home, run the home and they divide their responsibilities according to their own particular areas of expertise. Residents are provided with their own bedrooms and twelve of them have ensuite facilities, providing either a bath or a shower. The remaining bedroom has a private bathroom directly adjacent to it. Residents bedrooms are located on the ground and first floor levels and stair lifts have been installed on two flights of stairs, which enable easier access to the first floor for people with reduced mobility.
Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection, undertaken during the course of one day from 08:55 to 13:15. The inspection primarily focused on the direct care provided to the residents and the views of eight of the twelve residents in situ were sought on an individual basis. Comment cards were also received by the Commission from six residents and four relatives of residents residing at the home. Their comments are reflected within the body of the report. In addition, a check was carried out with regard to the requirements previously identified at the last inspection together with a range of the core standards. A tour of the premises was undertaken and records in relation to residents’ assessments, care plans, medication, menus, staff rotas and recruitment were checked during the course of the inspection. What the service does well:
The home provides residents with a warm, welcoming, safe and wellmaintained environment which meets their individual and collective needs. Residents are provided with their own bedroom which they have personalised to their individual wishes. Residents have access to safe, comfortable and suitably furnished and decorated communal facilities together with sufficient toilet shower and bathroom facilities. Residents have appropriate equipment to maximise their independence. The home is maintained to a high standard being clean, tidy and comfortable and provides suitable laundry facilities. Residents commented very favourably about the laundry arrangements in place, stating that their clothing is returned the following day in very good condition. Residents also commented that they were extremely happy with the size of accommodation, the facilities available to them as well as the standard of cleanliness maintained. The home continues to provide sufficient numbers of staff on duty at all times to meet the needs of the residents. The staff team collectively have a range of experience to meet the needs of the residents with the home continuing to work towards achieving a trained workforce in line with the National Minimum Standards. Residents are supported and protected by the home’s recruitment practices. The home is run in the best interests of the residents and their views regarding the care and services are sought periodically. Residents spoken to commented very favourably about the level of care provided, stating that the staff are very good, kind and would do anything for them, in fact they couldn’t wish for any better. Six comment cards received from residents also confirmed that they liked living at the home, they feel safe and well cared for, and they are treated well by the staff. Specific comments
Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 6 received from residents described the home as being a home from home, a wonderful place which is exceptionally well run, happy and caring where the residents appreciate the warm atmosphere, kindness, friendliness and cheerfulness from the boss through to the staff. Comment cards received from residents’ relatives confirmed that they are satisfied with the overall care provided. One relative stated that in her opinion standards are kept to a very high standard and the residents are given excellent care. Another relative commented that Wren House is a brilliant place and it can’t come much better. Residents’ health care needs are suitably met and their medication is managed carefully with their individual needs being taken into account. Residents’ privacy and dignity are respected at all times and comment cards received from residents also confirmed that their privacy is respected. Residents find the lifestyle experienced in the home matches their expectations and preferences, which satisfy their social, religious and recreational interests and needs. Residents exercise choice and control over their lives. Residents maintain contact with their families, friends and relatives in accordance with their preferences. Four comment cards received from residents’ relatives confirmed that they are made to feel welcome at any time and can visit their relatives in private. Relatives also stated that they are kept informed of important matters affecting their relatives. Residents receive a varied, appealing and balanced diet which caters for their needs and requirements. Residents spoken to were extremely complimentary about the quality and quantity of food provided. They confirmed that the food is excellent, they receive plenty of food and careful attention is given to the presentation of meals served. Comment cards also received from residents confirmed that they liked the food. Information is provided to residents on how to complain should they wish to and residents are confident that any complaints/concerns would be listened to, taken seriously and acted upon. Residents spoken to stated that they had no complaints. Four comment cards received from residents’ relatives confirmed that three of them were also aware of the home’s complaints procedure but none have ever needed to use it. Appropriate procedures are in place to protect residents from abuse. What has improved since the last inspection? What they could do better:
Further documentation in respect of medication would ensure that an accurate record is kept.
Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 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. Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6 Prospective residents are assessed by the home to ensure that their needs can be met. EVIDENCE: Most prospective residents make pre-visits to the home and are provided with a month’s trial. Mrs Anderson reported that the home’s pre-admission assessment form is completed both at the enquiries stage and once admitted. Evidence was available to confirm that assessments had been completed by the home. The home is not registered to provide intermediate care therefore this Standard is not applicable. Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Residents’ care plans set out their health, personal and social care needs. The health needs of the residents are met by the care staff and local services. Medication is managed carefully and individual needs are taken into account, however some further documentation is required to ensure that an accurate record is kept. Residents privacy and dignity are respected at all times. EVIDENCE: All residents have been provided with a care plan, although the content and needs of the residents is somewhat limited which may be a reflection of the needs of the residents accommodated. However, residents’ daily case notes are recorded in great detail. Residents are usually registered with a local GP, however there is provision for them to retain their previous doctor if they want to and the doctor is able to provide the service. Some residents are largely self-caring and staff support them where necessary. District nurses visit to treat certain conditions, take blood tests and offer advice. The use of specialist services including dental, chiropody and ophthalmology is recorded for individual residents. Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 11 Care staff read and sign an update sheet at the beginning of their shift which details any changes in care or medication. Residents are supported to retain some responsibility for their medicines if desired, following a risk assessment. Medication kept by the home is stored in locked cupboards. Records show all medicines received into the home, a list of all current medication for each resident, the medicines taken and those returned for disposal. However, this record does not differentiate between medication taken at the time and that left for the resident to self medicate later. Residents are provided with their own bedroom where they can conduct all their personal affairs in complete privacy, including medical examinations and any treatment. Discussion with residents confirmed that they can also choose whom and where to see any visitors, mail is given directly to them unopened, and staff knock and wait for a reply before entering their bedrooms. Residents are provided with a telephone line in their bedrooms and each has their own telephone, which enables them to make and receive calls in the total privacy of their bedrooms. Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents find the lifestyle experienced in the home matches their expectations and preferences, which satisfy their social, religious and recreational interests and needs. Residents maintain contact with their families, friends and relatives in accordance with their preferences. Residents exercise choice and control over their lives. Residents receive a varied, appealing and balanced diet which caters for their needs and requirements. EVIDENCE: Organised activities are not arranged by the home, as such although drink parties are held once a week. However, opportunities exist for residents to pursue their own hobbies and interests and games of bridge are organised by some of the residents, which also involves inviting people from within the community. Residents, within their physical capabilities, come and go as they wish and some go into town on their own whilst staff or their families would assist those who are less able. Monthly Church of England services are held within the home, although the frequency of these can be increased at the request of the residents. Other religious denomination services could also be arranged. A hairdressing service is provided within the home or alternatively residents can attend salons within the community. The home is situated only a short distance from Warminster town centre where residents can access the amenities, should they wish to do so. Most residents
Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 13 have contact with family and friends who are welcome at the home at anytime. Four comment cards received from residents’ relatives confirmed that they are made to feel welcome at any time and can visit their relatives in private. Relatives also stated that they are kept informed of important matters affecting their relatives. Observations and discussions with the residents confirmed that they can exercise personal autonomy and choice. Residents have brought items of furniture and personal possessions to make their bedrooms more homely, they choose how and where to spend their time, where to eat their meals, what time to go to bed and get up. Residents can also handle their own financial affairs in the privacy and comfort of their bedrooms. The home is keen to offer a ‘hotel’ service and meet all reasonable requests/wishes of the residents. A satisfactory and varied menu is in operation, which provides a choice at breakfast, which includes the option of a cooked meal and all residents eat their breakfast in their bedrooms. Residents are provided with a range of choices for their evening meal, although a set main meal tends to be provided at lunchtime. However, alternatives are provided for this meal, if required, to meet the preferences of the residents. Management reported that residents, to a large extent, determine what they will have to eat. Residents’ special dietary needs are well catered for and there is also flexibility with regard to mealtimes where residents can choose where and when to eat their meals. A range of drinks and snacks are available on request at any time day and night. Residents spoken to were extremely complimentary about the quality and quantity of food provided. They confirmed that the food is excellent, they receive plenty of food and careful attention is given to the presentation of meals served. Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Information is provided to residents on how to complain should they wish to and residents are confident that any complaints/concerns would be listened to, taken seriously and acted upon. Appropriate procedures are in place to protect residents from abuse. EVIDENCE: The home’s complaints procedure is written into the agreements drawn up with residents. To date, there has not been an occasion to use this. The complaints procedure provides contact details of the Commission for Social Care Inspection and this is included in the residents’ guide. Residents spoken to stated that they had no complaints and felt confident that if they did have any concerns these could be discussed with the proprietors and staff who would listen and deal appropriately with them. The home has developed internal procedures relating to abuse and protection, which refers to the requirement to involve other parties. Guidelines on whistle blowing for staff have also been developed. Management reaffirmed that all members of staff have been provided with their individual copy of the Swindon and Wiltshire Vulnerable Adults procedures, which are in line with the Department of Health Guidance “No Secrets” document. Refresher training has also been provided to staff. Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 24 and 26 The accommodation within the home is maintained to a very high standard. The home provides a warm, welcoming safe and well-maintained environment which meets the individual and collective needs of the residents. Residents are provided with their individual bedroom which they have personalised to their individual wishes. Residents have access to safe, comfortable and suitably furnished and decorated communal facilities together with sufficient toilet shower and bathroom facilities. Residents have appropriate equipment to maximise their independence. The home is maintained to a good standard being clean, tidy and comfortable and provides suitable laundry facilities. EVIDENCE: The home is situated only a short distance from Warminster town centre where residents can access the variety of amenities, should they wish to do so. The home offers high quality accommodation and continues to be kept clean, tidy and well maintained. The premises provide sufficient heating, lighting and ventilation and the standard of furnishings, fittings and decoration is maintained to a high standard. The building complies with the requirements of the local Fire and Environmental Health Officers’ departments. There is an
Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 16 ongoing maintenance programme within the home and maintenance staff are employed to undertake minor jobs with contractors being engaged, when necessary, for larger projects. The home provides a dining room, a main drawing room, and a couple of smaller sitting areas off the ground floor corridor. These are attractively furnished and decorated to a high standard. Residents enjoy spending time in the garden, weather permitting and a number of residents’ ground floor bedrooms have French windows, offering direct access to this. Twelve of the home’s thirteen bedrooms have en-suite facilities, providing either a bath or a shower. The remaining bedroom has a private bathroom directly adjacent to it. Residents are very appreciative of these facilities. Stair lifts have been installed on two flights of stairs, which enable easier access to the first floor for residents with reduced mobility. A call bell system with an added speech facility is installed in each room, which is used by residents to call for staff assistance. Residents’ bedrooms are suitably furnished and equipped to ensure comfort, privacy and meet their assessed needs. Residents are provided with a lockable storage space if they wish this facility to store their personal effects such as money and valuables. Residents have brought items of furniture and personal possessions to personalise their bedrooms to their individual wishes and to make them more homely. Most residents choose to spend much of their time in their bedrooms, which are large enough to entertain visitors in comfort. Residents commented that they were extremely happy with the size of accommodation, the facilities available to them as well as the standard of cleanliness maintained. Residents’ bedrooms are redecorated and re-carpeted when there is a change of resident. The home continues to be maintained to a high standard being clean, tidy and comfortable and free from offensive odours. The laundry room provides suitable facilities to meet the needs of the home with staff undertaking the washing and ironing duties. Residents’ clothing is labelled to ensure that garments are appropriately returned. Residents commented very favourably about the laundry arrangements in place, stating that their clothing is returned the following day in very good condition. Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The home continues to provide sufficient numbers of staff on duty at all times to meet the needs of the residents. The staff team collectively have a range of experience to meet the needs of the residents with the home continuing to work towards achieving a trained workforce in line with the National Minimum Standards. Residents are supported and protected by the home’s recruitment practices. EVIDENCE: The deployment of staff continues to ensure that during the week there are three carers on duty in the mornings with two in the afternoons and evenings. These staffing levels exclude those hours worked by a supervisor, normally undertaken by the manager or deputy manager. At weekends a helper substitutes a morning carer. There is one waking night member of staff on duty with one member of care staff sleeping in each night. The manager or deputy manager also provides an on call service. Management reported that, since the last inspection, there have been some changes within the staff team. Residents spoken to commented very favourably about the level of care provided by the staff, stating that the staff are very good, kind and would do anything for them, in fact they couldn’t wish for any better. Six comment cards received from residents also confirmed that they liked living at the home, they feel safe and well cared for, and they are treated well by the staff. Specific comments received from residents described the home as being a home from home, a wonderful place which is exceptionally well run, happy and
Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 18 caring where the residents appreciate the warm atmosphere, kindness, friendliness and cheerfulness from the boss through to the staff. Comment cards received from residents’ relatives also confirmed that they are satisfied with the overall care provided. One relative stated that in her opinion standards are kept to a very high standard and the residents are given excellent care. Another relative commented that Wren House is a brilliant place and it can’t come much better. A sample of files for two newly appointed staff were checked and showed that appropriate recruitment practices are being followed for the protection of the residents. These included two satisfactory written references being obtained as well as satisfactory CRB’s for all staff. The majority of staff have a number of years experience in the care profession. The manager reported that seven staff have recently completed the NVQ level 2 qualification. Management reported that funding is now available for further staff to undertake NVQ training. Since the last inspection, the deputy manager has now completed the NVQ 4 in management and care as well as the assessors course. Management are well aware of the need to continue to work towards achieving 50 of the staff workforce being qualified at NVQ level 2 by 2005 target. The home has established its own induction programme for new staff appointed which is based on the TOPPS specification. All new staff are considered as being supernumerary for their initial shifts. Management are aware of the need for staff to complete the various mandatory training courses, some of which have already been undertaken by staff with further training being provided. Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 The home is run in the best interests of the residents and their views regarding the care and services are sought periodically. EVIDENCE: The care and services provided by the home is monitored on a day to day basis by the manager and deputy manager with residents being given the opportunity to comment about the standard of care and services provided. Questionnaires had been developed, sent out and returned by residents and their relatives, as part of the home’s quality assurance system and the replies received were extremely positive about the care provided. A report of the results of the survey which has subsequently been produced is available to all current and prospective residents and their relatives should they wish to access to it. A copy has also been forwarded to the Commission for Social Care Inspection. Residents handle their financial affairs with the help of their families or their financial advisors. The proprietor or manager do not act as appointee for any
Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 20 residents and nor do they hold any money on behalf of any residents. Therefore this Standard is not applicable. Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x N/A x x x Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 22 No Are there any outstanding requirements from the last inspection? 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 9 Regulation 13(2) Requirement The registered individuals must ensure that a record of medication administered must clearly show any medicines given to the resident to take later and whether these are taken or returned for destruction. Timescale for action 21/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 9 Good Practice Recommendations The registered individuals should consider that the update sheet that care staff sign at the beginning of the shift should be kept as a record of changes in care. Wren House D51_D01_S56886_WrenHouse_V189245_010905_Stage4.doc Version 1.40 Page 23 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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