CARE HOMES FOR OLDER PEOPLE
York Lodge 54-56 Crofts Bank Road Urmston Manchester M41 0UH Lead Inspector
Kath Oldham Unannounced Inspection 9th October 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 York Lodge DS0000063237.V348520.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. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service York Lodge Address 54-56 Crofts Bank Road Urmston Manchester M41 0UH 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) 0161 748 2315 F/P 0161 748 2315 alan.machen4@ntlworld.com Mr Alan M Machen Mrs Ann Elizabeth Crowe Mr Alan M Machen Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home accommodates a maximum of 22 service users requiring personal care only by reason of old age. 19th April 2006 Date of last inspection Brief Description of the Service: York Lodge is a private care home providing personal care and accommodation for up to 22 older people. The communal facilities include three lounges, a dining room and a conservatory, which was being used as a smoking area. The furnishings and fittings were domestic in nature and of good quality. The conservatory was bright and airy with a small balcony seating area immediately off. The home is owned by Mr Alan Machen and Mrs Ann Crowe, and managed by Alan Machen. Since the previous inspection, the owners had installed a ramp to the front entrance to facilitate disabled access to the home. The home is situated in a residential area of Urmston and is close to shops, pubs, the post office and local amenities. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This visit was unannounced, which means York Lodge was not told we would be visiting, and took place on 9th October 2007, commencing at 9.15am. The inspection of York Lodge included a look at all available information received by the Commission for Social Care Inspection (CSCI) about the service since the last inspection. This included York Lodge filling in a questionnaire about the home, which gave information about service users, the staff and the building. York Lodge was inspected against key standards that cover the support provided, daily routines and lifestyle, choices, complaints, comfort, how staff are employed and trained, and how the service is managed. Comment cards were sent prior to the inspection for distribution to people staying at York Lodge, the views expressed in returned comment cards and those given directly to the inspector are included in this report. We got our information at the visit by observing care practices, talking with people staying at York Lodge; talking with the owner/managers and staff. A tour of York Lodge was undertaken and a sample of care, employment and health and safety records were also seen. The main focus of the inspection was to understand how York Lodge was meeting the needs of service users and how well the staff were themselves supported to make sure that they had the skills, training and supervision needed to meet the needs of residents. The care service provided to three service users was looked at in detail to help form an opinion of the quality of the care provided. The term preferred by people consulted during the visit was “service users”. This term is, therefore, used throughout the report when referring to people living at York Lodge. A brief explanation of the inspection process was provided to the managers at the beginning of the visit and time was spent at the end of the visit to provide verbal feedback. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection?
On the last inspection there was a requirement to review and update the service user guide to inform prospective service users that some bedrooms are not fitted with privacy locks due to fire regulations and that the home is accessible to people with disabilities. An appendix has been attached to the service user guide indicating this. A recommendation made on the last inspection to include a list of signatures of staff authorised to administer medication in the records has been undertaken. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 7 Staff have signed to say they have read and understood the local authority’s adult protection procedure and have had some in-house awareness training in relation to adult protection. What they could do better:
Good practice recommendations have been made on this inspection. The statement of purpose and service user guide would be better in large print, which would help the information to be easily read. When medication wasn’t given, the reason needs to be indicated by a recognised code and when using certain symbols, these need to be defined on each occasion they are used. This detail needs to be recorded to demonstrate an accurate record. The date of opening medication that has a limited shelf life needs to be indicated on the box and also on the medication bottle to make sure it is in date. Medication that needs refrigeration needs to be kept in a lockable fridge to ensure it is kept securely. When administering controlled drugs medication to service users, arrangements need to be made for one staff member to sign the medication administration records and a second staff to verify administration by indication of their signature in the records. The menu needs to detail the alternative meals that are available to service users for every meal and consideration should be given to display a menu for service users to refer to, so they are able to check what’s available at mealtimes. To further action the development of the service and to demonstrate that service users and complainants’ views are taken seriously, the action taken to remedy comments and complaints made needs to be recorded in the complaints record. Some bedroom doors do not have a lock fitted to them, others do not have one fitted as if they were locked the fire service have said this will impede exit from York House in an emergency situation. The remaining bedroom doors should be fitted with a lock, which is of a type and design that service users can access with a key and that staff can enter, in an emergency situation. This will promote service users’ privacy, dignity and independence. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 8 There is one requirement, which has not been addressed by York Lodge from the last inspection. This requirement is repeated and needs to be addressed. The second requirement is as a consequence to changes in the storage of controlled drugs. York Lodge continues to develop the service it provides and wants to provide a person centred home where service users are actively involved in developing the service. 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. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 9 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 York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 10 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 & 3 (Standard 6 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users are provided with information that helps them to decide if York Lodge is the right place for them. EVIDENCE: The statement of purpose and service user guide is a combined document. The manager said that all service users had received a copy of the guide, which are within bedrooms and were also available at the home for anyone asking for one. The guide would be better in large print, which would help the information to be easily read. The document needs to reflect the changes in the fees for staying at York Lodge and, when next reviewed, needs to detail the new address of the Commission for Social Care Inspection. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 11 The managers carry out the initial assessment of need by visiting the prospective service user in their own home. This is good, as service users are able to meet with the manager and staff in the security of their home to discuss any concerns, questions or anxieties. Three service users’ files were looked at and contained detailed pre-admission assessments, which inform staff about the service users in order to provide the care they need. The home does not provide an intermediate care service. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence, including a visit to this service. Service users are involved in decisions about their lives and in planning the care and support they receive. EVIDENCE: The care plans were well-organised and detailed service users’ care needs and how care was to be provided. There was a strong emphasis on involving people using the service. All care plans had been reviewed and updated to reflect the changes in care and support provided. This enables service users to receive continuity of care. Service users have a life history within their care files, which provides staff with an insight into service users’ past lives and history. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 13 A record is maintained on individual service user files of visits by or to the doctors, nurse support and chiropody and optical tests. This record enables at a glance to see what health care needs have been provided. An annual review with a service user’s GP would further demonstrate that service users’ health care needs are met and medication prescribed is reviewed. It was apparent in discussions and observations that staff have a good awareness of the individual needs of each person and the approach to use depending on their preferences and personalities. York Lodge had developed good working relationships with health and social care personnel and there was evidence to demonstrate that service users had access to specialists services, according to their specific needs. Daily routines were flexible and personal support was provided in private. Risk assessments are in place which identify when people are at risk of falling and what action can be taken to minimise that risk. This enables York Lodge to be aware of people who are at risk and have systems in place to reduce that risk. Staff administer medication to service users. The detail within the records was up to date, with no gaps in the records. The records seen were well maintained and evidenced that service users received their medication as prescribed by their doctor. When medication wasn’t given, the reason was not always indicated by a recognised code. This detail needs to be recorded to demonstrate an accurate record. Time and patience was shown towards service users when administering medication. Some service users are prescribed medication, which has a limited shelf life. The date of opening of this type of medication needs to be indicated on the box and also on the medication bottle to make sure it is in date. Medication that needs refrigeration needs to be kept in a lockable fridge to ensure medication is kept securely. This needs to be arranged at York Lodge. Some service users are on controlled drugs at night. Examination of these records confirmed that they were kept in line with safe practice. Best practice indicates that when administering controlled drugs to service users that these are double signed within the medication administration records. This safeguards service users and staff.
