Inspection on 06/12/05 for Gavin Astor House

This inspection was carried out on 6th December 2005.

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

Gavin Astor House 25/10/07

Gavin Astor House 09/01/07

Gavin Astor House 05/08/05

Gavin Astor House 08/12/04

Gavin Astor House 03/06/04

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Gavin Astor House Royal British Legion Village Aylesford Maidstone Kent ME20 7NL Lead Inspector Justine Williams Announced Inspection 6th December 2005 09:30 X10029.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 Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 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 and Care Homes for Adults 18 – 65*. 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. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gavin Astor House Address Royal British Legion Village Aylesford Maidstone Kent ME20 7NL 01622 791056 01792 717273 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) Royal British Legion Industries Limited Mrs Linda Alder Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (26), Physical disability (24) of places Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th August 2005 Brief Description of the Service: Gavin Astor House is a purpose built Care Home for adults over 18 years of age who have been assessed as needing “nursing care”. The establishment opened in 1993 and now provides 24 hour nursing care for up to 50 people. The home provides accommodation over two floors; all rooms have en-suite facilities and are designated for single occupancy. All areas of the home have been designed to accommodate wheelchair users. The home has a patio courtyard in the centre that has seating and wheelchair access. The nearest public transport to Gavin Astor is approximately half a mile (1km). There is ample parking in the visitor’s car park. The aims and objectives of the home and the care and range of services offered can be seen in detail in the “Statement of Purpose” and “Service Users Guide”. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An announced inspection was carried out on Tuesday 6th December 2005 between 9.45 am and 4.45 pm by regulatory inspector Justine Williams. During that time a number of residents, staff, the registered manager and unit managers agreed to speak with the inspector both in public and privately. Feedback was given to the manager and responsible individual during at the end of the inspection. This report contains assessments made from observation, conversation and records. As part of the inspection process comment cards were received from residents, relatives and professionals. Comments made included: “I am impressed by the way members of staff are more like friends than attendants” “I was very pleased to see the high standard of holistic care that this home offers to its residents” “my (relative)feels secure for the first time in years” “the matron and staff are always very helpful and most importantly my (relative) is happy with the staff” “ My wife and I find Gavin Astor a pleasant house to visit regularly” “There could always be more staff, as they can’t be everywhere at once” “the food needs to be more appetising and appealing to the eye” “there is a lack of care staff” “carers are rushed” What the service does well: Residents feel safe and comfortable living at Gavin Astor House with freedom to make decisions about their lives. The home is warm, friendly and well maintained. The specific complex needs of the service users are well met by the staff who in turn are supported to maintain and improve their skills. Residents are able to make an informed choice about whether they wish to move into the home. Residents records are maintained and stored safely. Residents benefit from the safe and open management practices at the home. Staff are well liked and are supportive of each other and the residents. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: 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. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5,6 Service users and representatives are given all the information they need to be able to make an informed decision to live at Gavin Astor House. EVIDENCE: Residents said they had made a positive decision to move into Gavin Astor house, some had the opportunity to visit prior to moving in others had their relatives look around on their behalf. Written information is available if needed, many relatives were not aware that there is an inspection report which they can read. A copy of the last inspection report is readily accessible. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 9 Staff at the home are very clear about the care they are able to provide and who to. The unit managers said they met and assessed individuals in their own homes and would consider the needs of the existing residents prior to offering a room. The written assessment is kept in the residents file. The assessment process establishes whether the staff have the skills to meet the needs of the individual. Gavin Astor offers accommodation and care to individuals with a range of needs some very complex. As such, careful consideration is given to whether these needs can be met. Staff spoke positively about caring for individuals in old age with nursing needs as well as those who, despite some physical disability, remain very independent. Respite care is offered where a room is vacant, recently 2 residents have moved into the home permanently following 6 weeks of respite care. Intermediate care is not offered. