Inspection on 05/03/07 for Yew Tree Care Home

This inspection was carried out on 5th March 2007.

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

Other inspections for this house

Yew Tree Care Home 18/08/08

Yew Tree Care Home 20/08/07

Yew Tree Care Home 24/07/06

Yew Tree Care Home 06/02/06

Yew Tree Care Home 11/10/05

Yew Tree Care Home 20/12/04

Yew Tree Care Home 24/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Yew Tree Care Home 60 Main Road Dowsby Bourne Lincs PE10 0TL Lead Inspector Moya Dennis Unannounced Inspection 5th March 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Yew Tree Care Home DS0000060593.V332435.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. Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Yew Tree Care Home Address 60 Main Road Dowsby Bourne Lincs PE10 0TL 01778 440247 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) yewtree.gallac@btconnect.com Yew Tree Residential Care Home Limited Mrs Patricia Gallagher Care Home 18 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (6) of places Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th July 2006 Brief Description of the Service: Yew Tree Care Home is a former rectory and is situated next to the church in the village of Dowsby, with several shops and a pub. It is six miles from the town of Bourne, in Lincolnshire, which has shops, banks, post office, pubs and leisure facilities. The home is registered to provide residential care for eighteen people of both sexes over the age of 65 years, twelve of whom may have the diagnosis of dementia. A single storey extension provides accommodation for ten residents; the first floor accommodation in the main building is accessed via a stair lift. There are twelve single rooms, two of which have en-suite facilities, and three shared rooms. The home is set back from the road and has large enclosed gardens with spaces for car parking. The home has a conservatory, which leads to the garden and patio. There were thirteen residents at the home at the time of inspection. Fees range from £330 to £545 per week. Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place in March 2007. The inspection was carried out by three inspectors, two of whom were pharmacy inspectors, and took place over 5 ¼ hours. All key standards were inspected. Medication issues were inspected in depth by the pharmacy inspectors. The inspection method used was to case track the care received by a sample of residents by looking at their records and discussing their experiences of care with them and with their relatives. General care practices were observed throughout the visit. The inspectors spoke to six residents, one visitor and six members of staff. One resident showed an inspector their room; other areas of the home were also seen. The manager was present throughout and assisted the inspectors. She was given general feedback about the outcomes of the inspection at the end of the visit. What the service does well: What has improved since the last inspection? What they could do better: The ground floor corridor, one bathroom, dining room and the main staircase are in need of repair, refurbishment and redecoration. The management of medication needs to be improved to ensure that residents are getting medication safely and correctly. In particular the medication Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 6 records, the administration of medication, the processes for removing out of date medication and the processes for training and assessing staff competencies require improvement. 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. Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People had access to sufficient information to decide if the home could meet their needs. Prospective resident’s needs were assessed and they had opportunities to visit the home before moving there. EVIDENCE: No residents had moved to the home since the last inspection. Prospective residents would be given a brochure of the home on initial enquiry. After consultation with them, relatives and any other professionals involved, the manager would visit to assess their needs. The manager would write to confirm that the home was able to meet the assessed need. A copy of such a letter was seen during inspection. Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 9 If the home was able to meet the assessed needs, prospective residents and/or their relatives would be invited to visit and look round. A visiting relative confirmed that they had done so and had been shown the available room. All stays were on a trial basis. All residents, or their relatives, had received a service user guide, statement of purpose, a contract and terms and conditions, as confirmed by a relative. Training programmes evidenced that staff had skills and experience to meet assessed needs. The home did not provide Intermediate Care. Yew Tree Care Home DS0000060593.V332435.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 poor This judgement has been made using available evidence including a visit to this service. Some health, personal and social care needs were met. However, poor or incomplete medication records compromised residents’ safety. EVIDENCE: The care of four residents was case tracked. The care plans gave clear information and relevant information for carers to deliver appropriate care. Risk assessments were completed for all activities of daily living, such as bathing, dressing, feeding and pressure care. However, care plans were not clear for medication, being incomplete and inaccurate. When residents refused medication, risk assessments and care plan had not been amended. One resident was being nursed in bed at the time of the inspection. Appropriate turning, fluid intake and nutritional charts were used. Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 11 Most residents were unable to contribute to their care plans but records confirmed that relatives had been involved in reviews and were informed of any changes. The management of medication in the home including records, storage, staff training and policies and procedures were inspected in depth by the pharmacy inspectors. Their findings were as follows: None of the four residents whose records were looked at in detail looked after and took their medicines themselves. Information available showed that residents were offered a choice in how medication was given and that consent for care staff to administer medication had been obtained. However records were not kept up to date for example where consent had been withdrawn the records had not been amended. Accurate and complete records were not kept to show that medication had been given correctly. Medication administration records were signed before medication was given to residents and did not show times when medication had not been taken. One record had been signed when no medication was available in the home to give. No medication records were being kept for one resident who was prescribed medication including when required medication. Medication was not being administered according to the prescriber’s instructions; for example medication prescribed for when required use was being given regularly and there was medication that was not recorded on the records. Medication usually prescribed for short-term use being used long term with no information available to confirm that this had been intended by the prescriber. Where medication was prescribed for ‘when required’ or ‘as directed’ use, for example for pain relief and for agitation, there was no information available to ensure that staff knew how to give it correctly. A member of staff was spoken to and they did not know what a medication was for that was being given ‘when required’ and said that there was no reference information available unless a leaflet had been supplied by the pharmacy. Accurate and complete records were not kept of medication that residents were taking when they came to the home and of any changes made. The audit trail for medication received, administered and disposed of was not accurate and complete enough to show that medication had been given correctly. When medication was not taken records including a code for the reason why were not made. When residents were prescribed a dose of one or two tablets no record was made of how many tablets had been given. Staff put tablets that had not been taken or had been found in an envelope with no record kept. Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 12 The medication policy referred to administration of medication by nurses rather than carers and did not reflect current practice at the home. There was no policy for the use of homely remedies, for minor conditions, which were in use at the home. Out of date policies can lead to care staff following incorrect procedures resulting in harm to residents. The manager said that she gave the medication training for staff and usually assessed competencies. Complete training records were not available for the staff administering medication at the time of the visit. The carer administering medication was spoken to and it was a concern that they did not know what the medication they were giving was for. There was out of date medication in use even though new stock was available. This included eye and eardrops where no date of opening was being recorded on containers. Fridge temperatures were not recorded to confirm that medication requiring fridge storage had been kept at recommended temperatures. These issues meant that residents were at risk of receiving medication that had lost potency or become contaminated. There were concerns about the security of medication storage. The trolley was not secured when not in use and the office door was left propped open. District Nurse supplies were not locked in a cupboard and the controlled drug cupboard was used to store items other than controlled drugs. Three immediate requirements were left and the manager provided evidence to the commission within 48 hours of the inspection that these issues had been discussed with their pharmacy, local GPs and the provider with measures put in place to improve the outcomes in this area. Care records confirmed that residents were able to see a GP when necessary. Medical consultations were conducted in residents’ own rooms. General care practices were observed. Staff addressed residents by their preferred name, as recorded on their care plans. The home operated a key worker system and workers were knowledgeable about the social history, likes, dislikes and needs of residents they were key worker for. Staff said they were instructed about the importance of treating all residents with respect. Residents said that staff were “very kind” and that they got on well with all of them. Visitors remarked, “I can’t fault any of the staff, or the care in general”. Staff were seen to interact with all residents in a caring, respectful manner throughout the inspection visit. Social Services’ staff recorded positive comments about the quality of care provided by the home. Yew Tree Care Home DS0000060593.V332435.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 excellent. This judgement has been made using available evidence including a visit to this service. Residents had access to social activity at a level appropriate for their needs, were able to exercise choice and control over their lives and enjoyed a well balanced diet that reflected individual preference and specific needs. EVIDENCE: Most residents were unable to participate in organised events and preferred one-to-one activities. Entertainers visited the home about six times a year. Staff were seen having conversations with residents throughout the visit. Relatives confirmed that one staff member was in the lounge at all times with residents. Most residents were unable to maintain links with the wider community but relatives said they were always made welcome and kept informed of any changes in their relative’s well being. Written records, reviews and general observations evidence that residents were able to exercise choice and control