Care Home: Ostley House

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What the care home does well What has improved since the last inspection? All staff responsible for the administration of medication are receiving appropriate training to support and guide their practice. Regulation 37 notifications are now being completed to report incidents and events in the home. Medication records have been improved with a record being maintained of all medication coming into or leaving the home. The manager is ensuring that staff who do not have the qualifications, skills and experience necessary for the role are not being left in charge of the home. What the care home could do better: The new manager has a good awareness of the shortfalls identified below and has plans in place to address the issues highlighted. The home must ensure all COSHH substance are securely stored at all times to maintain a safe environment. Medication management and administration records should be regularly checked and audited to identify errors and safeguard people. An appropriate number of staff should be on duty at all times to cover staff absences and to meet the needs of the people living in the home. It is recommended all staff receive training in relation to recognising and reporting abuse to make sure they can safeguard the people in their care. Formal induction training in line with Skills for Care standards should be provided for all new staff making sure they have the skills and knowledge required for their role.Infection control procedures should be reviewed in relation to the use of soap and sponges in bathrooms to prevent the risk of cross infection. COSHH risk assessments and data sheets should be reviewed and updated on a regular basis to make sure all COSHH substances are covered. CARE HOMES FOR OLDER PEOPLE Ostley House 355 Abbey Road Barrow-in-Furness Cumbria LA13 9JY Lead Inspector Ray Mowat Unannounced Inspection 21st July 2008 12:00 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 Ostley House DS0000022621.V368171.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. Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ostley House Address 355 Abbey Road Barrow-in-Furness Cumbria LA13 9JY 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) 01229 823566 01229 826064 info@barrowblindsociety.org.uk www.barrowblindsociety.org.uk Barrow and District Society for the Blind Limited Manager post vacant Care Home 44 Category(ies) of Learning disability (2), Old age, not falling registration, with number within any other category (44), Sensory of places impairment (44) Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home only - code PC, to people of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP. Sensory Impairment - Code SI Learning disability - Code LD (maximum number of places: 2) The maximum number of people who can be accommodated is: 44 Date of last inspection 30th April 2007 Brief Description of the Service: Ostley House is a residential care home that is registered for thirty eight mainly older people, most of whom have a visual impairment. Two younger people with visual impairment and learning disabilities also live there. The home is owned and operated by Barrow and District Society for the Blind. It is situated in a residential area of Barrow-in-Furness about two miles from the town centre. It is a large detached Victorian style house, on three floors, with four purpose built ground floor extensions. The buildings are set well back off the road amidst pleasant landscaped gardens. These are fully accessible by ramped paths. There is a passenger lift that serves all floors. Bathrooms have been specially adapted with a range of aids and adaptations. To the rear of the home are five sheltered housing style bungalows, which have an emergency call bell system linked to the home. The residents may also visit the home for a meal. An informative brochure including a service user guide is provided to all new residents, information is also available in the home including the last inspection report. The current fees range from £386 to £410 per week with additional charges for personal items such as toiletries. Ostley House DS0000022621.V368171.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. During the visit we (The Commission) met with people living in the home, visitors and relatives and spent time with the manager and assistant managers on duty. I also met with care staff individually and talked to them as they went about their duties. The manager completed a self-assessment questionnaire called an Annual Quality Assurance Assessment, which was used for this inspection. This provided us with information about how the home is run and the manager’s views on what the home does well and where they need to improve. There is also information about people living in the home and the staff. The views of people living in the home, their relatives, staff and other professionals were used to formulate the judgements made in this report. We also examined records relating to the running of the home as required by legislation, including personal care plan files. These provide staff with information about what is important to a person and how they like to live their lives. We also examined staff files and records relating to the maintenance and safety of the home. What the service does well: The home is completing individual needs assessments that provide relevant information to enable a personalised plan of care to be developed that guides staff in providing appropriate support and promoting people’s independence. People are given clear information about how the home is run to help them to make a decision about moving in. The following quotes were taken from surveys sent out as part of this inspection and from discussions with people during the visit, which identify a high level of satisfaction with the service provided. • • • “I have no complaints to make