Inspection on 01/06/07 for Kemp Lodge

This inspection was carried out on 1st June 2007.

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

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

Other inspections for this house

Kemp Lodge 23/08/06

Kemp Lodge 18/01/06

Kemp Lodge 06/05/05

Kemp Lodge 14/12/04

Kemp Lodge 21/06/04

Kemp Lodge 30/03/04

Kemp Lodge 23/04/03

Kemp Lodge 19/06/02

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

CARE HOMES FOR OLDER PEOPLE Kemp Lodge Haigh Road Waterloo Liverpool Merseyside L22 3XG Lead Inspector Mrs Sylvia Brown Unannounced Inspection 1st June 2007 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 Kemp Lodge DS0000017245.V334400.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. Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kemp Lodge Address Haigh Road Waterloo Liverpool Merseyside L22 3XG 0151 949 0826 0151 928 0641 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.c-i-c.co.uk. Community Integrated Care Mrs Helen Cook Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service Users to Include up to 38 (OP) One named female out of category service user, under pensionable age. The variation to cease when the service user leaves the home. One named female out of category service user, EMI Personal Care. This variation is applicable only to the named service user, should the named service user leave the home the variation will cease to apply. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 23rd August 2006 4. Date of last inspection Brief Description of the Service: Kemp Lodge Care Home is a purpose built facility that provides nursing care for 38 older persons. The home is located in a residential area in the Waterloo, Merseyside area close to local amenities and public transport, such as local buses and a train station approximately 10 minutes walk away. The Home is built on one level in grounds that it shares with a sister home next door. The grounds are well maintained and accessible by the residents. The Home is owned by a voluntary organisation Community Integrated Care (CIC) and has been operating since 1990. All bedrooms are en-suite with 24 single rooms and 7 double rooms. There are three small lounges and a dining room. There is also a relatives area that provides drinks and a notice board that supplies information of interest to the relatives. The current fees for accommodation range from £ 476 to £603. This fee includes contributions made by the people using the service. Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit to Kemp Lodge took place in one day with a total of 8hrs being spent on the premises. Before the visit the home completed a pre-inspection questionnaire (PIQ) that detailed some of the homes actions to ensure the safety of people who use the service and is one of the ways the CSCI gathers information. During the visit the inspector spent time with people who use the service talking about their daily lives within the home and what they think about the care support they receive. Time was spent observing staff as they went about supporting people who use the service. Two mealtimes were shared with people who use the service, some of whom invited the inspector to see their rooms. The building was inspected as were a number of records which related to the health and safety of people and the running of the home. Comment cards were provided to people who use the service, their family and professional visitors. Information received will be included within the report where it can be. What the service does well: Kemp Lodge appears to be a happy place to live. All the people spoken with spoke highly of the care and attention provided by care staff. The home’s ethos to encourage independence and individuality was clearly evident. Those people spoken with confirmed that they are enabled to continue to control their own lives as far as possible, they can plan their day as they wish, meeting with others or remaining in their room. People recently admitted said they were made to feel very welcome and they had been supported to move in. One person emphasised the considerable kindness and said staff made her feel very welcome. One person stated ‘They were very good, able to visit as often as I needed and only moved in when I was finally ready’. The staff keep people who use the service informed about events and changes within the home. One person stated ‘ we are always told about what’s going on’ ‘ if we don’t like it we can just tell them and they will sort it out’. People who use the service are aware of how to complain and have no hesitation In making their feelings known. Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 6 Care plans are personal and the people who use the service know and agree the plans. People who use the service commented favourably about the meals served at the home. The menu has a variety of meal options, it caters for all diets including soft which also has its own menu for choice. There is even a snacks menu to enable people who use the service chose enjoyable nutritious snacks throughout the day There is ample opportunity for people who use the service to join in activities and individual hobbies and interests are supported. The home supports all people who use the service to have personalised private rooms,one person commented that the home had really supported her and been kind, re painting her room in her favourite colour as a surprise, all of which has helped her to settle in the home. The building itself has been made homely and support people who use the service to feel that its their home. One person explained that they were particular about they way they wanted their room and although this creates some inconvenience for staff, they have never been made to feel awkward about it. What has improved since the last inspection? What they could do better: There were some minor shortfalls in medicines practice which could make infection control more difficult Organisation around meal times was raised as an issue by people using the service who felt they were not attended to if they were not in the dining areas. Fire protective doors were wedged open but the manager told the inspector that this was to be dealt with by the fitting of magnetic door closures attached to the fire alarm. Kemp Lodge DS0000017245.V334400.