over their daily routine. Their Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 14 interests, likes, dislikes and preferences were recorded on admission and contributed to the care plan. This information covered previous interests, favourite indoor and outdoor activities, favourite music and TV programmes, preferred times of rising and bath-times, whether they were active worshippers to how many pillows they preferred on their bed. Residents were largely unable to discuss their present preferences, limiting available choices. Sufficient staff were employed to spend social time with residents. Socialisation and activities were seen as part of residents’ care, rather than a separate duty. Staff were seen and heard to encourage residents to chose where they took their meals, what to eat and where to sit in the lounge. Residents were able to walk freely around the home, with staff accompanying them in a companionable way, and choose where to sit and when to do so. The home operated a key worker system and staff were knowledgeable about the residents they were key worker for. Residents signed their care plans if they were able and relatives were consulted about any changes. The cook demonstrated an excellent knowledge of resident’s individual likes, dislikes and needs. There was written information in the kitchen regarding special dietary needs. Menus were based on residents’ preferences and alternatives were always available. Meals were varied and looked appetising. Residents said they enjoyed the meals and visitors said, “The food always looks lovely”. Yew Tree Care Home DS0000060593.V332435.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 good. This judgement has been made using available evidence including a visit to this service. Residents and relatives benefited from a clear complaints procedure and they were assured that any concerns would be listened to. Residents were protected from abuse by well-trained staff. EVIDENCE: Copies of the home’s complaints procedure were included in the Statement of Purpose and Service User Guide. A copy was available in the manager’s office. Completed surveys evidenced that relatives knew how to make a complaint but had had reason to do so. The complaints file was made available during the inspection. No complaints had been received since the last inspection. Records showed that staff had received training in adult protection and they demonstrated their awareness and understanding of issues relating to abuse. They were able to suggest scenarios with the potential for abuse and describe what actions they would take to safeguard residents. They said they had received training during induction and the manager confirmed that further training was to be provided in the following weeks. They were aware of ‘whistle blowing’ policies and said they would feel confident to raise any concerns with senior carers or the manager. Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 16 The homes’ adult protection policy reflected Lincolnshire Adult Protection Committee (LAPC) guidelines. Allegations of abuse would be followed up promptly and actions taken recorded. Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 119,20,22,25,26.Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There had been general improvements in the environment overall but some parts of the home were in need of further improvement. EVIDENCE: Service histories were seen for the specialist equipment the home provided, such as hoists, rotundas, pressure mattresses and wheelchairs. A stair lift is fitted to provide access to the first floor. There are grab rails fitted throughout the home in hallways, bathrooms and toilets. Returned surveys showed that relatives thought décor to be, “below par”. Visitors said, “The only thing that lets the place down is that it’s old and a bit shabby”. Bathroom facilities on the first floor were clean, attractive and well maintained. New flooring had been laid in the main entrance hall. Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 18 Levels of hygiene within the home were mainly good. There were no offensive odours on the first floor, or in communal areas. The standards of décor and furnishing in the lounge, conservatory and dining room were generally good. Other others of the home were in need of repair, refurbishment and redecoration. The carpet in the dining room was stained and worn. The manager confirmed that there were plans to replace the carpet in the near future. Plaster in one corner of the wall in the main staircase was crumbling, and damp to the touch. The carpet on the ground floor corridor had a noticeable smell of urine and was stained and worn. The manager confirmed that it was due to be replaced in the near future and new flooring in other areas of the home. There was a raised drain cover in the ground floor bathroom and a pipe joint, both posing trip hazards to residents and staff. Wall tiles were missing in places. The toilet was old and stained. There were unsightly exposed pipes up the wall, with the potential to burn residents. There were no curtains at the window and the ambience of the room was not welcoming or homely. The manager explained that the curtains had been taken down to be washed and would be put back. There were no facilities for staff to change or to store personal belongings. The provider confirmed there were plane to make a room into a staff room within the next few months. Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were protected by a robust recruitment policy and well trained staff committed to provide a high standard of care. EVIDENCE: Four staff files were inspected. All demonstrated that correct recruitment procedures had been followed and contained the information required by National Minimum Standards. Two members of staff had achieved NVQ awards, two more had started NVQ training and one was in the induction phase. Conversations with staff and inspection of records confirmed that staff had clearly defined job descriptions. The training programme demonstrated that staff received foundation and regular mandatory training, in addition to more specialised training to meet the needs of residents. They had recently received training in effective record keeping and dementia care and adult protection training was scheduled for the following month. Yew Tree Care Home DS0000060593.V332435.