Inspection on 16/05/06 for Honeyfield

This inspection was carried out on 16th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Honeyfield 10/10/07

Honeyfield 23/04/07

Honeyfield 08/09/05

Honeyfield 21/04/05

Honeyfield 14/09/04

Honeyfield 20/04/04

Honeyfield 23/09/03

Honeyfield 13/06/02

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Honeyfield Honeyfields Rowhill Road Swanley Kent BR8 7RL Lead Inspector Gary Bartlett Key Unannounced Inspection 16th May 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 Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 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. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Honeyfield Address Honeyfields Rowhill Road Swanley Kent BR8 7RL 01322 664433 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 Care Home 68 Category(ies) of Dementia - over 65 years of age (68) registration, with number of places Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users can be admitted from 55 years of age Date of last inspection 8th September 2005 Brief Description of the Service: Honeyfield is a large purpose built, detached premises with accommodation for older people with a mental infirmity. The home is owned by Kent Community Housing Trust, a charity providing residential accommodation for some 600 people in 14 homes in Kent and Greenwich. As part of KCHT and according to its aims and objectives this home provides care and support which promotes independence, provides choice and maintains dignity, particularly for people with dementia, including Alzheimers disease. The home is located in the village of Hextable. There are 13 en-suite bedrooms on the second floor, 33 bedrooms without en-suite facilities on the first floor and 21 bedrooms without en-suite facilities on the ground floor. All bedrooms are single. There is an alarm call system and a passenger lift. There are a number of dining rooms and lounges for communal use. There is a small front garden and larger garden to the rear. There is a large car park to the front of the property. The home employs care staff who work a rota which includes a 4 members of staff on waking night duty. In addition to the care staff admin and management support is available at the local area office, which is shared with other homes. Current fees range from £402.26 to £476.69 per week. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 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 Honeyfield from 9.30 a.m. until 4.30 pm. During that time the Inspector spoke with some residents, visitors and some staff. Parts of the Home, 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’ reflections of the service in the report. Some comment cards were received prior to the inspection. Responses received from resident’s relatives and health professionals indicated they were generally satisfied with the standards of care. There is not currently a registered manager at Honeyfield. There is an experienced person in charge of the home. For the purpose of this report they will be referred to as the Manager. The Manager and staff gave their full cooperation throughout the inspection. What the service does well: What has improved since the last inspection? Some parts of the Home have been redecorated and there are plans for the refurbishment and improvement of the environment. The Statement of Purpose and Service Users Guide has been updated. Staff recruitment has been ongoing to ensure continuity of care. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 6 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. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 7 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 Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 8 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, 3, 4, 5 and 6 Quality in this outcome area was good. Residents 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. The Home did not provide intermediate care. EVIDENCE: The Manager said the Statement of Purpose and Service Users Guide had been updated to be accurately descriptive of the aims, objectives, philosophy of care, services and facilities and terms and conditions of Honeyfield. Copies of the Service Users Guide were provided for each resident or their representative. These were not inspected on this occasion. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 9 Senior staff visited prospective residents prior to admission to make a decision whether the Home could meet the persons’ needs. Information was obtained from 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 helpful in assisting their relative to settle. 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. As recorded later in this report, some staff had not received training in dementia awareness and challenging behaviour. Because of this they lacked the skills to interact appropriately to some behaviours resultant of the residents’ frailties. Intermediate care was not offered at Honeyfield. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 10 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. 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. EVIDENCE: Each resident had a care plan and four were inspected in detail. A new design of care plan was being piloted. Although it was clear that staff were striving to improve the care plans, they were not consistently adequate in regard to the detail of information in some parts. Care plans would benefit from including residents’ strengths and abilities in addition to their frailties. There were some very good examples of daily records but they were not consistently detailed or informative. Risk assessments had not been always been reviewed or recorded as a result of some incidents. The scope and content of risk assessments needed to be more comprehensive. It was important for necessary and current information to be recorded and readily available to staff for them to be able to meet residents’ needs, especially as agency staff were Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 11 regularly used. Some staff spoken with did, however, have a very good understanding of residents’ individual needs. The medicines storage room for Heather and Willow units was inspected. The room was very small, ill-lit and did not have hand washing facilities. A thermometer was present but the temperature of the room was not being monitored. Staff were doing their best within the confined space and it was clean and well maintained. Medications were seen to be stored in accordance with their instructions. 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 inspected had been completed appropriately. Medications were seen being administered in compliance with current guidelines. Records seen 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 generally treated residents with respect and promoted their privacy and dignity. There were exceptions. Although a staff member was seen to close the door when taking residents to the toilet, they did not lock it. This was poor practice, especially in view of many residents’ propensity to wander into rooms. There was a hand written notice that gave details of a resident’s allergy on general view in the dining area of one unit. Whilst recognising the need for staff to be advised of this, advice was given that residents’ privacy and dignity must be protected. The Manager undertook to seek an alternative method of alerting staff to individual residents’ needs. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 12 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. 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 limitations allowed. EVIDENCE: The division of the Home into separate units continued to have a beneficial effect on the general atmosphere, which was generally calm and restful during the inspection. Residents were free to roam within their units as they chose and rise and retire at will throughout the day, indicating routines were flexible and relevant. There was a variety of activities available to residents and support was given by Activities Coordinators. Good liaison was seen between the Activities Coordinators and care staff. A magician was visiting on the morning of the inspection and was very much enjoyed by the residents. Minibuses were available for outings. Honeyfield had a very active volunteer group, which involved relatives as much as possible and greatly benefited residents through environmental Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 13 improvement and befriending. Visitors spoken with said they were welcomed at all reasonable times and were provided with refreshments. Residents enjoyed food that was wholesome and well presented with choice that was offered in a way easily understood. Unfortunately, some staff did not give residents assistance in eating in a discreet and sensitive manner. What made this more concerning was that one staff member admitted they had been shown the appropriate manner in which to assist residents. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 14 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. 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: Residents benefited from the complaints procedure being readily available. A visitor described how they knew of the complaints procedure but had not had reason to use it. 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. A senior staff member spoken with had a sound understanding 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. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 15 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, 20, 21, 22, 24, 25 and 26 Quality in this outcome area was poor. The quality of life and safety of residents continued to be adversely affected by the failure to carry out the required improvements to the environment that had been notified in previous reports. Poor infection control placed residents at potential risk. EVIDENCE: The Home which was within easy walking distance of village shops, pubs etc, so residents could easily have access to them with assistance. The gardens continued to be beautifully kept with a great deal of assistance from the volunteer ‘Friends’ of Honeyfield. The accommodation was arranged on 3 floors with self-contained units on each floor. Although some areas had been redecorated since the last inspection there was still a need for many parts of the Home to be repaired or upgraded. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 16 This had a consequent adverse effect on residents’ quality of life, compromising their comfort and in some instances, placing them at potential risk. Kent Community Housing Trust had provided a programme of refurbishment scheduled over a number of years. It was proposed that this would address previously notified concern. For example, several toilets were large, cold and institutional, some rooms were not carpeted and bedrooms varied greatly in standards of décor, many needed redecorating and repair where there was damage. One bedroom seen had a cracked ceiling. There were still bedrooms without lighting that residents could control when in bed. A number of washbasins in bedrooms needed to be replaced. Lighting in a number of areas was still not domestic in character. Some remedial action was required sooner. The sluices were very dilapidated and did not provide an environment in which staff were able to maintain infection control. For the same reason parts of the laundry had to be improved. A staff member that was seen to give residents assistance with toileting and personal care, without using protective gloves and apron, also placed residents at potential risk. The staff member said they were aware of the availability of the protective wear. A senior staff member described how an assessment had been made of each residents’ in relation to the furniture and fittings to ensure that they were adequate and met the needs of the resident. Where they were able to use them, residents were provided with keys to their bedrooms. The Manager stated an Occupational Therapist had made an assessment of the premises and they were waiting for the report. Pipe work and radiators were guarded or had guaranteed low temperature surfaces to protect residents from the risk of burning. Pre-set valves were fitted at hot water outlets to minimise the risk of scalding. The water supply was periodically checked for Legionella. Emergency lighting was provided throughout the Home. Those parts of the Home inspected were clean and mostly free from unpleasant odours. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 17 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 poor. Recruitment processes were robust and offered protection to people living at the Home. It was not evident the Home’s staffing levels were adequate to meet the needs of residents. EVIDENCE: Visitors spoke highly of the staff, saying they were friendly and helpful. 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 problematic for the Home and there was a continued reliance on the use of agency staff to maintain staffing levels. It was not evident that staffing levels were adequate at all times of the day. There were protracted periods of time throughout the day when residents were not supervised. At lunchtime it was observed that, on some units, more residents needed assistance with eating than there were staff in the vicinity to help them. The staff rosters inspected indicated that two night staff members regularly worked 7 consecutive nights on alternate weeks. The Manager said they were Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 18 aware that residents could be at risk through the competency of staff being compromised by their working excessive hours. Efforts to change this shift pattern had not been successful to date. The Home’s staff were required to undertake a comprehensive induction programme. There was also an induction programme for agency staff to complete on their first shift at the Home. This was not inspected on this occasion but during a follow-up telephone conversation, it was suggested that this be expanded to include the administration of medicines. There was ongoing training for staff, which had recently included specialist areas such as dementia. Each staff file included a “staff training analysis sheet” to record training courses they had attended. Unfortunately there was not a training matrix that gave a ready overview of staff training needs. Such a tool was needed to assist with a more robust approach to ensuring staff received the training they needed, rather than making it “available to them”. This was especially necessary where there was some apparent resistance to training. Staff were seen to be generally sympathetic and supporting of residents. There were occasional instances in which some staff were observed to interact with residents in a manner that was not conducive to allaying residents’ anxieties or maintaining a calm atmosphere. This demonstrated a lack of understanding of dementia. Some staff said they had not received recent training in the management of challenging behaviour. Data provided by the Manager showed that 40 of staff were trained in NVQ. Some staff spoke of the support and assistance they were given in this. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 19 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): 33, 35 and 38 Quality in this outcome area was good. Residents’ financial interests were protected. Residents’ welfare was promoted through regular environmental and equipment safety checks. EVIDENCE: Most residents were unable to manage their own finances and the Manager explained that the Home encouraged residents’ families / representatives to give assistance with this. There was 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. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 20 The Manager described how residents and their representatives or relatives were regularly asked for their views about the service. There were annual questionnaires and a relatives meeting. Focused residents’ meetings were held every 2 or 3 months. It was suggested that residents’ relatives or representatives be invited to these meetings to help. Kent Community Housing Trust had recently reviewed all its policies to ensure they complied with current legislation and good practice guidelines. Records seen indicated that the Home was ensuring staff had fire training or had participated in fire drills. Staff spoken with had a sound understanding of emergency procedures. The Manager stated that all records of maintenance and safety checks were up to date. These were not inspected on this occasion. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 21 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 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 2 X 2 3 1 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 X X 2 X 3 X X 3 Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 22 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 OP7 Regulation 14(2)(b), 15(2), 17 Schedule 3, Schedule 4 Requirement Timescale for action 23/06/06 2 OP7 13(4) 3 OP9 12(1)(a), 13, “The registered person shall maintain records as specified in Schedules 3 and 4. The registered person shall keep the service user’s plan under review” in that service users’ individual plans and records must be kept and be up to date in that they must be consistent and specific in detail of information. An action plan must be received by CSCI by the given timescale. The registered person shall 23/06/06 ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated in that risk assessments must be more comprehensive and recorded in response to incidents and changes in residents welfare. An action plan must be received by CSCI by the given timescale. “The registered person shall 23/06/06 make arrangements for the recording, handling, safekeeping, safe administration of medicines” in that: 1. The temperature of the medicines storage areas DS0000023967.V294111.R01.S.doc Version 5.1 Honeyfield Page 23 4 OP15 5 OP19 6 OP21 must be monitored. 2. Better rooms with appropriate facilities, including improved lighting and provision for hand washing, must be provided for the storage and preparation of medicines. An action plan must be received by CSCI by the given timescale. 12(4)(a) “The registered person shall 23/06/06 make suitable arrangements to ensure that the care home is conducted in a manner which respects the privacy and dignity of service users”, in that: 1. The doors must be locked when staff are assisting residents with personal care in toilets. 2. Staff must give assistance in eating in a discreet and sensitive manner. 3. Personal information must be kept confidential. An action plan must be received by CSCI by the given timescale. 23(2) “The registered person shall 23/06/06 having regard to the number and needs of the service users ensure that the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally”. An action plan must be received by CSCI by the given timescale. 23(1)(a) “The registered person shall 23/06/06 23(2)(f)(j) having regard to the number and needs of the service users ensure that the physical design and layout of the premises to be used as the care home meet the needs of the service users” in that sufficient numbers of bathrooms and toilets must be available which are suitable to meet the service users needs i.e. DS0000023967.V294111.R01.S.doc Version 5.1 Page 24 Honeyfield 7 OP22 13(4) 8 OP26 12(1), 13(3)(4) (c) 16(2)(j) warm and non institutional “The registered person shall 23/06/06 ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety” in that support frames used around toilets must be secured to the floor An action plan must be received by CSCI by the given timescale. “The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home”, in that: 1.The laundry floor must be repaired and made impermeable, the washing machines must be mounted on an impermeable surface and walls of the laundry must be made good to promote infection control and adequate hygiene standards. 2.The sluices must be made good to promote infection control 31/07/06 and adequate hygiene standards. 3. Staff must use protective gloves and aprons when assisting service users with personal care with immediate effect. Failure to comply with the requirements by the given timescales may result in enforcement action. “The registered person shall, 23/06/06 having regard to the size of the care home, the statement of purpose and numbers and needs of service users – (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such DS0000023967.V294111.R01.S.doc Version 5.1 Page 25 9 OP27 18 Honeyfield 10 OP30 18 numbers as are appropriate to the health and welfare of service users” in that a review of staff levels must be undertaken to ensure they are appropriate to the needs of the service users at the home. The result of this review and its methodology must be received by CSCI by the given timescale. “The registered person shall 23/06/06 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 timescale. 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 3 4 5 Refer to Standard OP24 OP27 OP28 OP30 OP30 Good Practice Recommendations It is strongly recommended bedrooms are furnished to comply with Standard 24 It is strongly recommended staff do not work long consecutive shift patterns that may compromise their competency through fatigue. It is recommended that 50 of care staff in the home hold an NVQ qualification of level 2 or above. It is strongly recommended a training matrix is used to readily identify staff training needs It is strongly recommended the induction programme for agency staff is amended to include the administration of medicines. DS0000023967.V294111.R01.S.doc Version 5.1 Page 26 Honeyfield 6 OP33 It is strongly recommended that residents’ relatives or representatives be invited to residents’ meetings to help. Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 27 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 Honeyfield DS0000023967.V294111.R01.S.doc Version 5.1 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!