Care Home: The Manor House

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What the care home does well The home has a good system in place for assessing the needs of potential residents, planning their care and working to meet their health and personal care needs. In line with this the home has acted to promote the mental health of one resident with a referral to specialist services. A regular exercise activity held in the home aims at providing a number of benefits for residents both in terms of social activity and physical well being. A good choice of nutritious meals are provided that are clearly enjoyed by the residents. The home has obtained information and some staff have received training in the Mental Capacity Act 2005 with more planned. The home has started the process of improving the environment to provide better outcomes for residents. The home keeps residents informed of any changes and listens to their views about the home and the care they receive. Comments from resident`s representatives show the home has communicated with them well and developed good relationships in the interests of residents. There is a good approach to staff training to ensure that both nursing and care staff have the skills and knowledge they require to meet residents` needs. The home is well managed and is developing a system of quality checks. What has improved since the last inspection? Not applicable since the service is classed as `new`. CARE HOMES FOR OLDER PEOPLE The Manor House Ross Road Longhope Gloucestershire GL17 0LL Lead Inspector Mr Adam Parker Unannounced Inspection 17th July 2008 07:15 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 The Manor House DS0000071370.V364866.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. The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Manor House Address Ross Road Longhope Gloucestershire GL17 0LL 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) 01452 830291 Distinctive Care Ltd Ms Michelle Elaine Jarvis Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 30. This is the first inspection of a new service. Date of last inspection Brief Description of the Service: The Care Home is situated on the A40 on the outskirts of Longhope village, between Gloucester and Ross on Wye. Set back off the main road the house is set within its own grounds with ample parking. The bus from Gloucester stops at the end of the drive on an hourly basis. The local village is approximately half a mile away where there is a post office and a small provisions shop. There are two pubs locally. The nearest GP surgery is in the town of Mitcheldean. Private accommodation within the home is predominantly single bedrooms. All bedrooms have a washbasin or en suite facility and there are ample communal toilets and bathrooms. The ground floor offers a dining room and a separate, large communal lounge with dining space. The current private fees are £595.50 to £757.00 per week. The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The service was taken over by the new providers in 2008 and was therefore classed as ‘new’ for the purposes of this inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The inspection visit was carried out by one inspector on one day in July 2008. The registered manager of the home was present for the inspection visit that consisted of a tour of the premises and examination of residents’ care files. In addition staff recruitment and training was looked at as well as documents relating to the management and safe running of the home. A sample of residents were selected for inspection against a number of outcome areas as a ‘case tracking’ exercise. Survey forms were received from residents, their relatives, General Practitioners (GP) and other health care professionals. Five residents were spoken to during the inspection visit as well as three members of staff. We requested an Annual Quality Assurance Assessment (AQAA) from the home and although this was provided after the inspection visit it was comprehensive and gave us the information we asked for. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: The home has a good system in place for assessing the needs of potential residents, planning their care and working to meet their health and personal care needs. In line with this the home has acted to promote the mental health of one resident with a referral to specialist services. A regular exercise activity held in the home aims at providing a number of benefits for residents both in terms of social activity and physical well being. A good choice of nutritious meals are provided that are clearly enjoyed by the residents. The home has obtained information and some staff have received training in the Mental Capacity Act 2005 with more planned. The home has started the process of improving the environment to provide better outcomes for residents. The home keeps residents informed of any changes and listens to their views about the home and the care they receive. Comments from resident’s The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 6 representatives show the home has communicated with them well and developed good relationships in the interests of residents. There is a good approach to staff training to ensure that both nursing and care staff have the skills and knowledge they require to meet residents’ needs. The home is well managed and is developing a system of quality checks. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Manor House DS0000071370.V364866.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 The Manor House DS0000071370.V364866.