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): 31,33,35,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was run by an experienced and competent manger who had fostered good working relationships with other professionals. Residents and their families were able to give feedback through a good quality monitoring system. The health and safety of service users and staff is promoted through safe working practices. EVIDENCE: Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 21 The registered manager was well qualified, with years of experience in the management of care homes and delivery of care to older people. She had reviewed and updated the home’s policies and developed a good quality monitoring system. Relatives, residents, health and social care professionals were able to give their views. Responses were analysed and used to further improve the service. Questions covered accommodation, care, catering and the environment. Seventeen completed questionnaires were received: all gave positive feedback. The manager co-ordinated all training, was responsible for formal records, correspondence, staff rotas, supervision of maintenance work, enquiries and collection of medication. She worked with no administrative or secretarial support. This limited the amount of time she was available to supervise staff, interact with residents and maintain her ‘hands on’ approach. A recommendation was made that these arrangements be reviewed. No residents were able to manage their own finances. Most personal allowances were managed by their relatives, whom the home invoiced as necessary. The home held personal allowances on behalf of a few residents and recording and accounting systems were seen to be satisfactory. Fire safety and training records were satisfactory, as were water temperature and general maintenance records. Environmental risk assessments were reviewed regularly. The home’s health and safety policies and procedures gave guidance to staff and servicing records were maintained. Staff received awareness training on health and safety and infection control. Risk assessments had been completed for all service users and the premises. Some systems were in place minimise risks to residents who preferred to walk around the home, including the fitting of a safety gate to the kitchen door. Yew Tree Care Home DS0000060593.V332435.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 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 3 3 N/A 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 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X 3 X X 2 2 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 4 X 3 X 3 X 3 3 Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23 (2) (b) 23 (2) (d) Requirement The registered person must ensure the fabric of the building is maintained in a good state of repair, externally and internally. The registered person must ensure that bathroom facilities are comfortable, meet the needs of residents and kept in a good state of repair. The registered person must ensure the home is kept free from offensive odours. The registered provider must undertake an internal environmental audit of the care home to develop a clear action plan, with timescales, which fully identify and address the environmental needs of the home. All medication must be administered as prescribed. The registered manager must confirm with the prescriber that Fucithalmic eye drops, Locorten Vioform ear drops and Prednisolone soluble tablets are DS0000060593.V332435.R01.S.doc Timescale for action 01/05/07 2 OP21 01/05/07 3. OP26 16 (2) (k) 01/05/07 4. 5. OP9 OP9 13 (2) 13 (2) 05/03/07 05/03/07 Yew Tree Care Home Version 5.2 Page 24 intended for ongoing treatment and this must be recorded in the medication records. 6. OP9 13 (2) The date of opening must be 05/03/07 recorded on all medication that has a shortened expiry date once opened. Accurate, complete and up to date records must be kept relating to medication including: • Records of all medication received. • Records of all medication administered including the dose where variable doses are prescribed. • Records of all medication disposed of. • Records of medication in individual files including care plans. To ensure that medication is given correctly. There must be an up to date written medication handling policy including a homely remedies policy to ensure that medication is managed safely and given to residents correctly. Staff who administer medication must have received appropriate training, be assessed as competent and follow current medication policies and procedures in the home. Fridge temperatures must be regularly checked and recorded to ensure that medication requiring fridge storage is kept within the temperature range recommended by the manufacturer. Medication storage must be secure and only authorised staff must have access to controlled drugs cupboards DS0000060593.V332435.R01.S.doc 7. OP9 13 (2) 16/04/07 8. OP9 13 (2) 30/04/07 9. OP9 18 (1) (a) 30/04/07 10. OP9 13 (2) 16/04/07 11. OP9 13 (2) 16/04/07 Yew Tree Care Home Version 5.2 Page 25 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 OP19 OP9 Good Practice Recommendations It is strongly recommended that the registered person consult with the environmental health department to discuss arrangements for staff facilities. It is recommended that the registered manager undertake regular audits of medication to ensure that medication is being given correctly, that appropriate stock levels are available and that out of date medication is not used. Yew Tree Care Home DS0000060593.V332435.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Yew Tree Care Home DS0000060593.V332435.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!