Care Home: Priestnall Court

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What the care home does well The home provides a relaxed and flexible routine to suit the needs of residents. Residents said, "The food is very good here and I am very happy," "This is the best place I could have chosen" and "Sherry in the evening is the best part of the day." Residents were well looked after and were complimentary regarding staff meeting their personal needs. Comments made were " Staff do not discuss me with others and always maintain my confidentially" and "Staff always maintain my privacy." Many staff had worked in the home for a long period and knew the residents well. Over 50% of staff was trained to NVQ level 2. Staff receive detailed verbal handovers of the care needs of residents and tasks are allocated daily be senior staff. Residents are consulted about developments in the home. The minutes of residents meetings stated that they wished meetings to be more frequent, which the manager was acting on. What has improved since the last inspection? Staff supervision had commenced and records were maintained. The manager was reviewing staff inductions in line with the recommendations made by the Skills for Care council, which would provide new staff with a good understanding on how to meet the needs of the residents physically and emotionally whilst maintaining a professionals relationship. A requirement made on the last inspection was in relation to staff training in the protection of vulnerable adults. The home had met this in part by the purchase of a training video and a questionnaire. However, more in-depth training should be obtained to ensure staff understand all areas and action they would need to take in such an event. Some refurbishment had taken place in resident`s bedrooms. The manager said this was continuing in communal areas. What the care home could do better: Although outcomes for residents remained positive on this inspection the home needs to be better at recording the care they deliver, and why. The home`s assessment process required more information on the presenting problems of residents. The home needs to be sure of the needs of residents before the agree to care for them. Care planning information did not give sufficient detail to staff in order to be fully aware of the resident`s needs or communication problems and how they were to deliver care. Reviews were not recorded in full and daily reports needed more information on care delivery. This would ensure that staff worked with good, accurate information. Accident reporting was lacking in detail and in cases where several accidents had occurred professional help had not been sought or a review undertaken. This leaves residents at risk of further falls because staff do not know what guidance to follow to reduce or eliminate accidents. Risk assessments had not been completed in full which potentially means that staff are not aware of the risks to the residents and therefore are not working to reduce them. Risks in the environment must also be considered such as protecting residents from hot radiators. Medication policies and procedures needed to be reviewed especially in relation to self-medication in the home. There were also issues relating to the recruitment of staff that required attention, particularly in relation to poor record keeping. All these issues were discussed with the new manager who expressed an awareness of the issues to be addressed. She told us that a review of these procedures would be undertaken. CARE HOMES FOR OLDER PEOPLE Priestnall Court 14/16 Priestnall Road Heaton Mersey Stockport Cheshire SK4 3HR Lead Inspector Sandra Buckley Unannounced Inspection 04:06 12 March 2007 th 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 Priestnall Court DS0000008578.V320200.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. Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Priestnall Court Address 14/16 Priestnall Road Heaton Mersey Stockport Cheshire SK4 3HR 0161-432 1124 0161 947 9088 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) Mr. Michael Hugh Halliwell l Kate Hyslop Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 24 OP. Date of last inspection 5th October 2005 Brief Description of the Service: Priestnall Court is registered to provide care for up to 24 older people whose primary care need is due to old age. The home is comfortably furnished and well maintained throughout, creating a homely atmosphere. There are two lounges one of which is a non-smoking lounge, a dining room, 22 single bedrooms, 18 of which have ensuite facilities and one double bedroom with ensuite facilities. The bedrooms on the ground floor have patio doors, which lead on to a patio area with pleasant gardens including a waterfall rockery area. There is also a raised patio area to the front of the house with garden furniture where service users can sit. The home has a passenger lift. There is a car park to the front of the house. Priestnall Court is situated in the Heaton Mersey area of Stockport. It is close to local shops, cinema, bank, library and park. Stockport town centre, motorway network and public transport are all easily accessible. The range of fees are from £329-23p to £451-61p Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection which included a site visit was undertaken on the 12 March 2007. The home has a new manager who had been in post for only two weeks before the inspection. Before this, the individual was the deputy manager, and therefore continuity of care for residents is provided. This inspection included observation of care practices, talking with residents, staff, and relatives. The manager was also interviewed. A selected tour of the premises was taken and samples of care, staff and medication records were examined. We checked to see if everything we asked the home to do at the last inspection had been done. There was one matter relating to medication which had not been done. What the service does well: What has improved since the last inspection? Staff supervision had commenced and records were maintained. The manager was reviewing staff inductions in line with the recommendations made by the Skills for Care council, which would provide new staff with a good Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 6 understanding on how to meet the needs of the residents physically and emotionally whilst maintaining a professionals relationship. A requirement made on the last inspection was in relation to staff training in the protection of vulnerable adults. The home had met this in part by the purchase of a training video and a questionnaire. However, more in-depth training should be obtained to ensure staff understand all areas and action they would need to take in such an event. Some refurbishment had taken place in resident’s bedrooms. The manager said this was continuing in communal areas. 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. Priestnall Court DS0000008578.V320200.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 Priestnall Court DS0000008578.V320200.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 Quality in this outcome area is adequate. The assessment information in place did not fully show the full range of needs residents have, thereby increasing the risk that residents may be admitted to the home with needs which the home is unable to meet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents had been recently admitted into the home. Examination of the home’s assessment procedures in all three cases found them lacking full details of the residents needs. In addition to this the information obtained had not been fully transferred into care planning. During interviews staff demonstrated their knowledge of the residents presenting problems. However, they were unaware for what reason the resident had been admitted or the record of admission. Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 9 Residents were happy with the care at the home one said “ It is never to much trouble for staff to listen to what you have to say and do something about it.” The home does not provide intermediate care. Priestnall Court DS0000008578.V320200.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 7,8,9,10 Quality in this outcome area is adequate. Insufficient detail on the home’s recording systems and the failure to consult with health care professionals may pose a risk to residents. Medication policies and procedures need to be reviewed to ensure residents safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Interviews took place with residents in the lounge. Female residents said they are given the option to have their nails painted and hair done regularly. One male resident said “The men are offered this too without the polish.” Residents were keen to discuss their experiences in the home saying “The chiropodist comes to do my feet every eight weeks.” Another said, “The district nurse comes to me which saves me going to the clinic,” “Staff always maintain my Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 11 privacy” and “Staff do not discuss me with others they maintain confidentiality.” Although residents said they were satisfied with the care provided, record keeping needs to be improved to ensure that care is delivered to each person as they wish. As mentioned earlier in this report, assessments were not completed in full making it difficult to ensure a care plan matched the resident’s needs. Of the files examined there was a lack of detailed instructions to staff on care delivery and the assessed needs of residents. This was also apparent during staff interviews were they knew what the resident’s immediate presenting problems were but not the full assessment, which would have made understanding the resident needs easier. An example of this would be if a resident suffered a stroke and had communication problems, full details would enable staff to understand and develop an appropriate method of communication. Risk assessments were either not in place or those which where did not adequately reflected the risk and action to be taken. Accident recording did not give sufficient information of injuries sustained or the follow up required in the daily reports. It was noted that in one case a high number of falls had occurred, but no action taken. In this instance the home should discuss the situation with the falls prevention nurse or other professionals to seek their view on what can be done to reduce the number of falls. Daily reports did not give enough detail on what staff had done for the resident during the day. Judgements were sometimes made on presenting problems instead of keeping a factual record of the event. Reviews of care only gave the date and recorded “no change” – no detail as to what had been considered during the review was noted. Medication policy and procedures especially in relation to self-administration of medication need to be reviewed and updated. There were no risk assessments in place for those residents who self medicate (either orally or with the application of creams). In order to ensure the residents maintain their independence to self medicate consultations should take place with the pharmacist in order to implement safe working practices. The home must also maintain a record of current medication including creams and homely remedies for each resident who is self medicating. Controlled drugs were stored, administered and recorded appropriately. Samples of medication records were examined and it was noted that photos were not always available. Staff had received training in medication procedures and moving and handling techniques. Priestnall Court DS0000008578.V320200.