Care Home: 99 -105 Durham Care Homes

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What the care home does well People are well assessed on entry to the home and are provided with a good care plan for staff to follow. They are well supported with health care that meets their needs and their expectations. People experience good levels of privacy, have their dignity maintained, and their right to make decisions respected. They are encouraged to maintain contact with family members and friends and enjoy visits from these people any time of the day, and they are encouraged to exercise choice and control over their lives. People enjoy good food, which matches their expectations and preferences, but also offers a satisfactory level of nutrition. They are confident their complaints will be listened to and acted upon. People are protected from abuse by robust recruitment and selection procedures and practices. People experience a safe, clean and well-maintained environment. A sufficient number of care staff work in the home on each shift to meet the needs of people. The manager runs the home in the best interests of people living in the home, safeguards their financial interests, and maintains their health, safety and welfare. What has improved since the last inspection? We looked at the information sent to us on the AQAA and this told us that there has been an improvement in the way the home record peoples needs. This is now in a more user-friendly system and the information is more accessible for staff to use to meet the needs of the people who live at the home. The AQAA told us that the home has undertaken some refurbishment especially the dining room; this has been redecorated with new cushions and curtains have being bought. We were also told that the home are providing more in house training for the staff to provide them with the skills to care for the people who live at the home. What the care home could do better: The information which is kept about the people who live at the home for the staff to use to ensure they receive the correct care needs to be updated from time to time and the changing need of the people recorded. This will make sure that the staff have detailed up to date information to refer to, which in turn will make sure the people who live at the home receive the proper care and attention they need. Some times the staff at the home have to give out medication which is not part of the system which is used at the home. For example when a GP visits one of the people who live at the home and prescribes an anti-biotic this needs to be recorded accurately on the medication recording sheets the home uses. When this happens there should always be two signatures on the sheet to show thattwo staff have check that right information has been recorded. This makes sure that the person does not receive the wrong dosage at the wrong time. The people who live at the home should be able to move around safely and independently. Currently due to the amount of walking aids that are used by the people who live at the home the communal space both lounge and dining room can become cluttered and dangerous. This poses a real trip hazard for some of the people who live at the home when moving around and the staff while assisting. Some people`s walking aids are taken away to eliminate this, but then they have to ask for them and this restricts their freedom to move around independently. The owner need to re-evaluate the provision of communal space with the current needs of the people who live at the home and take steps to eliminate the risk and enable people to move around safely and independently. CARE HOMES FOR OLDER PEOPLE 99 -105 Durham Care Homes 99-105 Durham Street Holderness Road Hull East Yorkshire HU8 8RF Lead Inspector George Skinn Key Unannounced Inspection 9th December 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 99 -105 Durham Care Homes DS0000000845.V373400.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. 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 99 -105 Durham Care Homes Address 99-105 Durham Street Holderness Road Hull East Yorkshire HU8 8RF 01482 229766 F/P 01482 229766 durhamcarehomes@yahoo.co.uk 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) Durham Care Homes Mrs Joan Langfield Maxine Ann McKeen Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd January 2008 Brief Description of the Service: Durham Care Homes is situated to the east of the city of Hull, on Durham Street, which runs off a main road into the city. The home is registered to provide care and accommodation for twenty older people who may also be suffering from dementia. Charges this year for accommodation fees are. There are fourteen single rooms and three shared rooms. A large lounge and a dining room are available on the ground floor of the home, and a small lounge is available on the first floor. A small car park and patio/garden area is available to the rear of the premises for residents use, and this area is secured with wrought iron gates that are kept closed during the day and padlocked at night. Shops, churches and local health facilities are all accessible within a small distance, public transport is also available close to the home on the main road. 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include: • • • • Reviewing information that has been received about the home since the last inspection Information provided by the registered person on an Annual Quality Assurance Assessment (AQAA) Comment cards returned from people who live at the home, relatives and staff A visit to the home carried out by one inspector A site visit was carried out which lasted 5 hours. We spoke with the people who live at the home, their relatives and staff. We looked at records relating to the people who live at the home, staff and the management activities of the home. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The manager was available to assist throughout the day. What the service does well: People are well assessed on entry to the home and are provided with a good care plan for staff to follow. They are well supported with health care that meets their needs and their expectations. People experience good levels of privacy, have their dignity maintained, and their right to make decisions respected. They are encouraged to maintain contact with family members and friends and enjoy visits from these people 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 6 any time of the day, and they are encouraged to exercise choice and control over their lives. People enjoy good food, which matches their expectations and preferences, but also offers a satisfactory level of nutrition. They are confident their complaints will be listened to and acted upon. People are protected from abuse by robust recruitment and selection procedures and practices. People experience a safe, clean and well-maintained environment. A sufficient number of care staff work in the home on each shift to meet the needs of people. The manager runs the home in the best interests of people living in the home, safeguards their financial interests, and maintains their health, safety and welfare. What has improved since the last inspection? What they could do better: The information which is kept about the people who live at the home for the staff to use to ensure they receive the correct care needs to be updated from time to time and the changing need of the people recorded. This will make sure that the staff have detailed up to date