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(4)Tj ET /F1 12 Tf BT 1 0 0 1 392.28 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 423.61 140.37 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 454.95 140.37 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 486.28 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 517.6 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 548.96 140.37 Tm (9)Tj ET endstream endobj 6 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 612 792]>> endobj 7 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (2)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 768.28 Tm (Information about the care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 20.58 w 31.2 746.8 m 274.61 746.8 l S 0.001 w 1 1 1 RG 20.58 w 276.86 746.8 m 580.25 746.8 l S 0.001 w 0.95294 0.95294 0.95294 RG 73.32 w 31.2 697.6 m 274.61 697.6 l S 0.001 w 1 1 1 RG 73.32 w 276.86 697.6 m 580.25 697.6 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 648.4 m 274.61 648.4 l S 0.001 w 1 1 1 RG 20.58 w 276.86 648.4 m 580.25 648.4 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 625.57 m 274.61 625.57 l S 0.001 w 1 1 1 RG 20.58 w 276.86 625.57 m 580.25 625.57 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 602.74 m 274.61 602.74 l S 0.001 w 1 1 1 RG 20.58 w 276.86 602.74 m 580.25 602.74 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 579.91 m 274.61 579.91 l S 0.001 w 1 1 1 RG 20.58 w 276.86 579.91 m 580.25 579.91 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 735.39 m 582.46 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 659.82 m 582.46 659.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 636.98 m 582.46 636.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 614.16 m 582.46 614.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.33 m 582.46 591.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 758.22 m 582.46 758.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 735.39 m 582.46 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 659.82 m 582.46 659.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 636.98 m 582.46 636.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 614.16 m 582.46 614.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.33 m 582.46 591.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 568.49 m 582.46 568.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 759.29 m 30.07 567.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 275.73 759.29 m 275.73 567.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 759.29 m 581.38 567.42 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 742.03 Tm (Name of care home:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 742.03 Tm (Dalkeith)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 719.2 Tm (Address:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 719.2 Tm (285 Gloucester Road )Tj ET /F1 12 Tf BT 1 0 0 1 279.71 701.62 Tm (Cheltenham)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 684.04 Tm (Glos)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 666.46 Tm (GL51 7AD)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 643.63 Tm (Telephone number:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 643.63 Tm (01242522209)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 620.8 Tm (Fax number:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 620.8 Tm (01242522209)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 597.97 Tm (Email address:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 575.14 Tm (Provider web address:)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 539.2 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 519.71 m 353.25 519.71 l S 0.001 w 1 1 1 RG 20.58 w 355.5 519.71 m 565.9 519.71 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 496.88 m 353.25 496.88 l S 0.001 w 1 1 1 RG 20.58 w 355.5 496.88 m 565.9 496.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 474.05 m 353.25 474.05 l S 0.001 w 1 1 1 RG 20.58 w 355.5 474.05 m 565.9 474.05 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 508.29 m 568.1 508.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 485.46 m 568.1 485.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 531.12 m 568.1 531.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 508.29 m 568.1 508.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 485.46 m 568.1 485.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 462.63 m 568.1 462.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 532.2 m 30.07 461.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 532.2 m 354.37 461.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 532.2 m 567.02 461.55 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 514.93 Tm (Name of registered provider\(s\):)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 514.93 Tm (Camelot Healthcare Ltd)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 492.11 Tm (Type of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 492.11 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 469.27 Tm (Number of places registered:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 469.27 Tm (22)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 450.33 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 66.24 w 32.32 406.89 m 564.47 406.89 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 419.42 m 567.8 419.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 396.6 m 567.8 396.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 442.26 m 567.8 442.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 419.42 m 567.8 419.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 396.6 m 567.8 396.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 373.77 m 567.8 373.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 443.33 m 30.07 372.69 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.32 420.5 m 298.32 372.69 l S 0.001 w [] 0 d [] 0 d 2.25 w 432.52 397.67 m 432.52 372.69 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 443.33 m 566.72 372.69 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 426.07 Tm (Conditions of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 403.24 Tm (Category\(ies\) :)Tj ET /F1 12 Tf BT 1 0 0 1 302.3 403.24 Tm (Number of places \(if applicable\):)Tj ET /F1 12 Tf BT 1 0 0 1 302.3 380.41 Tm (Under 65)Tj ET /F1 12 Tf BT 1 0 0 1 436.5 380.41 Tm (Over 65)Tj ET 1 1 1 RG 35.16 w 31.2 351.68 m 297.25 351.68 l S 0.001 w 35.16 w 299.5 351.68 m 429.25 351.68 l S 0.001 w 35.16 w 431.5 351.68 m 565.9 351.68 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 370.39 m 568.1 370.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 332.98 m 568.1 332.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 371.47 m 30.07 331.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.37 371.47 m 298.37 331.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 430.37 371.47 m 430.37 331.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 371.47 m 567.02 331.9 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 354.2 Tm (old age, not falling within any other )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 339.63 Tm (category)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 354.2 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 354.2 Tm (22)Tj ET 0.95294 0.95294 0.95294 RG 109.98 w 32.32 255.37 m 564.77 255.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 289.77 m 567.8 289.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 266.95 m 568.1 266.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 312.61 m 567.8 312.61 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 289.77 m 568.1 289.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 266.95 m 568.1 266.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 200.38 m 568.1 200.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 313.68 m 30.07 199.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 313.68 m 566.72 199.3 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 296.42 Tm (Conditions of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 273.59 Tm (The maximum number of service users who can be accomodated is 22.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 250.76 Tm (The registered person may provide the following category of service only: Care home )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 236.18 Tm (providing personal care - Code PC to service users of either gender whose primary care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 221.6 Tm (needs on admission to the home are within the following category: Old age, not falling )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 207.02 Tm (within any other category \(Code OP\))Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 185.59 m 315.25 185.59 l S 0.001 w 1 1 1 RG 20.58 w 317.5 185.59 m 346.55 185.59 l S 0.001 w 20.58 w 348.8 185.59 m 377.9 185.59 l S 0.001 w 20.58 w 380.15 185.59 m 409.2 185.59 l S 0.001 w 20.58 w 411.45 185.59 m 440.55 185.59 l S 0.001 w 20.58 w 442.8 185.59 m 471.9 185.59 l S 0.001 w 20.58 w 474.15 185.59 m 503.2 185.59 l S 0.001 w 20.58 w 505.45 185.59 m 534.55 185.59 l S 0.001 w 20.58 w 536.8 185.59 m 565.9 185.59 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 197 m 568.1 197 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 174.17 m 568.1 174.