Key inspection report

Transcription

1 Key inspection report Care homes for adults (18-65 years) Name: Address: RNID Mulberry House Mulberry House 70 Lichfield Street Walsall West Midlands WS4 2BY The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a key inspection. Lead inspector: Date: Mandy Beck

2 This is a review of 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. The first part of the review gives the overall quality rating for the care home: 3 stars - excellent 2 stars - good 1 star - adequate 0 star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27

3 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 Adults (18-65 years) can be found at or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: Online ordering from the Stationery Office is also available: 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. Reader Information Document Purpose Author Audience Further copies from Copyright Internet address Inspection report Care Quality Commission General public (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. Care Homes for Adults (18-65 years) Page 3 of 27

4 Information about the care home Name of care home: Address: RNID Mulberry House Mulberry House 70 Lichfield Street Walsall West Midlands WS4 2BY Telephone number: Fax number: F/P address: Provider web address: Name of registered provider(s): Type of registration: RNID Care Services care home Number of places registered: 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 mental disorder, excluding learning disability or dementia 6 0 physical disability 6 0 Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia (MD) 6 Physical Disability (PD) 6 Date of last inspection Brief description of the care home Mulberry House offers residential placements for up to six service users who may have a mental disorder (excluding learning disability or dementia) and who may also be deaf or hard of hearing. The premises are made up of 2 self-contained bed-sits and 4 flats, set within a large detached property. The offices, kitchen and sleeping in room are attached to, but are separate from the main house. The 4 flats consist of a bedroom, sitting room, kitchen and bathroom/shower. There is a separate bathroom on the ground floor for service users who prefer to bathe rather than shower. Also on the Care Homes for Adults (18-65 years) Page 4 of 27

5 Brief description of the care home ground floor is a shared sitting room leading directly onto the patio. The home has a good-sized garden and off road parking to the rear of the property. A laundry is fitted with a coin operated washing machine and dryer. All of the service users sign to say they agree to any profits from this facility to go into the service users social fund. The home is located near to the centre of Walsall, close to many shops and facilities. There is a main road to the front of the building with many bus routes to other parts of the West Midlands and the local Arboretum faces the home. The range of fees the home charges for residency are not included in the service user guide and people are asked to contact the home directly for this information. Care Homes for Adults (18-65 years) Page 5 of 27

6 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: three star excellent service Our judgement for each outcome: Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection of the home, they were given no prior notice that we were going. The inspection was completed by one inspector over a period of two days. We were also accompanied by an interpretor for the deaf, on the first day. The enabled us to talk to people using the service and the staff supporting them. We looked at all the information that we have received, or asked for, since the home was last inspected in September This included the annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical about the service. Information we have about how the service has managed any complaints Care Homes for Adults (18-65 years) Page 6 of 27

7 What the service has told us about things that have happened in the home, these are called "notifications" and are legal requirement. We looked at the care of two people who use this service in depth. This is part of our case tracking process and helps us make judgements about the home's ability to meet people's needs. Care Homes for Adults (18-65 years) Page 7 of 27

8 What the care home does well: People who use this service can feel very confident their strengths, abilities and needs will be assessed in full before they move in. People know when they move into the home they will be undertaking a programme of rehabilitation and the home will support with this. People are encouraged to be as independent as possible and to make choices and decisions about their lives. People said "I go out shopping quite alot and have also been on holiday, if I am worried about anything the staff help me talk it through". The home has good systems in place for managing complaints and concerns and people feel confident about expressing their views. They told us "if we want we can pick up a slip and report it, or we can talk to the manager". The staff team is consistent and have worked at the home for many years. All staff have the required training and skills they need in order to support the people living in this home. This means they have the knowledge and understanding to promote people's independence. The home is purpose built, people have their own accommodation for their own privacy and comfort. There are also communal rooms where people can meet and socialise if they choose to do so. What has improved since the last inspection? The home has improved the way in which it records complaints. It has also updated the safeguarding policy to give staff clearer guidance when reporting safeguarding concerns. What they could do better: We have made no requirements or good practise recommendations as a result of this inspection. 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 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line Care Homes for Adults (18-65 years) Page 8 of 27