information to refer to, which in turn will make sure the people who live at the home receive the proper care and attention they need. Some times the staff at the home have to give out medication which is not part of the system which is used at the home. For example when a GP visits one of the people who live at the home and prescribes an anti-biotic this needs to be recorded accurately on the medication recording sheets the home uses. When this happens there should always be two signatures on the sheet to show that 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 7 two staff have check that right information has been recorded. This makes sure that the person does not receive the wrong dosage at the wrong time. The people who live at the home should be able to move around safely and independently. Currently due to the amount of walking aids that are used by the people who live at the home the communal space both lounge and dining room can become cluttered and dangerous. This poses a real trip hazard for some of the people who live at the home when moving around and the staff while assisting. Some people’s walking aids are taken away to eliminate this, but then they have to ask for them and this restricts their freedom to move around independently. The owner need to re-evaluate the provision of communal space with the current needs of the people who live at the home and take steps to eliminate the risk and enable people to move around safely and independently. 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. 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People receive the care they need because the home have thorough assessments done by the placing authority and the home before they move in. EVIDENCE: We looked at a sample of files which belonged to the people who live at the home and we saw that these contained copies of assessments undertaken by the placing authority and the home. This assessment information is then used to write a care or support plan describing what staff need to do to look after each person. The home does not provide intermediate care, which is a specialist service aimed at maximising people’s independence and return home after a hospital admission. 99 -105 Durham Care Homes DS0000000845.V373400.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 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Every body who lives at the home has a care plan, but there needs to be a record of when these are reassessed or changed along with the changing needs of the person. People who live at the home are treated with dignity and respect. People are protected by the home’s handling of mediation. EVIDENCE: We looked at 4 care plans, which belonged to the people who live at the home. We saw that personal support is provided in accordance with the care plan these contained risk assessments around the area of falls, tissue viability, nutrition and diet. It was not clear when these risk assessment or care plans had been reviewed or changed along with the changing need of the people who live at the home. We saw that the people who live at the home can access healthcare professionals like doctors and nurses when needed; some people also have input from specialist nurses like community psychiatric nurses (CPN). Some 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 11 people have involvement with psychiatrists, specialist social workers, physiotherapist and dieticians. When we spoke with the staff they were clear about how to maintain someone’s dignity and uphold their rights. We saw that the staff were sensitive to peoples needs when undertaking any personal tasks and were sensitive and patient when dealing with those people who have dementia. At no time did we hear any of the staff using any derogatory language or belittling any one in any way. We looked at the way the home handles and stores medication. We saw that the way this was done ensures the safety of the people who live at the home. The medication was stored in the proper cabinets and secured. The staff make sure that correct medication has been supplied by the pharmacist when it is delivered and any mistakes are quickly rectified. The staff make sure that the recording of the medication is up to date and gives a clear indication that the medication has been administered. The recording also indicates when the medication has not been given and why. All of the staff who give out medication have had the proper accredited training and we saw certificates which confirmed this. Sometimes the staff at the home have to administer medication which has not been included on the Medication Administration Record MAR sheet; for example if a GP visits and prescribes a course of antibiotic. When this happens the staff should make sure that two signatures are recorded on the MAR sheet to ensure that the right information has been recorded. 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at the home are able to take part in age appropriate activities both in the home and in the local community. People who live at the home are fee to come and go as they please and contact with relatives and friends is actively encouraged. People who live at the home are provided with food which is wholesome and nutritious. EVIDENCE: When we spoke with the people who live at the home they said they could make choices about activities, food, how to spend their time and when to get up and go to bed. The home encourages contact with relatives and friends. We saw that visitors were made welcome to the home and had good relationships with the staff. We saw that a selection of activities are arranged for the people who live at the home to take part in if they wish these included reminiscence, one to one discussions, bingo, quizzes, table top games, dominoes, crosswords and nail care. Advertisements around the home told us that that entertainers visit regularly and during the summer months trips out are booked, weather permitting. The people who live at the home told us that they had been out for 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 13 their Christmas lunch on the day before the site visit and that they had enjoyed this very much. When we spoke with the people who live at the home about the food they told us it was very good; people told us that “there is always plenty of choice” “the cook is a smashing cook and the food’s just right” “I like the puddings” Lunch on the day of the inspection was nicely presented and looked wholesome and nutritious. Staff helped those people who required assistance when eating in a relaxed unhurried manner. When we spoke with the cook she was knowledgeable about peoples diets and received the appropriate training. The home have been awarded a ‘B’ for the cleanliness of the kitchen by the Environmental Health inspector. 