Care Home: Woodlands Nursing Home

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What the care home does well The care plan is a working document reviewed regularly involving the person and their representatives, as appropriate. Reviews focus on asking what has worked for the individual, where there are progress, achievements, concerns and identifies action points. Individuals are actively encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and facilities are available for them. People using the service are given the opportunity to take part in a variety of activities both within the home and in the community.Woodlands Nursing HomeDS0000019048.V378459.R01.S.docVersion 5.2The home tries to be flexible and attempts to provide a service that is as individual as possible, using its staff and resources effectively. People have access to health care services both within the home and in the local community. The service has a complaints procedure that is clearly written and easy to understand. It is available on request in a number of formats. The home is well lit, clean and tidy and smells fresh. There are consistently enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity. What has improved since the last inspection? The provider has recruited new qualified staff and implemented a key worker system with key workers having weekly meetings and monthly reviews. Named nurse review takes place every fortnight and a manager’s review is held once a month. Improvement has been made with regards to the storage of medication. Staff training has started and is ongoing in order to promote the delivery of person centred services. Staff supervision has also commenced. Staff awareness to safeguarding vulnerable adult issues have been outlined through ongoing training. New furniture has been bought for the dining room and living room. Some of the bedrooms have been repainted. What the care home could do better: The provider must ensure that the administration/non-administration of all medication must be recorded accurately at all times for the health and safety of people who use the service. The provider must also ensure that medication is administered as prescribed at all times, with a record of the dosage administered where a dosage range is prescribed. There must be clear direction for all items of medication to ensure that people are receiving their medication accordingly and as prescribed by the General Practitioner. Presently enforcement action is being considered for continued failure. Staff files must contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001 for the delivery of good quality services and for the protection of residents.Woodlands Nursing HomeDS0000019048.V378459.R01.S.docVersion 5.2 Key inspection report CARE HOMES FOR OLDER PEOPLE Woodlands Nursing Home Woodlands Nursing Home 38 Smitham Bottom Lane Surrey CR8 3DA Lead Inspector Mohammad Peerbux Key Unannounced Inspection 11th November 2009 09:50 DS0000019048.V378459.R01.S.do c 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 homes for older people 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. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.2 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 Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands Nursing Home Address Woodlands Nursing Home 38 Smitham Bottom Lane Surrey CR8 3DA 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) 020 8645 9339 F/P 020 8668 9371 Regal Care Homes (Woodcote) Limited Manager post vacant Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow one specified resident with a learning disability to be admitted for as long as the home can continue to meet all of the resident`s assessed needs. 10th March 2009 Date of last inspection Brief Description of the Service: Woodlands is a home registered for up to eighteen people who, because of their age and general infirmity, require nursing care. Its relatively small size lends itself to the creation of a homely atmosphere not always seen in larger establishments. The home is situated in the pleasant suburb of Purley, within reasonably easy reach of the centre of Croydon and well placed for access to road and rail links. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This unannounced visit to the home was undertaken as a part of the inspection process for the year 2009/2010.The inspection was carried out by two regulation inspectors. In writing the report, consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. The new acting manager facilitated the inspection. Some of the residents were spoken to, however due to their cognitive ability it was difficult to seek their views. One visiting relatives commented “we are always welcomed very warmly; as soon as we arrive they bring us tea or coffee and biscuits, they are all so friendly”. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. A tour of the building was also carried out. The home continues to fail the medication standard and we are presently considering enforcement action. What the service does well: The care plan is a working document reviewed regularly involving the person and their representatives, as appropriate. Reviews focus on asking what has worked for the individual, where there are progress, achievements, concerns and identifies action points. Individuals are actively encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and facilities are available for them. People using the service are given the opportunity to take part in a variety of activities both within the home and in the community. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.2 Page 6 The home tries to be flexible and attempts to provide a service that is as individual as possible, using its staff and resources effectively. People have access to health care services both within the home and in the local community. The service has a complaints procedure that is clearly written and easy to understand. It is available on request in a number of formats. The home is well lit, clean and tidy and smells fresh. There are consistently enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity. What has improved since the last inspection? What they could do better: The provider must ensure that the administration/non-administration of all medication must be recorded accurately at all times for the health and safety of people who use the service. The provider must also ensure that medication is administered as prescribed at all times, with a record of the dosage administered where a dosage range is prescribed. There must be clear direction for all items of medication to ensure that people are receiving their medication accordingly and as prescribed by the General Practitioner. Presently enforcement action is being considered for continued failure. Staff files must contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001 for the delivery of good quality services and for the protection of residents. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.2 Page 7 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. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 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 who may use the service and their representatives have the information needed to choose a home that will meet their needs. EVIDENCE: The home understands the importance of having sufficient information when choosing a care home. It has innovative ways of helping prospective individuals to choose a home that will meet their needs and preferences. The previous inspection highlighted shortfalls in the process by which residents were assessed prior to their admission into the home. Full information is given to all prospective people and their families by way of a copy of the home’s Service Users Guide and the Statement of Purpose .The Service Users Guide is available in four formats: standard print, large print, picture language and Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 10 audio (for the visually impaired). Standard 3 has not been assessed as there has not been any new admission to the home since our last inspection. According to the Annual Quality Assurance Assessment (AQAA) which was filled in by the provider, every prospective person is visited either in their home or in the hospital/care home where they are staying prior to their admission to Woodlands. During these visits a pre assessment form is filled out, which is then used alongside reports from the Social work team, nursing team, community psychiatric nurse and any other information gained from any other sources to help the staff make the decision if the person’s needs can be met within the home. The information gained is also used to form the base of the care plan, alongside likes and dislikes and life histories. This home does not offer intermediate care. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are having their healthcare needs met in a way, which suits them and they are treated with respect and dignity. However the standard regarding medication remains inadequate and potentially places individuals at risk. EVIDENCE: 3 ladies were already in the sitting room. All were well dressed, in appropriate clothing for the time of the year. They had been helped to put on their make up, they are able to visit the hairdresser weekly and they have regular manicures. We looked at 3 care plans. They were well organised and comprehensive. They contain all of the information that would be needed for care staff to support them in the way that they prefer. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 12 Any problems have been identified with information about how they will be addressed and they are updated regularly. We could see that the resident and their relatives had been involved in compiling the plans and that they had been offered the opportunity to take part in the review process. We were told that care plans are audited by both the trained nurses and the manager on a regular basis. Risks have been identified and assessments undertaken. This includes for falls, bedrails and medication. Moving and handling plans are up to date. Equipment is in place for those identified as being at high risk of developing pressure sores. Life history work has been undertaken in order to understand about resident’s previous lives and achievements and about things that they particularly like or dislike. We especially liked the information titled referring to “my day at Woodlands”. This details how the resident prefers to spend their day and includes information about when they like to get up, go to bed, activities that they enjoy and their dietary preferences. They include picture prompts for those residents who have problems with communication. There was evidence that other healthcare professionals are consulted where it is appropriate, such as the GP and optician. However the standard regarding medication remains a concern to us as this could potentially place people at risk. The medication administration records (MAR) for all six residents were audited. There were two instances where the items of medication had been administered but not signed for. The administration/non-administration of all medication must be recorded accurately at all times for the health and safety of people who use the service. It was noted that on several occasions the staff were not keeping a record of the dosage administered where a dosage range is prescribed. For example one resident was prescribed “Tramadol” capsules 50mg one or two to be taken, no record was on the medication administration record (MAR) sheet on how many was being administered. A requirement was issued at the last inspection regarding the same issue. The provider must ensure that medication is administered as prescribed at all times, with a record of the dosage administered where a dosage range is prescribed. It was also noted that some items of medication was prescribed as directed no other directions were seen for administration. There must be clear direction for all items of medication to ensure that people are receiving their medication accordingly and as prescribed by the General Practitioner. This will ensure the health and wellbeing of the individuals as far as medication is concerned. Again this was a requirement made at the last inspection. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 13 The storage of medication has improved and items of medication are being kept at the correct temperature. This is in line with a requirement made at the last inspection. From our findings during this and the previous inspections, the provider continues to fail on the standard regarding medication and presently we are considering enforcement action. Personal care is delivered in residents own rooms and we observed staff talking with residents I a very pleasant and polite way. Both residents and their relatives told us that staffs are very kind with one person telling us “they do their utmost”. The relatives we spoke with said “we are always welcomed very warmly; as soon as we arrive they bring us tea or coffee and biscuits, they are all so friendly”. Staff are currently undertaking training in relation to The Gold Standard Framework. This will help them to understand and meet the needs of those people who are nearing the end of their lives. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 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 who live in this home consider that they have a lifestyle, which suits them. They are encouraged to make choices in order to maximise their independence wherever possible and they enjoy the meals that are served in the home. EVIDENCE: Residents told us that they are free to choose how they spend their day in Woodlands. One lady stays in her room all the time, watching television and another one told us that she sometimes joins the others in the lounge but not always. We met with one resident who prefers not to get up early in the morning and she said that staff did not have any problem with that. Staff told us that they arrange activity sessions every day although two of the residents that we spoke with said that there was not anything for them to do. On the day we visited a bingo session was organised and residents seemed to be enjoying it. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 15 Visitors are always welcome and we saw that they could be received either in the sitting room or in residents own rooms. The home is organising two events for Christmas, a lunch and a tea and relatives will be invited to come and celebrate with the residents. All the people that we spoke with said the food was good in the home. One said that the “food is always nice, but I could have something else if I didn’t like it”. We observed the lunchtime meal; it was well presented and hot. The table was nicely laid with a menu, fresh flowers, tablecloths and serviettes. Drinks were available and there was help for those who needed it. The menus also have picture prompts to help residents understand what will be served. The home does hold residents/ relatives meetings and at the last one there was a focus on the food that is served in the home in order to gain peoples views. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): P People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are generally managed well, which should ensure that individuals’ and relatives’ concerns are listened to however residents might be at risk at the recruitment procedure is not always consistent. EVIDENCE: The home has a complaints procedure that generally meets the national minimum standards and regulations. It keeps a full record of complaints and this includes details of the investigation and any actions taken. There are policies and procedures for safeguarding people who use the service. The acting manager stated that most of the staff working within the home are aware of the Safeguarding Adults procedures and know how to respond in the event of an alert. The acting manager had a good understanding of how he should report suspected adult abuse. Presently there is allegation of abuse being investigated by the local social services department. The Commission will continue to monitor the situation. Due to the number of serious concerns identified at the last key inspection, a referral was made to the local safeguarding team. The home was put under review and was being monitored under the local council Safeguarding Serious Case review procedure. This has now been removed as there has been Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 17 improvement made with regards to the issues that were identified at the last key inspection and we continue to monitor progress. Please refer to staffing/management standards for staff recruitment. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 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. The home is generally hygienic and clean, homely and comfortable; this environment therefore facilitates the residents’ health and emotional wellbeing. EVIDENCE: Overall the home was decorated to a good standard throughout and appeared to be very comfortable, bright and warm. The home has a rolling maintenance programme in place. Some of the furniture in the bedrooms has been replaced. The provider has refurbished most areas in the home and repainted some of the bedrooms. New furniture has been bought for dining and living room The home is kept clean and hygienic and free from offensive odours Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 19 throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. New alcohol gel dispensers are dispatched throughout the home. 70 of staff are trained in infection control. The staff are reminded that cleaning materials must be kept locked when not in use. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are generally satisfied that the care they receive to meet their needs, however the recruitment procedure remains inadequate and this could potentially place people at risk. EVIDENCE: There are consistently enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity. We were informed that more than 50 of staff have an NVQ level 2 qualification. With regards to staff recruitment it was noted that one staff who has been recruited recently did not have all the relevant information on their personnel file. Staff files must contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001 for the delivery of good quality services and for the protection of residents. This was a requirement at the last inspection too. The service recognises the importance of training, and tries to delivers a Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 21 programme that meets any statutory requirements and the NMS. We were informed that training offered includes core training, mandatory training, client specific and personal development with some training carried out in house and others accessed externally. A training matrix is visible on the notice board as well as a staff supervision matrix. The manager is proactive in ensuring staff obtain NVQ qualifications. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home generally provides guidance and direction to staff to ensure residents receive consistent quality care however recruitment procedures must be followed more robustly for the delivery of good quality services and for the protection of individuals. EVIDENCE: Since the last key a new acting manager has been recruited. He informed us that he is a Registered General Nurse with over 34 years experience and 4 years experience in managing in a nursing/care home environment, with a Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 23 Registered Manager’s Award. He is also a registered trainer in manual handling and health and safety. Effective quality assurance and quality monitoring systems based on seeking the views of residents are in place to measure if the home meeting their aims and objectives and the statement of purpose. We were informed that Regulation 26 visits are being carried out regularly. The acting manager informed that the home does not look after any resident’s money. Regarding records keeping, there have been improvements however it was noted that there were some missing information on a recently recruited member of staff. Records of routine maintenances of equipment were seen and were up to date. Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 N/A X 2 3 Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 25 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 OP9 Regulation 13(2) Requirement The administration/nonadministration of all medication must be recorded accurately at all times for the health and safety of people who use the service. Ensure that medication is administered as prescribed at all times, with a record of the dosage administered where a dosage range is prescribed. There must be clear direction for all items of medication to ensure that people are receiving their medication accordingly and as prescribed by the General Practitioner. Staff files must contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001 for the delivery of good quality services and for the protection of residents. Timescale for action 09/12/09 2. OP9 13(2) 09/12/09 3. OP9 13(2) 09/12/09 4. OP29 19 06/01/10 Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Woodlands Nursing Home DS0000019048.V378459.R01.S.doc Version 5.3 Page 27 Care Quality Commission Care Quality Commission London Region 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). 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