Care Home: Newtown House

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What the care home does well Residents and relatives are fully assessed as to whether the home can meet their needs prior to being offered a place at the home. Residents` health needs are met through well-documented care plans and with risk assessments carried out to minimisation of harm.There was good feedback from residents of the home about the way they were treated by staff. There was also good feedback about the way the home was managed. The home provides communal and individual activities to meet residents` social and recreational needs. Religious needs are also assessed and met. Residents in general reported that there was a good standard of food provided at the home. The home has full complaints procedures and staff have been trained in adult protection. The home is kept clean and applies infection control procedures. Staff are recruited in line with requirements of the Regulations and receive mandatory training. The home is well managed and run in the interests of the residents. What has improved since the last inspection? What the care home could do better: CARE HOMES FOR OLDER PEOPLE Newtown House Waterford Road Highcliffe Christchurch Dorset BH23 5JW Lead Inspector Martin Bayne Unannounced Inspection 21st July 2008 09:00 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 Newtown House DS0000060895.V366051.R02.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. Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newtown House Address Waterford Road Highcliffe Christchurch Dorset BH23 5JW 01425 272073 01425 274719 kwatts.newtownhouse@tiscali.co.uk 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) Highcliffe Nursing Services Ltd Mrs Karen Elizabeth Watts Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A minimum of 30 hours per week of the registered manager hours to be supernumerary to the staffing rota. The registered manager must complete the NVQ level 4 award in management by 31st December 2006. 26th July 2007 Date of last inspection Brief Description of the Service: Newtown House is a large detached older style property set in its own grounds in a residential road. The home is within walking distance of Highcliffe High Street and sea front/cliff top. The home offers accommodation to a maximum of 26 service users in the category OP (old age) and provides nursing care. Highcliffe Nursing Services Limited owns the home; the directors are Mr & Mrs Harris and Mr Harris is the Responsible Individual for the organisation. Karen Watts is the registered manager. Accommodation is on two floors with a lounge area, kitchen, nurse’s station and communal open plan area on the ground floor with nine single bedrooms and two bathrooms. There are eleven single bedrooms and three double rooms on the first floor and two bathrooms. All bathrooms are fitted with equipment for assistance. There is a passenger lift between floors. There are pleasant gardens to the rear of the property and the front of the home provides off road parking. Current fees are: £690 to £790. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choos.aspx Newtown House DS0000060895.V366051.R02.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. We, the Commission carried out a key unannounced inspection of the home between 9:15am and 3pm. The aim of the inspection was to evaluate the home against the key National Minimum Standards for older people and to follow-up on the five requirements and three recommendations made at the last key inspection in July 2007. Mrs Watts, the Registered Manager assisted us throughout the inspection, providing us with records and information about how nursing and care services were provided in the home. At the time of the inspection building work was being carried out on an extension to the property that will provide additional rooms and facilities within the home. During the inspection we spoke with five residents and with three members of staff. We also spoke with one relative who was visiting the home on the day of inspection. We were given a tour of the premises and had the opportunity to speak with residents. Other information used to form the judgements within this report were obtained through 4 returned comment cards from staff and 12 comment cards from residents of the home, as well as the returned Annual Quality Assurance Assessment document, (AQAA). We found that action had been taken to address all of the requirements and recommendations of the last inspection. Details are provided in the main text of the report. What the service does well: Residents and relatives are fully assessed as to whether the home can meet their needs prior to being offered a place at the home. Residents’ health needs are met through well-documented care plans and with risk assessments carried out to minimisation of harm. Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 6 There was good feedback from residents of the home about the way they were treated by staff. There was also good feedback about the way the home was managed. The home provides communal and individual activities to meet residents’ social and recreational needs. Religious needs are also assessed and met. Residents in general reported that there was a good standard of food provided at the home. The home has full complaints procedures and staff have been trained in adult protection. The home is kept clean and applies infection control procedures. Staff are recruited in line with requirements of the Regulations and receive mandatory training. The home is well managed and run in the interests of the residents. What has improved since the last inspection? What they could do better: Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 7 Recommendations were made in the following areas: • ‘Skin maps’ should be completed to record all marks or bruising when identified. • Where hand entries are made to medication administration records, a second member of staff signs and checks that the entry has been made correctly. • We found that required visits by representatives of the owners were taking place as required under Regulation 26 but the frequency should be increased to monthly visits. 