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 198.08 m 30.07 173.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 198.08 m 316.37 173.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 198.08 m 347.67 173.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 198.08 m 379.02 173.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 198.08 m 410.32 173.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 198.08 m 441.67 173.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 198.08 m 473.02 173.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 198.08 m 504.32 173.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 198.08 m 535.67 173.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 198.08 m 567.02 173.09 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 180.82 Tm (Date of last inspection)Tj ET 0.95294 0.95294 0.95294 RG 17 w 31.2 162.29 m 565.9 162.29 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 152.67 m 568.1 152.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 153.75 m 30.07 34.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 153.75 m 567.02 34.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 171.92 m 568.1 171.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 152.67 m 568.1 152.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 35.8 m 568.1 35.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 173 m 30.07 151.59 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 173 m 567.02 151.59 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 35.5 158.74 Tm (Brief description of the )Tj ET /F1 12 Tf BT 1 0 0 1 177.31 158.74 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 35.5 139.49 Tm (Since October 2007 Camelot Healthcare Limited are the new providers. Dalkeith is an )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 122.49 Tm (adapted older property, which has retained a number of its period features. It is )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 105.49 Tm (located in the St Marks area of Cheltenham. There is a post office/newsagent about )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 88.49 Tm (500 metres along the road, which is one of the main roads into the town. Buses pass )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 71.49 Tm (the front door and the railway station is close by.)Tj ET /F1 12 Tf BT 1 0 0 1 35.5 54.49 Tm (The accommodation is on four floors with a shaft lift providing access between the )Tj ET endstream endobj 8 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 9 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (3)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 17 w 31.2 776.72 m 565.9 776.72 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 767.1 m 568.1 767.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 768.18 m 30.07 525.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 768.18 m 567.02 525.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.1 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 767.1 m 568.1 767.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 526.85 m 568.1 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 766.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 787.43 m 567.02 766.02 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 35.5 773.16 Tm (Brief description of the )Tj ET /F1 12 Tf BT 1 0 0 1 177.31 773.16 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 33.25 756.16 Tm (ground floor and the first floor and a stair lift from the basement bedroom to the )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 739.16 Tm (ground floor. The communal rooms consist of four lounge areas, two of which also )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 722.16 Tm (have a dining area and one lounge area is on the first floor. Sixteen bedrooms have )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 705.16 Tm (en-suite facilities. Two of these have a bath and shower respectively. Four bedrooms )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 688.16 Tm (have wash hand basins only. There are three bathrooms two of which are assisted. Of )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 671.16 Tm (these, one has a bath hoist and the other is a `walk in? bath.)Tj ET /F1 12 Tf BT 1 0 0 1 33.25 654.16 Tm (There are large gardens, and seating areas at the rear of the home. Parking for several )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 637.16 Tm (cars is available at the front of the home.)Tj ET /F1 12 Tf BT 1 0 0 1 33.25 620.16 Tm (The accommodation fees range from approximately 485.00 to 625.00 pounds based on )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 603.16 Tm (facilities/room size and additional charges include hairdressing, chiropody, escort )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 586.16 Tm (duties and newspapers. Information regarding how fees are calculated and the criteria )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 569.16 Tm (for when local authority funded places are available is in the homes Service User )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 552.16 Tm (Guide.)Tj ET /F1 12 Tf BT 1 0 0 1 33.25 535.16 Tm ()Tj ET endstream endobj 10 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 11 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (4)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 745.27 Tm (What we found:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 691.53 w 31.2 389.44 m 580.26 389.44 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 736.33 m 582.46 736.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 737.41 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 737.41 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 720.15 Tm (Pharmacist inspector's report about arrangements for the handling of medicines that were )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 705.57 Tm (inspected at a random inspection on 24th August 2009.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 690.98 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 676.41 Tm (At this random inspection one of our \(the Care Quality Commission\) pharmacist )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 661.83 Tm (inspectors specifically examined some of the arrangements for the handling of medicines. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 647.24 Tm (The home had kept us informed about a problem with medication earlier in the year and )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 632.66 Tm (the action taken to deal with this. Our inspection was to check that there were still safe )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 618.09 Tm (arrangements in place for administering and handling medicines in this home.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 603.51 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 588.92 Tm (We looked at some stocks and storage arrangements for medicines and various records )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 574.34 Tm (about medication. We spoke to the deputy manager and another member of staff who )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 559.77 Tm (administered medication. In the afternoon we spoke to several people who were sitting in )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 545.18 Tm (the lounge. We gave feedback at the end of the inspection to the deputy manager. The )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 530.6 Tm (inspection took place during a five hour period on a Monday. We thank the staff for their )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 516.03 Tm (assistance during our visit.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 501.45 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 486.86 Tm (At the time of this inspection staff supported one person living in the home to self )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 472.29 Tm (medicate and look after some of his/her medicines. Staff also supported another person )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 457.7 Tm (to apply a cream. We looked at the risk assessment for these arrangements for one )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 443.13 Tm (person and found this needed to be kept up to date as one medicine staff administered )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 428.55 Tm (was not included. It also included eye drops that were no longer used. Monthly reviews )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 413.96 Tm (were not in place as the last was signed on 28 May 2009. Staff also need to record the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 399.39 Tm (quantities of each medicine handed to the person to look after with the date. This helps )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 384.8 Tm (with checks that the right quantity of medication is being used. One staff member told us )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 370.23 Tm (they check this each day.