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. Kemp Lodge DS0000017245.V334400.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 Kemp Lodge DS0000017245.V334400.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, 4 & 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service receive information about the home prior to moving in and are assisted to settle in when they move in. EVIDENCE: People who may wish to use the service are provided with a statement of purpose, service users guide, a homes brochure and a quality audit report for the company. If the decision is made to move in, then people receive a booklet called ‘Your Handbook’ which contains everything a person would want to know about the company and the services offered at the home. The home meets with prospective people in their own home or placement to conducts a assessment of need. Those who are funded are also assessed by Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 10 the Local Authority. Assessments looked at were of an appropriate standard and enabled the home to make decisions about suitability of the home to meet the personas need and assist in the development of initial care plans to ensure support was planned for from the first day. One person had an extensive moving in programme which they designed themselves to suit their own needs. This enabled them to take control of the moving process and settle into the home at their own pace. The person stated that though it was hard to leave their old home, everything was done to help them settle. They were able to visit and stay for as many times as they liked before moving in. Continuing they said that the home had found out their favourite colour and decorated the room as a surprise. This touched the person deeply and helped them feel cared for from the bringing. Unfortunately the home did not record this excellent process. Such practice would enable the home to formally monitor the person from the very start and the information gathered would help towards the formulation of the initial care plan and assist staff further in understanding the person. Kemp Lodge DS0000017245.V334400.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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service have their health care needs recognised and met. EVIDENCE: All people who use the service have written care plans in place which were based on assessments of needs. People are consulted about how they would like their care needs met and are able to state when they want care support. Care plans looked at were detailed, they contained information on ,care needs, personal information, photos, personal profile and the life history of the individual. In addition, health care issues were recorded as was the assistance required. Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 12 Personal histories of the individual included childhood, working life, family life, activities and hobbies. Such information assist staff to capture the essence of the person as a whole person and not someone who just requires assistance. Care files also identified personal preferences for bathing routines and oral health care. Key working information confirmed that people who use the service were offered a choice of where they wanted their care plan to be stored. One person confirmed that they had seen their information and had signed to say they agreed with the care plan. All comments received from people who use the service and their relatives confirmed they were satisfied with the medical support provided at the home. One relative commented that ‘the home does general and personal care well.’ Medication administration procedures were observed. The person administering medicines was sensitive to individual needs, taking her time explaining to some what their medication was for and ensuring they had a drink with their medication. Medication was administered during a meal time, the timing of this practice interrupted people who were dining and one person leaving the table was asked to wait until medication was administered. Throughout the administration process the administrator was observed to handle medication. There were no hand washing procedures observed and protective gloves were not worn. Such practice increases the risk of cross infection and contamination of the medication. Throughout the inspection people who use the service spoke positively about the manner in which they were cared for and of the support they were given, however comment cards returned indicated that some felt practice could be improved for those who chose to remain in their room or those which are less mobile. One person stated ‘buzzers take a while to be answered especially at meal times . This can be an issue when you need the toilet.’ Another said ‘Some service users cannot use the buzzer, I am not sure they are always checked enough to see if they want toilet or more drinks.’ One relative indicated that as staff are busy at meal times assisting others, leaving some people who use the service left to long when they need the toilet and have had ‘ accidents’. They stated ‘this is not nice or dignified.’ Kemp Lodge DS0000017245.V334400.