9 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27

10 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent 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: We found that significant time and effort is spent planning to make admission to the home personal and well managed. People are only admitted to RNID Mulberry House once a comprehensive assessment of their needs has taken place. We looked at the files of three people who had come to live at the home. The assessment of their needs is used to form the basis for care planning alongside appropriate and robust risk assessments. We saw from care records and from talking to people they are involved in their care planning including any restrictions of their freedom and choice that may be necessary. People have the opportunity to visit the home before they decide that this is an appropriate place for them to live. We spoke to people living in the home and they told us, "we like to help people settle in", "I was able to come and test if out before I moved in". The home told us in the AQAA they plan to develop a pre move booklet Care Homes for Adults (18-65 years) Page 10 of 27

11 Evidence: that will explain what the home is trying to achieve. Care Homes for Adults (18-65 years) Page 11 of 27

12 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are fully involved in decisions about their lives and play an active role in planning the care and support they receive. Evidence: The key principle of the home is that the people living there are enabled to be in control of their lives. Support plans alongside risk assessments support this principle but with action to ensure that the safety of people is always the main consideration. People have their own individual plan that comprehensively details all of their care and support needs. We found support plans are person centred this means they identify all levels of needs giving staff instructions on care that people will need if their mental health deteriorates. The support plan is drawn up with the person's involvement and is agreed by them. Support plans where appropriate identified the person's goals and comments about what they felt their care needs were. We spoke to people who told us "I go out regularly, I go to work, the staff offer me the support that I need. If feel unhappy with the care that I am getting I can discuss this with the staff". Care Homes for Adults (18-65 years) Page 12 of 27

13 Evidence: The home told us in the AQAA "sign language interpreters are booked for all appointments and meetings. Mulberry house recently campaigned and won the right for a person living in the home to have made available a British Sign Language (BSL) interpreter at their place of work. This was a council run scheme and the company has now changed it's policy on the matter". Staff encourage people living at the home to make decisions about their lives, they do this by offering them choice and giving them information needed to make decisions. A staff member told us "we try to support people in whatever they want to do". People told us they manage their own finances and the home supports them in doing this. People have locked money tins that they can either keep in their own flats or in a secure location within the home. The support the home provides in relation to money varies depending on people's needs. For instance one person is currently being supported in saving for a laptop, another is paying for a Sky subscription and one person is learning how to budget their money in preparation for discharge and independent living. People have their own individual risk assessments that enables him or her to live as independently as possible. All risk assessments show the potential risk such as violence to others, self harm and misuse of substances and the methods of risk reduction. Care Homes for Adults (18-65 years) Page 13 of 27

14 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are able to make choices about their lifestyles and are support to develop their life skills. Social, education, cultural and recreational activities meet their expectations. Evidence: Central to the home's aim and objectives is the promotion of people's right to live an ordinary and meaningful life both within the home and also within the community. People's goals are identified through discussion between them and staff at the home. We found that people have been supported to find employment, others told us they are going to college to improve their chances of finding a job in the future. We were told "I enjoy going to college". People living at the home are able to enjoy a full and stimulating life. People are Care Homes for Adults (18-65 years) Page 14 of 27

15 Evidence: supported to integrate into the local community with people telling us on the day of our inspection. "I go to the library, bank, shops and visit friends when I want to". Daily routines are incorporated into people's own person support plans. One person told us "I like to use the internet and ebay", another person said "I enjoy going to Wales and like to watch the football". The home has developed an "action" member of staff who makes sure that each person's wishes and wants are recorded and then signed off once completed. This gives the home a clear record of what people have asked for and what they need to do in order to meet their wishes. There are no fixed meal times due to the individual nature of the cooking arrangements. People are encouraged to sit with their key worker and plan their shopping and menu's. Staff will help each person to prepare and cook meals as outlined in their individual care plans. At present the home is working with people teaching them how to cook a roast dinner. One person said "I don't like the teaching bit much but I do enjoy the food at the end, I love a good Sunday dinner". All food is prepared and cooked in the privacy of people's own flats. The home routinely completed risk assessments for each person that looks specifically at their nutritional intake. People are supported to make choices about their diet. One person told us "I have started to look after my weight, I have bought low calorie beer". There are regular meetings where people can discuss events that are happening in the world, lifestyle issues and health concerns. Recent topics for discussion have included healthy eating and weight loss and hygiene products. Care Homes for Adults (18-65 years) Page 15 of 27