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 355.64 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 341.07 Tm (The rest of the people living in this home were therefore totally dependent on the staff for )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 326.48 Tm (this part of their care.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 311.9 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 297.33 Tm (Care staff who had undertaken medication training were responsible for handling and )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 282.74 Tm (administering all medicines to people living in the home. We spoke to two members of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 268.17 Tm (staff about this training but were not able to look at training records as the manager )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 253.59 Tm (designate was on leave. These staff members also demonstrated knowledge of medicines )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 239.01 Tm (used and peoples' needs but we did find evidence \(see below\) that knowledge about the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 224.43 Tm (correct handling of eye drops may be lacking. There was a list of staff authorised to )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 209.85 Tm (administer medicines including their signatures and initials so that we could tell from the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 195.26 Tm (records who had signed for particular doses.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 180.68 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 166.1 Tm (At lunchtime staff administered medicines to people living in the home. They took the full )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 151.52 Tm (packs of medicines with the records downstairs to where people were sitting. A locked )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 136.95 Tm (medicine trolley was available but was not always taken downstairs when only a few )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 122.36 Tm (medicines were needed.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 107.79 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 93.21 Tm (We discussed the times for giving medication, particularly about making sure that there is )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 78.63 Tm (at least a four hour interval between doses of certain medicines and also to achieve an )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 64.04 Tm (even spread of doses throughout the day. This helps get the best effect from medicines )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 49.47 Tm (such as painkillers and antibiotics. The staff we spoke to were aware of this. We noted )Tj ET endstream endobj 12 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 13 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (5)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (that the pharmacy printed times for medicine administration on the medicine record )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (charts but these were not in fact the times when medicines were always administered so )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (staff were signing against the wrong time in some cases. For example staff told us that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (the morning medicines were administered by night staff about 6.30am yet the medicine )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (records all stated 8am. Staff told us that most people would be awake at this time and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (they would not wake people for their medicines. The advantage of giving medicines )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (around this time is that there is a better spread of doses throughout the day and there is )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (a more appropriate interval before the lunch doses. We had some concern however that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (staff who had been on duty all night were responsible for administering all the morning )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (medicines. There are the greatest number of medicines to administer in the morning and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (it is not regarded as good practice for staff who have been on duty all night to be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (responsible for this. They may lack concentration as they are tired and wanting to get off )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (duty. Staff also told us that some other printed administration times were different in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (practice.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (We looked at records for one person who has some medication administered in a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (particular way and saw that these had been developed to make sure that their best )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (interest was considered. We also spoke to the deputy manager about any cultural or )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (equality and diversity issues affecting medication for people living in this home )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (particularly as this inspection took place during Ramadan when people of Muslim faith )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (may wish to fast. This can affect treatment with some medicines. The deputy manager )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (told us that there was nothing related to medication they have identified for anyone in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (the home at the moment and nobody was fasting.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (There were arrangements for keeping records about medication received, administered )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (and leaving the home or disposed of \(as no longer needed\) for each person living in the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (home. Accurate, clear and complete records about medication are very important in a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (care home so that people are not at risk from mistakes with their medicines and so that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (there is a full account of the medicines the home is responsible for on behalf of the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (people living there.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (We looked at some medication records for the previous last two weeks and these showed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (routinely administered medicines were all signed as administered and that these )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (medicines were all in stock. This indicated that people living in the home were receiving )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (their medicines as prescribed. We also made some checks of the packs of medicines on )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (the trolley which also helped to confirm this. We noted just a few issues from the records. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (For one person who was prescribed a variable dose of one or two tablets staff did not )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (always record what dose they gave. Staff we spoke to gave a different response about )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (the dose taken. We noted that the allergy box on the medicine charts recorded a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (penicillin allergy for one person. This box was blank on the other charts. It is good )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (practice to ask the pharmacy to print an entry in here even if this is 'none known' so that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (it clear this has been considered. Staff told us they were not aware of any other allergies. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (We also saw that some people were prescribed eye drops but the records did not always )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (indicate which eye. Staff were able to tell us about this. One person was recently )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (prescribed a cream but the records were not signed to indicate it was applied. This cream )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (should have been kept in the fridge but we found one new tube on the trolley and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (another in the medicine cupboard. We noted that some medicine charts seemed to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (contain medicines that were no longer in use but this was not clearly indicated.