Care Home: Acorns Care Centre

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What the care home does well What has improved since the last inspection? Several bedrooms have been redecorated and refurbished. Management have bought 2 specialist nursing chairs that will be comfortable for residents with high nursing needs and will also help in the prevention of pressure sores. A large flat screen television has been purchased for one of the lounges. This makes it much easier for the residents to watch TV. The home now has a monthly newsletter that keeps residents up to date with what is going on in the home and gives snippets of general information. The things that needed doing from the last inspection have been done. What the care home could do better: Staff must ensure that a safe system is always in place for managing the medicines. They must make sure that they write down accurately whether a medicine has been given or not. They must also make sure that the medicines are given in accordance with the prescription.The decor in several parts of the home needs attention. More attention must be paid to reducing the risk of infection/contamination by making sure that staff hand washing equipment is in place wherever personal care is being given. CARE HOMES FOR OLDER PEOPLE Acorns Care Centre Parkside Hindley Wigan Greater Manchester WN2 3LJ Lead Inspector Grace Tarney Unannounced Inspection 18th March 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 Acorns Care Centre DS0000030090.V358834.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. Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Acorns Care Centre Address Parkside Hindley Wigan Greater Manchester WN2 3LJ 01942 259024 F/P 01942 259024 hallkevin@f2s.com 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) Mr Kevin Hall Anne Susan Gardner Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39), Terminally ill over 65 years of age (2) of places Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 39 service users, to include: Up to 39 service users in the category of OP (Older People) ; Up to 2 service users in the category of TI (E) (Terminal Illness over 65 years of age) The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. That at all times a suitably qualified registered nurse is working in the care home. 23rd January 2007 2. 3. Date of last inspection Brief Description of the Service: The Acorns Care Centre is located on the outskirts of Hindley town centre, close to shops, a park, and other amenities. The main bus route runs close by. The Acorns is purpose-built, and accommodation for residents is provided on three floors that are reached either by stairs or a passenger lift. Accommodation is provided for a total of 39 residents, both male and female. The Acorns provides nursing and personal care. All accommodation is offered on a single-occupancy basis. All bedrooms have en suite facilities. The current weekly fees range from £476.36 to £578.34. The amounts charged depend on the needs of the resident and the care provided. Additional charges are made for private chiropody, hairdressing and newspapers. This information was received on the 18th March 2008. A copy of the most recent Commission for Social Care (CSCI) inspection report was displayed in the hallway. Acorns Care Centre DS0000030090.V358834.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 2 star. This means the people who use this service experience good quality outcomes. The home was not told that this inspection was to take place although many weeks before the inspection, questionnaires (comment cards) were sent out to the residents and their relatives. The questionnaires asked what people thought about the care and quality of the service provided. 1 was received from a resident and 2 from relatives. What they felt about the care and services provided is written in different sections throughout this report. Several weeks before the inspection we (The Commission) asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they did at present, what they felt they did well and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we do. The visit to the home by an inspector took place over 8 hours. During our time at the home we looked at care records and medicine records to make sure that the health and care needs of the residents were being met. We also looked around the building at some of the bedrooms, bathrooms, toilets and sitting areas to check if they were clean, warm and well decorated. We also looked at the menus in detail, to check what the residents had for their breakfasts, lunches and evening meals. We also checked how many staff were provided on each shift to make sure the residents’ needs were being met, and also looked at how the staff are trained to do their jobs properly. We also checked to see if the staff were properly recruited. In order to get further information about the home we also spoke to 3 relatives, 2 residents, one of the qualified nurses, the activities person and the cook. What the service does well: The Manager makes sure that the staff only care for those people whose needs they can meet. Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 6 The residents’ care plans contain a lot of important information about what they need help with, and how they are to be cared for. Residents feel that they are well looked after by the staff. Residents and relatives made the following comments: • They are very, very good. • They look after me well. Activities are considered to be an important part of the residents’ day. This brings enjoyment to lots of the residents. The meals provided are varied and nutritious and the residents have a good choice of menu. Enough staff are on duty to meet the needs of the residents. The staff make sure that the residents are clean, comfortable and well dressed. Management is making sure that the staff are properly trained and is providing the care team with the knowledge and skills they need to protect and meet the needs of the residents. Management makes sure that they check people out properly and safely before offering them a job. This helps protect residents from being cared for by unsuitable people. What has improved since the last inspection? What they could do better: Staff must ensure that a safe system is always in place for managing the medicines. They must make sure that they write down accurately whether a medicine has been given or not. They must also make sure that the medicines are given in accordance with the prescription. Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 7 The decor in several parts of the home needs attention. More attention must be paid to reducing the risk of infection/contamination by making sure that staff hand washing equipment is in place wherever personal care is being given. 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. Acorns Care Centre DS0000030090.V358834.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 Acorns Care Centre DS0000030090.V358834.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are properly assessed before they are admitted to the home and this gives an assurance to everybody that a person is only admitted if the staff can meet their needs. EVIDENCE: Before any resident was admitted to the home the manager or a senior member of staff from the home, undertook an assessment of their needs. The assessment looks at what help and support the prospective resident needs in all aspects of daily life. The 2 assessments looked at were detailed and gave a clear indication of the residents’ needs and what they could and could not do for themselves. Management told us in the AQAA that they ensure that the residents’ key worker is on duty when the resident is first admitted to help them settle in their new home. Standard 6 does not apply. The home does not provide Intermediate Care. Acorns Care Centre DS0000030090.V358834.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans show what care needs the residents have and care practices ensure that their needs are met. The poor recording of medicines could result in the residents not receiving the correct amount of medicines prescribed for them. EVIDENCE: Individual care plans were in place for each resident. The care plans of 2 of the residents were looked at. They contained detailed information about the care needed and the involvement of other health care professionals. One of the residents had been admitted from hospital to the home, with a pressure sore. This residents’ relative spoke highly of the care provided and stated, “thanks to the home the sore had healed”. The staff had written down the details of how the sore was to be cared for but there was not enough information in the care notes to give a true record of the condition of the sore at any one time. This was discussed with the manager who agreed to make sure staff wrote detailed information. Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 11 The staff looked at whether or not there was any risk in relation to the residents developing pressure sores, any risks of falling, and also if they were at risk due to problems with their diet and fluid intake. They also looked at and they wrote down how any resident was to be assisted with being moved around and by how many members of staff and what equipment, if any, was to be used to assist in safe moving and handling. The care plans were reviewed regularly so that any change in their condition could be identified and appropriate action taken. The manager also confirmed in the AQAA that they reviewed the care plans at least monthly. The care plans detailed the religious and cultural needs of the residents. At the time of the inspection there were no residents of any ethnic minority. The following were some of the comments made by relatives and residents: • They are all very, very good. • Smashing. • No worries about the home or the staff. The system for managing the medicines was looked at. The medicines were stored in a locked room and there were 2 medicine trolleys in use, one for residential residents and one for nursing residents. These trolleys were secured to the wall when not in use. The medicines, including controlled drugs, were securely stored. The medicine administration sheets however were not filled in accurately. The following things needed putting right: • Several of the residents were prescribed medicines routinely, for example 3 times a day. On many occasions staff were giving them only when it was felt they needed it. • A discussion with the manager showed that several of the medicines were no longer given, as the residents would not take them. • On several occasions staff were failing to write down if a medicine had or had not, been given. • The medicine administration sheets did not state the times for medicines to be given. Instead they stated morning, noon, teatime and bedtime. As these were not accurate times, and could mean different things to different people the manager was advised to speak to the pharmacist to discuss changing them to more specific times. • A handwritten instruction for medicines was not checked and countersigned. Signing and checking transcriptions protects the resident by reducing the risk of drug errors. Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 12 Staff were discreet when providing assistance to the residents however it was noted that a visiting chiropodist was treating the residents in the lounge in full view of others. This does not protect their privacy or dignity. The manager agreed to address this so that it did not happen again. The residents looked clean and comfortable and were suitably dressed. Staff confirmed that the importance of ensuring privacy, respect and dignity is part of their initial training. Acorns Care Centre DS0000030090.V358834.