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Archived: The Paddocks

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Inspection report

Date of Inspection: 1 August 2012
Date of Publication: 3 September 2012
Inspection Report - DN published 3 September 2012 PDF | 49.3 KB

People's personal records, including medical records, should be accurate and kept safe and confidential (outcome 21)

Meeting this standard

We checked that people who use this service

  • Their personal records including medical records are accurate, fit for purpose, held securely and remain confidential.
  • Other records required to be kept to protect their safety and well being are maintained and held securely where required.

How this check was done

We reviewed all the information we hold about this provider, carried out a visit on 01/08/2012, observed how people were being cared for, looked at records of people who use services and talked to people who use services.

Our judgement

The provider was meeting this standard.

Records were kept securely and could be located promptly when needed.

User experience

People we spoke with knew they had a care plan and told us they knew they could look at it if they wished.

Other evidence

Are accurate records of appropriate information kept?

Records seen included care plans, risk assessments, daily record sheets, staff rotas and training records. All records were fully completed and up to date.

Care plans were detailed and demonstrated that assessments and reviews of people’s nutritional status was undertaken regularly.

The three care plans we looked at contained Malnutrition Universal Screening Tools [MUST]. These showed that people using the service were having their weight monitored on a monthly basis or sooner if their needs required this.

Are records stored securely?

We saw that records were kept securely and could be located promptly when needed.

Care plans and personal records could only been accessed by people authorised to so.