Inspection on 21/07/08 for Keb House

This inspection was carried out on 21st July 2008.

CSCI found this care home to be providing an Adequate service.

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

Keb House 23/07/07

Keb House 25/07/06

Keb House 18/01/06

Keb House 19/07/05

Keb House 22/11/04

Keb House 15/06/04

Keb House 17/02/04

Keb House 14/11/03

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Keb House Haytons Lane Appleby Scunthorpe North Lincolnshire DN15 0AP Lead Inspector Rob Padwick Key Unannounced Inspection 12:30 21st & 23rd July 2008 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 Keb House DS0000002886.V368763.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. Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Keb House Address Haytons Lane Appleby Scunthorpe North Lincolnshire DN15 0AP 01724 733956 01724 734800 kebhy@aol.com 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) Mrs Helen Elizabeth Young Mrs Helen Elizabeth Young Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (18) of places Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd July 2007 Brief Description of the Service: Keb House is a care home situated in the village of Appleby near to the town of Scunthorpe. It comprises of an older Victorian style house and an annexe of a single storey purpose built extension. There is a courtyard used for parking and domestic needs and a garden and sitting area to the front of the home. The newer part of the home has its own kitchenette, dining area and lounges. There are no retail providers in the village, but residents can access a nearby church and public transport is available. The home has 14 single bedrooms and 2 shared bedrooms, 7 of which have en suite facilities. Information provided by the homes management identified that the weekly fees charged are between £342.00 and £393.00 with additional charges are made for chiropody, hairdressing and toiletries. Information relating to the home is available from the manager upon request. Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last key inspection of the home that took place on 23rd July 2007, together with information gained during a site visit to the home. As part of the inspection we send out an Annual Quality Assurance Assessment (AQAA), which is a self-assessment document that the registered person must complete and return to the Commission. It should show how well the home is meeting regulations and national minimum standards, what has been done to improve the service since the last inspection and what still needs to be done. On this occasion the provider did not return the AQAA to us so we did not have the necessary information to help us check what relatives of people living in the home or professionals working with then think of the service. This affects the judgements we are able to make about the service. This site visit took place on 21 July 2008 and lasted for 5.75 hours. As well as talking with the provider manager, we spoke to members of staff on duty as well as some people living in the home. As part of the visit we looked round the home including the shared areas, together with personal bedrooms, and inspected the records of people’s care, some staff files, the health and safety documents and other records kept in the home. What the service does well: What has improved since the last inspection? Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 6 Some of the recommendations made following our last inspection had been implemented so that more staff are trained to ensure people living in the home are safeguarded from possible abuse. People using the service had been consulted more fully about the choices of food provided to them and more activities had been developed, although more were still needed to ensure their individual needs are better met. What they could do better: Medication administered to people living in the home must be accurately recorded to ensure their health needs are safely met and they are not put at potential risk of harm. The home must be free from unpleasant smells and kept clean to ensure people using the service have a pleasant environment to live in. A robust training and development plan must be developed to ensure staff are equipped with the skills needed to meet the needs of people living in the home. Significant events effecting people living in the home must be notified to the Commission for Social Care Inspection in order to promote and protect their health, safety and welfare. Fire doors must not be left wedged open by unauthorised means to ensure people using the service are safeguarded from potential harm. Up to date information about the home should be available to help people thinking about using the service make a more informed choice about it and care plans belonging to people living in the home should be developed with details about their individual strengths and abilities in order to help staff support and engage with them better about their wishes and needs. Activities provided to people living in the home should continue to be developed to ensure the individual needs of people living in the home are met and staff should be encouraged to engage more fully them in order to enhance the potential for them to feel more in control of their lives. Items of food should be liquidised separately to ensure their appearance looks more appetising. The home’s maintenance plan should be developed and implemented to improve the environment provided to people living there and staffing levels should be reviewed to ensure their are enough of them on duty to meet the needs of people using the service. New staff should have a full Criminal Records Bureau check in place before they are allowed to start work in the home and the quality assurance systems for the service should be implemented further to ensure the service can monitor its progress and enable people to be consulted about it. Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 People who use this service experience good outcomes in this area. Whilst people using the service are assessed to ensure the home can meet their needs, more up to date information about it would enable people to make a more informed choice about using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home indicated they had been visited by the manager for the service as part of the admission process to the home. A sample of case files of people using the service all contained thorough assessments about them to ensure the service was able to meet their needs. The assessment of a person recently admitted was not dated and therefore difficult to confirm when it had been carried out, although the manager confirmed she had carried this out before they had moved in to the home. Information was available to help people make an informed choice about using the service, although the provider Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 10 manager told us this needed updating to reflect changes that had recently taken place in the home. A recommendation is made about this. The manager confirmed the service does not accept placements for intermediate care so standard six does not apply to this home. Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use this service experience adequate outcomes in this area. Whilst the health and personal care needs of people living in the home are generally well met, some medication errors placed them at risk of potential harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home indicated their individual health and personal care needs were generally well met and relatives of them we spoke to confirmed this. We inspected the case files of people using the service and these all contained care plans that provided information about a good range of their various physical, emotional and psychological needs. Whilst we saw evidence that people using the service had signed these wherever possible, it is recommended they are further developed to provide information about personal strengths and abilities. This would enable staff to involve them more directly in the delivery of their support and ensure that it meets their individual Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 12 wishes and needs and maximise their opportunities to be as independent as possible. We saw evidence that care plans were being regularly reviewed together with appropriate assessments about the management of risks to people living in the home. People using the service have a mixed range of needs and a number of them have memory and dementia related conditions. The provider manager indicated she was aware of the need to develop services for this group and on the day of our site visit had attended a Local Authority “Let’s Respect Seminar” which she was to provide staff in the home with more information about. Feedback from professional staff in the community was generally positive and a district nurse confirmed the home maintained good liaison with her whilst Social Services staff commented on the way the service had recently “bent over backwards” to meet the needs of a person who moved into the home. We saw evidence of regular monitoring of various aspects of health in the case files inspected together with visits from health professionals. On the day of our site visit a Chiropodist was visiting the home. Policies and procedure were available guide staff in the staff use and handling of medication. We saw evidence that staff responsible for this aspect of practice had received appropriate training but found some inconsistencies and gaps in the records of medication given to people using the service. A random inspection of these indicated that some medication had been signed for when it had not actually been given, whilst some other medication had been signed for when in fact it had not been given. A requirement is made about this to ensure people living in the home are safeguarded from potential harm. We observed friendly interactions between staff and people living in the home with staff responding appropriately to them in order to ensure their rights were maintained. Their were times however, when we observed staff were involved elsewhere in the home and a recommendation is made about this (See Staffing) Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use this service experience adequate outcomes in this area. Whilst a variety of activities were available for people living in the home, the further development of these would enable people using the service to make more meaningful choices about these and enhance their ability to experience greater wellbeing. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Following our last visit we recommended more activities are developed to enable people living in the home to have greater opportunities to participate and experience a lifestyle that matches their individual expectations. We saw evidence the provider had developed these since then but that more was still needed to ensure that individual outcomes of people using the service are better met. During our visit an activities coordinator took a group of people out for a walk around the local village and records inspected documented visits from entertainers, physical activity workers, local church singers and personal manicure sessions. However some people expressed a desire for more to be done to combat the potential for isolation and boredom in a home that is Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 14 situated in a relatively rural location. One relative commented the manager had spoken about developing some raised flower beds for those with an interest in gardening and a recommendation is made that staff engage more fully with people living in the home about their individual wishes and feelings in order to enhance their potential for increased wellbeing and ability to feel more in control of their lives. Relatives and friends were observed visiting people using the service and comments received from them confirmed they were welcomed to visit and take part in the life of the home. People using the service told us they liked the food that was served and we saw evidence they could make choices about what to eat and were consulted about what was provided to them as previously recommended. Case files documented aspects of weight and nutrition and inspection of the kitchen confirmed that a good supply of fresh and healthy ingredients was regularly used. We noted however that further improvements could be made with regard to the appearance of soft diets. A recommendation is made these items are served separately and not mixed together, in order to make them look more appetising. Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service experience good outcomes in this area. The concerns of people living in the home are taken seriously by staff who have been trained to ensure they are safeguarded from potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People using the service indicated they were generally happy living in the home and relatives confirmed it had a welcoming and responsive attitude and to complaints and suggestions. The service had an appropriate complaints policy to ensure the views of people living in the home are taken seriously and we saw evidence of a number of cards and letters of thanks included in the home’s complaints and suggestions log. The Commission for Social Care Inspection had received no official complaints about the service since the last time we visited and the homes complaints records confirmed that none had been received by the home. A referral had been made to Social Services by the home for investigating under its duties to safeguard people using the service since the last time we visited and we saw evidence of appropriate action to resolve this. Training about the protection of vulnerable adults had been delivered to staff to ensure they are aware of their responsibilities to safeguard people living in the home from potential harm as previously recommended and those staff on duty that Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 16 we spoke to indicated they would take appropriate action if they had any concerns regarding this aspect of practice. Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was generally comfortably furnished and although mostly clean and tidy, there were some areas where improvements were needed. The service comprises a modern ground floor annexe with separate ensuite facilities; together with a smaller traditionally styled period building that is split on two floors. Owing to the age of the property some rooms were in need of refurbishment, due to recent poor weather and associated damp problems, and some other areas in the home that smelt unpleasant. We saw evidence of building work carried out to rectify the damp issues and the manager stated the home’s maintenance plan was being updated and that affected rooms would be upgraded and new flooring laid, where existing cleaning methods were not resolving problems associated with the malodours. Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 18 The manager told us the home’s cleaner had recently resigned but confirmed she was in the process of advertising for a replacement. We made a previous recommendation about the need for the cleanliness in the home to be maintained and a requirement is now made about these matters. Whilst we saw staff being vigilant of the associated conditions of people living in the home, a recommendation is made that further guidance is obtained concerning the management of continence issues to ensure these continue to be appropriately met. No people living in the home commented adversely about the house or their living environment and we saw evidence they had been able to personalise their rooms according to their individual tastes. Keb House DS0000002886.V368763.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 People who use this service experience adequate outcomes in this area. Whilst people living in the home are supported by staff who are friendly and supportive, improved training and management of them would enable the needs of people using the service to be better met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Feedback received about staff was generally positive and a relative commented on the patience shown by them to people living in the home. At the time of our site visit their were three staff on duty as well as the home manager and an activity coordinator. However as previously noted, we observed occasions when people using the service were left and not actively engaged with and we were uncertain where staff were. A recommendation is made about this. The service had recruitment policies and procedures to ensure staff are safe to work with living in the home. The files of the three most recently employed members of staff all contained evidence of initial “POVA First” security checks having being carried out, together with references taken up and other required documents obtained before they started work. However, all of these files contained evidence that the members of staff had been allowed to begin work before a full Criminal Records Bureau check was received for them. The Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 20 manager was strongly reminded this should only be allowed to occur in exceptional circumstances in order to safeguard people living in the home from potential harm. A recommendation is made about this. We saw evidence in the staff files of previous training provided to ensure the needs of people living in the home are appropriately met, together with the development of a new induction programme for them that met the standards required by Skills For Care. The provider manager had unfortunately been away from the service for an extended period of time before our site visit and we were told the staff training programme therefore needed updating to ensure they have the right skills to do their jobs properly. A requirement is made about this. The manager advised she was aware that staff meetings and formal supervision arrangements of them also needed redeveloping. Keb House DS0000002886.V368763.