Care Home: Morrell House - City of York Council

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What the care home does well People who are considering moving into the home are invited with their family and chosen representatives to look around and have their questions answered. One relative commented, " We visited before hand to ensure we were happy with the place we had chosen for my mother". People`s needs are assessed properly. This includes help that is required to aid their memory to ensure people`s needs are known and can be met. Care is individualised and respects people`s privacy and dignity. Activities are provided to help people continue to live the life they choose. The activities coordinator creates word games to help stimulate people`s memories and care staff make time to undertake activities with people.Visiting is restricted at mealtimes to ensure people can concentrate on eating their meal. One person said, " The food is good, I like it". Special diets are catered for and finger foods are provided to encourage people to eat. A robust complaint`s procedure is in place to ensure that any concerns raised are investigated and dealt with thoroughly. Training for staff is provided to make sure that care is given by people who have knowledge of how to give care safely. What has improved since the last inspection? There were no requirements or recommendations made at the last Inspection. Meals are now cooked in the home rather that being provided by York hospital for part of the week and the smell of the food cooking has helped to stimulate people`s appetites. There has been an increase in staffing levels since the last inspection to improve the quality of care being delivered. What the care home could do better: Some areas of the medication system in operation in the home require some improvements to be made to ensure peoples health and safety is protected. CARE HOMES FOR OLDER PEOPLE Morrell House - City of York Council Morrell House 388 Burton Stone Lane York North Yorkshire YO30 6EZ Lead Inspector Denise Rouse Key Unannounced Inspection 29th July 2008 10:00 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 Morrell House - City of York Council DS0000034894.V368893.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. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Morrell House - City of York Council Address Morrell House 388 Burton Stone Lane York North Yorkshire YO30 6EZ 01904 658 998 01904 625496 elaine.pollard@york.gov.uk www.york.gov.uk City of York Council 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) Mrs Elaine Pollard Care Home 29 Category(ies) of Dementia - over 65 years of age (29), Old age, registration, with number not falling within any other category (4) of places Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Category OP applies specifically to named service users already resident in the home. No further service users are to be admitted in this category. 26th September 2006 Date of last inspection Brief Description of the Service: Morrell House is a care home run by City of York Council to provide a service for 29 older people over 65 years of age with dementia care needs. It is also registered to care for 4 older people who do not have dementia. Morrell House was purpose-built approximately 30 years ago and is located on the outskirts of a residential area on Burton Stone Lane. It has undergone much refurbishment over the past few years. The accommodation is provided in single rooms on two floors. The upper floor is accessible via an internal staircases and a passenger lift. Information is available in the service user guide, statement of purpose and last inspection report about what the home has to offer. People are financially assessed for their contribution towards the cost of their care. The current full charge on 29 July 2008 was £457.74 per week. Hairdressing, private chiropody, newspapers and magazines are charged for separately. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The accumulated evidence used in this report has included: • A review of the information held on the home’s file since its last key inspection. • Information submitted by the registered provider in the Annual Quality Assurance Assessment. • Surveys received from five people living at the home, four relatives, two health care professionals and two staff. • An unannounced visit to the home, which lasted five and a half hours, undertaken by one inspector. This included a full tour of the premises. • Evidence was gained by direct observation during the site visit; which involved talking with people living at the home, the manager and receptionist and other members of staff. • Inspection of records, including care profiles, medication administration records, staff files and some of the home’s policies and procedures. What the service does well: People who are considering moving into the home are invited with their family and chosen representatives to look around and have their questions answered. One relative commented, “ We visited before hand to ensure we were happy with the place we had chosen for my mother”. People’s needs are assessed properly. This includes help that is required to aid their memory to ensure people’s needs are known and can be met. Care is individualised and respects people’s privacy and dignity. Activities are provided to help people continue to live the life they choose. The activities coordinator creates word games to help stimulate people’s memories and care staff make time to undertake activities with people. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 6 Visiting is restricted at mealtimes to ensure people can concentrate on eating their meal. One person said, “ The food is good, I like it”. Special diets are catered for and finger foods are provided to encourage people to eat. A robust complaint’s procedure is in place to ensure that any concerns raised are investigated and dealt with thoroughly. Training for staff is provided to make sure that care is given by people who have knowledge of how to give care safely. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 7 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 Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 8 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): Standard 3. (6 Not applicable) People who use this service experience good outcomes in this area. People are assessed prior to being accepted into the home so that their needs are known and can be met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People who are considering moving into Morrell House have a detailed assessment carried out. This includes what people like to do and how they live their life as well as information about their mental health needs and other special needs they may have. Information from care managers, community psychiatric nurses and discharging hospitals is gained to ensure the home has a full picture of the care each person requires. Admissions are not made to the home if staff cannot meet people’s individual needs. Prospective residents and their relatives are able to visit the home. Some people stay for a meal or are admitted to the home for a few weeks to see how Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 9 they settle in. The manager and staff spend time with people to answer their questions. Surveys received indicated people felt they had enough information to decide if this was the right home for them. One relative’s survey received said, “ We visited beforehand to ensure we were happy with the place we had chosen for my mother”. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. People who use this service experience good outcomes in this area. People have their needs met and they are treated with dignity and respect. Some aspects of the medication system in operation could be improved, to help protect people. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People who use the service have their individual care needs recorded on night and day care plans. Risks to people’s well being are identified and a risk assessment sets out what action is required to keep people safe, whilst they remain as independent as possible. These documents are reviewed monthly or as the persons needs change. Six weeks after a person is admitted all interested parties review how the placement is going and any issues are resolved. This helps to ensure people are happy with the home and the services they are receiving. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 11 People are allocated a dedicated key worker who helps to support the individual and their family. These staff, get to know people well and instinctively know when the person under their care is not quite themselves and can look at why that might be. Specialist equipment is available, such as hoists and hospital beds this ensures that people’s special health care needs are met. Help and advice is sought from health care professionals to make sure that individuals get the special help they need to maintain their health. People are escorted to appointments or health care professionals attend the home as required. One relative stated “ My mother always has all the medical support she requires”. A survey from one health care professional indicated they would like staff to have training about chest infections and water infections. This was discussed with the manager who is implementing this. People’s privacy and dignity is maintained. Staff address people by their preferred names, and knock on bedroom doors before entering. Bedroom doors can be locked if individuals would like this, which helps to maintain people’s choice and privacy. People whose first language is not English have prompt cards to aid communication and family members give assistance to interpret their needs where necessary. Male care staff are available in the home so that people have a choice of what care staff attend to them. Staff help and support people who have issues remembering things in a sensitive and supportive way. People choose how they want to spend their time with gentle support and guidance from the staff. This ensures peoples individuality and independence is protected. Medication systems were inspected. One member of staff orders all the medications, this helps to protect people. However it was noted that one person had 3 handwritten items on their medication administration chart (MAR). Errors can sometimes be made when handwriting items on to MAR charts. A system should be put in place to reduce the risk of any potential errors being made. Also the upstairs cupboard where the medicine trolley is stored was very warm, it was suggested that the temperature of this cupboard should be monitored to ensure medications are stored within the optimum temperature range, so that they remain effective for people. One person had an agreement in place with their GP and relative for essential medication to be given in foods if it was refused, this should be reviewed to ensure the home is complying with the Mental Capacity Act. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 12 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 this service experience excellent outcomes in this area. Peoples social needs are known and are well met, they receive a nutritious well balanced diet. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Peoples preferred social activities are recorded in a care plan, this means their preferred activities and hobbies are known and staff can provide them. People who take part in activities have this recorded. Each person has “ A life profile” completed this tells staff about their family life and work, with any significant events recorded so that staff can help people reminisce if they want to. An activities co-ordinator is provided, she has received dementia training to enhance the activities available to people. She makes up her own memory games to suit the individual needs of people living in the home. This is commendable. Staff provide activities during their shifts and interact socially with people on a one to one basis as well as providing group activities. Staff sat and talked with people, played ball with a small group of people and another carer helped a person with word search puzzles. One person Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 13 commented “My relative is unable to do many activities but staff do all they can to encourage her”. The life histories of people are considered. One person who enjoyed visiting charity shops is taken out to shop in them by the staff. Another who had a connection with Elvington Air Museum has been taken back there to reminisce and see a memorial to their late relative. This helps people feel fulfilled. A variety of dogs visit the home for people to pat, there has also been visits by a guinea pig and a parakeet. Some residents who are comforted by nursing “babies” have dolls available to meet this need. Baking is undertaken by one person who is supervised to ensure they are safe, and they thoroughly enjoy being able to bake occasionally. Other people who want to help dust or fold towels or help the staff with the tea trolley are encouraged to do so. All these activities help people to exercise choice about their life and help them feel valued and keep active. Entertainment is provided monthly and a Summer Fayre was held at the home and raised £270.00. At Christmas the children from Burton Green Primary School come to sing and the Lord Mayor Visits. Local trips are organised there have been outings to a local Lavender Farm, Deans Garden Centre and the Wetherby Whaler fish restaurant. Halloween was celebrated with Pumpkin lanterns and at Easter the home was decorated with rabbits and chicks, and Easter eggs were given out. A Roman Catholic lady gives communion to those who want to receive this in the home. St Luke’s vicar attends on behalf of the Church of England. This ensures that people’s religious needs are being met. A hairdresser visits the home weekly and a private chiropodist also attends as required. Visitors are welcome at any time apart from mealtimes. This is because some people can be distracted from eating and preventing visiting helps people concentrate on their meal. People are encouraged and supported to go out with their family within the local community to promote their independence. One person goes out each week and spends part at the day at home with their relatives before coming back to the home. This is appreciated and enjoyed by their family. The kitchen was inspected, meals are prepared in the home for part of the week and some meals come from the hospital. Meals can be served in people’s bedrooms or in the dining areas. Care staff are sensitive to the needs of people who find it difficult to eat and need help and encouragement with this. Staff sit with people helping them feel comfortable and unhurried which helps people relax and respond in time. Food looked appetizing and people were offered as many choices as required to encourage them to eat. Special equipment is used such as plate guards, to help people maintain their independence to feed themselves. The chef knew who required special diets Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 14 this helps to ensure peoples nutritional needs met. One person said, “ The food is good, I like it, but don’t ask me what I had for lunch because I get forgetful at times”. Morrell House - City of York Council DS0000034894.V368893.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): Standards 16 and 18. People who use this service experience good outcomes in this area. People have their concerns and complaints listened to and issues raised are addressed. Procedures are in place to ensure people are protected from abuse. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The complaints procedure is available to people. Complaints are investigated and documented, and the person informed of the outcome. The manager has an open door policy anyone one can see her to make their views known at any time. A safeguarding policy is in place. Staff spoken with knew what to do if an allegation of abuse occurred. There has been one incident dealt with as a safeguarding issue since the last inspection. Ongoing training and information relating to the whistle blowing procedure has been given to all staff and issues are brought to manager’s attention to be dealt with. This ensures that people are being protected from abuse. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. People who use this service experience good outcomes in this area. People live in a home that is maintained and people’s wellbeing is protected by the infection control measures in place. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a welcoming and calm atmosphere, which helps people to relax and enjoy their surroundings. Ongoing maintenance is taking place to enhance the home’s facilities. A secure door entry system is in place to ensure people are kept safe. There are small sitting areas, and lounges where people can choose to sit. A variety of dining areas are provided. A new manager’s office has been created downstairs so she is more available to people. Areas of the home are colour co- coordinated to help people remember where they are. Toilets, bedrooms, bathroom and lounge doors have large signs on Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 17 them to help guide people. A lift is available to help people access all areas of the home. Bedrooms are personalised, eight have en suite bathrooms. There is an enclosed patio with borders of plants, which is accessible by people who can walk and those requiring wheelchairs. A local company very kindly provided this and it is enjoyed by people living in the home. A few people like to garden and they have planted tomatoes, which will be used in the kitchen when they are ripe. The home is clean and there is no malodour. The laundry facilities and systems in operation are satisfactory. Hand wash facilities are available in all areas of the home as well as hand sanitizer in reception. These infection control measures help to protect people. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People who use this service experience good outcomes in this area. People are looked after by staff who are well trained so that people can feel confident that their needs can be met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staff spoken with were friendly, approachable and positive about the role they played in the home. There has been an increase in staffing levels since the last inspection to improve the quality of care being delivered. Staffing levels are adequate to ensure people get the care they require. However staff commented on their surveys: “ We are often working short staffed. Although jobs are advertised people feel it is very hard work for the money we get. We also use agency staff but agencies are often not reliable and sometimes the people they send are not often appropriately trained to deal with residents with a dementia”. And “ Because the people who use our service have complex needs staff who are appointed in post have not fully understood their needs, so they leave. The council do a good job of explaining the position and advertise regularly, but you can work in a residential home for the same level of pay as an Elderly Mentally Infirm home and so people choose to work elsewhere as it is less work for the same money”. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 19 Senior managers have considered these issues and action has been taken to address the shortfalls. Recruitment policies and procedures are thorough. Where staff commence work before the results of their Criminal Record Bureau check is known a POVA first check is undertaken and they are fully supervised. This helps to ensure that staff who are not suitable to work in the care industry are not employed at the home. Staff receive regular training to ensure their health and safety is protected and that of the people living in the home. New staff are given induction from the deputy, and they complete recognised training to ensure they have good knowledge on which to develop their care skills. The home has over 50 of their care staff with a National Vocational Qualification in care this helps to enhance the care given to people. Staff commented on their surveys:“ We provide a person centred care approach” and “ I feel the staff we do have are well trained and experienced. Also very professional as the clients we look after have a dementia and some are very challenging. But staff put themselves out to make sure the clients are well looked after and all needs are met”. All staff including the cleaners interacted well with the people living in the home. One person said “ The staff are very good to me, anything you want they help me, they are very caring”. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38. People who use this service experience good outcomes in this area. People live in a home that is well managed so they get good support and their health and safety is protected. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The manager has been in place at the home for a long time, she is experienced and approachable and has gained her Registered Managers Award. Service managers visit the home regularly to monitor how the home is operating. Staff spoken with said the manager is approachable, helpful and supportive. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 21 Quality assurance procedures are in place and these are being strengthened by the introduction of a written audit on all areas of documentation and services provided, which is to be completed from this month onwards. The council also carries out a full audit in September of invoices, time sheets, safe contents, residents’ monies and the property. People who use the service and their relatives are sent a yearly survey about how they feel the home is performing. Informal auditing occurs in relation to accidents to see if there are any measures that can be put in place to help prevent people from falling keeping them as safe as possible. Staff meetings are held quarterly. Resident’s and relatives’ meetings are not held although these have been considered. The manager has an open door policy and talks with relatives when they attend the home to gain their views. Personal allowance accounts are operated for people living in the home and these were found to be correct, and safeguarding people from financial abuse. All necessary health and safety checks and regular maintenance is undertaken, to ensure people’s health and safety is protected. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 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 X X 3 Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Hand written entries on medication administration records should be avoided or countersigned by a second person to reduce the potential risk of errors being made. The upstairs cupboard where the medication trolley is stored should have the room temperature recorded regularly, to assess if this storage area is suitable for the storage of medication. And take appropriate action if the temperature is not suitable. The practice of administering medication occasionally to one individual in their food should be considered in view of the Mental Capacity Act to ensure the individuals’ rights are being protected. Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 24 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 Morrell House - City of York Council DS0000034894.V368893.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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