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 12,13,14,15 Quality in this outcome area is good. Routines were flexible and offered residents choices in their daily lives. Mealtimes offered a varied menu and visitors were made welcome, which aided the well being of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The day-to-day routine of the home was relaxed and flexible with residents having the choice to spend time in their rooms. Two residents were interviewed in their own rooms, which they had personalised with favourite possessions from home. A resident new to the home said, “I was told I could bring in some of my own furniture.” Some ground floor rooms have patio doors with access to the garden. One resident said, “I like to maintain my own bit of garden and pots for as long as I can.” Another resident said, “ I have requested an ensuite room and the manager said I can have the next one that becomes available. I know they will keep their word because a resident before me was waiting for one, which has now been allocated. The staff are very good like that.” Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 13 There was evidence that some residents go home for weekend or day visits and also have planned holidays with family. A local church visits on a weekly basis for those residents wishing to take part in Holy Communion. Several residents praised the staff team for their caring attitude and flexibility in routines. Three residents said “We can get up any time we are awake and go to bed at our leisure.” A four weekly three course menu is operated in rotation, all residents said the food was very good and there were choices available. The dining tables were attractively set with the meal of the day being home made soup, scampi and chips and a sweet. The inspector sampled the food, which was tasty and presented attractively. Staff were also observed asking residents if they would like second helpings of the main meal or sweet. For those residents who required a special soft diet, the kitchen staff kept vegetables and meat in individual portions making it more attractive for residents. One resident said, “The food is very good here and I am very happy.” During the evening staff went round offering sherry to residents. One resident said, “This is the best part of the day,” and another said, “This is the best place I could have chosen.” A list of events in the home is recorded in the diary together with the names of those residents who joined in the activity. Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 14 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 16,18. Quality in this outcome area is adequate Residents felt confident their complaints and concerns would be taken seriously and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a detailed complaints procedure; there had been no complaints made to the home or the CSCI since the last inspection. Residents said they knew who to complain to and were confident their concerns would be listened to. One resident said, “ I have brought issues that concern me up in the past and they are always acted upon.” The home has a procedure for responding to allegations of abuse. On the previous inspection it was recommended that staff receive professional training in the protection of vulnerable adults. The home has made some improvement in this area by purchasing a video and questionnaire on the protection of vulnerable adults. This is a useful tool has a refresher course. However, the manager should seek advice from Stockport Training Partnership with regard to more in-depth input for staff on this issue also training for management on investigative techniques. A high number of staff had completed their NVQ; an element of which covers protection of vulnerable adult issues. Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 15 Three staff were interviewed who demonstrated a good understanding of how abuse may present and their role in prevention and whistle blowing. Priestnall Court DS0000008578.V320200.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): Standard 19,21,24,26. Quality in this outcome area is adequate. Residents live in a comfortable homely environment, which is clean and free from odour. However, the lack of low surface temperature radiators or protective covers potentially poses a risk to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A selection of resident’s rooms was inspected and all communal areas. A number of areas in the home had been redecorated and new carpets, other areas looked tired. The manager said there were plans for more refurbishment in the lounge and dining area. All areas of the home were free from odour clean and tidy. A number of residents spent time within their rooms through choice. Most residents had personalised their rooms making a homely environment. One resident said, “ I was told I could bring my own furniture in if I wanted too.” Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 17 All but four of the bedrooms have ensuite facility. Toilet facilities are situated close to bedrooms and lounge areas. Inspection of bedrooms and communal areas highlighted these areas were still without low surface temperature radiators or protective covers which pose a risk to residents. This is especially so for those residents who have a lot of falls and are unable to help themselves in such a fall. The manager said risk assessments had been carried out. Examination of these found these applied to the room and not to the resident or their capabilities. The manager was advised to undertake immediate risk assessments and develop an action plan to provide protective covers for radiators ensuring the resident who are most at risk receive priority. Outside of the property is well maintained with attractive garden areas. Some of the ground floor rooms have patio doors leading to the garden. One resident said, “ I like to maintain my own garden pots for as long as I can.” Priestnall Court DS0000008578.V320200.