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at the home know who to complain to and they are confident that any concerns raised would be dealt with appropriately. People are protected by the home policies and procedures for dealing with any instances of abuse. EVIDENCE: The manager told us that the home had received no complaints since the last inspection. The home keeps a record of all complaints received and these are recorded properly with the out come and the satisfaction of the complainant being recorded. The CSCI have received no complaints about the home since the last inspection. The home has not been the subject to any safeguarding referrals or investigations In discussion with the people who live at the home they were aware that they had the right to make complaints and told us that they would talk to their key worker their family or the manager. The home has a policy and procedure for safeguarding adults and the staff interviewed were aware of this. The majority of the staff have received training about Protection Of Vulnerable Adults (POVA). Those staff who were new and were waiting for training were able to describe what they would do if they suspected any abuse was occurring with in the home. All the staff were 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 15 confident that the manager would take the appropriate action and they were aware that they could approach the local social service safeguarding department if they felt more action could be taken. 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home which is well maintained and comfortable. The communal space does not enable people who live at the home to move around freely or safely. EVIDENCE: We looked around the home and we saw that all rooms are clean, comfortable and very personalised. The lounge and dining room now both have limited floor space for need of the people who live at the home. Both are difficult for people to negotiate safely due to the amount of walking aids in use. Some of the walking aids need to be taken away from the people to ensure the safety of others and so as not to pose a trip hazard. This effectively limits the choice of the individual, as they have to ask for their walking aid to enable them to move. 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 17 We saw that those people that are hearing impaired have fire safety lights in their rooms to alert them to the fire alarms going off. There is a pleasant garden to the side of the home overlooking the car park. The home complies with the requirements of the local fire service and environmental health departments and the home has achieved a ‘B’ for the cleanliness of the kitchen. The home meets requirements of standard 26 in respect of laundry equipment and hygiene facilities. The laundry is clean and tidy and wall and floor surfaces are of a good impermeable quality to ensure safe cleaning etc. The laundry equipment meets the Water Supply (Water Fittings) Regulations 1999. People spoken to are satisfied with the cleanliness of the house and their personal space. 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are cared for by staff who are provided in enough numbers to meet their needs. People are cared for by staff who are qualified and competent to do so. EVIDENCE: There is a satisfactory staff rota in place that records the role of each member of staff. The staffing levels are based on the needs of the people who live at the home. There is a cook on duty each day as well as a kitchen assistant and other ancillary staff. This enables care staff to concentrate on assisting people with personal and social care activities. Training records indicated that that more than 50 of the staff are trained to NVQ level 2 which includes training on equality and diversity and an awareness of abuse. The recruitment and selection procedures remain robust and all checks are undertaken prior to staff commencing work at the home. The staff files looked at contained references from previous employer, an application form which identified gaps in employment and a completed Criminal Record Bureau CRB check. There is a training and development plan in place that shows all staff have undertaken core training. We saw that staff records include information about 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 19 individual training achievements and a copy of training certificates is kept on their file. Staff have refresher training as appropriate to ensure that their skills and knowledge are kept up to date. All staff have received mandatory training in Health and safety, Manual handling, Basic Food Hygiene, First Aid and Fire. Staff receive regular supervision and developmental opportunities are given for the staff to attend further training. When we spoke with staff they said they found the training excellent and where pleased that they were encouraged to attend lots of training. They felt this gave them the skills needed to care for the people who live at the home. 99 -105 Durham Care Homes DS0000000845.V373400.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 People who use this service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home which is run and managed in their best interests. People are safe at the home because the staff have received the appropriate training and guidance from the management of the home. EVIDENCE: The manager is registered with the CSCI and has the relevant qualifications and experience for this role. People who live at the home told us that the management are approachable and they have confidence in them. Staff told us that the management is supportive and provides them with good leadership. From speaking with the manager, and staff, it is clear that the home’s ethos is to promote participation and inclusion for the people who live at the home. 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 21 The home continues to have a well has developed quality assurance system that involves the people who live at the home carers, family staff and other professionals giving their views about the home. Surveys are completed throughout the year and an annual report is produced explaining the outcome of the surveys and any relevant action to be taken. People who live at the homes and/or their families continue manage their own financial affairs; some personal monies are kept by the home. The home has a fire policy and a fire risk assessment and the fire alarm is tested weekly. Tests on equipment are undertaken and fire drills are carried out on a monthly basis. The home has a nurse call system fitted to ensure that all the people who live at the home are able to request assistance when needed. All the equipment in the home is tested at the appropriate intervals and all maintenance certificates are up to date. The AQAA which was returned by the home prior to the site visit was well completed and told us about areas for improvement. 99 -105 Durham Care Homes DS0000000845.V373400.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 99 -105 Durham Care Homes DS0000000845.V373400.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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations The manager should make sure that there is a record in the care plans of when some ones needs are reassessed or change. This will ensure that the person needs are accurately recorded and staff are aware of when some ones needs change. When the home receive medication that is not printed on the MAR sheets they should make sure that two signatures are recorded when the staff transcribe information from the original packaging on to the MAR sheet. This ensures that the correct dosage is recorded and the person is not put at risk. The owners of the home should re-evaluate the amount of communal space, as this may now not be best suited for the changing needs of the people who live at the home. The lack of space and the amount of walking aids in use may now pose a trip hazard for the people who live at the home and compromise their safety. 2 OP9 3 OP19 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 99 -105 Durham Care Homes DS0000000845.V373400.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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