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, 33, 35 and 38 People who use this service experience adequate outcomes in this area. A more effective monitoring of the operation of the management and administrative systems for the home would enable people using the service to be better consulted about it and ensure that their health and safety is safeguarded from potential harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Feedback received from people living in the home indicated the service was generally being well run, although we saw evidence that improvements were needed due to the manager having been away from it earlier in the year as previously noted. The provider manager is a trained nurse and both she and the deputy manager have a recognised management qualification to manage Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 22 the home. The manager has an open and approachable style to running the home and we received comments from people using the service and their relatives that confirmed they felt confident their concerns would be listened to and taken seriously. There are no formal meetings held with people living in the home but were told staff often have talk with them and their relatives to get views about how the service can be improved. Due to her need to be away from the service, the manager had been unable to comply with the need to complete the home’s self-assessment document and it was therefore difficult to get a complete idea about what had happened to the service since the last time we visited. The home has quality assurance systems to monitor its progress and we saw evidence of past surveys sent out to people who use it or have an interest in it as part of these. However, the provider manager told us that due to her having to be away from the home, the development plan for the service needed updating and that she intended to send questionnaires out again to enable people to be consulted it. A recommendation is made about this. The manager told us that relatives generally took responsibility for looking after the finances of people living in the home. Where this does not happen, a running balance is maintained and receipts obtained. We inspected the records for these and found them to be accurately kept and up to date. We saw evidence of a regular safety checks carried out to ensure the welfare of people living in the home is promoted and protected. A random sample of maintenance records that were inspected provided evidence that certificates were kept up to date and that equipment was being appropriately serviced. We had not however always been notified about significant events effecting people living in the home and we noticed some fire doors that were wedged open, which posed a potential safety risk to the health, safety of people using the service, their relatives and staff and requirements are made about these. Keb House DS0000002886.V368763.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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 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 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 OP9OP9 Regulation 13 Requirement Timescale for action 22/07/08 2. OP26OP26 16(2)(k) 3. OP28OP28 OP30OP30 18 4. OP38OP38 37 The registered provider must ensure that medication administered to people living in the home is accurately recorded to ensure their health needs are safely met and they are not put at potential risk of harm. The registered person must 21/08/08 ensure the home is free from unpleasant smells and kept clean to ensure people using the service have a pleasant environment to live in. The registered person must 20/10/08 ensure the service has a robust training and development plan to ensure staff are equipped with the skills needed to meet the needs of people living in the home. The registered person must 22/07/08 ensure significant events effecting people living in the home are notified to the Commission for Social Care Inspection in order to promote and protect their health, safety and welfare. Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 25 5. OP38OP38 23 The registered person must ensure fire doors are not wedged open by unauthorised means to ensure people using the service are safeguarded from potential harm. 22/07/08 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 OP1OP1 Good Practice Recommendations The registered person should ensure that up to date information about the home is available to help people thinking about using the service make an informed choice about it. The registered provider should develop the care plans belonging to people living in the home to include details about their individual strengths and abilities in order to enable staff to support and engage with them more fully about their wishes and needs. The registered person should continue to develop the activities provided to ensure that the individual needs of people living in the home are appropriately met. The registered provider should ensure staff are encouraged to engage more fully with people living in the home about their individual wishes and feelings in order to enhance their potential for increased wellbeing and their ability to feel more in control of their lives. The registered person should ensure liquidised food items used in soft diets are not mixed together, in order to make them look more appetising to people living in the home. The registered person must develop and implement a maintenance plan for the service to ensure people living in the home have a pleasant environment that meets their needs. The registered person should review staffing levels to ensure their are enough staff on duty to meet the individual needs of people using the service. The registered person should ensure that new staff have a full Criminal Records Bureau check in place before they are allowed to start work in the home in order to safeguard DS0000002886.V368763.R01.S.doc Version 5.2 Page 26 2 OP7OP7 3. 4. OP12OP12 OP14OP14 5. 6. OP15OP15 OP19OP19 7. 8. OP27OP27 OP29OP29 Keb House 9. OP33OP33 people using the service from potential harm. The registered person should develop and re implement the services quality assurance systems to ensure it can monitor its progress and enable people using the service to be consulted about it. Keb House DS0000002886.V368763.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Keb House DS0000002886.V368763.R01.S.doc Version 5.2 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. 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