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. Newtown House DS0000060895.V366051.R02.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 Newtown House DS0000060895.V366051.R02.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from their needs being assessed prior to being offered a place at the home. This ensures that their needs can be met at the home. EVIDENCE: At the last inspection a recommendation was made that more detail be recorded when carrying out a pre-admission assessment of need for people who wish to move to the home. This recommendation was made to ensure that people’s needs could be met if they are offered a placement. At this inspection we tracked the personal records of two residents who had been admitted to the home since the last key inspection. We found that a thorough assessment had been made in respect of both residents and recorded on a preNewtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 10 admission assessment of need form. The recommendation had therefore been complied with. Where assessments have been carried out by care managers or following a person’s discharge from hospital, the home also obtains copies of these assessments to use as part of the home’s pre-admission assessment process. If a person’s needs can be met at the home, they are informed by letter with an offer of a placement at the home. Mrs Watts, the Registered Manager informed that she carries out the preadmission assessments and prospective residents or the families are made welcome to visit the home. Information is also made available in the form of the Service User Guide for the home. Newtown House DS0000060895.V366051.R02.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents health needs are met through a good standard of care planning. Medication is administered safely and residents are treated with respect and dignity. EVIDENCE: We found that residents’ health needs were being met through organised, systematic care planning. We looked at the care plans and related documentation for the two residents tracked through the inspection. These personal files were comprehensive and up-to-date. There was a photograph on the front of each person’s file so that they could be easily identified, together with an admission sheet providing key information. The actual care plans identified residents’ needs, with desired outcomes and actions required Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 12 by the staff to meet residents’ expectations. We saw that the care plans were being reviewed each month or one when a person’s needs had changed. We also saw that care plans were signed by either the resident or their relative, demonstrating that they had been involved in developing care plans. The care plans also contained risk assessments on how to minimise the risk of harm to residents. We saw that residents’ dietary needs were being met using nutritional assessment tools. Residents’ mobility and moving and handling needs were being met through moving and handling assessment and monitoring of any falls. We also found that people’s skin care needs were assessed and monitored, as well as accidents being recorded and monitored. We found within the daily recording that is maintained by staff on the half of all residents, that any bruising or marks to skin were recorded but that ‘skin maps’ were not always recorded and we recommend that these are used to record any marks or bruising found on residents. We found that the home provides a range of equipment to maintain skin integrity such as profiling beds and air mattresses. The home also has moving and handling equipment and aids to meet moving and handling needs of residents. We found that the care planning system, as well as providing information on how to meet health care needs also detailed information to carers on residents preferred routines, their likes and dislikes concerning food, their social and recreational interests and any other pertinent information on how residents wished to be cared for. Residents we spoke with said that they were treated well by the staff. Positive comments were also made within returned comment cards, an example being, ‘All the staff, including domestic and handyman are all friendly’ while acting in a professional manner’. We found that each resident is registered with a GP and that doctor’s visits were made appropriately to meet any healthcare needs of residents. We also saw that other healthcare needs were being attended to concerning chiropody, eye care needs, dentistry and physiotherapy needs. We discussed with Mrs Watts how medication was managed in the home and were told that all of the residents have their medication administered by the nursing staff. We saw a sample of signatures of the staff trained to administer medication. We looked at the medication administration records for all of the residents and found that these were being completed correctly with no gaps within the records. We also saw that known allergies were recorded on the medication administration records together with a photo of the resident, so that they could be easily identified. We recommend however, that where hand entries are made on medication administration records, these are signed and checked by a second member of staff to reduce the risk of errors in copying onto the records. We saw that the temperatures of the small fridge used in the nursing office for storing medications that require refrigeration, were being Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 13 recorded. We also saw that start dates were being recorded for medications with an expiry date, such as creams or eye drops. We looked in the medication administration cabinet and found that medicines were being stored correctly. We also saw that the home had a compliant controlled drugs cabinet and that there was a separate controlled drugs register being maintained and completed correctly when residents were prescribed controlled medications. At the last inspection a requirement was made concerning auditing of medications brought into the home. We found at this inspection that the medication systems had been tightened and that the home now had a system that could provide an audit trail of all medication entering the home. The requirement was therefore met. Newtown House DS0000060895.V366051.R02.