16 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practise. Evidence: There are appropriate arrangements in place to ensure that people have the health and personal care that they need. We saw evidence that people are seen by other professionals such as psychiatrists, community mental health nurses, doctors, chiropodists, dentists and opticians depending on their needs. We were also able to see that staff support people to take responsibility for their health care needs such as hospital appointments and collecting and ordering medication. There are support plans in place to manage specific health care needs for some people. In order to support people with specific health care problems staff have all undertaken further training so that they can do this. We spoke to people about how the home supports them when they are not well or in need of medical attention. They told us "the staff know before me that I need help, they recognise very quickly". We spoke to staff about how they recognise people's relapse signatures in relation to their mental health. It was very evident that all of the Care Homes for Adults (18-65 years) Page 16 of 27

17 Evidence: staff know and understand the needs of all of the people living in the home. The home has a policy and procedure for the safe handling of medication including self medication. All staff receive training prior to taking any responsibility for people's medication. We looked at the systems in place for the safe storage and administration of medication. We have made two good practise recommendations in order to improve the process further. Care Homes for Adults (18-65 years) Page 17 of 27

18 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at this home are able to express their concerns and have access to a robust and effective complaints procedure. The home makes sure that people are protected from abuse and have their rights supported. Evidence: The home's complaints procedure is widely available throughout the home. The RNID service user involvement group has now manufactured a BSL DVD explaining the complaints procedure in full BSL. An easy read script has also been published so that staff cans it with people and go through the process in both BSL and English to make sure they fully understand. The home has not had any complaints during the past twelve months. The manager told us "we like to address things as they crop up and deal with them straight away". We spoke to people about how they felt about making their concerns known. They told us "no problems at all, I am able to discuss any concerns I have", and "the staff are very quick to help and respond to any issues we raise". The home has told us there have been no safeguarding referrals made in the past twelve months. The manager makes sure that all staff have had or are currently in the process of undertaking safeguarding vulnerable adults training. At this inspection we found that staff we spoke to were clear of what may constitute abuse and what actions they should take to keep people safe and minimise any risk to them. Care Homes for Adults (18-65 years) Page 18 of 27

19 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, well maintained and provides excellent accommodation for people who live there. Evidence: All areas of the home were well maintained and clean. The home is made up of self contained flats, all of which have their own front door and their own flashing door bell. Loop systems are in place throughout the home to aid assistance with the use of hearing aids. The home has taken steps to make sure the home environment is deaf friendly with a range of equipment to enhance communication. We had the opportunity to visit one of the flats with the persons permission. It was decorated to their individual taste and the person said "I like it very much and I choose how I want to decorate it". The communal lounge has been redecorated and offers a relaxing place for people to sit and enjoy. There is a training room on site for people to use and has been re fitted with a cooking area that has fridge, cooker and sink. Care Homes for Adults (18-65 years) Page 19 of 27

20 Evidence: The garden has been furnished with a new table and chairs and high level planters for people to use. The organisation employs gardeners to care for the garden which is well kept and is a pleasant place to spend time. The laundry facilities are located in the training room and people are encouraged to do their own laundry when needed. We were reminded of good infection control practises by people living in the home. They showed us the alcohol hand rub and other hand washing facilities for reducing the risk of cross infection in the home. Care Homes for Adults (18-65 years) Page 20 of 27

