Care Home: Deerlands

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What the care home does well The home was well managed with clear structure which supports the manager who has the required skills and competencies. There was a stable staff group who work hard to provide a good standard of care to people who use the service. There was a warm welcoming atmosphere in the home and staff were observed speaking to people in a caring manner. Relatives said the staff were caring and they had made the right decision about choosing Deerlands. They said they were confident that staff would keep them informed of changes to their relatives care needs. Surveys confirmed that staff listens to people who use the service, and treat them with respect. Activities were well organised and people confirmed that they were able to join in when they wanted to. People said, "I like to join in with movement to music and quizzes". Others said "we like arts and crafts and games of bingo". What has improved since the last inspection? Medication procedures have improved since the last inspection, records looked at showed that staff had signed to confirm medication had been administered as prescribed. They continue to refurbish the home to improve both communal and private space. A number of areas have been redecorated and had new carpets fitted. Some of the rooms remain in need of redecoration and the corridor carpet was in poor condition, with stains and showing signs of wear. What the care home could do better: People who are identified as a fall risk must have a comprehensive care plan that states how a person must be moved and handled if a fall occurs. Highincidents of accidents are a concern, and the manager must address this with staff and health professionals. Medication procedures have improved, although care should be taken when receiving medication to ensure there is a clear audit trail. Eye drops should be dated when opened so that they are not used past the 28 days stated on the box. The safeguarding adult`s procedures were in place, although some staff requires training to identify signs of abuse. The training plan did not identify when refresher training was needed, although the trainer said safeguarding adults was covered in the foundation training. CARE HOMES FOR OLDER PEOPLE Deerlands 48 Margetson Road Sheffield South Yorkshire S5 9LS Lead Inspector Val Hoyle Unannounced Inspection 12th January 2009 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 Deerlands DS0000002956.V373258.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. Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Deerlands Address 48 Margetson Road Sheffield South Yorkshire S5 9LS 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) 0114 221 3258 0114 232 2138 diane.iwanejko@sheffcare.co.uk www.sheffcare.co.uk Sheffcare Limited Diane Iwanejko Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three service users between the ages of 55 and 64, inclusive, may reside at the home. 7th November 2006 Date of last inspection Brief Description of the Service: Deerlands Care Home provides care for male and female people over the age of 65, (three people may be between the age of 55 and 64). The home caters for 40 people and a day centre service is attached to the home. The home does not provide intermediate care. Deerlands is situated on Margetson Road with access to local amenities such as shops, library and churches. The home is situated on ground level and there are ramps and handrails provided where necessary. The home has a car park and gardens. Copies of the last Commission For Social Care inspection reports were available for people who use the service and their families to read. The weekly fees range from: £327 to £383. This information was provided on the 12th January 2009. The home charges extra for chiropody, toiletries, clothing, telephone, holidays and hairdressing. Deerlands DS0000002956.V373258.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 stars. This means that the people who use this service experience good quality outcomes. This unannounced inspection of this service took place over 6.5 hours starting at 09:30 finishing at 16:00, this included a partial inspection of the home. Five people who use the service, four staff and a visiting district nurse were spoken to during the visit; their views were included throughout the report. Information from three staff surveys and five surveys from people who use the service is also contained in this report. Three relatives were spoken to during the inspection to assess their views on the service. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Occupancy at this home follows current trends, with 31 of the 40 beds occupied on the day of the inspection. Two peoples care plans were looked at. Policies relating to medication, complaints, protection of vulnerable adults and handling of people’s monies were looked at. Three staff recruitment and training records were examined to assess how people were protected. Procedures and risk assessments relating to health and safety were looked at and discussed with the team leader (deputy). The registered manager is Diane Iwanejko, she has over 6 year’s management experience. She has achieved the Registered Managers Award and NVQ Level 4 award in management. She was unavailable on the day of this inspection, therefore the team leader (deputy) assisted with the process. The AQAA was sent to the home in August 2008, this was returned to us on time, which demonstrates responsiveness and cooperation. An annual quality assurance assessment is a self-assessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we will get information from providers about how they are meeting outcomes for people using their service. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 6 An Annual Service Review was carried out on the service on 8th January 2008. The outcome of the review confirmed people continue to receive a good level of service. The inspector would like to thank everyone who agreed to being interviewed as part of the inspection process, and the friendliness of staff. What the service does well: What has improved since the last inspection? What they could do better: People who are identified as a fall risk must have a comprehensive care plan that states how a person must be moved and handled if a fall occurs. High Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 7 incidents of accidents are a concern, and the manager must address this with staff and health professionals. Medication procedures have improved, although care should be taken when receiving medication to ensure there is a clear audit trail. Eye drops should be dated when opened so that they are not used past the 28 days stated on the box. The safeguarding adult’s procedures were in place, although some staff requires training to identify signs of abuse. The training plan did not identify when refresher training was needed, although the trainer said safeguarding adults was covered in the foundation training. 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. Deerlands DS0000002956.V373258.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 Deerlands DS0000002956.V373258.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 People who use the 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 were assessed before moving into the home to ensure their needs can be met. EVIDENCE: All new people receive a full comprehensive needs assessment before admission, this was carried out by the manager who had the required skills and competencies. The service was efficient in obtaining a summary of assessments undertaken by the placing authority, and insists on receiving a copy of the care plan before admission. Staff confirmed that information contained in the assessment was essential to understand what staff needed to do to ensure people’s needs were met. Two assessments were looked at and they focused on achieving positive outcomes for people who use the service. Before agreeing admission the manager and staff carefully considers the needs assessment for each individual Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 10 prospective person and the capacity of the home to meet their needs. Surveys received confirmed people received sufficient information before moving into the home, and people said staff helped them to settle into the home. Relatives said they had looked at a number of homes before choosing Deerlands. One relative said “the staff are very nice and we don’t worry about dad anymore because we know staff look after him”. Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People who use the 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 provide staff with sufficient information to meet the needs of people who use the service. Medication policies and procedures were well managed ensuring the safe administration of medication. EVIDENCE: Two care plans were looked at to ensure care was delivered as described. The information was sufficient, and included daily records which described the support provided throughout the day. Risk assessments ensure people can maintain their independence, while remaining safe. Risk assessments had been identified for one person who had fallen on a number of occasions, although improvements to the number of falls sustained had not decreased. The person had been referred to the falls clinic and there were clear records demonstrating the GP had visited. The care plan should give clear instructions to staff how to assist the person when falls occur. Accident records indicated that staff ‘lift’ the person from the floor manually, this could pose significant risk of injury to the person and to the staff. Reviews take place regularly and social services staff Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 12 undertakes a four week review to assess how the placement is working. One review had not been completed, although the deputy manager confirmed that the review had taken place. Staff was able to describe in detail the care needs of people, including how to maintain people’s independence and wellbeing. Surveys confirmed people’s needs were met and staff had the required skills and competencies to keep people safe. People said staff were very caring and always treated them with respect. Relatives said they were very happy with the care provided at the home. Peoples healthcare needs were met and there was clear evidence to confirm regular visits from healthcare professionals. Staff had a good understanding of how to ensure peoples nutritional needs were met, including supplements and the importance of fluids to keep people hydrated. The staff have regular contact with the district nursing services, they offer advice and support. A visiting district nurse said staff was very good, they always keep them informed about health issues and they always follow instructions about how to maintain healthy skin. Medication procedures have improved since the last inspection, and staff had received the required training to confirm they have the necessary competencies to administer medication safely. Medication was stored securely, on each of the wings and there was a separate fridge and controlled drugs cabinet. Records confirmed the fridge temperatures were taken daily and the controlled drugs were recorded correctly. Medication administration records were fully completed, although two people’s eye drops were still being used past the date when they should have been discontinued. Some medication had not been booked in correctly on the MAR (medication administration record). The team leader (deputy) was made aware of the error and took steps to rectify the mistakes. Throughout this visit staff were seen interacting with people who use the service in a kind manner, they spent time talking to people and were observed knocking on bedroom doors before entering. All people were referred to by their first name and this was agreed in the care plans examined. Deerlands DS0000002956.V373258.