The CQC (Care Quality Commission) is the government body assigned to ensuring every nursing home in the U.K. complies with a number of rules and regulations. While each home has some autonomy in setting some of its own policies and procedures, depending on the client group it supports, there are certain rules that must be adhered to in every residential unit. If a home is found in non-compliance, it can be issued with a warning, and a date by which the issues must be resolved. If the home still fails to comply, or has not shown enough progress, the CQC can close down the home.
Health and Safety
Every care assistant and nurse must have current moving and handling training, and must adhere to the current legislation. This is in place to limit unnecessary injuries to both staff and residents. Buildings must meet all government-approved standards. Kitchens must be sealed off from residents, and all dangerous implements must be locked away. Kitchens must have a visible list detailing special dietary requirements and allergies. All equipment must be serviced every year to ensure it is safe to use.
A risk assessment must be carried out for each resident, to assess not only the risk to himself, from things such as poor mobility and falls, but also what risk he poses to other residents or staff--for example, by exhibiting aggressive behaviour. The risk must be identified and recorded, whether the risk is high, medium or low. The risk assessment must also state what measures are in place to minimise the identified risk. The building and all items therein must also have recorded risk assessments. Each piece of equipment must be assessed for risk for each individual resident.
All staff must sign a declaration of confidentiality. All documents pertaining to residents and their families must be kept secure, and only those authorised to do so may view and alter these documents. No staff member may discuss a resident, her treatment or any other issue with anybody outside the home. Inside the home, staff may only discuss pertinent information regarding residents and relatives, and only if it is appropriate to do so. Any breach of confidentiality will result in disciplinary action, and may result in dismissal, depending on the severity of the breach.
Daily notes or observations must be recorded for each resident at least once every 24 hours, although once per shift is more desirable. These records are legal documents and must be treated accordingly. Each entry must be signed by the person recording the information. Any professional visits must be recorded, along with the outcomes. Care plans, medication lists, medical history and end-of-life requests must be present and updated monthly by each resident's assigned nurse.
Medication must be stored in locked cabinets or a locked fridge. In nursing homes, only the nurse in charge on shift may administer medication. All medication must be signed for by the nurse. If one is administering a "controlled" drug, another qualified staff member must be present as a witness and sign all necessary paperwork. If medication is not given, the reason must be recorded on appropriate paperwork, and signed by the nurse in charge. All medication, unless otherwise stated, must be stored below 25 degrees Celsius. A record of medication storage temperatures must be made twice daily.
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