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (Some people living in the home were prescribed medication only to use 'when required'. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (Staff gave us some explanation about how they would use some of these medicines and )Tj ET endstream endobj 14 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 15 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (6)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (that in some cases the person would be able to state their need for a particular medicine. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (It is important that there is clear written guidance for each person about how such a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (medicine is to be used to meet their identified needs. We discussed with the deputy )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (manager straightforward ways to achieve this. Any consideration of the requirements of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (the Mental Capacity Act 2005 must be included. We saw in one case the use of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (medication for pain was included in a care plan. We looked in some other care plans and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (found that some needed updating as information about medication was not current. The )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (monthly reviews were not always signed as carried out.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (Two people were prescribed liquid food supplements. We saw some records in place but )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (there were none for a third person who we found supplies for in the medicine room. The )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (care plans for these people needed reviewing as there was wrong information about the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (product used. This is an important part of treatment that the doctor has prescribed so )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (care plans need to include full up to date information about intended use and be reviewed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (regularly. We have published information about administration and recording of creams )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (and nutritional supplements on our website \(www.cqc.org.uk\) so this must be followed.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (We looked at the arrangements provided for storing the medicines and although these )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (were generally suitable there were some matters needing attention. The room felt warm )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (and a temperature of 25.6 degrees centigrade was recorded. This is very slightly above )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (the maximum recommended for medicine storage. It was possible the heat gain from the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (medicine fridge kept in this closed room could be the reason for this. The medicine fridge )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (was too cold at the time we inspected; this could lead to degradation of medicines stored )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (in here. There were arrangements for recording the temperature in the medicine fridge )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (and these also showed that it had previously sometimes been too cold. This gave the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (wrong temperature range for a medicine fridge \(0 to 5 degrees centigrade but it should )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (be 2 to 8 degrees centigrade\). The temperature control on the fridge was adjusted during )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (the inspection. The fridge needed defrosting as there was a considerable build up of ice. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (The temperature probe for the thermometer may be in the wrong place as it was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (positioned close to the ice box.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (There was a metal medicine cabinet but there was no separate storage for controlled )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (medicines so these arrangements do not comply with the Misuse of Drugs \(Safe Custody\) )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (Regulations 1973. All care home must comply with this now to make sure of safe storage )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (for this group of medicines. We publish information about this on our website )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (\(ww.cqc.org.uk\) so this must be followed. There was a standard record book in place for )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (keeping the extra records needed for this group of medicines. More attention to detail in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (these records were needed in order to keep a full account of these medicines. Some )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (pages did not have a proper heading with the strength or even name of the medicine. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (Some entries were crossed out which is very poor practice and there were some )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (medicines included in here which should not be included in these records. The stock )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (balances on some pages were wrong as stock was showing that was not in the home. The )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (deputy manager said these medicines had been returned when people had left the home. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (The stock balance for one liquid was higher than the calculated balance from the number )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (of doses given. This was probably due to slight variation in measuring a 2.5ml dose over )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (a period. The deputy manager showed us the spoon used to measure. It may be better to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (ask the pharmacy to supply a proper oral syringe to measure this dose which would be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (easier and more accurate. We suggested for liquid medication like this to balance the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (stock and note any differences when each bottle is used up rather than keeping records )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (for a number of different bottles on the same page. We found some stock totals had been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (changed down by one for some 30mg tablets on two separate pages \(40 and 43\). This )Tj ET endstream endobj 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 17 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (7)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 484.14 w 31.2 543.16 m 580.26 543.16 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 299.96 m 582.46 299.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 298.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 298.88 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (looked as though two tablets could not be accounted for and the deputy manager could )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (not explain this but thought in one case a tablet had been dropped. This must always be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (noted so as to explain discrepancies like this.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (We found arrangements for eye drops were not well managed. Staff were not sure about )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (period of use once opened \(which is four weeks in order to reduce risks of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (contamination\). On the trolley there was an eye drop bottle with an opening date on )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (20.07.09 \(more than four weeks in use\) and another bottle with no opening date. The )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (deputy manager immediately replaced these with new stock that was in cupboard. Other )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (packs of medicines on the trolley were generally not dated when opened. There were at )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (least two containers of capsules which have a six week period of use after opening and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (also a liquid medicine where the manufacturer specifies a 90 day period of use after )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (opening but there were no opening dates on these containers. The supplying pharmacy )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (should be able to provide information about discard dates after first opening.