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s admission procedure ensures that all residents are admitted on the basis of a full assessment of their needs, so that they can receive the care that they require. EVIDENCE: The assessment documentation for a number of residents recently admitted to the home was looked at. These had been completed before the resident had entered the home and had been carried out by the registered manager or on one occasion the deputy manager. The home had used a Royal College of Nursing assessment form. In addition where residents were funded by a local authority, relevant information had been obtained in the form of a care plan. One resident had been transferred from another care home and another from hospital and information had been obtained from both sources. The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 9 The home does not provide intermediate care and so Standard 6 does not apply. The Manor House DS0000071370.V364866.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): 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home works well to meet residents’ health and personal care needs whilst upholding their privacy and dignity. EVIDENCE: Following the pre admission assessment and an assessment of activities of daily living, care plans are produced. These are generally to a set format although allow for specific and individualised interventions to be recorded. A number of care plans addressed nutrition with an intervention being to check meal preferences daily. On the day of the inspection visit the cook was seen carrying this out with residents. Care plans had been reviewed on a regular if not always monthly basis. Although progress and evaluation had been recorded on a daily basis. The documentation in use allows for consultation with the resident to be recorded during the care plan review. Where the needs of one resident had changed in relation to communication, a care plan had been drafted to guide staff with appropriate interventions. The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 11 Out of six survey forms received from residents, five indicated that they “always” received the care and support they needed and one indicated “usually”. Risk assessments had been completed for pressure area care and the home has a standard care plan format for pressure ulcer prevention and management. In addition equipment in use for pressure area care had been recorded. Residents are also assessed for a number of other risks such as malnutrition and falls. The home provides exercise sessions to increase upper body strength and help to prevent falls. Residents care plan files contained records of visits from health and social care professionals. The home’s AQAA document stated, “The Home follows the ‘Best Practice Guidelines’ developed by the Gloucestershire POPP programme- which provides care homes with countywide, approved protocols and clinical guidance.” The home had acted to promote the mental health of one resident by requesting a review by the mental health team, which had recently taken place. If ongoing input is provided by the mental health team the home should check if Care Programme Approach arrangements are in place and request any relevant documentation and involvement in any review meetings. Medication storage and administration systems were looked at. Medication was stored securely. Storage temperature control and monitoring was in place although no temperature records had been made. Generally medication was being dated on opening as an indication of the expiry date. Medication administration records (MAR) had no gaps in recording and any hand written entries generally had two staff signatures and had been dated. Codes had been used to clarify any occasion when medication had not been administered. A detailed homely remedies list was in place. Examination of the controlled medication record book showed that on one occasion a resident’s medication had not been given within the correct time span. The registered manager was aware of this and it was noted that other such medication was given at consistent times. In addition there was a combination of twelve and twentyfour hour clock used for recording times of administration. One system should be used in the interests of making a clear and accurate record of administration. Both GPs who returned surveys indicated that medication was appropriately managed at the home. If medication is prescribed for residents on an ‘as required’ basis, protocols or plans should be in place to guide staff in administration. An Audit had been carried out in June 2008 on medication in the home. This looked at record keeping, storage and procedures and policies. The Audit produced a number of actions and gave responsibilities to staff to carry these out. This was a good approach to checking how medicines were being handled in the home. The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 12 The AQAA document received from the home stated that staff strive to preserve the privacy and dignity of Residents. One resident spoken to confirmed that staff knocked on the door before entering her room and were polite in their manner. Surveys returned by two health care professionals indicated that the home always respected individuals’ privacy and dignity. A number of environmental improvements are aimed at improving privacy and dignity for residents. One relative of a resident commented on a survey form about staff “ They are extremely caring & treat people with respect and dignity.” The Manor House DS0000071370.V364866.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. The home takes an active role in encouraging resident’s contact with family, friends and parts of the local community providing a good degree of social contact. In addition residents receive a choice of varied and nutritious meals. EVIDENCE: The home organises seated exercise sessions for residents on a twice weekly basis. As well as providing an activity this also helps residents gain upper body strength, which can assist in, falls prevention. One resident spoken to described how they enjoyed the exercise activity held in the home. An art project was running in the home with the involvement of up to five residents that was culminating in a presentation at Gloucester Cathedral. At the time of the inspection visit the home did not have an activity coordinator although there were plans to recruit one. Resident’s interests are recorded in the form of a ‘biography’ that records life history. The home produces a