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 good. This judgement has been made using available evidence including a visit to this service. Residents have a choice in how they spend their day and find enjoyment with the activities available and the meals provided. EVIDENCE: The residents’ routines of daily living and their social interests were recorded in their care plans. Throughout the day we saw that the residents were able to spend their day wherever they wished to. The home employs an activities organiser who works 30 hours each week and organises a programme of activities for the residents. A wide range of activities is offered at the home including bingo, 1-1 reminiscence where the residents can discuss the “old days”, a wine and film evening, sing-a-longs and outside entertainers. Whilst we were at the home we saw that one of the residents had been taken out for a walk in the park. Parties are held for special occasions such as Birthdays, Easter and Christmas. The home now has a monthly newsletter that is full of interesting news and activities. The majority of residents had a Church of England or Roman Catholic religious faith and staff told us that the clergy visit the home on a regular basis. Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 14 Residents and relatives told us that visitors are always made welcome. We saw several relatives visiting at different times of the day. One relative commented: I can come and go as I please. They are always welcoming. Staff told us that the residents are encouraged to bring personal possessions into the home. We saw that many of their bedrooms were personalised with pictures, photographs and ornaments. We were told that the residents may handle their own finances if they are able and wish to, although most are dealt with by their families. We were also told that the management do not handle any of the residents’ finances. We did not eat with the residents but saw what they were having for lunch. The residents have a choice of food at breakfast, lunch and teatime. The dining room was a very pleasant area and the tables were nicely set. Hot and cold drinks were served during the meal and throughout the day. The residents have a lighter meal for lunch and the main meal in the evening. There were plenty of choices available for each meal. Residents made the following comments: • Yes the food is good but I think teatime is a bit too early for me. • I always like the meals A relative stated: The kitchen staff cook lovely meals and a lot of it, and will make a visitor a cuppa any time. Acorns Care Centre DS0000030090.V358834.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. People know how to complain and staff have a good knowledge and understanding of what abuse is, thereby reducing the possible risk of harm to residents EVIDENCE: A detailed complaints procedure was in place and was displayed in the reception area. The complaints procedure was also included in the Service User Guide. It is easy to understand and gives an assurance that complaints will be responded to within 28 days. A record is kept of any complaint made and includes details of the investigation and any action taken. No complaints have been made to the CSCI since the last inspection. A discussion with the senior staff showed that they were very aware of the procedure to follow in the event of any allegation of abuse. Training in the protection of vulnerable adults has been undertaken by most of the staff and is ongoing. Records of training were kept on their file. The manager also confirmed in the AQAA form that was sent to us that staff training covers the Protection of Vulnerable Adults. Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 24 25 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents live in comfortable, suitably adapted surroundings that are in need of redecoration in parts. The lack of good infection control procedures in places, and the wedging open of fire doors, puts the residents at risk of harm. EVIDENCE: Accommodation is provided on three floors and can be reached either by a lift or the stairs. There is a dining room on the ground floor, several bedrooms and a small lounge. The second and third floors have bedrooms on each, and a large lounge. The lounges were clean, warm and suitably furnished. Toilets on each floor were close by to bedrooms and lounge areas. There were enough toilets and bathrooms to meet the needs of the residents. Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 17 They had a lock on the door to ensure privacy and were suitably adapted for disabled use. Several of the toilets were in need of redecorating as the walls and paintwork were badly marked. The corridors throughout the home were well lit and had grab rails for residents to hold onto if they needed. The paintwork on the skirting boards and doorframes along the corridors was badly marked in places and in need of redecorating. We looked at some of the bedrooms. They were clean and warm, although some of the bedrooms and their adjoining en suite toilet were in need of redecorating. They had a safety overriding door lock and a lockable space to store anything that is of value or importance to the resident. Several of the bedroom doors had been wedged open. This is a safety risk in the event of a fire. Management were told to remove the wedges on the inspection day. We saw the reports from recent visits that had been undertaken by the Greater Manchester Fire and Rescue Service and from the Environmental Health Department. Both departments had made requirements and we were informed that both had also made return visits to check compliance with their requirements. The management of the home have agreed to provide us with copies of the final compliance letters. The home has under floor heating and each room has a thermostat to control the heat individually. All sinks, baths and showers have thermostatic control valves so that the water discharges at a safe temperature and therefore reduces the risk of accidental scalding. We did see issues of concern in relation to the control of infection. Although staff wore disposable protective clothing to reduce infection, some staff were walking about wearing their “clean” gloves and therefore contaminating them from other surfaces. The bins for disposing of clinical waste did not have a foot pedal and this meant that staff were touching the surface of the bin. One bin was badly stained with what appeared to be bodily substances. Staff hand washing facilities, such as liquid soap and paper towels were not available in bedrooms where personal care was being delivered. They were in place in bathrooms and toilets. There was no sink in the laundry for staff to wash their hands after handling soiled clothing although protective clothing was in place. Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by enough staff that are suitably experienced and trained and safely recruited. EVIDENCE: Inspection of the duty rotas and a discussion with staff and residents showed that there was enough staff on duty over a 24-hour period to meet the needs of the residents living at the home. 24-hour nursing care continues to be provided by suitably qualified nurses who are supported by trained care assistants. The information received from the AQAA document showed that over 50 of the staff had obtained their NVQ level 2 in or above in care. This is good progress. The personnel files of 3 staff members were inspected. All were in order and these staff had been properly and safely employed. Induction training is provided for all newly employed staff. This is to make sure that they understand what is expected of them and that people are cared for properly and safely. Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 19 A wide range of appropriate and ongoing training in moving and handling, detection of abuse, basic food hygiene, fire safety, infection control and other relevant topics is provided to staff at the home. Training provided to individual staff is recorded in detail in their individual file and in the homes’ training file. Acorns Care Centre DS0000030090.V358834.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 is well managed and most practices within the home safeguard the welfare of the residents, staff and visitors. EVIDENCE: The manager is registered with the Commission for Social Care Inspection. She is a very experienced Registered General Nurse and has a lot of experience working within the Care Home Sector. She has been the manager of the home since 2005 and has a management qualification. Staff told us that she was very approachable and very supportive. Management make sure that they do a monthly check of lots of things in the home. They check to make sure that there are no hazards around the building and also check the records about care, medicines, food and any accidents that Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 21 have happened. They also check on staff training to see that it is kept up to date. Management also send out surveys to residents and relatives asking for their views on the services provided. The manager told us that resident and relative meetings, staff meetings and management meetings take place regularly. Also a managers surgery takes place every Wednesday. This is when residents and relatives can call in to speak to the manager about anything they want to. We saw the minutes of some of these meetings. We were told that management do not handle any of the residents’ money. Good systems were in place for the maintenance of services and equipment. Regular weekly checking and testing of fire detection system, fire exits and emergency lights was undertaken and documented. The management were in the process of putting the things right that the Fire and Environmental Health officers required. The practices in relation to infection control were not as good as they should have been. Management were made aware of this and agreed to put some of the things right almost straightaway. Acorns Care Centre DS0000030090.V358834.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 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 2 3 3 x x 3 3 1 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 x x 2 Acorns Care Centre DS0000030090.V358834.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 OP9 Regulation 13(2) Requirement To ensure that residents are getting their correct medication, medicines must be given in accordance with their prescription. If staff are of the opinion that the prescription needs changing then they must request a review of the medicines by the residents’ GP. Staff must record accurately whether medicines have or have not been given. To protect the safety of all persons in the home the fire doors must not be wedged open. If a resident wishes to have their door kept open then advice from the Fire officer should be sought. To prevent the spread of infection, suitable containers for the disposal of clinical waste must be in place. To prevent the spread of infection, staff hand washing facilities, such as liquid soap and paper towels, must be in place wherever personal care is provided. DS0000030090.V358834.R01.S.doc Timescale for action 24/03/08 2 OP19 23 (4)(c)(i) 18/03/08 3 OP26 13(3) 30/04/08 4 OP26 13(3) 31/05/08 Acorns Care Centre Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP9 Good Practice Recommendations To give a clear picture of the condition of a residents’ pressure sore at any one time, staff should keep accurate records of the size and grade of the sore. If staff need to handwrite a prescription they should sign the handwritten prescription and make sure that another staff member checks that what they have written is correct and then countersign. Signing and checking transcriptions protects the resident by reducing the risk of drug errors A planned programme of decoration should be developed to ensure all areas are maintained to a good standard. 3 OP19 Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road 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 © 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 Acorns Care Centre DS0000030090.V358834.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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