Inspection on 05/06/06 for Barnetts

This inspection was carried out on 5th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Barnetts 10/08/07

Barnetts 15/11/05

Barnetts 27/04/05

Barnetts 09/09/04

Barnetts 13/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Barnetts Barnetts Frant Road Tunbridge Wells Kent TN2 5LR Lead Inspector Gary Bartlett Key Unannounced Inspection 5th June 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barnetts Address Barnetts Frant Road Tunbridge Wells Kent TN2 5LR 01892 542983 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Kent Community Housing Trust Mrs Eileen Joyce Gilbertson Care Home 41 Category(ies) of Dementia - over 65 years of age (39), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (1) Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Care for a service user with a learning disability is restricted to one person whose date of birth is 13 August 1937 Care for service users of old age, not falling within any other category (OP) is restricted to one person whose date of birth is 8 March 1926. 15th November 2005 Date of last inspection Brief Description of the Service: Barnetts is owned and operated by the Kent Community Housing Trust. It is a detached purpose built premises with accommodation on two floors. The Home is equipped with a shaft lift. There are a total of 40 bed-spaces with 34 single and 3 shared rooms. All bedrooms are fitted with a staff call point and three have telephone points. Barnetts is located on a main road on the outskirts of Tunbridge Wells where there are the usual facilities of a large town. There is easy access to public transport with a bus stop near by and a main line railway station is approximately 1 ½ miles away. Space for car parking is available at the front of the building. There are gardens to the rear of the Home for service users to use. A small day centre is run on the site. The Homes senior staffing team comprises the Manager, an Assistant Manager and some Team Leaders. The Home employs Care Services Assistants who work a roster that gives 24hour cover. The Home also employs other staff for catering, domestic, administration and maintenance duties and Activities Co-ordinators. Current fees range from £358.96 to £476.89 per week. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was conducted by Gary Bartlett, Inspector, who was in Barnetts from 9.30 a.m. until 5.30 pm. During that time the Inspector spoke with some residents, visitors and some staff. Parts of the Home and some records were inspected and care practices observed. Due to the nature of the service provided it is difficult to reliably incorporate accurate reflections of residents’ views of the service in the report. Some comment cards were received prior to the inspection. Responses received from residents’ relatives indicated they were very satisfied with the standards of care. Responses from health professionals also indicated good standards of care. Statements on comment cards included: • “There seems to be care and concern for the residents.” • “So far the staff have been very caring and have nothing but praise for the way the home is run.” • “We always feel that there is a warm, caring and friendly atmosphere in the Home.” • “Very satisfied with the quality of care. Barnetts has a good, jolly atmosphere which is good for the residents, families and staff alike.” • “A great, well managed home. More beds/rooms please!” • “I feel extremely fortunate that my mother has a place there.” The Manager and staff gave their full co-operation throughout the inspection. What the service does well: Information about the Home is easily accessible. The Home is effective in helping residents to settle in. Residents’ general health needs are well met and medication is given correctly and reviewed to make sure they are on the right medication. The Home enjoys good relationships with other health care professionals. Residents are encouraged to partake in activities suited to their Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 6 preferences and capabilities. There are good procedures to protect residents from abuse. Robust recruitment processes ensure only appropriate people are employed directly by the Home. Staff are kind and caring and the Manager is approachable and understanding. Residents enjoy a wholesome and varied menu of meals. Residents’ visitors are made welcome. What has improved since the last inspection? What they could do better: The Home must continue to try to recruit and retain staff. This is fundamental to them being able to provide the continuity of care needed by the residents and to ensure all staff have received the specialist training necessary. Care planning and daily records must improve so staff know what to do for each resident. The Home must be maintained in an adequate state of repair and decoration to provide comfortable and safe surroundings for all residents. Equipment must be stored so as not to cause obstruction. Parts of the garden must be better maintained so as to be safe and attractive for residents to use. The Home must be better able to ensure all staff receive the induction and training they need and put that training into practice. The use of shared bedrooms should be reviewed in view of the mental frailty of the residents and the associated behaviours. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 and 6 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service Residents and their relatives/representatives were provided with the information they needed about the Home. Good pre-admission assessments and the opportunity to visit the Home prior to admission ensured residents were appropriately placed and the Home could meet their needs. EVIDENCE: The Manager said the Statement of Purpose and Service Users Guide were accurately descriptive of the aims, objectives, philosophy of care, services and facilities and terms and conditions of Barnetts. Copies of the Service Users Guide were provided for each resident or their representative. These were not inspected on this occasion. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 10 The Manager and/or the Assistant Manager visited prospective residents prior to admission to make a decision whether the Home could meet the persons’ needs. Information was obtained from other parties, including relevant health care professionals, to assist in assessments. Residents were able to visit the Home before moving in and a visitor said staff had been very helpful in assisting their relative to settle. A statement on a comment card received prior to the inspection included: “I would like to comment on how wonderful all the staff are at Barnetts – they have so much time and patience to help my mother settle in and help me and my family to cope with having to place my mother in a home.” Each resident or their representative was provided with a contract between the Home and themselves. The contract clearly stated the responsibilities of the organisation and the rights of the resident. Intermediate care was not offered at Barnetts. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to this service Residents’ health and welfare would be better promoted by care plans being more directive, daily records more consistently maintained and risk assessments being written when necessary. Residents’ health needs were and they were protected by adherence to good practice guidelines in the storage and administration of medicines. EVIDENCE: Each resident had a care plan. Four were inspected in detail. There were improvements since the last inspection, but they were still not consistently adequate in regard to the detail of information in some parts. For example, by providing staff with an understanding of residents’ current behaviour patterns by linking them with the their previous experiences. This would also give staff Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 12 possible strategies to use with individual residents. Care plans would benefit from including residents’ strengths and abilities in addition to their frailties. Some staff spoken with had a very good understanding of residents’ individual needs. There were some very good examples of daily records but many were not detailed or informative. Appropriate records had not always been made as a result of some incidents. The Manager explained that the Home’s reliance on agency staff had made it very difficult to improve the care plans and achieve a consistently high standard of daily record keeping. Medications were seen to be stored in accordance with their instructions. The Manager stated that was intended to refurbish the medicines-room to maintain health and safety standards. The Team Leader on duty had a sound understanding of good practice and medications were observed to be administered in accordance with current guidelines. Records were available to indicate that all staff administering medications had been trained and signed off as being competent to do so. The Medication Record Administration Record (MAR) sheets that were inspected had been completed appropriately. Records inspected and comment cards received indicated the Home had a good working relationship with the specialist and local health care professionals, supporting residents in their health care needs. From observation and discussion with residents’ relatives it was clear that staff treated residents with respect and promoted their privacy and dignity. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service Residents could enjoy a fulfilling lifestyle with good outside links maintained and as much choice and control over all aspects of their lives as their individual abilities allowed. Dietary needs of resident were well catered for with a balanced and varied selection of food that met their tastes and choices. EVIDENCE: Residents and their relatives spoken with were happy with the flexibility the Home offered in regard to meeting personal preferences where practicable, for example what time they got up, went to bed etc. The home operated a key worker system, which enabled closer resident/staff relationships where likes, dislikes and needs were shared. Family and friends felt welcome and knew they could visit the Home at any reasonable time. Staff always made time to talk with visitors and share pertinent information. The design of the Home provided seating areas within the communal areas of the home where residents could entertain their visitors, Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 14 in addition to the privacy of their own room. It was clear that the Home encouraged individuals and groups from the community to visit the home. The Activities Co-ordinators were seen to be continuing to work very hard and residents appreciated their efforts. Some residents mentioned they would like more activities and outings. The Manager explained that the current resources were being used as best they could to provide meaningful activities for residents with significantly differing abilities. This range of abilities had a limiting effect on group work. There was some discussion as to whether the number of hours allocated for the co-ordination of activities should be reviewed to ensure adequacy. Residents spoke favourably of the meals, said they had plenty to eat and enjoyed the choices available to them. The meals were well presented and looked appealing. Lunch was taken in a relaxed atmosphere and staff were seen to offer assistance in a discreet and sensitive manner. The menus seen were varied and alternatives were offered. Residents were offered drinks and biscuits during the day. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service Residents and their relatives could have confidence their concerns and complaints would be listened to and acted on. There were systems to ensure residents were protected from abuse. EVIDENCE: The service had a complaints procedure that was up to date, clearly written, and easy to understand. The complaints procedure was widely distributed, and had a high profile within the service. Those spoken with had a good understanding of how to make a complaint and they were clear of what could be expected to happen if a complaint was made. Records of complaints were kept and these included details of investigation and action taken and were used to inform future practice. There were procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. Staff spoken with had a sound knowledge of adult protection procedures. The Manager stated that any allegation of abuse would be referred to the concerned agencies without delay. This was particularly important taking account of the aggression that can be exhibited due to the nature of the residents’ mental frailties. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 16 Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 23 and 26 Quality in this outcome area was poor. This judgement has been made using available evidence including a visit to this service The quality of life and safety of residents was adversely affected by the need for improvements to the environment. EVIDENCE: The parts of the Home inspected were commendably clean and free from unpleasant odours. Parts of the Home were in need of redecoration and refurbishment, for example the first floor corridor wallpaper had been peeled away and the Honeysuckle lounge décor looked “tired”. Several first floor bedrooms had ceilings that were cracked. The garden to the front and side of the Home was very overgrown and the external pathway was uneven with potential hazard to residents and staff. The Manager had already notified KCHT head office of the need for this to be addressed. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 18 Improvements were needed to the sluice rooms to better promote infection control. The Manager explained that a commode washer was due to be fitted on the ground floor. There was some discussion as to whether an additional machine should be sited on the first floor, in view of the continence management needs of the residents. The laundry was being developed to provide better facilities. In the meantime the Home was using alternative arrangements which were satisfactory. There had been an increase in the number of wheelchairs in the Home and their storage was seen to be problematic in that they obstructed easy access through a busy corridor. This was particularly dangerous for residents that used walking aids. Some bedrooms were shared and fitted with privacy screening. The use of shared bedrooms should be reviewed in view of the mental frailty of the residents and the associated behaviours. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to this service Recruitment processes were robust and offered protection to people living at the Home. The Home was addressing the training of its staff so they had the skills to meet the needs of the residents. EVIDENCE: Resident’s relatives thought very highly of the staff. Statements on comment cards received prior to the inspection included: • “The residential staff are lovely people.” • “The key-worker always makes a point of speaking to use when on duty. Just for a general update as well as to discuss anything specific.” • “I have always been impressed by the dedication of the staff and respect they have for the residents in what can be very difficult circumstances and limited resources.” Records seen indicated that robust recruitment procedures were used and ensured the Home directly employed only staff that had been properly vetted. The recruitment and retention of staff continued to be very problematic for the Home. As a result the Home was still reliant on the use of agency senior, care Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 20 and ancillary staff to maintain adequate staffing levels. Where possible, the Home used the same agency staff so there was a degree of continuity. Residents and visitors said there were always staff available when needed. The Manager was monitoring that staff levels remained appropriate as residents’ dependency levels increased. As mentioned earlier in this report, there was some discussion as to whether the number of hours allocated for activities co-ordination was now adequate. The staff rosters inspected did not show any staff to be working long consecutive shift patterns that could compromise staff competency through fatigue and thereby put residents at risk. The Home’s staff were required to undertake a comprehensive induction programme. Two staff members’ induction records did not show that they had undertaken core parts of the induction programme. Fortunately, discussion with these staff members established they did have the necessary skills. There was also an induction programme for agency staff to complete on their first shift at the Home. An agency staff commenced their first shift at the Home on the afternoon of the inspection and their induction had been duly completed and recorded. It had been suggested at the previous inspection that the agency staff induction be expanded to ensure that they had a clear understanding of their roles and responsibilities. The Manager said this had been passed to head office but there had not been a response to date. There was ongoing training for staff, which had recently included specialist areas such as dementia and challenging behaviour. Each staff file included a “staff training analysis sheet” to record training courses they had attended. A training matrix had been written. Unfortunately this had not been kept up to date so it did not provide a ready overview of staff training needs. Such a tool was needed to ensure staff received the training they needed, rather than making it “available to them”. The staffing situation had improved in that the Home now employed a Night Team Manager. However, particularly at weekends, some shifts were mostly agency staff, very occasionally all agency staff. As noted at previous inspections, 3 staff agencies were used. The Manager explained they had requested to see the training certificates of the agency staff to confirm their competency but only one agency had agreed to this. This was especially concerning in view of the specialist needs of the residents. Data provided by the Manager showed that only 7 of staff were trained in NVQ. The Manager described how the NVQ training had been disrupted by the demise of a training organisation but alternative trainers had been identified and NVQ training was recommencing. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 21 Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 36 and 38 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service The Home benefited from a Manager who was accessible and supportive. Residents’ welfare was promoted through regular environmental and equipment safety checks. EVIDENCE: A statement on a comment card received prior to the inspection included: “Barnetts home is very well run.” Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 23 Throughout the inspection, the Manager demonstrated a desire to provide a high quality service and a commendable openness and honesty. Staff and residents and their visitors said they considered the Manager to be very approachable. The Manager had many years experience and had completed the “Leadership in Dementia Care” course. She was undertaking the Registered Manager’s Award. The Manager continued to conduct “spot-checks” of the Home to ensure the quality of the 24 hour service. Staff records seen complied with the Regulations. Staff supervision had been implemented but not as regularly as required. The Manager described how residents and their representatives or relatives were regularly asked for their views about the service. Most residents were unable to manage their own finances and a staff member explained that the Home encouraged residents’ families / representatives to give assistance with this. The staff member demonstrated a sound system of holding and recording residents’ cash, which facilitated ease of monitoring. Residents’ relatives did not express any concerns about the Home’s management of monies or valuables held on the residents’ behalf. Kent Community Housing Trust had recently reviewed all its policies to ensure they complied with current legislation and good practice guidelines. Records were seen to be kept in a manner that preserved confidentiality. Records seen indicated that the Home was ensuring all staff had fire training or participated in fire drills and fire exits were kept clear of obstruction. Staff were seen to be diligent in ensuring COSHH requirements were adhered to and those spoken with had a sound understanding of emergency procedures. The kitchen had been redecorated and replacement refrigerators and freezers obtained to maintain good food hygiene standards. The Manager stated that all records of maintenance and safety checks were up to date. These were not inspected on this occasion. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 2 X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X 3 Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 14(2b)15( 2)17Sch3 &4 Requirement The registered person shall maintain records as specified in Schedules 3 and 4. The registered person shall keep the service users plan under review in that: service users individual plans and records must be reflective of their care needs directive as to how those needs are met. Daily records must be more comprehensive. Although being addressed, this remains a requirement from previous inspections. An action plan must be received by CSCI by the given date. The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection in the care home in that the fabric of the sluice rooms must be made good. An action plan must be received by CSCI by the given date. The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to DS0000023903.V296130.R01.S.doc Timescale for action 30/06/06 2 OP26 13(3) 30/06/06 3 OP22 13(4) 30/06/06 Barnetts Version 5.2 Page 26 4. OP30 18 their safety in that: 1. Wheelchairs must be stored in such a place so as to not cause obstruction. 2. External paths must be made safe. An action plan must be received by CSCI by the given date. “The registered person shall having regard to the size of the care home, the statement of purpose and the number and needs of the service users ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they perform including structured induction training An action plan must be received by CSCI by the given date. 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP19 OP23 Good Practice Recommendations It is strongly recommended the garden to the front and side of the Home be better maintained. The use of shared rooms should be reconsidered with service users offered a single room or sole use of the shared room unless they have made a positive informed choice to share. It is strongly recommended that a commode washer be installed on the first floor in addition to the ground floor. It is strongly recommended that an assessment be made as to whether there are adequate hours allocated for the co-ordination of activities. It is strongly recommended that agency staff training certificates are seen to ensure the competency of those staff and the staff numbers and skills mix is appropriate to DS0000023903.V296130.R01.S.doc Version 5.2 Page 27 3 4. 5. OP26 OP27 OP27 Barnetts 6. 7. 8. 9. OP28 OP30 OP30 OP36 the assessed needs of the service users It is recommended a minimum ratio of 50 of staff are trained to NVQ level 2 or equivalent by December 2005. It is recommended the training matrix is kept up to date and current. It is strongly recommended the induction programme for agency staff is amended to include roles and responsibilities It is recommended care staff receive formal supervision at least 6 times per year. Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Barnetts DS0000023903.V296130.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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