Inspection on 23/04/07 for Honeyfield

This inspection was carried out on 23rd April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 16/05/06

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 23rd April 2007 10:10 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.V337152.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. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 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) www.kcht.org Kent Community Housing Trust Post Vacant Care Home 68 Category(ies) of Dementia - over 65 years of age (68) registration, with number of places Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users can be admitted from 55 years of age Date of last inspection 17th January 2007 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 some 1,000 registered care placements across Kent, Medway, Greenwich and Bexley. 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.V337152.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 Honeyfield on Monday, 23rd April 2007 from 10.10 a.m. until 3.30 pm. and Wednesday, 25th April from 8.00 a.m. until 9.40 a.m. During that time the Inspector spoke with some residents 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’ reflections of the service in the report. 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. This inspection was resultant of concerns from external agencies about the health of residents and poor hygiene standards within the home. As detailed in the report, these concerns were substantiated and immediate requirements notices were issued as a result. What the service does well: What has improved since the last inspection? Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 6 Two new washing machines have been provided and parts of the laundry floor improved. The temperatures of medicines rooms are now being monitored and handwritten amendments to the Medication Administration Record sheets are clear and signed by trained staff. Building works are being undertaken to improve areas of the middle floor and some areas have been redecorated 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. The summary of this inspection report can be made available in other formats on request. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 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.V337152.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 and 6 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There are good pre-admission assessments and the opportunity to visit the home prior to admission. The home cannot evidence that staff have the skills to meet residents care needs. EVIDENCE: Senior staff visit prospective residents prior to admission to make a decision whether the Home can meet the person’s needs. Information is obtained from Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 9 relevant health care professionals to assist in assessments. Residents and/or their relatives are able to visit the Home before moving in. As recorded later in this report, records seen and observed practices did not show that all staff have received the training needed to meet the residents’ needs. Consequently, residents may be at risk through some staff’s lack of knowledge of dementia, challenging behaviour, moving and handling, infection control and adult protection issues. It was not evident that staffing levels were always adequate to promote residents’ welfare. Intermediate care is not offered at Honeyfield. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care plans must be more consistently maintained to promote residents’ health and welfare. Their dignity is compromised by the unclean conditions in which they live. Residents are also at potential risk through the unsafe storage of the medication room keys. EVIDENCE: Each resident has a care plan and five were inspected in detail. There are some improvements to care planning and the Manager is aware that further work is required. The Manager said they are addressing this through the regular review of care plans and risk assessments. Not all care plans are reflective of residents’ current care needs or as comprehensive and directive as necessary to ensure staff know how they are to be met. The standard of daily record keeping is generally good. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 11 There is a key worker system but staff do not feel they are enabled to contribute to the review of care plans as fully as they might. Care plans show that residents have ready access to GPs, chiropodists etc as necessary. The medicines storage rooms were inspected. The temperatures of the rooms are now being monitored and handwritten amendments to the Medication Administration Record sheets are clear and signed by trained staff. KCHT has stated that improved medication storage facilities will be provided as part of the planned building programme. In the meantime, the existing facilities must be kept cleaner to protect the residents and reduce the risk of cross infection. Records are available to indicate that all staff administering medications have been trained and signed off as being competent to do so and medications were seen being administered in compliance with current guidelines. However, a recent health visitor to the home has reported that they observed staff administering medication by hand to the residents and placing it in their mouths, the practice of doing this from resident to resident places them at risk from cross infection. Although a response from KCHT to a pharmacy inspection conducted on 15th February 2007 states that senior staff have been made aware to carry the medication keys on them at all times, the keys are being left in places that other people have access to. This puts residents at potential risk. Staff speak with residents politely and with courtesy. However, residents’ dignity is compromised by living in a unclean and unhygienic environment. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service Residents are supported in enjoying a fulfilling lifestyle with good outside links maintained and some control of their lives as their individual abilities allow. Dietary needs of resident are well catered for with a balanced and varied selection of food that meets their tastes and choices. EVIDENCE: Generally, staff are aware of the need to plan the routines and activities of the home in a way which meets the choice and wishes of residents. Because of residents’ mental frailties, it is often difficult to consult them about providing a flexible lifestyle that meets their wishes. Consequently, it is essential for the home to promote close links with relatives, the provision of independent advocacy and provide help with communication skills by staff. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 13 Policies, procedures and guidance promote residents’ independence and choice. Residents are given the opportunity to take part in a variety of activities within the home. There is good liaison between the Activities Co-ordinators and care staff. Minibuses are available for outings. The home has open visiting arrangements and residents can entertain their family and friends in their own room. If they prefer they can use community areas of the home to talk with visitors. Members of the community often visit the home. Residents said they enjoy the meals and have plenty to eat. The meals are well presented and look appealing. Lunch is taken in a relaxed atmosphere and staff offer assistance in a discreet and sensitive manner. The menus seen are varied. Residents are offered drinks and biscuits during the day. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service A complaints procedure is readily available. There are systems to ensure residents are protected from abuse but not all staff have had appropriate training or are present in sufficient numbers to ensure residents are safe from harm. EVIDENCE: The service has a complaints procedure that is up to date, clearly written, and easy to understand. The complaints procedure is widely available. Records of complaints are kept and show one complaint has been received in the last year. There are procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. Some staff have not had training around Safeguarding Adults, leading to inconsistent knowledge and practice within the service. There are two current adult protection alerts relating to the home including one which has been raised as a result of the latest concern re lack of infection control and poor hygiene practices. There Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 15 are high numbers of incidents of aggression between the residents and there are not always staff in attendance to minimise the risk of harm to residents. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22 and 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Poor standards of hygiene place residents at potential risk. The quality of life and safety of some residents continues to be adversely affected by required improvements to the environment and furnishings. EVIDENCE: The accommodation is arranged on 3 floors with self-contained units on each floor. Kent Community Housing Trust has provided a programme of refurbishment scheduled over a number of years. It is proposed that this will address previously notified concerns. Building works are being undertaken to improve areas of the middle floor and some areas have been redecorated since Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 17 the last inspection. There is still a need for many parts of the Home to be repaired or upgraded. This includes the sluices which are very dilapidated and do not provide an environment in which staff are able to maintain infection control. Staff practices will also have to improve. The sluices are unclean and cluttered. Cleaning tools such as mops are not properly stored and there are items that should never be in a sluice room, such as an inhaler. Waste bins in high-risk areas are not foot operated. Evidence received prior to the inspection indicated that there are insufficient bins and bags at Honeyfields to store infectious waste. Further incidents of poor practice were also evident in many residents’ bedrooms. Two carpets were fouled with faeces, as was one wardrobe, even though staff had been obviously in those rooms recently. Many commode frames are filthy and some frames have parts missing. Residents’ personal toiletries, soaps, soap dishes, tooth-bushes and their holders, hairbrushes, combs, razors etc, were found to be dirty. The cleanliness of some handbasins was no better. In one bedroom, the bed was made with stained linen and the dressing gown hanging on the door was heavily stained. This disregard for good practice was further evidenced by some staff members entering the kitchen without putting on protective aprons. One such staff member said they are aware of the home’s procedures. Recent health visitors to the home have reported that staff were observed to move from room to room with the same aprons and gloves on. At a time when there was a diarrhoea and vomiting outbreak at the home this poor practice placed residents at risk. Two new washing machines have been provided and parts of the laundry floor improved. It is planned to carry out the remaining repairs, notified in previous inspection reports, necessary. This includes further areas of the laundry floor to be made good. The laundry is cluttered and contained an apparently disused mangle, stained and unclean needs to be removed. Parts of the home are malodorous and indicative of continence management problems. Many carpets are stained and some are sticky. The above failures to maintain satisfactory standards of hygiene are particularly concerning in view of the outbreak of diarrhoea and vomiting amongst a large number of residents the week before the inspection. Members of the Kent Health Protection Unit visited the home on 20th April 2007 and recommendations were made to improve infection control precautions. Despite a requirement in the last key inspection report, some support frames around toilets are not secured, posing a potential hazard for residents. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 18 The gardens continue to be well kept with a great deal of assistance from the volunteer ‘Friends’ of Honeyfield. Honeyfield DS0000023967.V337152.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Recruitment processes are robust and offer protection to people living at the home. It is not evident there are always sufficient, competent staff to meet the needs of residents. EVIDENCE: Records seen indicate that robust recruitment procedures are used and the home directly employs only staff that have been properly vetted. The recruitment and retention of staff continues to be problematic for the home and there is a continued reliance on the use of agency staff to maintain staffing levels. It is not evident that staffing levels are adequate at all times of the day. There are periods of time throughout the day when residents are either not supervised or there is only one care worker on a unit. This is sometimes a new Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 20 and inexperienced carer alone on duty. Consequently, residents are potentially at risk, especially in view of the high number of aggressive incidents recorded. Whilst acknowledging staffing levels have been recently affected by illness, it is not evident that they are sufficient to maintain suitable standards of hygiene within the home. Staff are required to undertake an induction programme. There is also an induction programme for agency staff to complete on their first shift at the home. Although each staff member has a “staff training analysis sheet” to record training courses they have attended, the training matrix used to give a management overview of staff training needs is not up to date. Consequently, it is not readily evident that staff are receiving the necessary training, either general such as moving and handling, or specific such as dementia, and challenging behaviour. Observed poor practices, by some staff, indicate residents may be at risk through inadequate staff training or supervision. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The management of this home does not safeguard residents. EVIDENCE: There is not a registered Manager at Honeyfield. The current Manager has been in post since 2005 and the Commission is still waiting to receive an application for registration. As mentioned previously in this report, there is a high number of incidents within the home and it is not readily evident staff have had sufficient or recent training to enable them to work safely. Some Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 22 staff were seen to ignore basic safe practices and cut corners. Examples being unsafe moving and handling methods that caused distress to residents and could cause injury. The Manager stated there is regular formal staff supervision; this was confirmed by a senior staff member. This clearly needs to be supplemented by more robust practical day to day supervision. The management of the hygiene standards within the home is clearly failing as evidence by the poor standards observed during an outbreak of diarrhoea and vomiting amongst a large number of residents. Staff spoken with would like to be able to contribute more to the review of residents’ care, considering their knowledge of residents’ daily needs would be a valuable contribution not currently utilized. Most residents are unable to manage their own finances and the Manager explained that the home encourages residents’ families / representatives to give assistance with this. There is a sound system of holding and recording residents’ cash, which facilitates ease of monitoring. Staff were seen to be diligent in ensuring COSHH requirements were adhered to and those spoken with have a good understanding of emergency procedures. The care plan cupboards in communal areas are left unlocked. Therefore the care plans are not securely stored when not in use, and the confidentiality of residents’ personal information is potential compromised. 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. The Manager stated that records of maintenance and safety checks are in order. These were not inspected on this occasion nor were the Home’s environmental risk assessments. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 23 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 X X 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 3 2 2 X X X 1 STAFFING Standard No Score 27 1 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 2 X 3 2 2 1 Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 24 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 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 so staff know service user’s care needs and how they are to be met. Adequately detailed care plans must be in place by the given timescale, if not sooner, and maintained thereafter. Previous timescale of 30/03/07 not met. The registered person shall 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. Adequately detailed risk assessments must be in place by DS0000023967.V337152.R01.S.doc Timescale for action 30/06/07 2. OP7 13(4) 30/05/07 Honeyfield Version 5.2 Page 25 3. OP9 12(1)(a), 13, the given timescale, if not sooner, and maintained thereafter. Previous timescale of 30/03/07 not met. The registered person shall 30/05/07 make arrangements for the recording, handling, safekeeping, safe administration of medicines in that the medicines rooms must be kept clean. To be completed by the given timescale, if not sooner and maintained thereafter. 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 their safety in that support frames used around toilets must be secured to the floor To be completed by the given timescale, if not sooner and maintained thereafter. The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home, in that: 1. All parts of the home must be kept clean and hygienic. 2. Service users’ personal toiletries must be kept and stored in a hygienic manner. An immediate requirement notice has been issued. The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home, in that: 1. Disused equipment must be DS0000023967.V337152.R01.S.doc 4. OP22 13(4) 30/05/07 5. OP26 12(1), 13(3)(4) (c) 16(2)(j) 23/04/07 6. OP26 12(1), 13(3)(4) (c) 16(2)(j) 15/05/07 Honeyfield Version 5.2 Page 26 7. OP26 12(1), 13(3)(4) (c) 16(2)(j) 8. OP26 12(1), 13(3)(4) (c) 16(2)(j) 9. OP26 16(2)(k) 10. OP27 18 removed from the laundry. 2. Appropriate waste disposal bins must be provided in high risk areas. To be completed by the given timescale, if not sooner and maintained thereafter. The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home, in that the laundry floor must be made good to promote infection control and adequate hygiene standards. To be completed by the given timescale, if not sooner and maintained thereafter. The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home, in that a written response to the recommendations made by the Kent Health Protection Unit resultant of their visit of 20th April 2007 must be received by CSCI by the given timescale, if not sooner. The registered person shall, having regard to the size of the care home and the numbers and needs of service users keep the care home free from offensive odours and make suitable arrangements for the disposal of general and clinical waste. To be completed by the given timescale, if not sooner and maintained thereafter. The registered person shall, 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 DS0000023967.V337152.R01.S.doc 30/05/07 30/05/07 31/05/07 31/05/07 Honeyfield Version 5.2 Page 27 11. OP30 18 12 OP37 12(4)(a) 13 OP38 12(1)(a) suitably qualified, competent and experienced persons are working at the care home in such 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 if not sooner. “The registered person shall, 30/05/07 having regard to the size of the care home, the statement of purpose and numbers and needs of service users ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform including structured induction training” in that a detailed training analysis must be made for every staff member that includes: 1. Training they have undertaken 2. Training courses booked 3. Details of training providers and any accreditation they may have. A copy of this must be received by CSCI by the given timescale. “The registered person shall 01/06/07 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 the care plans on all units must be stored securely when not in use. To be completed by the given timescale, if not sooner and maintained thereafter. “The registered person shall 15/05/07 DS0000023967.V337152.R01.S.doc Version 5.2 Page 28 Honeyfield 14. OP38 12(1)(a) ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users” in that staff must transport service users in wheelchairs in a safe manner, with particular regard to the footplates. To be completed by the given timescale, if not sooner and maintained thereafter. “The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users” in that only safe and appropriate techniques of moving people are used to avoid injury to service users and staff. To be completed by the given timescale, if not sooner and maintained thereafter. 15/05/07 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. Refer to Standard OP9 OP9 OP28 Good Practice Recommendations It is strongly recommended that key security be reviewed. It is strongly recommended that KCHT proceed with the stated aim of providing improved facilities for the storage of medicines. It is recommended that 50 of care staff in the home hold an NVQ qualification of level 2 or above. It is strongly recommended the training matrix is kept up to date and current. 4. OP30 Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 29 6. OP33 It is strongly recommended that residents’ relatives or representatives be invited to residents’ meetings to help. Honeyfield DS0000023967.V337152.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V337152.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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