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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities were organised which were appropriate to the needs of the people who use the service. Mealtimes were well managed and people were encouraged to make choices and control over their own lives. People who use the service could maintain contact with family and friends, and have good opportunities to maintain links with the local community. EVIDENCE: There was a warm and friendly atmosphere on entering the home and people appeared comfortable sitting in lounges and their bedrooms. People who live at the home said activities and outings were very good. One person said they liked joining in quizzes, while others said games of bingo were their favourite pass-time. Activities were arranged to meet the needs of the people who live at the home and staff frequently ask people what they want to do and where they want to go. The home employed a staff member who had responsibility to organise activities, including trips to garden centres, and pub lunches, and parties inside Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 14 the home. She completes a social care plan which includes every activity offered to people. Movement to music and dominoes were observed throughout this inspection, and staff interacted throughout the day. The activity co-ordinator said she spends time with people who like to spend time in their bedrooms. People said there was always something going on, although they preferred to watch TV in their bedroom. Staff asks people what foods they liked and the meals were included in the menus. The meals were served from heated trolleys to the various dining rooms. Mealtimes were well managed by staff who have a good understanding of people’s dietary needs. Staff were seen giving assistance in an unobtrusive way, and meals served to people in their bedrooms were accompanied with a drink. People said they had enjoyed their meal of fish pie and vegetables followed by pear tart and custard. The quality was very good and plentiful. People said the food was good, one person said we get all the food we want including their favourite meal of fish and chips. Deerlands DS0000002956.V373258.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 People who use the 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 could access the complaints procedures and the manager ensures any concerns were recorded and investigated appropriately. Adult safeguarding policies, procedures were in place, although some staff training is needed to promote the protection of people from abuse. EVIDENCE: The home had a complaints procedure that was available to people and visitors. The procedure was also referred to in the information given to new people, identifying the stages to follow; this includes the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection was included in the procedure, although the address and telephone number needed to be updated. The information contained in the Annual Quality Assurance Assessment confirmed that one complaint had been made in the last twelve months. The complaint was discussed with the manager who confirmed that procedures were followed, and action was taken to resolve the complaint. Surveys confirmed that they were aware of the complaints procedure and who to speak to if they had a concern. Regular residents meetings were also used to enable people to raise any concerns, and the manager makes herself available to people to encourage people to talk about things they would like improved. The home had there own Safeguarding Adults and Whistleblowing policy, which would be followed if any incidents of abuse was raised. The AQAA confirmed Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 16 that there had been one safeguarding referrals. The manager said she would investigate fully any allegations of abuse and would follow the necessary procedures if any were substantiated. The manager holds discussions with staff to talk over issues and how to recognise different forms of abuse, although some staff requires training in the protection of vulnerable adults. Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 People who use the 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 using the service were provided with a clean, comfortable environment, although some refurbishment was planned to improve furnishings and carpets. There were sufficient staff to maintain good hygiene standards. EVIDENCE: The registered providers continue to refurbish the home to create a homely environment, new carpets have been fitted in some areas and some bedrooms, and some communal areas had been decorated. A partial tour of the building found bedrooms to be homely and personalised to individual taste; people said they liked their bedroom and have things around them to remind them of family and friends. The décor in some of the bedrooms and bathrooms looked tired and corridor carpets were stained and showing signs of wear. Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 18 The home was clean and fresh and people said the home was always clean and tidy, relatives said staff worked very hard to maintain good hygiene standards. Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 19 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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have the skills and knowledge to fulfil their roles within the home, a stable staff group ensures continuity of care by staff that knows the people who use the service. Recruitment policies are followed ensuring the safety and protection of people who live at the home. EVIDENCE: Training records examined show the staff have the required skills and competencies to deliver a good service. Discussion with the team leader and staff confirmed that there was a stable staff group who had worked at the home for a good period of time. Staff said they enjoy working at the home, and felt supported by the manager. The Partnership for Older Peoples Project provide valuable support to the home, through training and advice which helps staff to develop new skills which helps them do their job better. There was a comprehensive induction and probationary package, which was service specific. It meets the ‘Skills for Care’ standard. One induction programme for a new member of staff was looked at and had been fully completed. The manager confirms permanent employment when satisfied that competence and progress has been shown to be satisfactory against their standards. Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 20 Staff rotas and observation during this visit showed there were sufficient staff to meet the needs of people who live in the home. People said there was mostly enough staff and they were good at their job. Discussion with the team leader (deputy) confirmed the arrangements for staff to work in specific areas of the home. Staffing levels should be kept under review, when occupancy increases, to ensure peoples needs can be met. Staff had the required skills to meet the needs of people, and they are commended for meeting the requirement of 50 NVQ level two qualified staff. 13 of the 17 permanent members of staff have achieved the award in care. There were robust recruitment and selection procedures that ensure people who use the service are safe and protected. A number of staff recruitment files were examined, and there was evidence that all the required employment checks have been undertaken prior to commencing work at the home. Evidence confirmed all staff had a Criminal Records Bureau check. Two references were seen on two of the files looked at. A third staff file only had one reference. The team leader said a risk assessment had been completed for the member of staff as they had no response from the candidate’s last employer. The manager should check the date on all existing CRB’s as good practise suggests that a new CRB check should be carried out every three years, to ensure the information is up to date. Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 People who use the 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 were protected by sound management practises, and their views were actively sought to improve the service. The financial interests of people were safeguarded, and good health and safety procedures ensured they are protected. EVIDENCE: The manager was unavailable during this inspection, the team leader (deputy) assisted with the inspection process. The manager has over six years experience and has the required qualifications and competencies. She operates an open door approach and people spoke fondly of her. They said she was very good and always helped them with any problems. Staff said the manager and Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 22 team leaders were very supportive and were always available for advice and training. There was evidence that the home actively seeks the views of people who use the service. There was a satisfaction survey and they also have meetings to enable people to discuss problems and give there views on how they want the home to be run. People who use the service were able to manage their own finances, although some prefer the manager to assist with dealing with their personal monies. Records were looked at and they were an accurate reflection of the accounts held on people’s behalf. Accident records were looked at. They indicate very high levels of falls. The manager should undertake a falls audit for each person who has had multiple falls and develop risk assessments to assist in the management of falls. Some records looked at indicated that staff were manually lifting people from the floor. This could pose significant risk to the safety of both staff and people who use the service. Action must be taken to prevent the practise continuing. Maintenance and service records examined were up to date and current to the services provided. The home has the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures were in place and service records were examined and were current, ensuring the safety of people who use the service. Deerlands DS0000002956.V373258.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 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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 2 Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15 Requirement Care plans must give clear direction to staff to ensure they move and handle people safely. They must record in detail how they assist people when falls occur. Safeguarding adults training must be made available to all staff, including cooks, and domestic staff. The training plan should identify safeguarding training so that it is clear when staff require refresher training is due. Staff must use appropriate moving and handling equipment to ensure people are moved safely, when fall occur. Timescale for action 01/03/09 2. OP18 18 01/03/09 3. OP38 13 01/03/09 Deerlands DS0000002956.V373258.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 OP9 Good Practice Recommendations Eye drops should have the date started written on the box to state when they were commenced to ensure they are not used past the recommended 28 days. MAR (medication administration record) should show when medication was received and the amount received. Refurbishment and redecoration of the home should continue including consideration to replace corridor carpets that were badly stained and showing signs of wear. Good practise suggests that a new CRB check should be carried out every three years, to ensure the information is up to date. A review of the way falls are audited should be undertaken to reduce the frequency of falls. Risk assessments must be detailed to reduce the risk of falls. 2. 3. 4. OP19 OP29 OP38 Deerlands DS0000002956.V373258.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Deerlands DS0000002956.V373258.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. 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