newsletter and the issue for summer 2008 was examined. This provided news items and photographs about the residents and staff of the home and included a contribution from one resident in the form of The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 14 a drawing for the cover. Other residents had provided their recollections of past holidays. Holy Communion service is held in the home once a month from the local Church of England. Residents in the home are able to maintain links with the local community through a luncheon club that meets in the home on a monthly basis. This had been suspended while refurbishment was taking place in the dining room.However was part of the plans for the future of the home as well as developing further links with the local community. The home places no restrictions on times of visiting with this confirmed on a survey form from one relative of a resident who also noted “ A good atmosphere prevails.” The home has information about advocacy services for older people Residents in the home have made use of the Age Concern advocacy service. There is also information available from the Gloucestershire Older Persons Assembly. Residents are also able to bring personal possessions into the home including furniture and examples of these were seen during a tour of the premises. The home has a menu that changes every four weeks and gives a choice of main course each lunchtime. Traditional dishes are offered as well as some more contemporary choices. Fruit juice is also provided with lunch. The evening meal consists of a choice of soup and sandwiches or a hot snack with a dessert provided. One resident commented that fruit was also provided with the evening meal. Another described the meals as “ splendid ” and one resident commented positively about the choice of dishes on offer. Surveys received from residents all gave positive indications about the meals provided. No special diets were being provided at the time of the inspection visit. The home has employed staff as ‘dining hosts’ to assist with serving breakfast and lunch. The Manor House DS0000071370.V364866.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): 16,17 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available if any resident or their representative should wish to make a complaint and the home’s approach to training staff should ensure that residents are protected from abuse. EVIDENCE: The home had not received any written or verbal complaints since registration. A suggestion and feedback box is provided in the home for the use of residents or their representatives. The complaints procedure is displayed on the wall in the entrance hall of the home. Six residents returned survey forms and all indicated that they knew how to make a complaint. Out of nine survey forms received from relatives of residents, six indicated that they knew how to make a complaint. When spoken to residents stated that they were kept informed about developments in the home and one commented that residents were listened to. In relation to resident’s legal rights, the home has information on the Mental Capacity Act 2005 and training has been provided for some staff with more planned. The registered manager also demonstrated a good awareness of legal issues regarding the liberty of residents. The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 16 A number of staff in the home had received the ‘Alerter’s’ training in adult protection provided by the local authority with one member of staff attending the enhanced training in this area. The majority Staff that had not attended the training were booked to do this in September 2008. Staff induction includes ‘whistleblowing’ and questions on adult protection. Although the home had a copies of the local authority ‘Alerter’s guide’ it did not have it’s own policy on adult protection. The Manor House DS0000071370.V364866.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 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Maintenance work and refurbishment were being carried out to provide residents with a safe environment suitable for their needs. EVIDENCE: A tour of the premises was undertaken. Refurbishment work had started in a number of areas including the dining room and work to provide a new ‘wet room’ and toilet in place of outmoded toilet facilities on the ground floor. When spoken to a number of residents were aware of the new facilities and were positive in their view of these. An interesting touch were photographs relating to the history of the home that have been displayed in the entrance hall. Following an inspection by the local authority a deep clean had been carried out on the kitchen and further refurbishment work was planned. Work had also been carried out on a new hairdressing room which will allow hairdressing and podiatry treatments to be carried out in private and away from communal The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 18 areas. Outside the fishpond had been emptied and the area was awaiting further development to provide an area accessible to residents with paths and seating. The registered manager indicted other areas outside of the building where further development would allow access for residents. Improvements had been made to a number of individual rooms such as provision of new furniture and washing facilities. The home was noted to be generally clean despite the ongoing work. The laundry has washable wall surfaces. Consideration needs to be given to the type of flooring used throughout this facility although it was reported that it may be re-sited within the home. Although this outcome area is rated as adequate it reflects the situation in the home at the time of the inspection visit. It is accepted that ongoing work in the home when complete will provide better outcomes for residents. The Manor House DS0000071370.V364866.