Care Home: Cherub Cottage Care Home

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cherub Cottage Care Home The Old Rectory Cottage Church Lane Walton Milton Keynes Buckinghamshire MK7 6BB two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Date: 2 1 0 4 2 0 0 8 Barbara Mulligan This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Cherub Cottage Care Home The Old Rectory Cottage Church Lane Walton Milton Keynes Buckinghamshire MK7 6BB 01908 661955 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Zenona McDonald The registered provider is responsible for running the service care home 4 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : People with Learning disability Additional conditions: Number of places (if applicable): 4 The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). The maximum number of service users to be accommodated is 4. Date of last inspection 0 2 0 4 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Cherub Cottage is registered to provide care to four younger adults with a learning disability. The property is set in a lovely country lane behind the Open University in Milton Keynes. The home is close to public transport links. The home is set out over two floors and you can reach the upper floor by stairs. There is one ensuite bedroom on the upper floor and the remaining three bedrooms are on the lower floor. There is a large enclosed garden to the back of the house that is well maintained with off road parking to the front and rear of the property. Fees range from £1500 to £3500. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. This inspection was carried out over one day. One survey form was received from people who use the service. The inspection officer was Barbara Mulligan. The registered provider and manager is Zena McDonald. The evidence seen and comments received indicate that this service meets the diverse needs (e.g. religious, racial, cultural, disability) of individuals within the limits of its Statement of Purpose. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well The home provides a very pleasant and comfortable place to live. People can personalise their own rooms with their own furniture and belongings. Care plans tell the staff how to care for the people living in the home. The home provides good healthy meals for all the people who live there. Care Homes for Adults (18-65 years) Page 8 of 30 The people who live in the home enjoy a wide range of activities. Medicines are well looked after so the people who live in the home are safe. People who live in the home can make their own choices. Training for care staff is good and they are trained to look after the people who live in the home. There is a good complaints procedure and all complaints are taken seriously and acted upon. Care Homes for Adults (18-65 years) Page 9 of 30 What has got better from the last inspection What the care home could do better. No requirements were made at this inspection. However there are some good practice recommendations. Care Homes for Adults (18-65 years) Page 10 of 30 Risk assessments should have more detail to show how the risks to people using the service are minimised. Handwritten entries on medication records should be dated and signed by two staff. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact The Oast Hermitage Court Hermitage Lane Care Homes for Adults (18-65 years) Page 11 of 30 Maidstone Kent ME16 9NT 01622724950 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries.southeast@csci.gsi.gov.uk or by telephoning our order line - Care Homes for Adults (18-65 years) Page 12 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 13 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use the service are confident that the care home can support them. This is because there is an accurate assessment of their needs that they or people close to them have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. Evidence: At the previous inspection there were no people using the service. There are now two people using this service. The home uses its own assessment tool. The needs assessments were examined for the two people using the service. Some of the areas this covers includes hearing, communication, sight, mobility, personal care, eating and drinking, physical health, cultural heritage needs and family history. The assessment tool is detailed and informative. The provider/manager of the home said she would be involved with the admissions procedure and would ensure the equality and diversity of Service Users is reflected in the assessment process, ensuring religious and social needs can be met by the home. The needs assessment needs to be signed by the person completing the assessment and is recommended. Care Homes for Adults (18-65 years) Page 14 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Care plans are in place, which adequately documents the care needs of people who use the service, and how these are to be met, within a risk assessment framework. People who use the service are enabled to make decisions and be as independent as possible. Evidence: The care of the two people using the service was case tracked. Each file contains a daily routine for each person, a timetable of activities, a food diary, likes and dislikes and a person centred plan, which is detailed and comprehensive. The person centred plan covers personal care, travel and holidays, health care needs and future plans. These provide detailed guidelines for staff to follow to ensure they can meet people’s needs. One person using the service has Afro Caribbean needs and the care plan details how the cultural needs of this individual are being met. Care plans seen provide evidence of personal development, further learning and how services will meet aspirations and goals of people who use the service. All documents seen are reviewed regularly and are signed and dated. There is Care Homes for Adults (18-65 years) Page 15 of 30 evidence of service user involvement in the care plans and details the individuals key worker and preferred term of address. Daily notes are detailed and informative. People who use the service are given opportunities to make decisions about their lives, with assistance as needed. This includes help to make decisions about their choice of activity, menu planning and preferred daily routines. Pictures and photos are used to assist people using the service when making a choice, and this was seen during the visit. The provider/manager said that people using the service are given a choice about the colour schemes for their bedrooms. These are bright and cheerful and reflect the individual likes and interests of each person. There are no formal meetings held for the people who live in the home, however the provider/manager said that because there are only two people using the service, discussions take place every day. Staff join the residents of the home at meal times and this is where most discussions take place on a daily basis. On the day of the visit the inspector observed staff offering residents of the home a choice such as what to eat for breakfast, clothes to wear and activities to take part in. In the returned survey from an individual using the service, it said that