Care Home: Carrow Hill

Similar services:

• Chesham House
• Argyll House
• Dorset Lodge
• Acacia House
• Dial House Nursing Home
• Cromwell Avenue (9)
• Abbey Lodge

What the care home does well People told us that they like living in the home and the manager and staff work hard to create a homely and calm atmosphere for one person said that "they liked being in the home and felt that they were being well looked after". The home is exceptionally good at encouraging independence and providing opportunities for the service users to live independently in the community. Four people have moved on since the last key inspection to live more independent lives. People living in the home say that they feel safe there and that they know who to talk to if they have any concerns. One service user said that, "they go to the manager or any member of staff because they are all very supportive". There are good links with other professionals who can help people stay stable or manage difficult situations. The home is managed well and the staff team and service users have recently taken part in an assessment of the work that they do. What has improved since the last inspection? The system for the administration and handling of medication has improved. There is now a robust system in place for the recruitment of new staff with all the appropriate checks being in place before employment of new staff. Some first floor windows now have restrictors in place. Formal supervision has been increased to the recommended six times a year. The home has now improved its recording of the quality of the service it provides. Staffing of the home has improved; to allow for more activities to take place and service users say that "there is more going on in the home now". What the care home could do better: There are still aspects of the environment that need improving. Two windows on the first floor were found not to have window restrictors in place. The communal toilets need to have paper towels and liquid soap in place to avoid the use of terry towels and bars of soap. Valves on all hot water `out lets` need to be checked. Staffing stills needs to be improved at the weekends. Staff members must have access to care plans, which provide clear information about people who have special medication needs so that they can support them safely. Tippex must not be used on the medicine record charts. The manager must ensure the risk assessments completed are reviewed more frequently for those people who are responsible for taking their own medicines. CARE HOME ADULTS 18-65 Carrow Hill 2-4 Carrow Hill Norwich Norfolk NR1 2AJ Lead Inspector Mrs Marilyn Fellingham Unannounced Inspection 1st May 2008 09:45 Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 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 Carrow Hill DS0000027439.V364049.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 Adults 18-65. 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. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carrow Hill Address 2-4 Carrow Hill Norwich Norfolk NR1 2AJ 01603 632626 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) St Martins Housing Trust Mrs Jacqueline Hursey Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (20) of places Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd May 2007 Brief Description of the Service: Carrow Hill is a registered Care home operated by the St Martins Housing Trust, a local charity working with people who have experienced homelessness often through enduring mental health problems or addiction to drugs and/or alcohol or both. The charity also runs another care home and a number of small group living units. Carrow Hill offers residential accommodation to a maximum of 22 persons. It is situated within easy walking distance of the centre of the city. The building is a former detached period residence situated on a secluded wooded site. All the accommodation (on three floors) is in single rooms with a cluster of two or three sharing bathroom and toilet facilities. The second floor also has shared kitchen facilities, which allows it to be used for service users planning to move on to more independent accommodation. There is easy access to the local G.P.’s surgery, shops and the city centre of Norwich. The fees range from £434 per person with additional funding arrangements for one to one care. Copies of CSCI’s inspection reports are made available on request from the home’s office. Carrow Hill DS0000027439.V364049.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 that the people who use the service experience good quality outcomes. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. We have rules that tell us how to do this and we think that some of these groups are more important than others because of the way they affect people’s safety. This was an unannounced inspection visit that took place over six hours. Whilst visiting the service the opportunity was taken to tour the home, speak with service users and staff, and look at records. We spoke with four people living in the home, the manager and four members of staff. We got other information from the Annual Quality Assurance Assessment (AQAA), which the manager had completed before our visit. The AQAA is sent to us by the manager and it tells us what the manager is doing and how people are being supported to live as independently as possible. Before we made our visit we also asked people what they thought and received written comments from seven people living at the home. This inspection report reflects changes that have taken place since the last key inspection along with evidence and outcomes from inspection of the Key Standards. What the service does well: People told us that they like living in the home and the manager and staff work hard to create a homely and calm atmosphere for one person said that “they liked being in the home and felt that they were being well looked after”. The home is exceptionally good at encouraging independence and providing opportunities for the service users to live independently in the community. Four people have moved on since the last key inspection to live more independent lives. People living in the home say that they feel safe there and that they know who to talk to if they have any concerns. One service user said that, “they go to the manager or any member of staff because they are all very supportive”. There are good links with other professionals who can help people stay stable or manage difficult situations. The home is managed well and the staff team and service users have recently taken part in an assessment of the work that they do. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2,3 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who enter the home are confident that the service will be right for them. The thorough assessment prior to admission means that people’ s diverse needs are identified. EVIDENCE: Files for two people who recently moved to the home showed that information gathered was sufficient to ensure that their needs could be met. One person arrived at the home and was assessed on admission; the assessment process was detailed and indicated that this person did not have serious needs and was not admitted to the home but more suitable accommodation was found. One person whose needs could be met felt that they were given enough information before they arrived at the home to allow them to “make up their mind” about whether the home was suitable for them. Because of the situation of some of the people who are admitted to the home, for example if they are homeless, it is not always possible for them to ‘test drive’ the home first; where this is the case the manager showed that they get the initial assessment right. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 9 Records available and discussions with the manager, staff and people who live at the home confirmed that other agencies and specialists are involved in the admission process. The surveys we received from the service users indicated that the majority thought that they had been given enough information about the home before they were admitted. Those that felt that they were not given enough information also said they moved to the home under exceptional circumstances and needed a home urgently. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practice regarding the planning and delivery of care means that all service users can be sure that their physical, mental and personal care needs will be fully met. EVIDENCE: The care plans looked at were focused and related to all areas of need identified in the assessment process. The interventions required are clearly specified in all cases with particular attention to the therapeutic interventions for increasing independence. A new system for reviewing the care plans has been introduced, discussion with the manager as well as documentation on files shows that the residents are involved in this process as well as updating of care plans after these reviews have taken place. There were very detailed daily notes and any changes in behaviour noted were then seen to be addressed in the care plans with dates of reviews. Monthly reviews take place Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 11 on all service user care plans and these are used to up date other agencies that are involved with the care of the service users. Risk assessments are part of the care planning process and those service users we spoke with confirmed that this was so; one service user commented that, “the staff have been very supportive and helped me move on”. Other service users that we spoke with indicated in their conversations with us that they make decisions about their lives and one remarked that “the staff have helped me with my money and how to manage it better”. The manager holds monthly meetings with the residents and the manager told us that they are hoping to extend these. The people that we spoke with said that they attended these meetings when they wanted to and felt that they were involved with all aspects of running the home. Some service users agree to be involved with some house duties at these meetings and take on responsibility for various tasks around the home. One resident has done a basic food hygiene course and helps in the kitchen. People also told us they are involved in the interview process for new staff and this was confirmed by the manager and one service user. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 11,12,13,14,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A wider range of activities within the home and community now being offered which means that the service users have many opportunities to participate in meaningful and motivating activities. Meals are managed well which means that the people enjoy their food. EVIDENCE: The manager has recognised the shortfall in staffing and the effect that this had had on helping to create opportunities for personal development and activities for the people who use the service. A new member of staff has been employed who has not been put on the duty roster but is available for providing direct support together to help people get involved in activities. We noted during our inspection visit that a number of people were going out or who had been out. The manager now offers basic education sessions, which are provided by the local college. People told us they chose whether or not Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 13 they attended these sessions and we were party to a discussion where the manager was clearly offering a choice to a service user who had decided that they did not want to attend. One service user told us that they enjoyed these sessions and felt that they were helping them move forward and giving them opportunities that they had not had before. The manager told us how they have negotiated with Norwich City Football Club to obtain concessionary tickets to attend matches, something that many people said they enjoy doing: this was the result of a survey asking the residents what they would like to do. As a result of this survey a number of residents now take advantage of the City Councils passport to leisure and use the local swimming pool and gym. Two residents said that they felt that there was “more going on in the home now” and this was also confirmed by the staff members we spoke with. One resident spoke of how they go out to local antique shops and proudly showed us some of their coin collection. This person also indicated that they felt there was a lot more going on and that they were always encouraged to follow their own pursuits. Daily notes and care plans showed evidence of activities and outings that the service users had participated in. On the whole the service users said they felt that their meals were good and that they were offered many choices that were well balanced and nutritious. Discussion with the cook confirmed this as well as examination of the menus. We noted one service user being given lunch at his request way beyond lunchtime and the cook said that this was not a problem. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are well supported by the staff and receive support in the way that they prefer. The improvement in the administration and recording of medication means that the service users are not at risk. EVIDENCE: Discussions with service users confirmed that they were well supported by the staff and that they were encouraged to make decisions about their daily lives and chose what they wanted to do. One service user told us that the staff had helped them with their drinking problem and that they felt that they had been encouraged to become more independent. Another said that “the staff had helped them and that they liked living there and that they were helped with things that they wanted to do”. Staff have an overall understanding of people with mental health needs and were seen to interact with them in an appropriate way. Those staff members Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 15 we spoke with were aware of the care plans and used them to give the support and assessed care to the residents. The administration and recording of medicines has improved since the last key inspection. The medication record charts were examined and only one gap was found. Auditing of medication now takes place three times a day; records were seen for this activity. We did notice that ‘tippex’ had been used on some medicine record charts. A number or residents were prescribed when necessary medication, no care plans were in place to justify the continued use of this medication. A number of residents self medicate and risk assessments were in place for this activity however there was no evidence of review for this activity. Those residents prescribed special medication did have care plans in place but these did not include all the details about what symptoms to look for when additional support is needed for people. We spoke to the manager about this who said she would take action to ensure that care plans were reviewed and fully updated to include special individual medicine needs. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place for dealing with complaints, which means that service users feel safe and listened to. EVIDENCE: A complaints procedure is available for all service users; the surveys returned to us by the service users indicated that they were aware of whom to go to, to air their concerns. Those service users we spoke with knew how to make a complaint and felt that they were listened to. One comment made in the survey stated that they “would talk to staff” if they were not happy. Staff spoken to had an understanding of safeguarding adults and were aware of the policies and procedures relating to this; they have had training in this and training records verified this. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24,25,26,27,28,29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of maintenance in some areas and the provision of suitable facilities mean that service users could be potentially at risk. The poor décor in a number of areas around the home means that service users live in an inadequate environment. EVIDENCE: A tour of the home was made and it was found to be generally clean and tidy. Many of the residents keep their own rooms tidy. One resident who has now moved on is employed as a domestic and is responsible for keeping the house clean. There are toilets in the home that all the people who live there use. The toilets had soap and terry towels in them. We saw that there may be a risk of people getting infections through the sharing of soap and towels. We spoke to the Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 18 manager about this who said she would immediately order liquid soap and paper towels for people to use. The manager said she recognised that there were areas in the home where the décor needed to be upgraded; she also said that some windows needed painting. The manager said she would speak to the home owners about the work needed. The hot water in the bathroom was found to be too hot and we were not able to hold our hands under it. The manager started to take action to make the hot water safe to use. We found that two windows on the first floor are still without window restrictors. The garden is undergoing changes to enhance its appearance and small plots are being provided to enable those service users who like gardening to grow vegetables and flowers. A new shelter is also being provided for those who smoke. Individuals liked their rooms and there was evidence of personalisation. We noted on the day of inspection that a number of rooms were in the process of being re decorated. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,32,33,34,35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has shown improvement in staffing levels, however further improvement would result in better outcomes for the service users. EVIDENCE: Discussion with staff members confirmed that they felt that they were well supported by the management and they were clear about their roles within the home; they also said that the manager operates an open door policy and felt that they could approach her about anything. The manager and staff confirmed that they felt that the staffing levels had improved since the last inspection and this was also evidenced by the duty rosters; weekends, holiday periods and sickness caused staff shortages and ultimately an affect on the provision of activities and support for the service users. Some people told us that at the weekends there wasn’t much to do because the staff were doing the cooking. The cook confirmed to us that here is no cook on duty on Fridays and Saturdays which means that what staff are on duty are also responsible for providing meals. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 20 Records for newly appointed staff were looked at carefully and showed all the proper checks are carried out by the manager before staff are employed. Those staff we spoke with stated that they felt that training was good and the training records that we saw confirmed this. A number of the staff have now attended training in the Mental Capacity Act and we discussed with the manager the implications of the Act and the care planning system. New staff members confirmed that they had been given an induction and records were seen for this. Formal supervision takes place once a month, records were seen for this and the staff that we spoke with also said that this was so. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,38,39,40,41,42, and 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is meeting the needs of the service users and there is an efficient quality monitoring system in place, this means that the people who live in the home can be sure that they have good outcomes. EVIDENCE: Observations made of interactions between staff, the manager, service users and information we saw on records showed us that the home is well managed. Records for maintenance of equipment were seen and the recent record for testing the electrical equipment. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 22 A more formal system for monitoring the service the home provides has now been introduced and results have been formalised. The manager has also produced a report of the home’s achievements and highlighted those aspects that could be improved upon, this we saw and read. The manager is committed to promoting equality and diversity in the service and this was reflected in the information we received in the AQAA. We looked at a number of policies and procedures that told us all about the areas we were looking at; they were up to date and reflected research and up to date legislation. The manager is keen to ensure that the home meets the National Minimum Standards, she also ensures that the home promotes good safe working practices as was highlighted by constant letter writing to the maintenance manager to make sure all electrical equipment in the home was tested and made safe. Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 3 3 2 3 Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA33 Regulation 18(1) Requirement Sufficient staff must always be on duty especially at the weekends to ensure that the needs of the service users are met. First floor windows have restrictors fitted to ensure service users are free from hazards and are safe. Those people who are prescribed ‘when required’ medication must have care plans in place to justify continued use. Paper towels need to be provided with liquid soap in all communal toilets to enhance the control of infection within the home. The valve must be checked on the tap for hot water in the bathroom on the first floor to ensure that the temperature of the water is not too hot that could ultimately scold the people who use the service. Timescale for action 01/05/08 2. YA24 13 (4) (a) 01/05/08 3. YA20 13 (4) (2) 19/06/08 4. YA24 13 (4)(a) 01/05/08 5. YA24 13 (4) (a) 01/05/08 Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations It is recommended that the residents who are prescribed special medicine needs have care plans for this to ensure that all staff are aware of the signs and symptoms that can occur with the use of special medicines medicine. Tippex should not be used on medication record charts; this can cause confusion and not an acceptable practice. 2. YA20 Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Carrow Hill DS0000027439.V364049.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!