Care Home: Silver Birches

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What the care home does well People are happy living at the home. They feel well cared for and have a good relationship with each other and staff. They are able to contribute their ideas about what happens in the home. Families are made welcome and are encouraged to participate in the running of the home and contribute their ideas. The Manager listens to the things that people who live at the home, staff and others say about the home and makes plans to improve things to make sure everyone is happy. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 People are given the support they need to stay healthy. The staff have lots of good training and they feel this has helped them do their jobs better. What has improved since the last inspection? The manager and staff have worked hard to do the things which we asked them to do at the last inspection and this has improved the care and support for the people who live at the home. The manager has worked with the local authority to look at ways to improve things and make sure people’s needs are met. People who live at the home have had more opportunities to make decisions about their lives and things that happen at the home. The manager has plans for them to have even more support to do this in the future. What the care home could do better: The staff need to make sure they always give people the best support with their medication so that they stay healthy and safe. The manager needs to make sure all the staff have regular, planned supervision meetings and opportunities to appraise their own work so that their practice improves and everyone has a consistent approach. Key inspection report CARE HOME ADULTS 18-65 Silver Birches 2-6 Marchmont Road Richmond Surrey TW10 6HH Lead Inspector Sandy Patrick Key Unannounced Inspection 26th November 2009 10:00 Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Silver Birches Address 2-6 Marchmont Road Richmond Surrey TW10 6HH 020 8948 5423 020 8332 7286 silverbirches@efitzroy.org.uk www.efitzroy.org.uk Elizabeth FitzRoy Support 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) Ms Bose Ogunlolu Care Home 15 Category(ies) of Learning disability (15), Physical disability (15) registration, with number of places Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd April 2009 Brief Description of the Service: Silver Birches is registered for fifteen people who have a learning disability and may also have a physical disability. The service is owned and managed by Elizabeth Fitzroy Support, a national charity who provide residential support, day care and support for people in their own homes. The home is in Richmond, a short distance from the town centre. There are good transport links and local shops. The home has its own car park and vehicle. The home is divided into three separate flats and a day centre that is part of the service. The Community Team for People with Learning Difficulties work with the staff to offer support. The home is staffed 24 hours a day and each flat and the day centre have their own allocated staff. Fees charged range from £940.00 to £1,235 per week. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection included an unannounced visit to the home on the 26th November 2009. The inspection visit was made by a regulation inspector and a pharmacy inspector. The pharmacy inspector looked at how medication is managed at the home. Their report is included in Section 4 of this report. We met with some of the people who live at the home, staff on duty and one of the deputy managers. The manager was not at the home on the day of our inspection. We looked at records, the environment and how people were being cared for. We asked the manager to complete a quality self assessment about the service. We wrote to people who live at the home, their representatives, staff and other professionals and asked them to complete surveys about their experiences. We looked at all the other information we had received about the home since the last inspection. Some of the things people said about Silver Birches were: ‘They give a lot of care and support and use the community a lot.’ ‘They go the extra mile.’ ‘It provides a safe haven and they treat people with respect.’ ‘Silver Birches is nice.’ What the service does well: People are happy living at the home. They feel well cared for and have a good relationship with each other and staff. They are able to contribute their ideas about what happens in the home. Families are made welcome and are encouraged to participate in the running of the home and contribute their ideas. The Manager listens to the things that people who live at the home, staff and others say about the home and makes plans to improve things to make sure everyone is happy. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 6 People are given the support they need to stay healthy. The staff have lots of good training and they feel this has helped them do their jobs better. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have enough information and opportunities to visit the home to help them make a decision about moving there. They have their needs assessed to make sure the home is the right place for them. EVIDENCE: No one has moved to the home since our last inspection. There is a good range of information available for people who are interested in moving to the home. The organisation has procedures so that the manager assesses people’s needs to make sure the home is suitable for them. People who are interested in moving to the home are able to visit and spend time there before making a decision. The manager told us that the way in which people’s needs are assessed before they move to the home has improved over the last year. She also told us that the people who live at the home are helping to develop more information for people who are thinking about moving there, this will include a DVD guide. At the last inspection in April 2009, people told us that they had enough information to help them make a decision about moving to the home. They Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 9 said that they had been able to visit and had short stays there before deciding to move there. Some of the things people said were, ‘my family visited the home to see if it would be suitable for my care and various needs, they visited 20 other homes’, ‘we chose the home for our relative, but she had odd days and weekends there to make sure she was happy before she moved in’, ‘my parents came to view the home and we liked it’ and ‘I had visits and short stays and met other residents and staff, got to know the routine’. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given support to meet their needs and the staff are well informed about these needs through care plans, regular reviews and close work with families. People are starting to be consulted and have more choice about their lives. They would benefit from even more choice and control. EVIDENCE: People told us that they were happy with the care they received. They told us that they were able to make choices about the things that they did each day. Everybody has their needs recorded in a care plan. Over the past few years the staff have worked hard to improve these. Information is now clearer and based around what the people living at the home want, including their personal preferences. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 11 Everyone’s care plan identifies their individual wishes and choices. There are clear guidelines for staff telling them what support each person needs. Care plans have been regularly updated. The staff have assessed the risks which each person experiences and have recorded these assessments. They have looked at how risks and choices affect people’s wellbeing and how opportunities to take risks might benefit them. The assessments are very comprehensive. They are regularly reviewed. We saw that new assessments had been made following incidents where people had been injured or had an accident. The staff have signed risk assessments to show that they have read and understood these. The staff have tried to introduce things to help people to make more decisions about their lives. However, we felt that this was an area they could improve further. The staff use some photographs and pictures to help people decide what food they want and to help them remember where things are kept. But they need to do more of this so that people have even more information so that they can make informed choices. In some flats there were pictures to tell people which staff would be on duty, but in other flats there were not. This information needs to be clear for everyone. There is a forum for people who use services in the organisation and they meet every few months. People who live at Silver Birches are able to participate in this forum if they wish. They are able to contribute their ideas and opinions about the services. The manager told us that in the last few months people who live at the home have been involved in recruiting the staff who support them. This is really positive. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 11, 12, 13, 14, 15, 16 & 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to participate in different activities and educational opportunities. This is an area the home has improved and is continuing to improve to make sure people get the support they need to do things of their choice. People are able to see their friends and families when they want. People are treated with respect and dignity. EVIDENCE: People we met seemed happy and relaxed. People told us that they liked living at the home and were able to do the things that they wanted to do. One person told us, ‘I like the music and activities’. Another person said, ‘we have a lot of activities’. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 13 There is an activity centre at the home and people who live there can use the resources, which include a trampoline. People are able to make individual choices about what they want to do. People told us that they were supported to go out shopping, swimming, places of worship and to places of interest. They told us that they also did things at home like helping with the cooking. There is an activities coordinator. Their role is to create an individual plan of activities for each person and make sure their needs are being met. Family members told us that they visited regularly. Some of the family members help out at the home with activities, such as cooking and gardening. There is a quarterly meeting for family members where they discuss planned projects for the home and arrange special events. We saw that the staff were polite, caring and respectful towards people who live at the home. We saw that they communicated well about what they were doing, asked for people’s views and opinions and gave them choices. We saw the staff knocked on people’s bedroom doors before entering. When we spoke to staff about individual people, they showed us that they knew them well and that they were fond of them. People who live at the home are involved in preparing meals. All food is freshly prepared. appropriately stocked with fresh food and fruit. meals, snacks and drinks. One person said, ‘nice choosing, shopping for and We saw that kitchens were We saw staff offering people food’. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to stay healthy and have their personal needs met. People are supported with their medication, although there needs to be further improvements in this area to make sure people are always safe. EVIDENCE: People told us that they had the support they needed to stay healthy and well cared for. People’s individual health and personal care needs are recorded in their care plans. We saw evidence of regular consultations with health care professionals and saw evidence that the staff had listened to these processionals and followed their advice. We saw that people’s health and weight are regularly monitored. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 15 We carried out a specialist pharmacist inspection to see how safely medicines were managed. We looked at the homes medication policy, the storage of medication and the recording of receipts, administration and disposal. We looked at the corporate medication policy and procedure and noted it to be comprehensive covering additional service specific areas such as managing epilepsy and medication away from the home. We noted additionally that there were local procedures available in each flat regarding ordering and administration of medication. Each resident had their own medication folder which contained medication profiles, Medication Administration Records (MAR) and essential information to the individual. We noticed that allergies were printed on the MAR but that these did not always correlate with information in the care plan. We noticed that there were daily check sheets for staff to initial when they gave medication. But on the day of the inspection we noted that there were gaps on the MAR for the administration of sodium valproate liquid and two laxatives. The check lists had been signed and witnessed and staff concerned told us that they had given the medicines but had not signed the MAR. An audit of a laxative suggested that it had not been given. We looked at all the MAR and otherwise records were accurate with no omissions or reasons for not giving. We counted several medicines supplied in the original packs and with the exception of the laxative and sodium valproate tablets where there were two tablets short, all balances were correct. We noticed that there were good guidelines for giving all as required or (PRN) medicines. Sometimes when the dose was variable e.g. lactulose one or two spoonfuls the actual dose given was not stated. Several residents were prescribed rectal diazepam and there were individual protocols available for how to manage seizures. There were charts to record when and how long seizures occurred and what the action taken was. We noted on the seizure charts that no resident had needed rectal diazepam but that it was not listed on the current MAR’s. All staff received training on how to administer rectal diazepam and we noticed in the training records that training was current. Storage of medication was good in all units. Trolleys were secured to the wall and fridge medicines were stored in a lockable container in the domestic fridge. Dates of opening were written on liquid medicines and eye drops and there was no excess stock of any medicines noted. We noticed that the home kept a schedule 3 controlled drug Temazepam.This was not stored in a controlled drug cabinet as per the Misuse of Drugs Act. We looked at three care plans and noticed that they were very person centred with personal information on how the residents took their medicines with risk assessments. There were records of visits by healthcare professionals and information on individual medicines. We noticed that weight was recorded and that an exercise programme was initiated when weight gain was increasing. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 16 Team leaders carried out weekly audits and there were 6 month assessments for all staff. We looked at the training file and that all staff had received medication training. We were told that further training was planned for all staff at the beginning of December 2009. Overall we were satisfied that medication was handled safely in the home. Much work had gone into systems for recording and checking and auditing. Perhaps some thought could be given to simplifying processes and ensuring that there is consistency in documentation between flats and files. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to make a complaint and procedures which are designed to protect them are in place. EVIDENCE: People told us that they knew how to make a complaint and who to talk to if they were unhappy about anything. There is an appropriate complaints procedure and a record of all complaints. The organisation has procedures on abuse and whistle blowing. The staff are aware of the local authority procedures and have had training in this area. The staff demonstrated a good understanding of what to do if they suspected abuse. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained and clean environment. EVIDENCE: The building is divided into three flats. Each flat is decorated and furnished according to the needs and wishes of the people living there. The building is generally well maintained with some areas of wear and tear. We felt that areas of the home could be made more homely. The home employs a full time maintenance worker who updates decoration and attends to repairs as needed. People told us that they liked the building, their bedrooms and the garden. They told us that the home was kept fresh and clean. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by staff who have training and support. There are systems in place to make sure the staff who are recruited are suitable. The staff do not always have regular formal supervision and they need this to make sure they are caring for people in the best possible way. EVIDENCE: People told us that they liked the staff and found them kind and caring. One person said, ‘the support workers are nice’. Some of the things the staff told us were, ‘we work well as a team’, ‘good communication’ and ‘I am happy working at Silver Birches’. There are appropriate procedures for recruiting staff and we saw that checks are made on staff suitability to work in the home. These include formal interviews, reference checks and criminal record checks. The manager told us Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 20 that people who live at the home have been involved with recruiting staff and some people have interviewed potential staff. There is information for the staff on how to do their jobs. The staff told us that they went on a range of training and we saw evidence of regular training and updates when needed for all staff. We saw that there were regular team meetings for the staff team. The managers told us that they had started to make sure all staff had regular individual meetings with their line manager to discuss their development and work. We found that some staff had not had regular individual meetings. We felt that all the staff needed more regular planned individual meetings. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a service which is well managed. EVIDENCE: The manager is appropriately qualified and experienced. Since she has worked at the home she has introduced changes and made improvements. She works with other agencies to help make sure people living at the home get the support they need. People told us that they found the manager approachable and that she listened to what they had to say. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 22 The organisation makes regular checks on the quality of the service. They hold regular staff forums and forums for people who live in their services. The manager completed a very comprehensive quality self assessment for us. This showed how the service had improved and areas which needed further improvement. We saw that the manager was committed to making further changes which would benefit the people who live at the home. She showed how she had consulted people who live there about the things that they want. There are recorded checks on health and safety at the home and these show that any problems are identified and action taken to make sure people are kept safe. The managers have quarterly health and safety meetings which look at all the accidents, health and safety concerns and checks in the home. Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 X X 3 X Version 5.3 Page 24 Silver Birches DS0000017394.V378347.R01.S.doc 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 YA20 Regulation 13 Requirement Timescale for action The registered person must 07/12/09 make sure that all current prescribed medicines including those with variable doses are recorded accurately on the MAR and when administered. If not administered the correct endorsements should be used. There should be balances carried forward for all medicines so that stock levels can be easily identified and evidence of accurate administration quickly identified. The registered person must 01/03/10 make sure that the home has a controlled drug cabinet meeting the requirements of the Misuse of Drugs Act and that Temazepam is stored in it and recorded in a register. The Registered Person must make sure all the staff have 31/01/10 regular, planned, supervision meetings with their manager. 2. YA20 13 3. YA36 23 Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 25 Previous requirement partly met 30/06/09 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 YA9 Good Practice Recommendations That the home reviews it’s auditing and records systems with a view to simplification. Particular attention should be given to ensuring that there is consistency in records of the allergic status of residents in care plans and MAR. The Registered Person should make sure people are given the information they need everyday in a format which they understand The staff should think of creative ways to furnish and make flat 2 feel more homely. 2. YA7 3. YA24 Silver Birches DS0000017394.V378347.R01.S.doc Version 5.3 Page 26 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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