York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 14 Changes in the storage of controlled drugs medication indicates that a controlled drugs cupboard should be obtained. This needs to be arranged at York Lodge to comply with new regulations. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users’ lifestyle choices, expectations and preferences in daily routines are respected and met. EVIDENCE: The home employs an activity co-ordinator. Individual activities would also benefit service users, as one service user said she would like to go shopping but wasn’t aware if this could be provided. Another service user said they would like to go out for a walk but couldn’t do this alone, as they would tire easily. The manager said he was aware that individual activities would be of benefit to service users and this is being researched. A number of the care files did include service users’ past lifestyles in relation to activities and additional information; discussion with service users would assist in the development of this service. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 16 The residents’ meeting was suggested as a way of finding out service users’ feelings and views on this. These meetings are arranged regularly and it is hoped by the manager that this will provide service users with another opportunity to contribute to the development of the activities provided at York Lodge. Menus are varied and based on the known and recorded preferences and suggestions of service users. The main meal is indicated on the menu; the alternatives were not indicated. The alternative was “salad on request”. The manager said that they always provide an alternative and have stocks of food if a service user were not to like or fancy a particular meal. Service users were not aware of the meal to be served and said they will know when it arrives. To promote service users’ independence, thought should be given to having a menu displayed so those able could refer to it to check the meal of the day. The meal served during the visit was home cooked using fresh produce. Staff were observed providing appropriate, yet discreet interventions to those service users requiring additional help and support. Service users spoken to were complimentary about the meals served in the home. One service user said, “The food is lovely”. Service users were promoted to remain independent at lunchtime and individual pots of coffee and tea were served. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 17 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. Service users are listened to, taken seriously and feel safe. EVIDENCE: Service users spoken with all confirmed that they could speak to staff if they had any concerns and that action would be taken in response to their worries. Service users were clearly comfortable approaching staff to ask questions or seek reassurance and the open door policy was appreciated by those consulted. A record is maintained of all comment or complaints made. The action taken to remedy the problem needs to be detailed within the records. The Commission for Social Care Inspection has not received any complaints about the service provided at York Lodge. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 18 Staff have signed to say they have read and understood the local authority’s multi-agency policy for the protection of vulnerable adults and have received in-house guidance about adult protection. Staff would benefit from attending external courses in relation to this specialism to ensure they have the knowledge and skills to recognise potential abuse and ensure they are clear about the actions to take if abuse was alleged. Discussions with staff confirmed that staff understand their role in protecting service users. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 19 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users are provided with a pleasant, comfortable and clean living environment. EVIDENCE: A visitors’ book is placed in the conservatory entrance and visitors to York Lodge are encouraged to sign in and out of the book. This is to ensure that if there is an emergency situation, everyone in the building is accounted for. A number of adaptations have been made to the building to assist service users with reduced physical mobility, such as handrails being fitted. This approach demonstrates that York Lodge addresses the diversity of the service user group and promotes their independence.
York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 20 Ramped access is available, which allowed those people in wheelchairs or with walking difficulties access to the outside of the house. The lounge areas were well furnished with comfortable seating. There is a call bell system within the lounge areas, which can be used to call for staff assistance or help. The home has a large lounge and smaller lounges. A communal dining room is on the ground floor. The dining room looked bright and welcoming with tables set with table linen and napkins. All service users spoken to expressed satisfaction about their environment. There was evidence of an ongoing routine maintenance programme. One service user said they liked to spend a lot of time in their bedroom, they said, “I am a private person, and it suits me”. A partial inspection of the building identified that bedrooms were personalised by people living at York Lodge and their families. One person said they had everything that they needed in their bedroom and had brought things with them from home to make it more their own. One visitor said their relative had a beautiful room and was comfortable and happy there. A number of bedroom doors do not have locks fitted, which does not promote the privacy of service users. Further bedrooms cannot be locked. This is due to the design of the building and the fire officer’s stipulation that these bedrooms would be used as a means of escape in an emergency. York Lodge have allocated the conservatory to wish to smoke. The conservatory is positioned of which is also the entrance to York Lodge. environmental health department to check that the new smoke-free law. be used by service users who on the back of the house, part Advice was given to contact these arrangements meet with A number of bedroom doors were wedged open. The manager said that York Lodges fire risk assessments identifies this and the fire procedure details the action to be taken in an emergency situation. All public areas of the home seen were clean and tidy. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 21 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. Service users were protected by the recruitment and training practices operated by York Lodge. EVIDENCE: There had been no staff appointments since the last inspection. On that inspection, it was reported that pre-employment checks had been undertaken on all staff employed to work at York Lodge. It was evident that staff have a good knowledge of the needs and personalities of individual service users. Communication between staff is good. The information about service users provided was detailed and helped to ensure good continuity of support for service users. Eight staff have obtained NVQ level 2 or above and two staff are working towards NVQ qualifications. This enables staff to have the knowledge and expertise to provide support to service users. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 22 There were sufficient staff on duty to care and support service users living at York Lodge. The deployment of staff was good, with service users commenting that staff are available to them. Examination of the duty roster identified that the full names of staff were not indicated. This needs to be included on these records. The manager said that he had devised the duty rota on past advice from the Commission but would amend the recording to make it simpler to understand. The training records seen identified that some staff had not received annual updates to their moving and handling training, as identified in Health and Safety legislation. The manager said that staff have had updates in the last three months or so and would provide confirmation of this fact to the Commission for Social Care Inspection. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 23 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 management is approachable and there is a focus on meeting the needs of people living at the home. EVIDENCE: The manager is currently studying to obtain NVQ level 4 and it is envisaged that he will complete this before the end of November 2007. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 24 The service users at York Lodge benefit from a committed staff team. The manager operates an open management style and encourages service users and staff to make use of the ‘open door’ policy. At the heart of this style of management is a person centred approach where the focus is on how the individual service user wants their care needs to be met. Discussions with the manager provided evidence of an open and transparent management style, where any issues highlighted in the inspection visit were seen as an opportunity to improve the service. There was a strong focus on developing the staff team and an emphasis on consulting with service users informally and formally in order to improve the service. All service users spoken to expressed satisfaction on the way York Lodge was run and the quality of the services delivered by the staff. A manager was in charge during this visit and demonstrated, along with the senior staff, a high level of competence and knowledge. Service users, visitors and staff described an open and friendly atmosphere in which people’s views are listened to and acted on. A quality assurance system is in place that seeks and acts upon the opinions of service users in terms of their day-to-day experiences and improvements that could be made. This could be extended to obtain the views and opinions of relatives and friends and professional visitors to York Lodge. This information would further demonstrate how York Lodge takes the views of everyone involved in the home seriously and how they plan to continually develop the service provided. Health and safety procedures presented as being effectively implemented. A selection of records relating to the maintenance of equipment and the fire detection systems was looked at. These were appropriately maintained. York Lodge should inform the Commission for Social Care (CSCI) of events that affect the health, safety and welfare of service users. The inspection undertaken in April 2006 described that the manager said this had been an oversight. These notification have not been forwarded to the Commission in line with Regulations. Staff confirmed they were provided with protective equipment, including disposable gloves and aprons, to minimise the risk of cross-infection. Examination of the record of personal allowances identified that the balances maintained on behalf of people living at the home. Receipts were in place for purchases made on behalf of people living at the home. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 25 Not all staff have met formally with their line manager in supervision to develop their skills and knowledge, to identify any training and to examine the philosophy of the home. The manager said that he had undertaken some of these sessions with staff and accepted that the management team must include these into their work programme. York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 26 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 Standard No Score 16 3 17 X 18 3 3 X X X X X 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 3 X 3 X X 3 X 3 York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 27 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 OP9 Regulation 13 Requirement Obtain a controlled drugs cupboard to comply with changes in the storage of controlled drugs medication. York Lodge must inform the Commission of any event that affects the health, safety and welfare of service users. (Previous timescale of 19/05/06 not met). Timescale for action 31/12/07 2 OP38 37 09/11/07 York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 28 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 OP1 Good Practice Recommendations The statement of purpose and service user guide would be better in large print, which would help the information to be easily read When medication isn’t given, the reason needs to be indicated by a by a recognised code and when using “O” this needs to be defined on each occasion it is used. This detail needs to be recorded to demonstrate an accurate record. The date of opening medication that has a limited shelf life needs to be indicated on the box and also on the medication bottle to make sure it is in date. Medication that needs refrigeration needs to be kept in a lockable fridge to ensure medication is kept securely. When administering controlled drugs medication to service users, arrange for one staff member to sign the records and a second to verify administration by indication of their signature in the medication administration records. Detail on the menu the alternative meals that are available to service users for every meal and display a menu for service users to refer to so they are able to check the menu. To further action the development of the service and to demonstrate that service users and complainants’ views are taken seriously, the action taken to remedy comments and complaints made by service users needs to be recorded in the complaints record. To safeguard service users and staff, arrange for all staff to attend external training in what constitutes abuse and the action to take if abuse is alleged. Install bedroom doors with a lock, which is of a type and design which service users can access with a key and that staff can enter, in an emergency situation. This will promote service users’ privacy, dignity and independence. OP9 3 4 5 OP9 OP9 OP9 6 OP15 7 OP16 8 9 OP18 OP19 York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 29 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 10 Refer to Standard OP26 Good Practice Recommendations On reviewing the fire risk assessment and fire procedure, discuss the contents with GM Fire Officer to ensure the arrangements in the home with regard to wedging open fire doors does not compromise the safety of service users and staff. To ensure a full record is available of staff working hours ensure that the full names of staff are indicated on the staff duty roster Arrangements should be put in place for all staff to receive supervision at a minimum of six times each year. This will support the further development of staff. 11 12 OP27 OP36 York Lodge DS0000063237.V348520.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Manchester Local Office 11th Floor, West Point 501 Chester Road Old Trafford Manchester M16 9HU 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
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