21 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. people living in the home are supported by competent and qualified staff. There are sufficient staff to meets people's needs. Evidence: There are enough members of staff on duty to meet people's needs. The home has a very stable staff group and has only recruited two new staff since our last inspection. People said "the staff are very friendly and very helpful", "nothing is too much trouble for them". We spoke to staff who told us "there is alot of training and support for us", "because the staff group is stable there isn't much moving around and this means that we know what people's needs are and can meet them". All staff are trained to a minimum of National Vocational Qualification level 2 in health and social care (NVQ). Some staff have also completed NVQ level 3. Other training is in place to make sure staff are kept up to date with current best practise. such as infection control, food hygiene and first aid. In addition to this staff have also undertaken training to give them the skills to care for very specific health care needs for one of the people who live there. Staff recruitment and selection is undertaken appropriately and meets the required standard. All required checks against the Protection of Vulnerable Adults list (PoVA) Care Homes for Adults (18-65 years) Page 21 of 27

22 Evidence: and Criminal Records Bureau (CRB) have been completed. The home make sure that is obtains references for people. These measures will help the home prevent unsuitable people from working with vulnerable adults. We were told that all new staff receive formal induction training that meets "skills for care standards". Each member of staff has their own individual training plans and the organisation has good systems in place to identify when staff are due for training updates. This ensures that all staff has the required knowledge and skills to support people living at the home. All staff have regular supervision, this gives them the opportunity to discuss their progress and to identify any specific training needs they may have. The manager will also complete an annual appraisal for each member of staff. Staff we spoke to during the inspection told us that they were all satisfied with the support and supervision they received. Care Homes for Adults (18-65 years) Page 22 of 27

23 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and people's health, welfare and safety is promoted. Evidence: The home is managed by Chrissie Beckett. She has a very clear vision for the home and the direction of the service they offer to the people living there. The manager is able to demonstrate through formal qualification and professional experience she is highly competent in a range of areas. The manager is working hard to improve the overall status of the home and we have been told by people live in the home that she is approachable and very supportive. They told us "if there is a problem I know who I can talk to to sort it out", "the manager is very good she gives us all the support we need, she is very flexible and always thinks about what is best for the people living here". There is a quality assurance system in place, this includes the regular auditing of the environment, medication, and care planning, and the manager also audits untoward occurrences, accidents and incidents. This helps identify any trends that may occur and allows the manager to formulate an action plan to reduce any risk to people. Care Homes for Adults (18-65 years) Page 23 of 27

24 Evidence: Regular "resident" meetings are held which give people opportunity to discuss the home. proposed trips out and holidays. Surveys are sent out to people living at the home, their relatives and other professionals annually in a attempt to seek further information about people's satisfaction with the home or how they can continue to improve. The home has efficient systems in place to ensure that the people's money is kept safely. People are supported by staff to manage their own money. One person told us that he is currently being supported in saving for a new computer, another person told us they were having Sky television installed. We were able to see that the home has implemented and ensures that the Mental Capacity Act 2005 deprivation of liberty safeguards, are well managed to protect people living at the home. Some staff have received training and understand the Mental Capacity Act and the deprivation of liberty safeguards and their implications for day to day practise and care planning. No one is being unlawfully or inappropriately deprived of their liberty. Record keeping at the home is of a consistently high standard. Records are kept securely and staff are aware of the requirements of the Data Protection Act. Safe working practises within the home are a priority and all staff have annual updates or statutory training. This helps to keep their knowledge and skills updated. The manager has a training matrix that identifies when staff training is due so that all staff are assured of a place and do not miss out. Safety certificates for the building are all up to date; the manager indicated this in the AQAA document she completed prior to our visit. Care Homes for Adults (18-65 years) Page 24 of 27

25 Are there any outstanding requirements from the last inspection? Yes No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27

26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 20 Handwritten entries on the Medication Administration Record sheet (MAR) should be signed by two staff in order to reduce the risk of errors in transcribing occuring. This will reduce the risk to the people living in the home The home should not use pharmacy sticky labels on MAR sheets. This will reduce the risk of errors occurring, other medication being covered by the label and labels being stuck to the wrong MAR sheet. Care Homes for Adults (18-65 years) Page 26 of 27

27 Helpline: Telephone: Web: 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. Care Homes for Adults (18-65 years) Page 27 of 27