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): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents social, recreational and religious needs are assessed and met. Residents are also provided with a good standard of food. EVIDENCE: The home employs an activities coordinator who works 12 to 18 hours per week. We saw on the residents’ notice board the communal activities arranged for the month ahead. We saw that an ‘extend’ exercise group was held on two afternoons a week and there were outings planned for a pub lunch, celebrations of birthdays and a wedding anniversary. We were told that in August the home was arranging a garden party and that there was a planned visit to a theatre in Christchurch. We found that as well as communal activities individual time was spent with residents and a record was maintained of how social and recreational interests of residents were being met. The residents we spoke with told us they were happy with the content and scope of activities Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 15 that were arranged within the home. One resident told us how they enjoy playing Scrabble with the staff and other residents and another reported that they found the exercise groups very helpful. We were told that a Catholic priest visits the home each month to conduct Mass and we saw that spiritual needs are identified through the assessment processes when residents are admitted. The relative we spoke with told us that, ‘The home has done marvellously with my mother and she is a changed woman’. The residents we spoke with told us of their high regard for the staff and observing the interaction between staff and residents we saw that there was a good rapport between staff and residents. Generally, the feedback from residents was that the standard of food provided at the home was good. One comment card from a resident said however, that they felt there should be more choice offered to people who required a diabetic diet. Residents’ likes and dislikes of food are investigated and recorded as part of the assessment of need. Residents are provided with a choice of meals with their choice being recorded by the staff on the previous day. Residents are able to eat within their rooms or have meals served in the dining area. We saw that specialist diets were catered for, such as puréed or soft food or diets for people with diabetes. We also saw that ‘build up’ drink supplements were provided. We also saw within residents’ bedrooms that drinks were provided and that residents who needed assistance were supported by the staff. Newtown House DS0000060895.V366051.R02.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): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well publicised complaints procedure and confidence in the management to investigate complaints seriously. They also benefit from the staff being trained in adult protection. EVIDENCE: The home has a well-publicised complaints policy as this is detailed in the Service User Guide for the home, a copy of which is in all residents’ rooms. The home maintains a log of complaints that details investigations and outcomes. There have been no adult protection investigations carried out since the last inspection in July 2007. Returned comment cards from residents informed that they knew how to complain and that they had confidence that complaints would be dealt with appropriately. We saw within the training records of staff that training is provided in adult protection. Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 17 As found at previous inspections, the home has policies and procedures, including whistle blowing and adult protection that are accessible to the staff. Newtown House DS0000060895.V366051.R02.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): 19 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a safe, ‘homely’ and well maintained environment. EVIDENCE: On the day of inspection we found the home to be clean and free from adverse odours. The home has dedicated domestic staff providing cleaning duties seven days a week. The home is currently undergoing refurbishment and since the last inspection a new laundry area and a new kitchen have been provided. A new assisted bath has also been installed, providing better and safer facilities for bathing residents. We discussed the planned new extension that is soon to Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 19 be built at one end of the building. Part of the plan is to provide better staff offices and a clinic room as well as additional bedrooms and a conservatory. During the inspection we were invited into four residents’ bedrooms and we saw that they were able to personalise their rooms with their furniture possessions. We saw that radiators in bedrooms and communal areas had been covered and that thermostatic mixer valves have been fitted to hot water outlets of baths and showers to protect residents from scalding water. The home has two sluicing areas fitted with sluiced disinfectants. We would told that staff are provided with gloves, aprons and protective clothing in the interest of infection control and alcohol gel dispensers are positioned around the home. We discussed infection-control with the manager who was proud of their record in minimising cross infection. Newtown House DS0000060895.V366051.R02.