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 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to continue to make their own decisions and choices about their daily routine and lifestyles. EVIDENCE: Throughout the inspection people who use the service were observed to be chatting and laughing with each other, staff and visitors. They appeared to know each other well with good friendships evident. People who use the service continue to direct their own lives and have control over their daily routines. They were observed coming and going from the home as they desired with a number travelling independently into the community to meet friends, visit hairdressers and or undertake shopping for themselves. Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 14 The home employs an activities co-ordinator who is dedicated to ensuring that people who use the service receive stimulating activities which they enjoy. One person who uses the service explained that the home had a notice board which displayed ‘all the comings and goings on’ They confirmed that activities were provided every day and that there was always ‘something to do if one wanted.’ On the day of the inspection visit an external entertainer was visiting the home and arrangements were in place to celebrate someone’s birthday. Care files confirmed that people who use the service are consulted about their preferred activities. Records maintained that people who did not wish to join in group activities received one to one time each week. One person invited the inspector to visit their room which had been arranged in an individualised manner to fit computer equipment and support their hobby. The home’s menu is extensive and caters for everyone’s needs and preferences. There are multiple choices of vegetarian and soft diets offered each day along side a variety of main meals on offer. Diabetic items are discreetly coded so service users know which food are suitable to them and which food poses a risk. People who use the service are also offered a ‘specials’ and ‘snacks’ menu which offers snacks throughout the day and evening. One person informed the inspector that ‘meals were very good’ and a comment card recorded ‘ on the whole I like all the meals. I am a fussy eater and am always given an alternative’. The home provides a dining room assistant in the mornings, she was familiar with all the service users and took time to chat with each one whilst obtaining their morning food options. However tea was automatically served to all service users, even though it was evident that some retained the ability to pour drinks for themselves. Likewise, cereals automatically had milk added and or sugar by the assistant when the person themselves could complete such takes. Such practice reduces peoples independence. At lunch time care staff provided one to one support to those who required assistance. Kemp Lodge DS0000017245.V334400.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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are protected by staff who are trained in adult protection procedures and known complaints procedures. EVIDENCE: The home has a written complaints procedure in place and service users are given details of how to make a complaint prior to and throughout their stay. One persons stated within their comment card that ‘I have no complaints’ at inspection one person confirmed that if they had a complaint they ‘ would tell the manager or activities organiser’. The completed PIQ stated that their had been no incidents or allegations of abuse reported. Staff confirmed that they had received adult protection training. The registered manager also stated that the Local Authority also ensures that they receive training and up to date information in adult protection issues. People who use the service receive information about keeping safe and reporting any concerns or suspicions of abuse at the time of their admission. Information is also displayed within the home. Kemp Lodge DS0000017245.V334400.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, 20,21,22,23,24,25 & 26. Quality in this outcome area is good .This judgement has been made using available evidence including a visit to this service. People who use the service live in comfortable and homely environment which is equipped with aids and adaptations to meet all their needs. EVIDENCE: Kemp Lodge presents itself as a warm homely environment which is bright and cheerfully decorated and equipped with aids and adaptations to meet the needs of those accommodated. Lounges and dining rooms were pleasant areas offering people who use the service comfort and safety when relaxing. Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 17 The inspector was invited to look at a number of bedrooms. All viewed were nicely looked after. Each one was individual in colour and layout. People spoken with were proud of their own living areas and regarded them as their ‘quiet place’ One person spoken with had purchased their own phone and along with others had brought some furniture from home. One person also confirmed that the home had provided them with a television set, however it was their intention to buy their own in the near future. Another person had their room laid out in a individual and unusual manner, they stated this enabled them to maintain their hobbies and interests. The person confirmed that the home had offered them a larger room which they declined preferring the smaller room. Communal toilets and bathroom did not reflect the homeliness shared in other parts of the home. The visitor’s kitchen facilities had lots of other items stored in there and the visitors toilets appeared shabby. People who use the service spoke fondly of the ancillary support, stating they would do anything if requested. Throughout the inspection visit all parts of the home were observed to be clean and free from odours. All rooms have call points to enable people who use the service to summon assistance when required. Hand rails and hoist were in place and for those they required individual equipment, medical professional services supported the home to provided individualised equipment. Throughout the first part of the inspection visit, many internal fire safety doors were observed to be wedged open. Staff appeared familiar with this practice and unconcerned. The manager stated they had been trained to remove all wedges in the event of a fire emergency. The registered manager stated that the home was planning to fix electronic closures to main doors but not bedroom doors and she would contact the fire officer and discuss what can be done if service users insist on having their bedroom doors open. Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 18 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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service receive support from trained and competent staff who are in sufficient numbers to meet their needs. EVIDENCE: Inspection of staffs files confirmed that the home has followed correct recruitment and selection procedures when employing staff. Statutory checks are made and received prior to employment commencing. Prospective staff complete an application, attend for interview and provide evidence of training as part of the selection process. The registered manager stated that the home has completed some international recruitment which did not turn out was well as expected culminating in the home experiencing a higher turn over of staff usual. People who use the service did not indicate that standards had been affected by this. New staff complete an e-learning induction which meets the standards required by skills for care. They also complete a two-week shadowing period Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 19 before working alone. Experienced care staff are also designated as mentors throughout that period. Although there appeared to be sufficinet staff on duty there were comments from people who use the service which indicated that the deployment at busy times should be looked at. One comment card stated that ‘Sometimes staff rush a bit when they are helping you.’ Another stated ‘To improve, I think they (staff) should spend more time with people, sit and chat with them and keep them company. They should spend time popping into see service users when they are walking up and down the corridor, because it’s a long time on their own. Staff are trained with 56 of staff having achieved training at NVQ level 2 or above. Furthermore the home employs ten registered nurses. Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 20 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 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Kemp Lodge is a well managed and run home. EVIDENCE: There have been no changes in the management structure since the previous inspection. People who use the service have their own meetings and are able to make comment of service provision. Their comments are taken seriously and records of the meeting are made and shown to the managers. Changes are made to routines and systems at the request of those who use the service. Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 21 Many people at the home made positive comments about how they felt listened to. They felt their views were valued and respected. Records are made where the home manages small balances for people at the home. The home takes responsibility for managing one persons finances, they have been provided with a high interest savings account and finances are managed in their best interest. Regulation 26 visits which form part of the homes quality monitoring process are undertaken each month as required. However the details contained within the report are not sufficient. The records should demonstrate the actions and outcomes of consultation with people who use the service and staff, checks made to records and aspects of the running of the home. Policies and procedures are maintained appropriately and kept under review. Health and safety records were in place and identified that the home completes appropriate checks and services to equipment, protecting as far as possible the safety of people who use the service. Fire safety records indicated that appropriate checks to equipment was undertaken and that all staff have received a fire lecture training, however fire practical fire drill training could not be fully confirmed as staff signatures were not evidence to confirm practical fire training. Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 4 4 4 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 3 4 4 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 2 Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP25 OP38 Regulation 23 Requirement Make sure that fire doors are not wedged open to prevent them closing in the event of a fire Timescale for action 30/06/07 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 4 5 6 Refer to Standard OP5 OP9 OP9 OP10 OP27 OP15 OP21 Good Practice Recommendations Pre admission visits should be recorded in detailed including support provided, observations and assessments made. Staff should cease handling medication . People’s meal times should not be disrupted by medication administration procedures. Consideration should be given to alternative routines. Staff should be deployed to provide timely care and support to people who use, particularly during mealtime periods. Independence should be promoted at meal times by the provision of individual teapots and milk jugs. Communal bathing and toileting areas should be personalised and reflect the homely standards evident throughout other parts of the home. DS0000017245.V334400.R01.S.doc Version 5.2 Page 24 Kemp Lodge 7 OP33 Regulation 26 visits should contain the details required to demonstrate the outcome of monitoring, consultation with people who use the service and staff and any issues arising from record keeping to enable action to be taken and monitored. Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Kemp Lodge DS0000017245.V334400.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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