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (The home returned unused medicines to the pharmacy at the end of each month. Care is )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (needed not to waste NHS resources as with proper stock control some medicines may not )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (need ordering every month. Unused stock could be used the next month with records of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (amounts carried forward on the medicine charts as an audit method. Staff should then )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (only order new stock of what is actually wanted. We also explained the way audit checks )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (can be made of medicines if dates of opening were written on packs.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (In the medication room there was medication policy written in 2002 by the previous )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (owners of the home so this should not be in use. The guidelines from the Royal )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (Pharmaceutical Society about handling medicines in care homes was the 2003 edition )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (which is out of date as a new different edition was published in 2007. Before this )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (inspection the company operations manager had sent us detailed medication procedures )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (for this home and the deputy manager found these in the office. Some of the information )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (in here was not what we found in the home and some other issues about handling )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (medicines need including or clarifying so that staff have clear direction about how the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (company expect them to manage and handle medication. This new policy needs to be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (readily available for staff. There was an up to date medicine reference book for staff to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (refer to. )Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 281.89 Tm (What the care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 175.95 281.89 Tm (does well:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 93.48 w 31.2 223.96 m 580.26 223.96 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 271.83 m 582.46 271.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 176.1 m 582.46 176.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 272.9 m 30.07 175.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 272.9 m 581.38 175.02 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 255.64 Tm (Medication needed by people living in the home were in stock.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 241.06 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 226.48 Tm (Medicine records indicated that people living in the home had received their medicines )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 211.9 Tm (correctly.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 197.32 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 182.74 Tm (Staff support some people to self medicate. )Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 155.77 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 103.16 w 31.2 94.13 m 580.26 94.13 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 146.84 m 582.46 146.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 41.42 m 582.46 41.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 147.91 m 30.07 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 147.91 m 581.38 40.35 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 130.65 Tm (Make sure that risk assessments for people who self medicate are up to date and that )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 116.07 Tm (records are kept when any medicines are given to people to look after in their rooms.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 101.49 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 86.91 Tm (Use a lockable carrying case or other secure means of taking medicines around the home )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 72.33 Tm (when the trolley is not used so that medicines can be easily secured in the event of an )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 57.75 Tm (emergency arising that staff have to deal with.)Tj ET endstream endobj 18 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 19 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (8)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (Make sure the times of medicine administration on the record charts are a more accurate )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (reflection of the times when medicines are administered.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (Risk assess and review the safety of the arrangements for night staff administering )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (medicines in the morning.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (Make sure that the actual dose of medicine administered is always recorded where a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (variable dose is prescribed and that directions for eye drops indicate which eye\(s\) is to be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (treated.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (Make sure accurate and complete records are kept about the use of any prescribed food )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (supplements.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (Make sure the allergy section of the medicine chart is always completed.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (Make arrangements to keep medicine administration charts up to date by clarifying which )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (medicines are not in current use and to liaise regularly with the pharmacy to remove such )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (medicines from the printed charts.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (Make sure that there is clear written guidance to staff on how to reach decisions for any )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (medicine prescribed to be administered 'when required' and how staff are to reach the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (decision to administer. This is especially when people in the home are not able to ask )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (when they need these and also to take account of the provisions of the Mental Capacity )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (Act 2005.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (Review and improve monthly stock control arrangements so as to minimise any wastage )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (as outlined in the report above.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (Make sure that medicines needing to be kept in the medicine fridge are in fact stored )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (there and that this fridge is regularly defrosted and is always running within the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (temperature range of 2 to 8 degrees centigrade.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (Record the medicine room temperature daily and take appropriate action should the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (temperature routinely exceed 25 degrees centigrade.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (Always read the manufacturers' instructions about in use expiry dates for medicines \(for )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (example the eye drops, capsules and liquid medicine found at this inspection\) and make )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (sure that these are followed.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (Upgrade the storage arrangements for controlled drugs to comply with the Misuse of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (Drugs \(Safe Custody Regulations\) 1973.