about Ostley house. The staff are always helpful and caring of the residents and the residents family. I could not be looked after any better”. “I am very happy here”. “Residents are well cared for and helped in every aspect, staff look to every need of residents”. DS0000022621.V368171.R01.S.doc Version 5.2 Page 6 Ostley House • • “Staff respect individuality, service users are well stimulated, the home is always clean and provide the right equipment”. “Good service in all departments. Very friendly staff who care about all our residents”. The home provides a very high quality living accommodation that it is decorated, furnished and maintained to an excellent standard. The home is providing a good range of activities on a weekly basis and people are encouraged and supported to lead an independent lifestyle both in the home and in the local community. People living in the home feel safe and secure and have a range of aids and adaptations to promote their independence and keep them safe. What has improved since the last inspection? What they could do better: The new manager has a good awareness of the shortfalls identified below and has plans in place to address the issues highlighted. The home must ensure all COSHH substance are securely stored at all times to maintain a safe environment. Medication management and administration records should be regularly checked and audited to identify errors and safeguard people. An appropriate number of staff should be on duty at all times to cover staff absences and to meet the needs of the people living in the home. It is recommended all staff receive training in relation to recognising and reporting abuse to make sure they can safeguard the people in their care. Formal induction training in line with Skills for Care standards should be provided for all new staff making sure they have the skills and knowledge required for their role. Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 7 Infection control procedures should be reviewed in relation to the use of soap and sponges in bathrooms to prevent the risk of cross infection. COSHH risk assessments and data sheets should be reviewed and updated on a regular basis to make sure all COSHH substances are covered. 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. Ostley House DS0000022621.V368171.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 Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New assessments are ensuring people’s needs are fully assessed and the home has the resources to respond to them. EVIDENCE: In addition to any Social Work or specialist assessments the home complete their own needs assessment, this ensures a person’s individual needs and preferences are recorded. We examined three care plan files including one person who had recently moved into the home. The assessments in place were comprehensive and informative and gave you a real insight to what is important to a person in their life and how they prefer to be supported and cared for. They included an informative pen picture, which really brings the care plan to life. The home works closely with other agencies such as the community support team and community health team to support people with challenging or specialist needs. Ongoing assessments and recordings are being maintained so that information can be analysed and care plans updated, Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 10 to ensure appropriate strategies are in place and a consistent approach by staff that supports people’s individual needs. On the whole people are confident their needs can be met when they move into the home. All the people who responded to surveys, sent out as part of this inspection, said they were given sufficient information about the home to make an informed choice about moving in. The home ensures specialist needs are responded to with referrals made to other agencies for guidance and support such as the Psychiatrist, Parkinson’s Nurse and the community health team. Aids and adaptations are in place that helps to keep people safe and promote their independence around the home. These include moving and handling equipment, pressure care equipment and aids for people with visual impairments. Strategies are also developed with input from other professionals that support and guide staff in dealing with difficult or challenging behaviour. Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans have improved and provide staff with detailed information about people’s personal and healthcare needs ensuring their safety and welfare are maintained. EVIDENCE: The care plan format has been reviewed and improved to ensure a more detailed record of people’s personal and healthcare needs are recorded. They include a photograph and informative pen picture that gives a real insight to the person and what is important to them in their lives. A ‘residents profile’ is completed, which captures personal information such as medical history and personal details and relationships. Daily care notes are completed at the end of each shift, which help to maintain a continuity of care. The care plan was sectioned into key areas of care and support such as communication needs, personal care and social interests. Risk assessments for pressures care, moving and handling and for maintaining a safe environment were also in Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 12 place. Care plans are kept under review on a monthly basis and are signed off by staff completing the review. Specialist assessments and referrals to specialist health professionals ensure specific needs are assessed and responded to appropriately. The home uses pressure care equipment under the guidance of the community health team to manage pressure care needs. Nutritional screening is completed in addition to the monitoring of people’s weight on a regular basis. Pressure mats and wander guards are used to alert staff to safeguard people who are at risk from falls. People spoken to during the inspection and who completed surveys confirmed they were able to access GP and other health services when required. Medication procedures have been reviewed and improved with a clear record maintained of all medication held in the home. A front sheet has been included in the MAR charts including the person’s photograph and date of birth to help staff to identify people more easily and prevent errors. Staff responsible for medication administration receive suitable training in the safe administration of medicines. Medication management and administration records should be regularly checked and audited to identify errors and safeguard people. People’s wishes upon death and during illness are recorded within the care plan including any cultural or religious beliefs. Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are enjoying a fulfilling lifestyle and are able to pursue their individual interests and hobbies both in the home and in the local community. EVIDENCE: The home has a programme of activities planned for each week, which includes a daily exercise session, a quiz, bowls, nail care, skittles, and various tabletop activities. Another popular activity is staff reading the news from the local paper. The home has a ‘Friends of Ostley House’ volunteer group who fund raise and organise social events throughout the year. They recently organised a trip to a local hotel for afternoon tea that proved very popular. Other events included bulb planting, flower arranging and musical concerts with a visiting entertainer. The next event planned was a coffee morning in the home. As part of the recent expansion of the home an activity centre has been built, which is used to provide different activities on two afternoons and one evening each week. Computers have been installed in the centre with Internet access Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 14 and the home has two laptop computers enabling people to pursue their interest in I.T. One person is particularly keen and has been involved in the production of a monthly newsletter. This is displayed in the home and a copy issued to each resident providing them with an update about what is happening in the home and the local community. There is a ‘what’s happening’ notice board in the foyer, which displayed notices for services available in the home such as religious services, Chiropody and hairdressing as well as adverts for forthcoming events. One person said they “are kept busy if they want to join in” and another commented on how much “they enjoyed the trips out and entertainers”. The home issued surveys to people regarding the food provided to ensure people’s dietary requirements and personal preferences were being accommodated. In response to the surveys the four week menus have been changed and now provide a good selection of nutritional meals including special diets such as low fat or low sugar etc. Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are aware of their responsibilities in listening to and responding to concerns and ensuring people are safeguarded at all times. EVIDENCE: The home has a clear complaints policy and procedure that is issued to people as part of the service user guide. Staff are also issued with a copy of key procedures making sure they are aware of their responsibilities. A record is maintained of all complaints and concerns, which we examined. There has been one complaint since the last key inspection, which was fully investigated, recorded and resolved to the satisfaction of the complainant. People responding to the survey said they were aware of how to raise concerns and complain. The home has made appropriate referrals relating to the mistreatment and abuse of adults, which ensures people are safeguarded. This related to an altercation between two people living in the home and was handled sensitively and resolved satisfactorily. Staff spoken to had a good awareness of their roles and responsibilities in identifying and reporting abuse, however training in the mistreatment and abuse of vulnerable adults has not taken place since 2006. It is recommended all staff receive training in relation to recognising and reporting abuse. Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 16 Only small amounts of personal finances are retained by the home at the request of the person or their representative. The finances are securely stored in a safe and all transactions are checked and signed with receipts retained. We checked the financial records of three people and found these to be up to date and in order. Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Ostley House continues to be decorated, furnished and maintained to a high standard providing a safe and comfortable environment that is suitable to meet the needs of the people living there. EVIDENCE: Since the last key inspection the home has been extended with the addition of 8 new rooms and an activity room. The extension has been completed to a high standard in keeping with the existing building. The home is decorated and furnished to a high standard, both in service users rooms and in the communal areas. The layout of the home is suitable for the needs of residents, it is safe and accessible and promotes people’s independence. The gardens and grounds are also well kept with pleasant seating areas enabling service users to enjoy them when the weather allows. People are appreciative of the standard of décor and cleanliness of the home. A visiting relative we met described the home as “being like a good hotel”. Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 18 There were no hazards identified during my tour of the building everything was well maintained all the passageways were clear and equipment was stored appropriately. The home has a range of bathing and shower facilities to meet the many and varied needs of service users. All the resident’s rooms have a lockable space and residents have personalised their rooms with furniture and equipment of their choosing. The home was clean and hygienic throughout with no malodours. Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There have been shortages of staff that have impacted on the quality of care provided. EVIDENCE: Since the home has been extended and the number of people living in the home increased there have been staff shortages that have impacted negatively on the quality of care provided. Staff surveys confirmed this with the following comments. • • • • “Quite often short staffed due to sickness & holidays”. “Constantly working understaffed especially on days”. “Not enough experienced staff to cover for holidays”. “Need to employ more experienced relief cover”. Despite concerns with the number of staff on duty the care provided by staff is valued by people living in the home, with the following comments being typical. • • “The staff are always helpful and caring of the residents and the residents family. I could not be looked after any better”. “We are very lucky to have such wonderful carers”. DS0000022621.V368171.R01.S.doc Version 5.2 Page 20 Ostley House The manager is aware of these issues, which we discussed and she was able to confirm that recruitment was ongoing to improve the relief cover. There are suitable recruitment procedures in place that ensure new staff are suitable and safe for their role with all staff having an up to date Criminal Record Bureau (CRB) disclosure in place. All new staff are issued with a job description, code of conduct and contract of terms and conditions. A new induction record is being introduced to ensure people’s skills and qualifications are recorded and training and development needs identified. Training records have improved with the manager maintaining individual records of all courses people have attended and ensuring skills deficits are identified and appropriate courses planned. Recent courses have included Manual Handling x 3, Fire Training and Mental Capacity Act, with further courses planned re visual impairments, infection control and end of life care. Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. On the whole people are enjoying a good quality of life with the home being run in the best interests of the people living there. The management team provide good leadership and support. EVIDENCE: The new manager has completed the Registered Manager award and has applied to the Commission for registration and is awaiting an interview date to complete the process. Staff confirmed they get “good support and supervision from the manager or assistant managers”, another talked about it being “a good home and we work well as a team”. Staff felt valued and that they were contributing to the running of the home. A new system for handovers between shifts has been introduced to improve communication and the sharing of Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 22 relevant information. This involves senior carers meeting with assistant managers at the end of a shift and the introduction of a communication book. Another development is the introduction of a more formal on-call system that will be covered by the management team and a review of the management structure and rotas to improve management support in the evenings and weekends. The home has a formal quality assurance system using questionnaires to gather feedback from people living in the home and significant others. The results from these are compiled into a report and included in future planning. We examined personal financial records held by the home and these were up to date and in order. Staff supervision has been formalised and is being completed on a regular basis with clear records of the meetings being maintained. Staff spoken to during this visit said, “We are a good team”, “we get on well with management and can raise issues and concerns”. There is a good range of risk assessments in place to ensure the safety of people living and working in the home. Fire risk assessments are being updated to accommodate the new extension ensuring compliance with new fire safety legislation. Infection control procedures should be reviewed in relation to the use of soap and sponges in bathrooms. Individuals should have their own soap and/or sponges and these should not be left in communal bathrooms. Also when examining the contents of bathroom cabinets it was noted that some cleaning materials were being stored there, which are COSHH substances. Although these were immediately removed the home must ensure all COSHH substance are securely stored at all times. Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 4 4 3 3 3 3 4 4 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 2 Ostley House DS0000022621.V368171.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP38 Regulation 13(4) Requirement The home must ensure all COSHH substance are securely stored at all times. Timescale for action 01/08/08 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 Medication management and administration records should be regularly checked and audited to identify errors and safeguard people. An appropriate number of staff should be on duty at all times to cover staff absences and to meet the needs of the people living there. It is recommended all staff receive training in relation to recognising and reporting abuse. Formal induction training in line with Skills for Care standards should be provided for all new staff. Infection control procedures should be reviewed in relation to the use of soap and sponges in bathrooms. COSHH risk assessments and data sheets should be reviewed and updated on a regular basis. DS0000022621.V368171.R01.S.doc Version 5.2 Page 25 2 3 4 5 6 OP27 OP30 OP30 OP38 OP38 Ostley House Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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. 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