CARE HOMES FOR OLDER PEOPLE
Kenwyn Nursing Home Newmills Lane Kenwyn Hill Truro Cornwall TR1 3EB Lead Inspector
Diana Penrose Unannounced 09 August 2005 09:30 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 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. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Kenwyn Nursing Home Address Newmills Lane Kenwyn Hill Truro Cornwall TR1 3EB 01872 223399 01872 223884 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Barchester Healthcare Mrs Valerie Baggott, Manager Designate Care Home 108 Category(ies) of Dementia - over 65 years of age (34), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (34), Old age, not falling within any other category (60), Physical disability (14), Terminally ill (60) Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1) Pencarrow & Trelissick - Service users to include up to 60 adults of old age (OP) 2) Pencarrow& Trelissick - Service users to include up to 60 adults with a terminal illness (TI) 3) Tresco Unit - Service users to include up to 34 adults aged over 65 with a mental illness (MD{E}) 4) Tresco Unit - Service users to include up to 34 adults aged over 65 with dementia (DE{E}) 5) Glendurgan Unit - Service users to include up to 14 adults aged 18-65 years on admission with a physical disability (PD) 6) Total number of service users not to exceed a maximum of 108 Date of last inspection 20/01/05 Brief Description of the Service: Barchester Healthcare owns Kenwyn Nursing Home; the home has a designated Manager who has applied to the Commission for Social Care Inspection to become the Registered Manager. Kenwyn is situated on the outskirts of the City of Truro. It is a large home that offers both residential and nursing care for up to 108 people. The service provides care and accomodation for service users who experience differing care needs; older people, nursing, dementia, mental disorder, physically disabled and terminally ill. Accommodation is on two floors and divided into four separate units. There are two lifts accessible to service users. There are four double bedrooms the rest are single, all have en suite facilities. All rooms have accessible call bells. Meals are prepared in a well-equipped kitchen on the ground floor. There is a secondary kitchen on the first floor. Meals are served in the dining rooms on each unit or individual bedroom if preferred. The extensive grounds are attractive, well maintained and easily accessed by service users. There are patios with seating and tables. Car parking space is provided. A Senior Nursing Sister supported by a team of qualified nurses and care staff manage each unit. The Hotel Services Manager is responsible for the catering and domestic staff. Two Recreational Therapists are employed to organise activities and trips out. There are opportunities for socialising and visitors are actively encouraged. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Three inspectors visited Kenwyn Nursing Home on the 09 August 2005 and spent six and a quarter hours at the home. This was an unannounced visit. The purpose of the inspection was to gain an update on the progress of compliance with the requirements and recommendations identified in the last inspection report dated 20.01.05. In addition the inspectors focused on the following key areas of care: assessment and care planning, health care, meals, leisure, complaints, some of the environment and health and safety. On the day of inspection 103 service users were resident in the home. The methods used to undertake the inspection were to meet with a number of residents, staff, the manager and regional manager to gain their views on the services that Kenwyn offer. The home’s records, policies and procedures were examined and the inspectors toured the building. This report summarises the findings of this inspection. What the service does well:
A member of the management team visits prospective residents whenever possible and a needs assessment is carried out. The assessment involves relatives and health professionals as necessary and records are kept. An individual plan of care is compiled from the initial assessment. A number of risk assessments are undertaken, for example to prevent pressure sores, to ensure adequate nutrition and to prevent falls. The nurses maintain daily records, and they are informative. Residents spoken with said their health needs are met and they have access to their GP or other health professionals when required. Pressure relieving equipment such as special mattresses and cushions and equipment for the safe moving and handling of residents is provided. There is a medicines policy and system in place for the administration of medicines. A qualified nurse administers the medicines at all times. There is an activities programme for residents and two co-ordinators employed. Activities take place on each unit and there is a designated area upstairs by the lounge where games, jigsaws and craft materials are available for service users use. The Eden room is used for film shows with popcorn and ice cream provided and weekly bus trips are arranged. A Memory Lane project had started in the dementia unit in the home based on promoting lifestyle through activities. A hairdresser visits regularly and there is a designated room for hairdressing. There is a record of visitors to the home and residents said they could receive visitors in private and at any time. There is a room at the end of one unit that service users or their relatives can rent for entertaining and meals.
Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 6 There is a menu with a good choice available each day and a sweet trolley with fresh fruit. Meals are very well presented and nutritious. Residents said the food they receive is very good and there are choices available. There is a suitable complaints procedure and method for recording complaints. The home is clean, well furbished and maintained. The grounds are beautiful and very well maintained, with raised flowerbeds, a garden of remembrance and a sensory garden. Specific staff manages the homes laundry. The management team endeavour to ensure that working practices are safe and staff receives statutory training as appropriate. What has improved since the last inspection? What they could do better:
The initial assessment of prospective residents must contain more comprehensive information and include details of who was involved. The residents’ care plans must cover all the needs of the individual including social, religious and emotional needs. They must be in sufficient detail to guide and direct the care staff on how to meet the needs of the resident. All care plans should indicate who was involved in the compilation and should be signed by those people if possible. There should be information as to how identified risks will be managed and any changes in the care of a resident must be documented. The medicines policy needs to be reviewed and updated and the same policy used throughout the home. Medicines reference books should be renewed annually to ensure staff have access to up to date information. Anything hand written on the medication administration records must be signed by two members of staff; the manager stated that she hoped the doctors will sign all hand written medicines in future. Medicines prescribed for an individual resident must not be given to anyone else; this refers to bottles of liquid medicines such as Lactulose. Insulin vials and pens in use must be stored at room temperature not in the fridge. A formal audit of the medicines must take place regularly with records kept.
Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 7 The corridor lighting in some areas requires improvement and all strip lights must have covers fitted. There needs to be a review of the dining facilities as there is not enough seating for all residents to use the dining areas; the Manager has started to address this. Wheelchairs must be stored so as to ensure the residents’ safety. Accessibility to the garden could be improved for wheelchair users and those with impaired mobility. Staff must adhere to notices on doors that state, “keep shut” or “keep locked”. Dangerous substances must be stored appropriately in a locked facility. Staff must know how to access the policies, procedures and information relevant to their work. 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. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Service users are only admitted to the home following an assessment of their needs, however, the pre admission assessment process must be expanded to address all care needs and ensure the home can provide adequate care EVIDENCE: The Manager explained the procedure for the initial assessment of prospective service users and completed assessment documents were inspected. The assessment forms lacked detail and there was little evidence of who was involved in the assessment. Information from Social Services and hospital staff is obtained when appropriate. An individual plan of care is compiled from the initial assessment. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 9 Individual care plans are generated for each service user but do not adequately inform and direct the staff in their care provision. Service users have access to health care services as necessary to ensure their assessed needs are met. There are suitable systems and policies in place for dealing with service users medicines: extra vigilance is required in some areas to further ensure service users safety. EVIDENCE: Each service user has a written care plan but not all sections give clear instruction to staff. The care plans must cover all the needs of the individual including social, religious and emotional needs. They are reviewed monthly but changes are not always recorded so some information is confusing. The Standex system is used along with the homes own documentation. Risk assessments include Waterlow scoring, nutrition, moving and handling and falls. There is not always information as to how an identified risk is to be managed. There is no evidence that care plans are compiled with the service user or representative and they are not signed. Daily records are maintained and informative, the care staff do not record in these at present, they have a chart to complete each day.
Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 11 The care documentation must be reviewed, the Manager stated that weekly clinical meetings are held and that they are developing care plans. She agreed to audit one care plan per unit each month. There is new care documentation that will be used in all Barchester homes when finalised. Service users spoken with said their health needs are met and they have access to their GP or other health professionals when required. Pressure relieving equipment and equipment for moving and handling is provided. There is a medicines policy and system in place for the administration of medicines. A new policy had been distributed but was not in use on all units. The policy requires some updating and additions made. Patient information leaflets are supplied and used for reference, there are also medicine reference books but those seen were over two years old. The medicines reference books should be renewed annually and be available to staff. The designated manager said there is a new book in the home. Storage of medicines is safe and secure. All medicines received into the home must be recorded and signed for on the medicine administration chart. Transcribing onto the charts was not signed by two members of staff; the manager said she hopes the doctors will sign all transcribing in future. Alternative arrangements must be made to ensure that medicines prescribed for an individual service user are not administered to anyone else, for example Lactulose syrup. The medicines were administered in a safe and professional manner during the inspection. However medicines trolleys were unlocked and left unattended in some areas, which is unsafe practice. Creams should be dated when opened for use so they can be discarded at the appropriate time. There were a few gaps on the medication administration record charts where medicines had not been signed as given. The sister spoken with said she checks the charts periodically; a more formal audit is required with records maintained. Controlled drugs are recorded appropriately and Temazepam is recorded in a book on each unit; it is recommended that Temazepam be recorded in a Controlled Drugs register. Insulin in use must be stored at room temperature. The labels on the bins used for ‘sharps’ disposal must be completed appropriately. Medicine pots must be washed in the kitchen or appropriately in the treatment rooms, in a designated bowl with hot water and washing up liquid, then dried and stored. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and 15 The home provides suitable activities and aims to offer a lifestyle that meets individual service users needs. Links with family, friends and the community are good and allow service users the opportunity to socialise. EVIDENCE: There are two activity co-ordinators employed. There is an activities programme that is distributed to service users, those spoke with were aware of activities taking place. There is an area upstairs by the lounge designated for activities where games, jigsaws and craft materials were observed. Music was playing during the inspection and a film show-taking place in the afternoon with popcorn and ice creams. Six service users actively participate with the gardening; there are raised flowerbeds and a sensory garden. The management team stated they hoped that Kenwyn would become a centre of excellence for the ‘memory lane’ project, which is looking at promoting lifestyle through activities. A lifestyle kitchen is planned as well. There are opportunities for painting and one service user hopes to recommence sculpting. Weekly bus trips are organised and some service users go out shopping. Religious needs are catered for by one of the co-ordinators. A hairdresser visits regularly and there is a designated room for hairdressing. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 13 There is a record of visitors to the home and there were visitors in the home during the inspection. Service users said they could receive visitors in private and at any time. Visitors can stay for a meal if they wish. There is a room at the end of one unit that service users or their relatives can rent for entertaining and meals. Visitors spoken with said they are made welcome in the home. Service users said the telephone arrangements in the home are good; there is a line in each bedroom. Each service user has a nutritional needs assessment and some likes and dislikes are recorded. There is a menu with a good choice available each day and a sweet trolley with fresh fruit available. Meals are served in the dining areas or individual bedrooms. It is hoped to stagger the mealtimes upstairs to enable more service users to use the facilities. Meals are very well presented. Appropriate assistance was given with meals in some areas in others there was little communication between carers and service users. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has a satisfactory complaints procedure however there must be one procedure used throughout the home EVIDENCE: There is a suitable complaints procedure displayed in the reception area of the home. The complaints procedure shown to the inspectors did not contain all of the relevant information and this needs to be reviewed. There is a method for recording complaints, the action taken and the outcome. There have been no complaints since March 2005 when the designated manager took up her post. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,22 and 26 The home and grounds are well maintained providing a safe environment for residents, staff and visitors. Indoor and outdoor communal facilities are accessible but could be accessed more safely by service users if further aids were put in place. The home is very clean and free from unpleasant odours making it a pleasant place for service users to live in. EVIDENCE: The home is clean and well maintained, refurbishment and redecoration is in progress; the Company has their own design team. Some service users had chosen the décor for their room. Comfortable furniture is provided in the lounges and there are facilities for service users to entertain visitors. The corridor lighting was very dim in some areas and requires improvement and all strip lights must have covers fitted. There was a lack of grab rails in the corridors. There are dining facilities on each unit that require reviewing; an action plan should be in place for the eventuality that all service users can use these facilities at the same time. The Manager said she had started to address this and mealtimes are to be staggered to achieve this.
Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 16 Some cupboards have been built for storage and this is an improvement. Wheelchairs were stored in a toilet on Tresco unit, the Manager said the toilet is out of commission at present; the door must be locked whilst temporarily used for storage to maintain a safe environment for service users. The grounds are beautiful and very well maintained, with raised flowerbeds, a garden of remembrance and a sensory garden. Some service users are actively involved with the gardening. There is reasonable accessibility but there are areas that could be more level for wheelchair users and handrails could be considered for those with impaired mobility. An audit of the premises and the garden must be undertaken in respect of improving independence and safety, with an action plan that includes appropriate risk assessments. The laundry facilities appear small for the size of the home as all laundry is dealt with on site. There is an area for dirty laundry and a separate area for the clean laundry and the ironing. Hand-washing facilities and protective clothing are supplied for staff. The home has a machine for labelling the service users clothes to ensure they go back to the correct person. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These standards were not inspected on this occasion. It is noted that there were no staffing vacancies in the home. Staff spoken with were happy with the current staffing levels. All staff had recently undertaken dementia care training. The management team stated that it is hoped to make Kenwyn a centre of excellence in ‘memory Lane’ dementia care, based on life skills. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Appropriate training and safety checks are undertaken to ensure the health safety and welfare of service users and staff however staff must ensure that policies are put into practice EVIDENCE: The management team endeavour to ensure that working practices are safe. Relevant service checks take place as required. Staff receive statutory training regularly, additional fire training in the use of extinguishers is being arranged. There is a person trained in first aid on duty at all times. The kitchen staff have received food hygiene training. Accident reporting complies with data protection and the Registered Manager audits all accidents in the home. Health and safety risk assessments have been undertaken. Staff must adhere to notices on doors that state, “keep shut” or “keep locked”. Staff are aware that information regarding COSHH, for example, and policies and procedures are in place but not all know where they are kept. Staff must know how to access the policies, procedures and information relevant to their
Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 19 work. The restraint policy must be updated and appropriate for the Flammable liquids are stored openly in the laundry; these must be safely in a locked facility. COSHH data sheets must be up to date in all Clinical waste bins must be kept locked at all home. stored areas. times. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 2 x x 2 x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 2 Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 21 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 14 Requirement The assessment of prospective service users must be more detailed and show who was involved in the assessment The Registered Provider must ensure that the care plan relates to the relevant risk-assessment and sets out in detail the action, which needs to be taken by care staff. (Timescale of 01/02/05 not met) Care plans must cover all the individuals needs and be kept up to date The care plans must be compiled with the service user or their representative whenever possible and this must be evidenced. The medicines policy must be updated All medicines received into the home must be recorded and signed for on the medicine administration chart. Transcribing onto the medicine charts must be witnessed and signed by two members of staff or a doctor Medicines prescribed for an individual service user must not
D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Timescale for action 12/12/05 2. 7 15 12/12/05 3. 4. 15 15 7 7 12/12/05 12/12/05 5. 6. 13 13 9 9 14/11/05 09/08/05 7. 13 9 09/08/05 8. 13 9 09/08/05
Page 22 Kenwyn Nursing Home Version 1.40 be administered to anyone else 9. 10. 11. 12. 13. 14. 13 13 13 13 13 23 9 9 9 9 9 19 All medicines administered must be signed as given A unlocked medicine trolley must not be left unattended Insulin vials and pens in use must be stored at room temperature. The labels on the bins used for ‘sharps’ disposal must be completed appropriately Medicine pots must be discarded after use or washed appropriately washed The lighting in corridors must be reviewed and appropriate bulbs installed, all strip lights must have covers fitted The dining facilities must be reviewed The out of use toilet, used for the storage of wheelchairs, must be kept locked An audit of the premises and the garden must be undertaken in respect of improving independence and safety, with an action plan that includes appropriate risk assessments. Staff must adhere to notices on doors that state “keep shut” or “keep locked”. Staff must know how to access the policies, procedures and information relevant to their work. The restraint policy must be updated and appropriate for the home. Flammable liquids must be stored safely in a locked facility COSHH data sheets must be up to date in all areas Clinical waste bins must be kept locked at all times. 09/08/05 09/08/05 09/08/05 09/08/05 12/09/05 14/11/05 15. 16. 17. 23 13 13 and 23 22 19 19 16/01/06 09/08/05 16/01/06 18. 19. 13 13 38 38 09/08/05 14/11/05 20. 21. 22. 23. 13 13 13 13 18 38 38 38 16/01/06 01/09/05 14/11/05 09/08/05 Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 23 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 7 9 9 9 16 Good Practice Recommendations The Manager should audit one care plan per unit per month Temazepam should be recorded in a Controlled Drugs register The medicines reference books should be renewed annually and be available to staff. Creams and lotions should be dated when opened for use so they can be discarded at the appropriate time the complaints policy must be reviewed and Kenwyn must have one policy throughout the home. Kenwyn Nursing Home D52-D04 S9256 Kenwyn V243187 090805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection John keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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