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (Make sure that records kept in the controlled medicine record book are always complete )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (and accurate. Investigate the stock balance anomalies we pointed out at this inspection )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (and take appropriate action to deal with these.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (Consider using an oral medicine syringe to more accurately measure a 2.5ml medicine )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (dose.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (Some parts of medication policy and procedures need reviewing and made readily )Tj ET endstream endobj 20 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 21 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (9)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 90.48 w 31.2 739.98 m 580.26 739.98 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 693.62 m 582.46 693.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 692.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 692.54 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (available for staff to refer to. Any old policy, procedures and guidance must be removed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (to avoid confusion.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (Please note, outstanding statutory requirement 1 listed below was not followed up at this )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (specialist medication inspection so is still listed. This will be checked as properly actioned )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (at a future inspection. )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 677.56 Tm (If you want to know what action the person responsible for this care home)Tj ET /F1 12 Tf BT 1 0 0 1 483.55 677.56 Tm (is taking )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 661.56 Tm (following this report, you can contact them using the details set out on page 2.)Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 24 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (10)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 36.25 w 29.47 752.7 m 564.97 752.7 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 753.83 m 568.3 753.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 773.08 m 568.3 773.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 753.83 m 568.3 753.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 734.58 m 568.3 734.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 774.15 m 27.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 423.22 754.9 m 423.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 468.22 754.9 m 468.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 495.22 754.9 m 495.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 540.22 754.9 m 540.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 774.15 m 567.22 733.5 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 33.75 759.89 Tm (Are there any outstanding requirements from the last inspection?)Tj ET /F1 12 Tf BT 1 0 0 1 429.75 740.64 Tm (Yes)Tj ET /F2 12 Tf BT 1 0 0 1 476.37 742.58 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 501.75 740.64 Tm (No)Tj ET /F2 12 Tf BT 1 0 0 1 546.75 742.58 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 317.1 w 32.32 519.4 m 564.97 519.4 l S 0.001 w 1 1 1 RG 213.12 w 31.2 468.54 m 91.05 468.54 l S 0.001 w 213.12 w 93.3 468.54 m 197.4 468.54 l S 0.001 w 213.12 w 199.65 468.54 m 289.45 468.54 l S 0.001 w 213.12 w 291.7 468.54 m 473.8 468.54 l S 0.001 w 213.12 w 476.05 468.54 m 566.1 468.54 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 577.3 m 30.07 359.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 577.3 m 567.22 359.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 608.77 m 568.4 608.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 576.22 m 568.3 576.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 577.3 m 92.17 359.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 577.3 m 198.52 359.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 577.3 m 290.57 359.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 577.3 m 474.92 359.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 680.2 m 568.4 680.2 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 608.77 m 568.4 608.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 576.22 m 568.4 576.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 360.85 m 568.3 360.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 681.28 m 30.07 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 609.85 m 92.12 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 609.85 m 198.52 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 609.85 m 290.62 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 609.85 m 475.02 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 681.28 m 567.32 575.14 l S 0.001 w [] 0 d /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 662.99 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 644.58 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 629.99 Tm (been met.)Tj ET /F1 12 Tf BT 1 0 0 1 95.57 629.99 Tm ( )Tj ET /F1 12 Tf BT 1 0 0 1 104.02 629.99 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 615.41 Tm (Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 96.58 615.41 Tm ( Regulations 2001 and the National Minimum Standards.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 597.59 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 594.59 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 594.59 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 594.59 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 594.59 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 582.45 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 560.03 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 560.03 Tm (27)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 560.03 Tm (18)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 560.03 Tm (The registered person must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 545.46 Tm (ensure that there are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 530.88 Tm (sufficient care staff on duty )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 516.29 Tm (at peak periods of activity to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 501.71 Tm (help meet people's needs.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 487.14 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 472.55 Tm (Not inspected at random )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 457.98 Tm (inspection on 24th August )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 443.39 Tm (2009 but will be checked as )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 428.82 Tm (properly actioned at a future )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 414.23 Tm (inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 399.65 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 385.08 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 367.49 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 478.9 560.03 Tm (04/07/2008)Tj ET endstream endobj 25 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 26 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (11)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 770.27 Tm (Requirements and recommendations from this inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 754.85 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 108.12 w 32.32 692.47 m 564.97 692.47 l S 0.001 w 1 1 1 RG 20.58 w 31.2 649.83 m 91.05 649.83 l S 0.001 w 20.58 w 93.3 649.83 m 197.4 649.83 l S 0.001 w 20.58 w 199.65 649.83 m 289.45 649.83 l S 0.001 w 20.58 w 291.7 649.83 m 473.8 649.83 l S 0.001 w 20.58 w 476.05 649.83 m 566.1 649.83 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 662.32 m 30.07 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 662.32 m 567.22 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 693.79 m 568.4 693.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 661.24 m 568.3 661.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 662.32 m 92.17 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 662.32 m 198.52 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 662.32 m 290.57 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 662.32 m 474.92 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 748.78 m 568.4 748.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 693.79 m 568.4 693.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 661.24 m 568.4 661.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 638.41 m 568.3 638.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 749.86 m 30.07 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 694.87 m 92.12 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 694.87 m 198.52 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 694.87 m 290.62 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 694.87 m 475.02 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 749.86 m 567.32 660.17 l S 0.001 w [] 0 d /F1 12 Tf BT 0 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2.25 w 28.99 226.93 m 568.3 226.