Care Home: Hazlehurst

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What the care home does well Health professionals visited the service to assist in maintaining peoples health care needs. There appeared to be very good working relationships between the staff working at the service and the professional healthcare workers that support the service. People said: "I`m very happy here". "The staff and care are very good". "We are treated very well." "Nothing is too much trouble." "Staff treat us very well, marvellous." People looked clean, well dressed and had been supported to receive a very good level of personal care. Hazlehurst was clean and tidy and no unpleasant odours were noticeable. People said that the home was always kept "spotlessly" clean. There were 2 homely lounges for residents to use. They were small enough to give an intimate feel and allow conversations to take place across the rooms, between clients. The clients liked this". People spoke highly of the staff team and said staff always listened and acted on what they said. People said that staff were "always" available when needed. Staff said that they enjoyed working at Hazlehurst and got a lot of job satisfaction. Staff said they were receiving supervision and support from their managers on a regular basis. What has improved since the last inspection? Improvements in the storage of controlled medications have been made. Staff are monitoring peoples nutritional needs more closely. Staff are monitoring the temperatures of the fridges in the dining area on a daily basis to ensure the health and safety of the staff and people at the service is maintained.Staff said they were now receiving supervision and support from their managers on a more frequent basis. The service had improved financial records so a clear audit of the community fund in the home could be followed. CARE HOMES FOR OLDER PEOPLE Hazlehurst 1 Dyche Drive Jordanthorpe Sheffield S8 8DN Lead Inspector Michael O`Neil Key Unannounced Inspection 10th March 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hazlehurst DS0000035749.V360631.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. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazlehurst Address 1 Dyche Drive Jordanthorpe Sheffield S8 8DN 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 293 0174 0114 203 7703 none None Sheffield City Council Vacant Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2007 Brief Description of the Service: Hazlehurst is a single story purpose built service, in the Jordanthorpe area of Sheffield. Hazlehurst provides a service on a short-term basis. Thirteen beds are used by the NHS Trust for people discharged from hospital or admitted from the community for rehabilitation, which involves input from the physiotherapist and occupational health and a Qualified Nurse. The service has 9-flexi/short term care beds mainly used for stays on a rolling programme or to meet other short-term needs. All the bedrooms are single; there are dining rooms, lounges, toilets, and bathrooms sufficient to meet the needs of the service users, all of which are easily accessible. The service is close to public transport, shops and community facilities. Information about the home is available in the entrance hall to the service. The latest Commission for Social Care Inspection (CSCI) inspection report and the complaints procedure are also available in the entrance hall. There was no fee for people requiring intermediate care. Fees for other people ranged from £121.75 – £390.00 per week. Hazlehurst DS0000035749.V360631.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*. This means that the people who use this service experience good quality outcomes. This was an unannounced key inspection carried out by Mike O’Neil, regulation inspector. An ‘expert by experience’, Jan Colombo also assisted with the visit. An ‘expert by experience’ is a person who, because of their experiences of using services, visits a service with an inspector. This helps the inspector get a picture of what it is like to live in or use the service. Jan’s main focus was talking to people about how they felt their privacy and dignity was respected and what their daily routines and meals were like. She also observed how staff spoke with people and cared for them. This site visit took place between the hours of 9.30am and 3:30pm. Jan visited between 10.30am and 2:30pm.Christine Thorpe is the manager and was present during the visit. Christine is currently going through the registration process with the CSCI to become registered manager. The previous manager of Hazlehurst retired last year. Prior to the visit the manager had submitted an Annual Quality Assurance Assessment (AQAA) which detailed what the service was doing well, what had improved since the last inspection and any plans for improving the service in the next twelve months. Information from the AQAA is included in the main body of the report. Surveys, regarding the quality of the care and support provided, were sent to people who use the service, their relatives and the staff involved in peoples care. The CSCI received nine surveys from people using the service and five from staff. Comments and feedback from these have been included in this report. On the day of the site visit opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the service, check the services policies and procedures and talk to 10 staff and nine people. We checked all key standards and the standards relating to the requirements and recommendations outstanding from the services last key inspection in March 2007. The progress made has been reported on under the relevant standards in this report. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 6 We wish to thank the people using the service and the staff for their time, friendliness and co-operation throughout the inspection process. What the service does well: What has improved since the last inspection? Improvements in the storage of controlled medications have been made. Staff are monitoring peoples nutritional needs more closely. Staff are monitoring the temperatures of the fridges in the dining area on a daily basis to ensure the health and safety of the staff and people at the service is maintained. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 7 Staff said they were now receiving supervision and support from their managers on a more frequent basis. The service had improved financial records so a clear audit of the community fund in the home could be followed. 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. Hazlehurst DS0000035749.V360631.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 Hazlehurst DS0000035749.V360631.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): Standards 3 and 6. 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. Pre admission information ensured the home was able to meet peoples health, social and care needs. EVIDENCE: People were admitted to the home for intermediate care or short term/flexi care, often-coming straight from hospital. Health professionals and staff from the home assessed people’s needs on admission and throughout their stay. The aim of the home is for people to regain control of their lives and return home. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 10 Staff talked about the ways in which they supported people to regain their independent living skills. Evidence of this was seen in peoples care plans. Equipment was provided to promote mobility, continence and self-care. Specialist services and staff are deployed at the service to meet the assessed needs of people who need rehabilitation support. Hazlehurst DS0000035749.V360631.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): Standards 7, 8, 9 and 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. People’s plans of care did not contain all of the required information or contained conflicting information, which could result in people not being supported as needed or as they preferred. Medications were generally well managed, which ensured that people were protected from medication administration errors. People were very complimentary about the way staff cared for them. EVIDENCE: We checked the care plans for two people who use the service. The care plans had been developed from the needs identified in the person’s original assessments. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 12 The plans also included information on the staff action required to ensure assessed needs were met. (Previous recommendation met). Staff were aware of the contents of care plans and were knowledgeable about peoples individual care needs. The care plans however were inadequate because: • Each person had two care plans. One had been developed from the Primary Care Trust team and the other from the Team Leader employed at Hazlehurst. This was confusing as there were some slight differences in the plans as to the action staff needed to take when providing support to people. It was unclear as to which plan staff were following meaning that a persons continuity of care could be affected. The service said they were adopting a person centred approach to care planning. However the care plans did not evidence that people and/or their relatives were involved in drawing up and reviewing the care plans. Staff were failing to record the time they were actually writing the daily notes and were also leaving gaps between each different day they made recordings. These omissions could affect the legality of the care records. Staff had not reviewed a persons care plan since the person’s admission to the service over two months ago. • • • The care plans identified that a range of health professionals visited the service to assist in maintaining peoples health care needs. Peoples healthcare and social care needs are also discussed with members of a multidisciplinary team (MDT) at least once a week during a meeting held at the service involving several disciplines of the MDT. There appeared to be very good working relationships between the staff working at the service and the professional healthcare workers that support the service and people. We discussed with the manager the inadequacies in the care plan documentation. She was aware of the need to improve the plans and informed us of the reviews involving the Primary Care Trust to improve the documentation. People said: “I’m very happy here”. “The staff and care are very good”. “It is a very sociable place, very good.” Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 13 “We are treated very well.” “Nothing is too much trouble.” “Staff treat us very well, marvellous.” People looked clean, well dressed and had been supported to receive a very good level of personal care. Medicines were securely stored around the home in locked cupboards. Staff were clear as to how to store Temazepam and cupboards were available to store this medication. (Previous requirement met) Medicine Administration Records (MAR) checked were completed with staffs’ signatures. Staff said that, if appropriate, people were enabled to maintain control of their medication, with self-administration risk assessments in place. People were not fully protected from medication administration errors because two of the MAR sheets contained hand written instructions with no signature as to the prescriber. Two staff members, who check that the correct information is documented, or ideally the General Practitioner should sign any handwritten instructions on the MAR sheets. Staff said they had completed an in-depth training programme. This gained them the competencies needed to administer medications. Staff were aware of the need to treat people with dignity and respect and were observed interacting in a friendly and pleasant way. People said that they felt well cared for, staff treated them with respect and they were able to spend time in their room if they wished. Jan “All communication that I witnessed between staff and residents showed interest, care and was appropriate. Clients told me that staff treated them with respect and dignity”. We feel that people at Hazlehurst were and are still receiving good and positive outcomes with their health and personal care. This judgement is based on the view that there were very positive aspects in other areas of people’s health and personal care at the service. Also the manger has given a real commitment to improve the care plan documentation at Hazlehurst. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 14 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): Standards 12, 13, 14 and 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. People had a choice of lifestyle within the home and were able to maintain contact with family and friends ensuring that they continued to be involved in community life. Activities on offer promoted choice and maintained interests. Meals served were of a good quality and offered choice, which ensured people received a healthy balanced diet. EVIDENCE: People said they were able to get up and go to bed when they chose, and were seen to walk freely around Hazlehurst, if able. Some people said they preferred to stay in their room at certain times of the day and that the staff respected their decision. The lunchtime period was very positive for people. Jan saw the tables had flowers, tablecloths, paper serviettes and place mats. At lunchtime, there was Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 15 a teapot on each table. Cruet was on each table and she saw a member of staff collect some relish for a person. Jan also made the following positive observation “ a person had earlier declined the two main course options and had said she would have soup. When the soup was brought to her, the staff member asked if she was sure that she did not want the steak pie, She said that she did not want any meat. The staff member offered to get her vegetables and gravy. Mary accepted this and ate it after her soup. It was good that her first request was not just accepted”. Jan” I had lunch with the clients and it was excellent. The food was well prepared and presented. It was hot and good size portions. Clients told me that the food was always to this standard”. People did say there were some activities organised. A lot of these were based around improving their independence. Staff were seen spending time with people on a one to one basis. Due to people’s primary need being able to go and live at home, this was time well spent and people benefited from this individual time and attention. People did ask if it would it be possible to purchase some jigsaws and some boards so that the jigsaws can be put away when the space is needed. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 16 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): Standards 16 and 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. Complaints procedures were in place and people felt confident that any concerns they voiced will be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure that people were protected from abuse. EVIDENCE: People had been given a copy of the services complaints procedure, which was also on display in the entrance hall. This contained details of who to speak to at the service and who to contact outside of the service to make a complaint should they wish to do so. People said they had no concerns about the staff or service provided. They said that they felt very comfortable in going to any member of the staff or management team, knowing that any concerns they may have would be addressed without delay. The service kept a record of complaints, which detailed the action taken and outcomes. The home had received three complaints since the last inspection. The manager had responded to these and outcomes had been reached. We had not Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 17 received any complaints about the service. Staff were clear how to respond and record any complaints received. Policies and procedures relating to Adult Protection were in place at the service and staff were aware of their responsibilities for reporting and responding to any potential abuse. Staff said they had undertaken training in adult protection. A staff-training programme was in place for adult safeguarding training. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 18 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): Standards 19, 24 and 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. The environment within the home was well maintained and clean providing a comfortable, safe environment for people. EVIDENCE: Hazlehurst was clean and tidy and no unpleasant odours were noticeable. Lounge and dining areas were domestically furnished to a good standard. People said that the home was always kept “spotlessly” clean. Bedrooms checked were comfortable and homely. People said their beds were comfortable and bed linen checked was clean and in a good condition. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 19 Jan said, “The interior areas looked extremely clean and tidy. All toilets and bathrooms I saw were very clean”. “There were 2 homely lounges for residents to use. They were small enough to give an intimate feel and allow conversations to take place across the rooms, between clients. The clients liked this”. Staff were monitoring the temperatures of the fridges located in the two dining rooms. This will help to ensure the health and safety of the staff and people at the service. (Previous recommendation met) Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 20 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): Standards 27, 28, 29 and 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 were employed in sufficient numbers and recruitment procedures promoted the protection of people. People received care from a well-trained staff team who had the skills to maintain the safety of themselves and other people at the home. EVIDENCE: Staff and the manager said that there were enough staff employed to meet peoples needs and there were ‘good hand over periods’ included in the services rotas. People spoke highly of the staff team and questionnaires returned identified staff always listened and acted on what people said. People said that staff were “always” available when needed. Three staff files were checked. The files contained a range of information including two references and a declaration of health and identification. The staff had undertaken a criminal record bureau check (CRB), at the enhanced level. This confirmed thorough recruitment practices were in place, which was sufficient to safeguard people. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 21 Staff said that they enjoyed working at Hazlehurst and got a lot of job satisfaction. The staff training records and the AQAA provided the evidence that the staff have all of the training needed to make sure that they can care for people. This included all of the mandatory health and safety training specific to the needs of people at Hazlehurst. Staff were able to talk about the various training courses that they had attended. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 22 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): Standards 31, 33, 35, 36 and 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. The procedures and ethos of the home ensure that Hazlehurst is run in the best interests of people who use the service. In the main people’s monies were safely handled, which ensured that finances were accurate and safeguarded. The services procedures promote the health, safety and welfare of people who use the service and the staff. EVIDENCE: The manager has submitted an application to the CSCI to register as manager. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 23 The manager has a registered managers award and her national vocational qualification level four in care and management. The manager has had many years experience within the caring profession. She was committed to ensuring that people staying in the home were consistently well cared for, safe and happy. Staff said they found the manager supportive. People spoken to and information from questionnaires confirmed that people, staff and relatives were all happy to approach the manager at any time for advice, guidance or to look at any issues. They all said that they were confident that she would respond to them appropriately and swiftly. The manager and provider had ways in which to check out the quality of the service that they were providing. Regular staff meetings were arranged. Management audits for health and safety, the kitchen, cleaning, record keeping and medication were completed. The responsible individual visited the home on a regular basis, a report was written following the visits and any identified actions taken. The service carried out yearly satisfaction surveys and comments had been acted upon. People were able to maintain control over their finances if they wished and had the capacity to do so. The service handled money on behalf of others. This was checked for two people. Account sheets were kept. Staff signed any deposits made and people signed when they made withdrawals. One person’s finances however were not being adequately safeguarded. The person had a larger amount of money that was being safely stored. However the service were unclear as to whether the amount involved would be covered under the services insurance policy. It was agreed that the money would be banked within 48 hours. Staff said they were receiving supervision and support from their managers on a regular basis. The inspector saw records to confirm that staff supervision had taken place. (Previous recommendation met) The fire risk assessment had been reviewed in March 2007 and was due for a further review. No issues requiring attention were highlighted in the review. Staff said they had received recent fire safety and other health and safety training .A sample of records showed that staff were receiving this statutory training. At the time of the visit, fire exits were clear and hazardous products were safely stored in the home. This will promote the safety and welfare of the people. Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 25 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 12,15 Requirement Care plans must be clear and concise to ensure that the person receives a consistent high standard of care. Reviews of the care plans must include the wishes and opinions of people or their advocates. Timescale for action 01/06/08 2. OP7 12,15 01/06/08 Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Staff should record the time they actually write a persons daily notes. No gaps should be left between recordings made on different days. Care plans should be kept under review. The Medication Administration Records should contain a General Practitioner or two members of staffs’ signatures alongside any directions regarding the name and dosage of the medication or the time the medication is to be dispensed. People ask if it would it be possible to purchase some jigsaws and some boards so that the jigsaws can be put away when the space is needed? Procedures should be followed to ensure that people’s finances are safeguarded. 2. 3. OP7 OP9 4. OP12 5. OP35 Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 27 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 Hazlehurst DS0000035749.V360631.R01.S.doc Version 5.2 Page 28 - 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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