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 good. This judgement has been made using available evidence including a visit to this service. Sufficient staff are deployed and training is undertaken in a number of areas to meet residents needs. EVIDENCE: At the time of the inspection visit, staffing for 24 residents was one registered nurse on duty during the day with four or five care staff in the morning and four in the afternoon. At night there is one qualified nurse and one care assistant on duty. Ancillary staff in the home consisted of a cook and a kitchen assistant, a laundry worker, a cleaner and a maintenance worker. Out of ten care staff employed in the home, seven had achieved an NVQ level two in health and social care and three of these have achieved an NVQ at level three. There has been no recruitment at the home under the new registration. A discussion was held with the responsible individual regarding the requirements for staff recruitment under the Care Homes Regulations 2001 and amendments. In addition the responsible individual confirmed that any new staff recruited would receive induction training in line with national specifications. The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 20 Staff had received training in care planning, dementia and in a number of other areas relevant to the needs of the residents in the home. Nursing staff had undergone clinical training in a number of areas including ‘Early Recognition of the Sick and Deteriorating Resident.’ Staff spoken to confirmed the training courses they had attended. The Manor House DS0000071370.V364866.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): 31,33,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed in the interests of residents with a developing quality assurance system. A number of further safety checks would ensure that the safety and welfare of residents is fully promoted and protected. EVIDENCE: The registered manager is a registered nurse and has achieved the registered managers award. She has previously managed a nursing home and has in the recent past worked for a project to raise standards in care homes in Gloucestershire. Recently she has completed training in adult protection as well as some clinical nursing training. The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 22 The arrangements for looking after residents’ money was looked at and satisfactory arrangements were in place with records kept. A check on the money held for one person showed this to be accurate in relation to the records kept. The home is developing its quality assurance systems with plans for obtaining feedback about the service provided using a number of methods such as audits and surveys. Staff have received training in infection control, food hygiene, moving and handling, first aid and the control of hazardous substances. During the inspection visit staff were observed moving a resident in the lounge with a hoist and sling. Staff explained their actions to the resident throughout the procedure. The home has a fire risk assessment and fire awareness training has taken place. At the time of the inspection visit the home had not received a visit from the fire safety officer. The home has ensured the servicing and maintenance of electrical and appliances as well as hoists, the lift and fire equipment. It was unclear if the electrical installation had been checked and this should be investigated. Regular checks are made and recorded on hot water temperatures. Records showed that these had been maintained at appropriate levels. Checks are also made on lights and call-bells. A system of checks should be introduced to ensure that all window restrictors are functioning correctly and the management of the home are made aware of any that are not in the interests of residents’ safety. A risk assessment had not been completed regarding the potential risk to residents from Legionella in the home. This should be completed with reference to guidelines published by the Health and Safety Executive. Cleaning materials were securely stored with no decanting from large to small containers evident. Following some problems with the heating, work was planned to improve the heating system before the winter. At the time of the inspection visit there was no risk assessment in place regarding the security of the premises and one should be completed in the interests of residents safety and security. Accidents had been recorded appropriately and there were plans to audit these in the future. The Manor House DS0000071370.V364866.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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Not applicable. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action No Statutory Requirements. 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 OP7 Good Practice Recommendations Where residents are receiving input from mental health services, the home should check if Care Programme Approach arrangements are in place and request any relevant information and involvement in any review meetings. One time system should be used for recording the administration of controlled medication. Protocols or plans should be in place to guide staff in the administration of medication prescribed on a PRN or ‘as required’ basis. Keep a record of medication storage temperatures to check that medication is being kept at the correct temperature. The home should draw up it’s own policy and procedure to guide staff in responding to any allegation of, suspicion of or actual abuse of a resident. Checks should be made on window restrictors to ensure they are functioning correctly in the interests of residents’ DS0000071370.V364866.R01.S.doc Version 5.2 Page 25 2 3 4 5 6 OP9 OP9 OP9 OP16 OP38 The Manor House 6 7 8 OP38 OP38 OP38 safety. A risk assessment for Legionella should be completed taking into account guidelines from the Health and Safety Executive. A risk assessment should be completed regarding the security of the premises. A check should be made as to when the electrical installation is due a safety inspection. The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Manor House DS0000071370.V364866.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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