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 41.42 m 568.3 41.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 603.24 m 30.07 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 534.25 m 92.12 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 534.25 m 198.52 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 534.25 m 290.62 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 534.25 m 475.02 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 603.24 m 567.32 499.55 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 588.98 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 568.98 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 554.4 Tm (Standards Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 166.31 554.4 Tm (Regulations 2001 and the National Minimum Standards. 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294.55 396.96 Tm (administering all the morning )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 382.38 Tm (medicines and to have a )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 367.8 Tm (secure method of carrying )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 353.22 Tm (medicines around the home )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 338.64 Tm (when the medicine trolley is )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 324.06 Tm (not used. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 306.48 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 291.9 Tm (This will make sure that )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 277.32 Tm (people are not put at )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 262.74 Tm (unnecessary risk from )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 248.16 Tm (medicines because of unsafe )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 233.58 Tm (practices. )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 484.44 Tm (01/11/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 210.75 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 210.75 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 210.75 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 210.75 Tm (Always keep accurate and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 196.17 Tm (complete records in the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 181.59 Tm (controlled drug record book. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 167.01 Tm (Investigate the stock balance )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 152.43 Tm (anomalies identified at this )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 137.85 Tm (inspection and take )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 123.27 Tm (appropriate action to deal )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 108.69 Tm (with these. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 91.11 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 76.53 Tm (This is to help make sure )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 61.95 Tm (that all these medicines are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 47.37 Tm (properly accounted for and )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 210.75 Tm (01/10/2009)Tj ET endstream endobj 28 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 29 0 obj <>stream 0 J 0.75294 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0 0 1 294.55 575.9 Tm (Regulations 1973 are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 561.32 Tm (complied with when any )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 546.73 Tm (controlled drugs are kept in )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 532.16 Tm (the home. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 514.58 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 499.99 Tm (This is to make sure of safe )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 485.42 Tm (storage of these medicines )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 470.83 Tm (and to comply with the law)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 634.22 Tm (01/12/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 448.01 Tm (4)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 448.01 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 448.01 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 448.01 Tm (Make sure that the medicine )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 433.42 Tm (fridge is always kept in the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 418.85 Tm (correct temperature range of )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 404.27 Tm (2 to 8 degrees centigrade )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 389.68 Tm (and action is always taken to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 375.11 Tm (correct this if it is found to be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 360.52 Tm (at the wrong temperature. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 342.95 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 328.36 Tm (This is to make sure that )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 313.79 Tm (medicines are stored at the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 299.2 Tm (right temperature as directed )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 284.63 Tm (by the manufacturers in )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 270.05 Tm (order to maintain their )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 255.46 Tm (correct potency and not put )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 240.88 Tm (people living in the home at )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 226.3 Tm (risk from using medicines )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 211.73 Tm (that are no longer stable. )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 448.01 Tm (01/10/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 188.9 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 188.9 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 188.9 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 188.9 Tm (Always keep accurate, clear )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 174.32 Tm (and complete records about )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 159.74 Tm (any medication kept in the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 145.15 Tm (home and administered to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 130.57 Tm (people who live in the home. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 116 Tm (\(This is to particularly )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 101.42 Tm (address the issues identified )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 86.83 Tm (in the report\). )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 69.25 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 54.67 Tm (This is to help make sure all )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 188.9 Tm (01/10/2009)Tj ET endstream endobj 30 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 31 0 obj <>stream 0 J 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(medicine dose. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 114.08 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 114.08 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 114.08 Tm (Record the medicine room temperature daily and take )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 99.5 Tm (appropriate action should the temperature routinely exceed )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 84.93 Tm (25 degrees centigrade. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 62.1 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 62.1 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 62.1 Tm (Review and update the medicine policy and local )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 47.51 Tm (procedures and make sure these are readily available so as )Tj ET endstream endobj 32 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 33 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 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registered person\(s\) should consider them as a way of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 723.42 Tm (improving their service.)Tj ET /F1 10 Tf BT 1 0 0 1 34.05 702.6 Tm (No)Tj ET /F1 10 Tf BT 1 0 0 1 96.15 702.6 Tm (Refer to Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.45 702.6 Tm (Good Practice Recommendations)Tj ET /F1 12 Tf BT 1 0 0 1 200.25 685.45 Tm (to provide all staff with clear direction about the way )Tj ET /F1 12 Tf BT 1 0 0 1 200.25 670.86 Tm (medicines are safely managed and handled in this home. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 645.78 Tm (4)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 645.78 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 645.78 Tm (Make arrangements to write the date on containers of any )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 631.21 Tm (medicines when they are first opened to use and record the )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 616.63 Tm (quantity of any stocks of medicines that are carried forward )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 602.04 Tm (to the next medication cycle. This is to help with good stock )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 587.47 Tm (rotation in accordance with the manufacturers' or good )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 572.89 Tm (practice directions and to enable audit checks that )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 558.3 Tm (medicines are being used correctly and the right quantities )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 543.72 Tm (remain in stock. )Tj ET endstream endobj 34 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 35 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 768.28 Tm (Reader Information)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 20.58 w 28.35 746.8 m 229.46 746.8 l S 0.001 w 1 1 1 RG 20.58 w 231.71 746.8 m 581.74 746.8 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 723.97 m 229.46 723.97 l S 0.001 w 1 1 1 RG 20.58 w 231.71 723.97 m 581.74 723.97 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 701.14 m 229.46 701.14 l S 0.001 w 1 1 1 RG 20.58 w 231.71 701.14 m 581.74 701.14 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 678.31 m 229.46 678.31 l S 0.001 w 1 1 1 RG 20.58 w 231.71 678.31 m 581.74 678.31 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 735.39 m 583.94 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 712.55 m 583.94 712.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 689.72 m 583.94 689.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 758.22 m 583.94 758.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 735.39 m 583.94 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 712.55 m 583.94 712.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 689.72 m 583.94 689.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 666.9 m 583.94 666.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 759.29 m 27.22 665.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 230.59 759.29 m 230.59 665.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 582.86 759.29 m 582.86 665.82 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.2 742.03 Tm (Document Purpose:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 742.03 Tm (Inspection Report)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 719.2 Tm (Author:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 719.2 Tm (Care Quality Commission)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 696.37 Tm (Audience:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 696.37 Tm (General Public)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 673.54 Tm (Further copies from:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 673.54 Tm (0870 240 7535)Tj ET /F1 12 Tf BT 1 0 0 1 335.41 673.54 Tm (\(telephone order line\))Tj ET /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 652.59 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 638.01 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 623.42 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 78.9 w 25.8 581.46 m 563.3 581.46 l S 0.001 w /F1 12 Tf BT 1 0 0 1 34.05 605.84 Tm (Our duty to regulate social care services is set out in the Care Standards Act 2000.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 591.27 Tm (Copies of the National Minimum Standards )Tj ET /F1 12 Tf BT 1 0 0 1 303.94 591.27 Tm (Care Homes for Older People can be )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 576.68 Tm (found at www.dh.gov.uk or got from The Stationery Office \(TSO\) PO Box 29, St )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 562.1 Tm (Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 547.53 Tm (the Stationery Office is also available: www.tso.co.uk/bookshop)Tj ET /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 526.95 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 509.36 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 494.79 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 480.2 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 34.16 w 25.8 460.61 m 563.3 460.61 l S 0.001 w /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 455.08 Tm (Helpline:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 420.92 Tm (Telephone:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 147.95 420.92 Tm (03000 616161)Tj ET /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 389.27 Tm (Email:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 99.55 389.27 Tm (enquiries@cqc.org.uk)Tj ET /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 357.61 Tm (Web: )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 88.63 357.61 Tm (www.cqc.org.uk)Tj ET /F1 18 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 327.95 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 18 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 299.21 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 28.35 276.5 Tm (We want people to be able to access this information. If you would like a summary in a )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 259 Tm (different format or language please contact our helpline or go to our website.)Tj ET /F1 18 Tf BT 1 0 0 1 28.35 232.98 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 210.26 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). This publication may be reproduced )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 192.76 Tm (in whole or in part, free of charge, in any format or medium provided that it is not used for )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 175.27 Tm (commercial gain. This consent is subject to the material being reproduced accurately and )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 157.77 Tm (on proviso that it is not used in a derogatory manner or misleading context. The material )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 140.28 Tm (should be acknowledged as CQC copyright, with the title and date of publication of the )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 122.78 Tm (document specified.)Tj ET endstream endobj 36 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 37 0 obj <>stream  cvt gxfpgm;_glyfˬ ^head< H6hhea$ $hmtx ploca76maxp 1t prepF 8}11c1bbDu1c111D1>}1(111{-1(3c1J`7]1bP2Jb2(11124bb(()_b{8P>2;IV`bbz!&BF7>>TtNmmn{{(hxAYiU\.t/J\cx{{{ ""(/23>CFHPSfijkrsx,.88AMP\ik| ,,Alx=>o:BX~9`/111:<JJLWstx  ((-WYZZZZprr."+`x =.:WX]]SlCcM*SclAq],C]"D>;KeJPBQLQLT7Z\WU:rrE@78743210/.-,+*)('&%$#"!  ,E#F` &`&#HH-,E#F#a &a&#HH-,E#F` a F`&#HH-,E#F#a ` &a a&#HH-,E#F`@a f`&#HH-,E#F#a@` &a@a&#HH-, <<-, E# D# ZQX# D#Y QX# MD#Y &QX# D#Y!!-, EhD ` EFvhE`D-, C#Ce -, C#C -,F#pF>F#pFE: -,EJ#DEI#D-, E%EadPQXED!!Y-,Cc#b#B+-, EC`D-,CCe -, i@a ,b`+ d#da\XaY-,E+G#DGz-,TX CTXJIDDYY-,CXE+#DzEi #D QX+#Dz!zYY-,-,KRX!ED#E %ERXD!!YY-,/-, %EI#DEJ#DEe#E %`j #B#hj`a Ry!J@JE TX#!?#YaDRyI@ IE TX#!?#YaD-,C#C -,C#C -, C#C -, C#Ce -,C#Ce -,C#Ce -,KRXED!!Y-, %#I@` c RX#%8#%e8c8!!!!!Y-,Ei C`:-,%# `#-,%# a#-,%-, ` <<-, a <<-,++**-,CC -,>**-,5-,vK#p KE PXaY:/-,!! d#d@b-,!QX d#d b@/+Y`-,!QX d#dUb/+Y`-, d#d@b`#!-,&&&&Eh:-,&&&&Ehe:-,E# E %PX&a&`YD-,F#F`F# F`ab# #KKpE` PXa@Yh:-,3+**-,CXY-,CXY-#@/?103!%!!8 P@+  { /999?999/10&''&&'632!!!!67`,9) KgJ*JJ&J (""" """ zJzJee") """"!!""+ ]+PV =`9PPPP""""""""""""""""""""""kk4!!!!!!!!!!!!o!!!!!!!o!!!!!!!!!po==!!!!!!!!!!!!!!!!!!b!Q!?!.!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!}!&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&`9_@ FF@H H2 %H2 #H2 "H2 !H2  H2 H2 H2 H2 @[H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 yH2 nH2 dH2 _H2 ]H2 ZH2 XH2 H2 H2 H2 H2 H2 H2 H2 @LH2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 \H2& & 7E@CzweaWU$"   KKSBKcKb S# QZ#BKKTB8+TXCXYY++++++++++++++++++++++++++++++++KPyAP*&+++++KSyAP*&+++++P2Ka`+++++++++++++++++++++++++++++++++++++++++++++++++++++++++EiSBKPXBYC\XBY CX`!YBp>CX;!~ +Y #B #BCX-A-A +Y#B#BCX~;! +Y#B#B endstream endobj 38 0 obj<> endobj 39 0 obj<>/Subtype/CIDFontType2/Type/Font/W [53[891]133[891]]/CIDToGIDMap/Identity/DW 1000>> endobj 40 0 obj <>stream /CIDInit /ProcSet findresource begin 12 dict begin begincmap /CIDSystemInfo << /Registry (Adobe) /Ordering (UCS) /Supplement 0 >> def /CMapName /Adobe-Identity-UCS def /CMapType 2 def 1 begincodespacerange <0035><0085> endcodespacerange 2 beginbfrange <0035><0035><0052> <0085><0085><00a3> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 23 0 obj<> endobj 41 0 obj <>stream %!PS-AdobeFont-1.0: Verdana Typeface and data 1996 Microsoft Corporation. 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