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Residents’ health and care needs are met and documented. EVIDENCE: Each resident has a plan of care. The care plans were regularly reviewed. Changes to care needs were recorded in the review document but not in the care plan. To get an accurate picture of the care needs, staff would have to read the care plan and all the reviews. The care plans would benefit from being clearer in this respect. The initial assessment and information given by family Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 11 and professionals are used to form the care plan. Residents spoken with had little involvement in the care plan or review and had not signed them. Formal reviews are now taking place whether the resident has a care manager or not. The summary sheets give reasonable detail to ensure the resident’s wishes and needs can be met in an individual way. The trained nurses record the daily events on purple sheets and the care staff on white. Information about the resident is therefore disjointed and not in chronological order. Staff understand the need for good record keeping and ensure records of the day for each resident are made. The home runs a keyworker system and named nurse system. The trained nurse is responsible for care planning and updating the care plan and the care staff and trained nurse will take a special interest in a designated resident. Health care is well maintained with specialist and outpatient attendances supported. Chiropody, hearing and sight tests are sourced. Records of in house and external health care visits are made. Evidence of timely referrals to the GP were seen. Staff administering medication are registered nurses. Administration is by monitored dosage with records of administration signed appropriately. Storage of medication was appropriate within designated locked clinical rooms. The clinical rooms have hand washing facilities and ample storage. Some residents are supported to self administer medication, appropriate risk assessments and storage and checking mechanisms are in place. Residents spoke very highly of the staff team, with comments like “they are a lovely lot”, “they can’t do enough for me”. Staff were observed knocking on doors and waiting to be invited in. Staff are aware of the extra care and support needed by residents and their families during a resident’s last stage of life. Information regarding the resident’s wishes at the time of their death is recorded. Every effort to provide for the needs and wishes for residents who are terminally ill or dying is made. Deteriorating conditions are understood and well managed. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Service users can make choices about aspects of their daily lives. The range of activities offered is limited. Food standards need improvement. EVIDENCE: The staff, manager and residents said the activities offered would benefit from including arts, crafts and other hobbies. The manager is actively trying to recruit a suitable person to bridge this gap. Staff said some residents became bored at weekends as no formal organised activities were on offer then. There are two activities staff working at the home at present. Staff and residents said that staff rarely are able to offer 1 to 1 trips out due to staff shortages and Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 13 lack of appropriately trained drivers. The house owns are minibus and has benefited from the recent purchase of a van which is suitable for wheelchair users. Information about the activities for the week and for the month was on display and residents were aware of what was on offer. Residents are supported to make choices about whether they participate in activities, what they choose to eat, what time they get up when they bathe etc. The home has frequent and numerous visitors including local groups providing entertainment, singing and dancing etc. Gavin Astor uses contractors to provide catering. Recently work has begun to resolve issues around the pureed and soft diet offered. The Primary Care Trust dietician took food for analysis, the results necessitated a number of recommendations being made. Work is now being undertaken to improve food cooked for special diets. Residents comment cards ask whether they like the food, many ticked ‘no’. When discussing this with residents on the day of the inspection they said the food was not hot enough sometimes, that they were not asked formally by the catering company for their comments and input, and that they would like locally grown ingredients. Residents also said they could no longer have food brought in as staff were not allowed to warm it for them. The menus showed 2 choices at each meal time plus additional omelettes chilli, baked potatoes etc, and choices for pudding including fresh fruit, yoghurts and ice-cream etc. The home has a kitchenette area on the upper floor where residents may prepare their own drinks. Menus are now displayed in tables. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17, 18 Residents are protected from the risks of abuse, are able to complain and be listened to, with appropriate action taken. EVIDENCE: The home has a clear and accessible complaints procedure, though the profile of the procedure should be raised with relatives as many said they were unaware of the policy. Evidence that the manager keeps detailed records of investigations and outcomes was seen. Residents said they knew how and to whom they could complain to, and those who had made a complaint were satisfied that it had been dealt with. A new complaint form has recently been devised for complaints specific to the catering company, these are monitored by the manager and passed to the responsible individual and to the catering company. Residents said they had there legal rights protected and were enabled to participate in voting in elections. Access to advocates is arranged when required. Staff on duty had a sound awareness of how abuse might present, referring to learning gained from covering this area in their NVQ, NAPPI and POVA training. Residents felt they were safe in the home and any risks were well managed. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 15 Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,25,26 Service users live in a comfortable and purpose built home, which would be enhanced further by better equipment storage. Service users would feel safer and more independent with the fitting of automatic door closures. ( this is being addressed following the last inspection) EVIDENCE: The home was purpose built in 1993. The home is decorated to a good standard. All rooms are single with en-suite facilities. Those visited were personalized and adequately meeting service users needs. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 17 The home has an array of moving and handling equipment suitable to the needs of the residents, as well as grab rails assisted toilets and bathrooms etc. Individual residents have access to Occupational Therapists. Every corridor had alternative moving and handling equipment within easy access by staff. Corridors, although wide, have hoist and wheelchairs stored (albeit to one side) this makes them cluttered. At the last inspection it was identified that many fire doors are propped open with doorstops, as these doors are fire doors this is potentially dangerous. The manager said the program for fitting appropriate door closure devices has commenced. One resident spoke of how she is responsible for the raised beds in the courtyard. The home was warm and residents confirmed that they are able to control the temperature of their own rooms. The home was hygienic clean and pleasant. The laundry does not have a hand washing sink and is somewhat snug, however the dedicated staff member who works there had good working knowledge of infection control. The remaining standards were inspected extensively at the last inspection and were met. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the 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 Service users needs are met by the skill mix of the staff, but would benefit from additional staff being on duty at peak times. EVIDENCE: The unit managers described how skill mix and dependency studies are conducted regularly. As a result of the most recent study a post has been created for a “short early” and twilight shift every day. This post has not yet been filled, but when staff have worked this shift both residents and staff said there was an improvement in the care. The staffing rota shows which staff are in the building on duty. 44 of staff have attained NVQ qualifications and the manager continues to put staff forward for training. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 19 The remaining standards were inspected extensively at the last inspection and were met. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34,36,37,38 Residents are confident that the home is well managed and safe. EVIDENCE: Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 21 The manager has many years experience in the running services for older people, and younger adults. Residents spoke very highly of the manager and unit managers confirming that an open door policy is in place. The registered manager is a Registered General Nurse and has a diploma in care home management. Residents understood the ‘hierarchy’ of the home as did staff on duty. Staff are encouraged to make their own decisions but know when to refer issues to more senior staff. Residents and staff considered the manager and unit managers to be both competent and approachable. Residents have a forum with an elected chairperson secretary and treasurer, the forum occasionally invites the manager to attend. Questionnaires are sent out to residents and relatives regularly to seek their views about how the home is run and include a range of topics such as food. Suitable insurance is in place. Staff are regularly supervised with records held of each session. Unit managers take responsibility for supervising RGN’s. RGNs supervise care staff and the manager is responsible for supervision of all the ancillary staff. Records required by regulation and as good practice are held, are regularly updated and stored securely. Staff practices protect residents. Staff have updated moving and handling, fire safety, first aid and COSHH training. Records received with the pre inspection information indicate that servicing and maintenance of equipment is up to date and undertaken regularly. Staff have policy documents, including health and safety, to refer to. The manager now includes a summary of quality assurance audits with the regulation 26 documentation and sends this to the commission. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 22 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 3 2 X 3 3 4 3 5 3 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 3 23 X 24 X 25 3 26 3 STAFFING Standard No Score 27 2 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 3 35 X 36 3 37 3 38 3 Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 23 yes Are there any outstanding requirements from the last inspection? 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 OP19 Regulation 23(4)(a) Requirement Following consultation with the fire authority take adequate precautions against the risk of fire including suitable fire equipments:In that appropriate method of holding fire doors open and that will close safely if the fire alarms are activated. This requirement is repeated from the last inspection The registered person shall provide in adequate quantities, suitable, wholesome and nutritious food which is varied and properly prepared and available at such times as may reasonably be required by service users Timescale for action 30/03/06 2 OP15 16(2)(i) 30/01/06 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 Refer to Standard OP7 Good Practice Recommendations It is recommended that when care plans have been DS0000026172.V262376.R01.S.doc Version 5.0 Page 24 Gavin Astor House 2 3 4 OP12 OP26 OP27 reviewed any changes are recorded in the care plan itself. It is recommended that the manager continue in her efforts to improve the range of activities offered. It is recommended that a hand washing sink be fitted in the laundry room to minimise risk of cross infection. It is recommended that reviews be undertaken to establish the number of care staff required at peak times of the day, in order to meet the needs of residents in a timely fashion. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 25 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. Gavin Astor House DS0000026172.V262376.R01.S.doc Version 5.0 Page 26 - 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. 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