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 27,28,29,30. Quality in this outcome area is adequate. The home has sufficiently trained staffed to meet the needs of residents. Recruitment and staff induction needs to be more thorough to ensure the continued protection of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of this inspection the home was sufficiently staffed to meet the needs of the residents. Staff were observed to have good relationships with residents. All the residents interviewed spoke highly of the staff team and said that nothing was too much trouble. Some of the comments made included “Staff treat us very well” and “I am very happy living here and the way I am treated.” Over 50 of staff had achieved NVQ2 in care with 80 completing health and safety training. There was evidence of additional training in, moving and handling, health and safety and administration of medication. Staff induction was being reviewed in line with Skills for Care. This needs to be fully implemented in order to ensure resident’s needs are met. Three newly recruited staff files were examined and were found to be lacking in some details. Start dates of employment were not always recorded making an audit trail of criminal record bureau checks and references difficult to Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 19 review. Some of the criminal record bureau and protection of vulnerable adults checks were not available for inspection. The manager said that these were held in the main office, which was locked at the time of inspection. References had been sought, some of which were not dated or stamped ‘received’ by the home. In one instance, a query on a reference had not been explored. The manager said this had been explored but had not been recorded. Priestnall Court DS0000008578.V320200.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 31,33,35,37,38. Quality in this outcome area is adequate. Residents have opportunities to influence how the home is managed. Arrangements are in place to ensure resident’s monies are safe guarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new manager has only been in post three weeks at the time of this inspection. They hold the NVQ4 registered managers award and are presently undertaking the care component training. Residents meetings take place and the minutes are distributed among the residents. The residents would like the meetings to be three monthly. The agenda showed that residents raised concerns about the television reception. Action had been taken to resolve these concerns. Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 21 The manager said quality assurance questionnaires were sent out yearly. Unfortunately, these were locked in the main office and were unavailable for inspection. Staff supervision had commenced and additional training provided. Although the home had made improvements raising staff awareness in the protection of vulnerable adults, more in depth training needs to be obtained for staff. Throughout the inspection issues that needed to be addressed like improving residents’ assessment, care planning, reviews, medication issues and risk in the environment, were discussed with the manager to enable them to develop at plan of action to improve these issues. Three resident’s financial records were examined and found to be correct. Monies held matched the recorded balances and there was no inappropriate use of funds. Professionals maintain equipment and appliances in the home and staff are trained in health and safety. The manager demonstrated an awareness of the issues she needs to work on. Priestnall Court DS0000008578.V320200.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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 2 2 Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 4/5 Requirement The registered person must ensure that accommodation is not provided to residents unless their needs have been fully assessed. The assessment must be in sufficient detail to enable care staff to meet the resident’s needs. The registered manager must ensure that service users who wish to manage their own medication are assessed as to their ability to do so, before medication is provided to them. (Timescale of 5/10/05 not met) The registered person must ensure that care plans of residents meet their assessed needs, providing staff with instructions on care delivery and communication methods. Risk assessments must be completed in full. The registered person must ensure that accident recording is completed in full, signed and dated. The registered person must ensure that start dates of DS0000008578.V320200.R01.S.doc Timescale for action 30/04/07 2. OP9 13(2) 30/04/07 3 OP7 13 31/05/07 4 OP8 13 31/05/07 5 OP29 19 31/05/07 Priestnall Court Version 5.2 Page 24 employment are clearly recorded. References must be explored fully with any anomalies recorded. Evidence that the CRB check has been undertaken must be provided. 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 OP19 OP18 Good Practice Recommendations The registered person should ensure that radiators within the home are assessed for the risk they present to the people who use the service and action to minimise the risk The registered person should ensure that in addition to the video training for the protection of vulnerable adults staff receive more in depth training. The manger should also undertake training in investigative techniques. The registered person should ensure that staff induction is carried out in line with Skills for Care Council. The registered person should ensure that a review of the policies and procedures and recording systems take especially in relation to assessments, care planning, reviews and accident recording The policy in relation to medication procedures, selfadministration and homely remedies should be reviewed to reflect procedures in the home. Discussion must take place with the pharmacist in relation to safe practices for those residents who self medicate. Documents must be signed and dated, reviewed on a regular basis. 3 4 OP28 OP37 5 OP9 6 OP37 Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Priestnall Court DS0000008578.V320200.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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