decisions are made around what we want to do. Risk assessments are in place and staff complete these before each activity takes place. This can be time consuming and creates a lot of unnecessary paperwork. This was discussed with the provider/manager and it was felt to be more appropriate to have a risk assessment in place for each area where risk may present itself, then this will be reviewed on a regular basis rather that a new one completed each time an activity is undertaken. Risk assessments would benefit from more detail on how to minimize the risks to people using the service and this is strongly recommended. Care Homes for Adults (18-65 years) Page 16 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use the service have a varied and active lifestyle, which reflects their interests, and are supported to maintain family links and friendships inside and outside the home. Menus are developed by people who use the service with support from care staff which promotes independence and choice. Regular monitoring of individuals weights needs to be carried out on a regular basis to ensure people stay healthy and that issues associated with eating are well managed. Evidence: From the information in care plans and by talking to people using the service it is evident that individuals living at the home take part in activities of their choice, and are able to use the local community facilities. One person using the service said she attends college and enjoys this. She would like to attend more regularly and the manager said they were arranging this. On the day of the inspection people using the service attended various activities with staff support. Examples of activities undertaken by people using the service include shopping, meals out, walks, bowling, hairdressers and the cinema. Care Homes for Adults (18-65 years) Page 17 of 30 There are no restriction about family and friends visiting. One person using the service said that they are visited by relatives regularly and they have weekend breaks with their family and staff provide support to write to family members. People who use the service are able to receive visitors in the privacy of their own rooms, and are able to choose whom they see and do not see. One person using the service told the inspector that they have a friend who visits them regularly. Daily routines are flexible and promote individual choice and independence. Each person living in the home has been offered a key to their room but have decided not to use this facility. From observations on the day of the visit, staff members were seen to treat the people living in the home with respect, and they are encouraged to take responsibility for some household tasks, such as menu planning, helping with food preparation and tidying of the kitchen and dining area. Meal times are flexible and the main meal is usually in the evening. The inspector joined everyone for a lunchtime meal and was told that staff and people who use the service always sit down together and share meal times. Lunch was relaxed and there was lots of discussion taking place with service users. One person living in the home writes her own menu and the inspector was shown this. Pictures and photos are used as an aid to menu planning. The menus seen show that individual needs such as cultural and healthy eating are being met. Monthly weights are recorded but not on a regular basis. The provider/manager said that she has drawn up weight charts and is about to start recording weights monthly. Each individual has a food diary that records dietary input, likes and dislikes and nutritional screening. Care Homes for Adults (18-65 years) Page 18 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The health and personal care needs of people living at the home are well met, promoting health and well being, ensuring that they receive medication in a safe and consistent manner. Evidence: People who use the service are supported to choose when they like to go to bed, have a bath, have their meals and take part in other activities. This information is recorded in individual care plans. This was also confirmed in discussion with one person using the service who described several activities she wants to do and was being supported to arrange them. There is good information in care plans about individual’s daily routines, likes and dislikes. These are detailed and provide staff with enough information to know how each person likes to receive personal support in the way they prefer. There is detailed evidence of health screening in personal files. These show that health care needs have been identified and dealt with in a timely manner. Records of health care appointments are being noted, showing that routine and specialist medical advice is sought. The home uses a pre-dispensed system for administration of medicines. This means Care Homes for Adults (18-65 years) Page 19 of 30 that the majority of medicines arrive at the home in blister packs with the medicine already measured by the pharmacist. The blister packs are named and the medicine is packaged in individual doses with the time to be given clearly marked. This system is used to reduce risk to individuals using the service. The person giving out the medicine then records on a Pre -printed form that the medicine has been given, or if it hasnt been given and the reason why. On examination of this record it was found there were no gaps in recording. However there were some handwritten entries on the medication administration records and it is strongly recommended that these are always dated and signed by two staff. None of the people using the service are able to administer their own medicines. Records show that all medication received, leaving the home or disposed of are recorded appropriately. There are no controlled drugs in use at the time of the visit but the home has the facility to store these if the need arise. Storage of medicines is in two metal cabinets. Each person using the service has their own cabinet and these are kept in a locked room. The home received a visit from the supplying pharmacist on 13/03/08. They made a recommendation that the temperature of the room where the medicines are kept is maintained. It is pleasing to see that this has been completed. Care Homes for Adults (18-65 years) Page 20 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Procedures for managing complaints and adult protection are in place ensuring people who use the service are listened to, kept safe and protect people who use the service from harm. Evidence: The home has a complaints procedure and this includes timescales for responding to complaints and how to contact the Commission for Social Care Inspection. There is a complaints book for each person who uses the service. One complaint has been made since the last inspection and was seen to have been dealt with, within timescales. However this needs to have the action taken and the outcome of the complaint recorded. The one survey received indicated that they knew how to make a complaint. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The inspector looked at the homes Adult Protection Policy and within this there are guidelines about the responsibilities of staff, types and signs of abuse, and what to do if you suspect abuse. A requirement was issued at the previous inspection for the home to obtain a copy of the Milton Keynes Multi Agency Protection of Adults Policy. It is pleasing to see that this has been complied with. Training records show that all care staff completed safeguarding Adults training on 17/04/2008. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The building is comfortable, well maintained and clean, providing a safe and homely place for people who use the service to live. Evidence: Cherub Cottage is registered to provide care to four younger adults with a learning disability. At the time of the inspection there are two people using the service. The house is set in a small country lane behind the Open University in Milton Keynes and is reasonably convenient for local amenities and is accessible by public transport. The accommodation is over two floors and access to the upper floor is via stairs only. There is one en-suite bedroom on the upper floor and the remaining three bedrooms are on the lower floor. There is a large enclosed garden to the rear of the house that is well maintained with off road parking to the front and rear of the property. The home has one spacious main lounge and one smaller quiet area. The internal decoration of the home is of a high standard and is in good repair. There are many personal touches around the home such as flowers, pictures, books and plants. The main lounge opens onto a decked area in the rear garden. The kitchen area is bright, spacious, clean and well maintained. Access to the kitchen area is good and able to accommodate wheelchairs. There are accessible toilets available throughout the home. Laundry facilities are sited so that soiled articles, clothing and infected linen are not Care Homes for Adults (18-65 years) Page 22 of 30 carried through areas where food is stored, prepared, cooked or eaten and do not intrude on service users. The laundry floor finishes are impermeable and these and the wall finishes are readily cleanable. The home has an infection control policy and the inspector observed this. There are instructions in place for the washing of soiled linen. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There are sufficient, trained staff to meet the needs of people who use the service in a supportive and flexible manner. Recruitment procedures are thorough ensuring that people who use the service are protected from unsuitable carers. Evidence: The home has a small group of four staff providing support and care to two people using the service and a further staff member has just been recruited and is awaiting the completion of the recruitment checks. At the time of the visit one staff member was undertaking National Vocational Training level 3. There is a staff training programme in place and the training needs for staff are identified as part of the annual planning cycle. Three staff were on duty at the start of the visit, one of whom was the provider/manager. The number of staff on duty was sufficient to meet the current needs of people who use the service. Staff spoken to have a good understanding of residents needs and were gentle and interactive with them. Four staff files were viewed at this inspection, including these new to the service. The files all include the staffs personal details, including next of kin details. All of the staff files seen contain an application form and a copy of terms and conditions relating to the post. There is evidence that references and Criminal Records Bureau disclosures had been obtained before the staff member commenced work. The provider/manager confirmed that face-to-face interviews were held and interview records kept. Care Homes for Adults (18-65 years) Page 24 of 30 There is an induction programme in place to ensure that new staff members are familiarised with the home, their roles and responsibilities. The induction includes fire safety, moving and handling techniques, medication training, safeguarding adults training and basic food hygiene training. Training records reflect that staff have received mandatory training and records seen show that this is up to date for all staff. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home needs to implement an effective quality assurance system, based on seeking the views of people who use the service to ensure the home is run in the best interests of the residents. The home has a provider/manager in post ensuring continuity of care and there are systems in place within the home to ensure that the health, safety and welfare of the people who use the service are promoted and protected. Evidence: The registered provider has been acting as the manager for the last twelve months due to the fact that the previous manager left the post after a short period. She now needs to decide if she is to continue in this role. If she is, then the provider needs to complete the Registered Managers Award. The inspector requests that the provider informs the Commission about her decision in writing. Further training undertaken by the provider/manager includes all mandatory training, medication training, health and safety and infection control training. The home has a complaints procedure and a whistle blowing procedure in place, which enable staff and service users to voice concerns and affect the way in which the Care Homes for Adults (18-65 years) Page 26 of 30 service is delivered. People who use the service have been living in the home for less that a year and the manager said that she was looking at quality assurance systems to implement. There are however monitoring systems in place to audit medication, care planning, complaints and maintenance. There is also a process for supervision and appraisal for staff. There is a suggestion box in the hallway for staff, people who use the service and visitors to the home to use. Training for staff in health and safety, infection control, fire awareness, food hygiene, first aid and moving and handling is up to date for all staff. Health and safety practices around the home are consistent. There are thorough procedures and checks in place in the kitchen. A satisfactory environmental health inspection took place on 26/06/2007. A range of health and safety are carried out on a daily, weekly or monthly basis. Fire safety records show that the fire risk assessment is fully completed and is dated 26/11/2007. There are service certificates in place for PAT testing and electrical installation. There are no gas appliances in the home. Fire safety records show that maintenance of the fire equipment is carried out on a regular basis and weekly fire testing is carried out weekly. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 2 9 It is recommended that the initial needs assessment is signed by the person completing the assessment. It is strongly recommended that the risk assessments contain more detail on how to minimise risks to the individual. It is strongly recommended that all hand written entries on the pre-printed medication administration records are dated and signed by two staff. 3 20 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - 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!