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): 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well trained staff team with an improvement in staff meeting needs of residents. EVIDENCE: At the last inspection a requirement was made that the home carry out an audit of staffing levels as there was some concern that the staffing levels did not meet the needs of the residents. This was with particular reference to meeting the laundry needs of residents. The manager told us that laundry duties are now delegated to two staff and there has been an improvement with no complaints about laundry from residents. Laundry issues were not mentioned when we spoke to residents and there were no concerns about laundry raised in returned comment cards. One comment card stated that the home could benefit from more staff but this was not raised as an issue in other comment cards. Residents we spoke with on the day of the inspection told us that their call bells were answered and that their care and nursing needs were met. The AQAA informed that there is a trained nurse on duty 24 hours a day and that between 7:30am and 7:30pm in addition to the registered nurse Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 21 there are three carers on duty. During the night-time period between 7:30pm and 7:30am there is one registered nurse and two carers on duty. Mrs Watts dedicates 30 hours a week to managing the home and works on average one shift per week ‘on the floor’. In addition the home employs domestic staff, kitchen staff and a maintenance person. We saw a duty roster for the week ahead that reflected the above staffing. The manager informed us that additional staffing is put in place when there is an assessed need. She provided an example where additional staffing had been put in place recently, to care for residents who had palliative care needs. We were satisfied that the manager was monitoring staffing levels to match the needs of the residents with the requirement therefore met. The returned AQAA document informed us that the home now exceeds the standard of at least 50 of the care staff having been trained to NVQ level 2 or above. At the last inspection a requirement was made concerning staff recruitment. It had been found at that time that not all of the requirements of Schedule 2 of the Regulations were being complied with. At this inspection we sampled two recruitment records of staff who had been recruited to the home since the last inspection. We found on this occasion that all the required checks had been complied with. We found that references had been taken up appropriately, Criminal Records Bureau checks had been undertaken before staff started work at the home, full employment histories had been taken up and staff had signed a health declaration. We looked at the training records for the two staff tracked through the inspection. We found that the staff had received induction training, compliant with Skills for Care and that mandatory training had been provided in such areas as moving and handling, health and safety, fire safety, first aid, protection of vulnerable adults and infection-control. We also saw that annual appraisals were taking place and regular supervision linking to staff training needs. Newtown House DS0000060895.V366051.R02.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): 31 33 35 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a home that is well managed and run in the interests of the residents. EVIDENCE: Mrs Watts has now completed the Registered Managers Award. This had been a requirement that previous inspections. A deputy manager supports Mrs Watts in managing the home. We saw the records of visits undertaken on behalf of the owners of the home as required by regulation 26. We found that Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 23 there were some months when a visit had not been made and we recommend that action be taken to ensure that these visits occur each month. As reported at previous inspections, the home carries out annual quality assurance surveys with residents and relatives that feed into development plans. One returned comment cards told us, ‘Our manager is very approachable’ and another said, ‘I have a very high regard for all aspects of the home and management’. Residents meetings are held so that residents can collectively feedback to the management any issues of concern to them. Some residents have small sums of money held on their behalf. We checked the records of transaction the balances for three residents. The records were detailed with a record of money deposited and withdrawn with a balance of money held. Residents and staff also sign for these transactions. We found that the balances tallied with the money deposited. At the last inspection a requirement was made that staff member’s loyalty cards cannot be used to purchases made on behalf of residents. We found at this inspection that this requirement had been complied with. At the last inspection requirement was made that action be carried out as identified within the home’s fire work place risk assessment. We found that this requirement had also been complied with. The home is currently working with the Environmental Health Officer in meeting their requirements concerning the new kitchen. There were no hazards identified during this inspection. Maintenance staff ensure that the fire safety system is tested each week to the required timescales. Newtown House DS0000060895.V366051.R02.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 x 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 3 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 Newtown House DS0000060895.V366051.R02.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. 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. 2. Refer to Standard OP8 OP9 Good Practice Recommendations It is recommended that ‘skin maps’ be completed to record all marks or bruising when identified. It is recommended that when hand entries are made to medication administration records, a second member of staff signs and checks that the entry has been made correctly. It is recommended that action is taken to ensure that visits under Regulation 26 taken place every month. 3. OP31 Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Newtown House DS0000060895.V366051.R02.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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