Inspection on 25/04/06 for Keswick

This inspection was carried out on 25th April 2006.

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

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

Other inspections for this house

Keswick 13/08/07

Keswick 25/07/05

Keswick 13/06/05

Keswick 27/01/05

Keswick 30/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Keswick Keswick Eastwick Park Road Great Bookham Surrey KT23 3ND Lead Inspector Sandra Holland Unannounced Inspection 25th April 2006 09:20 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 Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Keswick Address Keswick Eastwick Park Road Great Bookham Surrey KT23 3ND 01372 456134 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) sharon.blackwell@anchor.org Anchor Trust Ms Shona Bradbury Care Home 51 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (51), of places Physical disability over 65 years of age (10) Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Of the 51 Residents accommodated, up to 15 may fall within the category DE(E). Of the 51 service users accommodated, up to 10 may fall within the category PD(E). 25th July 2005 Date of last inspection Brief Description of the Service: Keswick is a care home which is owned and operated by Anchor Trust. It is situated in the Surrey village of Great Bookham, a short distance from the high street, which has a range of shops and services. The home is adjacent to a health centre and a junior school. The home is arranged into seven units, each with six to eight bedrooms, a communal lounge/dining room with open plan kitchenette and bathroom and toilet facilities. The building is of two storeys with a passenger lift providing access to all areas. A wheelchair lift enables access to one residential unit. There is a large lounge/dining room on the ground floor which is used for activities. This room is also used as a day centre for non-residents. A spacious conservatory overlooks the rear garden which has a patio area, lawn and flower beds. The main entrance lobby is light and airy with a reception desk and a seating area for residents. Car parking spaces are provided to the front of the property. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the first to be carried out in the Commission for Social Care Inspection (CSCI) year April 2006 to June 2007. As the inspection was unannounced, no one at the home knew it was to take place. Mrs Sandra Holland, Lead Inspector for the service carried out the inspection over eight and a quarter hours. Ms Shona Bradbury, Manager was present representing the service. A number of documents and records were examined, including staff files, care plans, staff training records, medication administration record (MAR) sheets and resident finance records. An additional inspection visit was made to Keswick on 13th September 2005. The reason for this visit was to follow up a number of issues which were raised at a meeting regarding the protection (safeguarding) of a vulnerable adult. A letter format report was completed after the additional visit. This report is not published but is available on request. The people who live at Keswick prefer to be known as residents and that is the term that will be used throughout the report. What the service does well: What has improved since the last inspection? All staff involved in the administration of medication have received training in this and staff involved in a previous medication incident have been assessed Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 6 as competent. No gaps in the recording of medication administration were noted. The standard of the recruitment processes and documentation has improved. What they could do better: Assessments of resident’s needs must be carried out before admission to the home. Each resident’s care plan must be completed and kept up to date. All prescribed medication must have a pharmacy label stating the name of the resident to whom it has been prescribed, the administration instructions and the date of issue. If a prescribed medication is repeatedly refused or not administered, the resident’s general practitioner should be informed. The corporate complaints policy must be suited to the needs of the residents. Any references to a health complaint on a application for employment health questionnaire, should be referred to the organisation’s occupational health department. A record of the induction of members of staff must be maintained and kept in the home. Unannounced visits to the home under Regulation 26 of The Care Home Regulations must take place each month and a record of these must be kept in the home. (Please see Standard 33 for more detail). A record should be held and be available at the home, to demonstrate that staff supervision has taken place. Doors that are fitted with automatic closers which are activated by the fire alarm system, must not be propped open. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 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. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 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 Keswick DS0000013691.V290366.R01.S.doc Version 5.1 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 the following standard(s): 1, 3 and 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s statement of purpose and service user has been updated. A preadmission assessment of resident needs has been carried out for some, but not all residents. EVIDENCE: The statement of purpose and service user guide supplied to the CSCI is outdated as it refers to the National Care Standards Commission and a number of staff who no longer work at the home. The manager stated that these documents have been updated and copies of each will be supplied to CSCI. The records for a number of residents were seen and of these, one had a completed pre-admission assessment, one had pre-admission notes taken, but were not completed and one had no pre-admission assessment. The deputy manager stated that the a pre-admission assessment had not been carried out for the last resident because the resident was known to the home and staff, as Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 10 she had attended the home’s day centre prior to admission. It should be noted however, that a resident’s needs at a day centre may differ greatly from those of residential care and a pre-admission assessment must be carried out for all residents. The manager stated that the home does not offer intermediate care. A requirement has been made regarding Standard 3. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although each resident has an individual plan, these were not complete and did not contain all the required information. Resident’s healthcare needs are well met. The overall standard of the administration of medication has improved, with only one shortfall noted. EVIDENCE: The manager stated that an individual plan is drawn up for each resident on admission, to guide staff to the resident’s care and support needs. Of those individual plans seen, some had not been completed, others had gaps in the recording of information and others did not reflect the resident’s current needs. One care plan stated that the resident had a urinary catheter, but gave no information regarding the management of this. The carer who was present advised that the resident’s catheter had been removed some time previously, but no record or reference had been made of this. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 12 For another resident, the care plan had not been completed with the resident’s religion or whether they had any allergies and no mention had been made of the resident’s daughter as next of kin, in the “others involved” section. Elsewhere in the care plan it states that the resident’s daughter is usually the first point of contact in an emergency. It was also noted that assessments of risk had not been drawn up, even when there were known risks to the health or safety of residents. One resident had a fall the day after she was admitted and a “falls diary” had been started but no risk assessment had been completed. Another resident had fallen the day prior to the inspection and the entry in the daily notes stated that she was very unsteady, but this was not referred to elsewhere in the care plan and no risk assessment was in place. The overall standard of the administration of medication has improved. No gaps were noted on the MAR sheets and most medications were stored appropriately. The Controlled Drug (C.D.) stock and record were seen and accurately matched. One shortfall was noted, in that a medication was stored in a unit medication trolley without a pharmacy label to indicate who it should be administered to, at what dose, time or frequency. For one resident, two medications were rarely being administered, either because the resident was asleep or had refused the medication. It is recommended as good practice to advise the resident’s general practitioner (G.P.) of these omissions, as the medications or the timings may need to be changed or the medication discontinued. Staff were observed to treat residents with respect and to provide assistance with personal care in a way which promoted privacy. Staff interacted with residents in an informal but appropriate manner and were seen to offer residents choices. Requirements regarding Standard 7 and a recommendation regarding Standard 9 have been made. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A variety of activities are available to residents and they are encouraged to maintain their community links. Meals served looked appetising and well balanced. EVIDENCE: Residents spoken to stated that they are welcomed and able to join in the activities in the day centre which takes place in the main lounge of the home. These include word games, musical events, bingo and painting and craft sessions. Some residents said they do not attend these activities due to the limitations of their poor sight or poor hearing. The manager advised that a new manager for the day centre and two part time activities co-ordinators have recently been recruited to improve the provision of activities. One of the co-ordinators was spoken with and she advised that she was trying to ensure residents were included in the everyday activities of the home, such as table laying and assisting with laundry and folding linens, if they were able. She also said she encouraged other staff to understand that Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 14 involving residents more actively in their personal car and interacting with them more widely, could be part of their daily activities. Residents spoke of their involvement in the community, with one resident going out regularly on the “Dial-a-Ride” bus to visit relatives locally. Another resident spoke of her husband visiting her most days and another told of her daughter who visits frequently. It was pleasing to hear that one resident who has few family, received a phone call from a relative in New Zealand following her recent admission to the home. Staff were observed to offer residents choices when supporting them with their personal care and in moving around the home. The selection of meals for the following day were also offered in a friendly and informative manner. The administrator stated that residents are encouraged to manage their own affairs if at all possible, to promote their independence and to minimise the home’s involvement. The lunchtime meal was seen to be nourishing and well-balanced, with a choice of two main course items and a selection of vegetables offered. A dessert was also offered and fresh fruit and yoghurts were available as alternatives. The meals are delivered to each unit in a heated trolley and are served by the staff of the unit. This enables staff to offer residents the specific items and portion size they prefer. The meal was taken in a relaxed way and assistance was offered discreetly to those residents who needed it. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The corporate complaints policy in the home still needs to be reviewed, but a local policy is available. Staff are aware of their responsibilities in the protection of residents. EVIDENCE: A requirement was made at the inspection carried out on 25th July 2005, that the home’s complaints policy must be reviewed to ensure it is suited to the needs of the residents. A timescale of the 24th October 2005 was given and this has not been met. The manager stated that this is a corporate policy and is currently being reviewed by Anchor Homes, but has not been completed and issued to the home. This was confirmed at a recent meeting between CSCI and the managing director of Anchor Homes. The deputy manager stated that the home has a local complaints policy, advising residents or others to address any complaints directly to the manager or deputy manager. This was seen displayed on the unit notice boards. Residents and visitors stated that they knew who to approach if they had a complaint, even though one resident said she was not aware of the complaints procedure. Staff spoken to said they would tell the manager, deputy or senior in charge if they had any concerns regarding the abuse or suspicion of abuse, of residents. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 16 Some staff members stated that they had attended training on the protection (safeguarding) of vulnerable adults and details were seen confirming a further training session booked for this month. A requirement regarding Standard 16 has been made. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well laid out, suited to purpose and is effectively maintained and attractively decorated. The premises are clean and pleasant and appear hygienic. EVIDENCE: The manager stated that the home has been purpose built as a care home and is divided into seven smaller, family sized units, each for six to eight residents. Residents are provided with individual bedrooms on their units, which also have a communal lounge, dining room and kitchenette. Toilet and bathroom facilities are easily accessible on each unit. It was clear that the home is clean and free from odours. The manager stated that one unit and other areas of the home had recently been decorated. All areas were attractively decorated in a colourful and homely style. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 18 A number of garden areas surround the home and are well maintained and tidy. The main, rear garden area is accessible to residents from the entrance hall or the conservatory. It was pleasing to see that a separate, covered area of the garden had been provided for residents, visitors and staff who smoke. The laundry is situated off the main entrance hall and is away from the kitchen and food preparation areas. Hand-washing facilities with liquid soap and paper towels are provided in all appropriate places to maintain hygiene. The manager stated that as part of the programme of planned improvement and upgrading, she has been allocated a specific premises budget. As part of this allocation, a number of purchases have been made already, including new armchairs, beds and commodes. As part of the improvement programme, it is proposed that one unit will be modified to accommodate residents with dementia. This will enable the layout of the unit and the staffing and activities to be specifically designed for the needs of those residents. Residents, their representatives and staff are being consulted about the changes. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A full complement of staff are employed to meet the needs of residents. The standard of recruitment processes in the home has improved. Staff receive training appropriate to their role. EVIDENCE: The manager stated that following a recent recruitment drive, a number of new staff have been employed to meet the needs of residents. These include a receptionist, a day centre manager, a laundry assistant and two activities coordinators. Other prospective staff are still completing the recruitment process and have been interviewed, are awaiting references or a start date to be arranged. The recruitment records of recently employed staff were seen and contained the required records and documents. It was noted that one member of staff had declared a health condition on the pre employment health questionnaire, but no action had been taken in relation to this. It is recommended that any declarations on the pre-employment health questionnaire are referred for a medical reference or to the Occupational Health department, to ensure the applicant is fit for the role they are applying for and will not present a hazard to the residents. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 20 Staff in the home advised that they have undertaken a number of training courses, some required by law, such as first aid, food hygiene and fire protection, and others to develop their knowledge and skills, such as National Vocational Qualifications (NVQ’s), dementia care and care of the dying. The training undertaken by staff is related to the role they carry out. Housekeeping staff for example, have received training in the Control of Substances Hazardous to Health (COSHH), as they are regular users of these products. Induction training records for new staff were not available for inspection. The deputy manager stated that staff take the records to update them and may have taken them home. These must be retained in the home and made accessible to staff there. This will prevent any loss and ensure that these records are available for inspection, as required. A requirement and a recommendation regarding Standard 30 have been made. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is being effectively managed. A survey of the quality of the service offered has been carried out with positive results. The recording of resident’s monies held for safekeeping should be more robust to protect residents and staff. Supervision has been planned but records of this were not available. EVIDENCE: The manager of the home is appropriately qualified and trained to manage the home and had an open and accessible approach with residents, visitors and staff. Monthly, unannounced visits to the home under Regulation 26 of The Care Home Regulations must take place and a record of these must be kept in the home. These visits must be undertaken by a person nominated by the parent Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 22 organisation (Anchor Homes), to monitor the quality of the service offered. During the visit, the person should speak to residents and staff, look around the premises and a short report of their findings should be written and left at the home. The manager stated that these visits are carried out, but from the documents available at the home, it appeared that the most recent Regulation 26 visit took place in July 2005. A Quality Assurance survey was carried out by a national company who are independent of Anchor Homes, in February 2006. A summary of the responses was supplied at the inspection. It was pleasing to see that a number of positive comments had been received and a number of staff had been individually praised for the level of care and kindness they displayed. Of the fifty-one surveys sent to residents, eleven responses were received. Fortyseven surveys were sent out to resident’s next of kin and eighteen were returned. The home was measured against thirty-six attributes, such as cleanliness, bedrooms, laundry, food, personal need, staff attention and complaints. The overall outcome was very satisfactory, in that twenty-nine of these areas met or exceeded the average for all the homes that were surveyed. The manager and deputy manager stated that supervision has been planned & is being carried out, but records were not available for inspection. Although the manager was able to advise of the dates of her supervision by her line manager, there were no documents available to confirm that this had taken place. The administrator stated that wherever possible residents are encouraged to handle their own financial affairs. For those residents who wish to, the home will hold monies for safekeeping and records regarding this were seen. The amounts of monies held were checked with the record held and these accurately matched. All transactions were recorded and residents or their representative had signed when making deposits or withdrawals. It was noted that the member of staff handling the transaction had not signed the record sheet, even though the sheet had a space for this. It is strongly recommended that for all transactions two signatures are recorded, to safeguard residents and staff. A number of records relating to health and safety (but not all) were seen. These included fire alarm testing, fire system servicing and the fire risk assessment and these checks had been carried out to the required frequencies. It was noted that not all staff had signed to indicate that they had read the fire policy and procedure and it is recommended that they are asked to do so. Requirements regarding Standards 33, 36 and 38 and a recommendation regarding Standards 38 have been made. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 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 2 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 2 2 x 2 Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 24 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 OP1 Regulation 4&5 Requirement Timescale for action 27/06/06 2 OP3 14 3 OP7 15 4 OP9 13 (2) The statement of purpose and service user guide must be updated to reflect the current facilities in the home. A copy of these must be forwarded to CSCI Surrey area office - Eashing. Accommodation must not be 25/04/06 provided at the home unless the needs of the resident have been assessed by a suitably qualified or trained person; a copy of the assessment has been obtained and the resident or their representative have been consulted about the assessment. A written plan as to how the 30/05/06 resident ‘s needs will be met must be compiled; the resident must be consulted about the plan; the plan must be available to the resident; the plan must be kept under review and must reflect the resident’s current needs. All medications received into the 25/04/06 care home must be labelled to indicate to which resident it belongs or is to be administered to; the dose and frequency that DS0000013691.V290366.R01.S.doc Version 5.1 Keswick Page 25 5 OP16 22 6 7 OP30 OP33 18 & Schedule 4 26 8 9 OP36 OP38 18 & Schedule 4 13 (4) (c) has been prescribed and the date of supply. A complaints procedure that is suited to the needs of residents must be made available. UNMET FROM 24/10/05 A record of the induction of staff must be maintained and retained in the home. Unannounced visits by a representative of the registered provider under Regulation 26, must be carried out on a monthly basis. A report of the visit must be completed and must be retained in the home. A record of the supervision of all staff must be maintained and retained in the home. The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. Specifically, fire doors must not be propped open. 25/07/06 25/07/06 25/07/06 25/07/06 25/04/06 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 Refer to Standard OP9 OP29 Good Practice Recommendations It is good practice to advise the resident’s general practitioner if medication is repeatedly refused or not administered for any reason. It is recommended that applicants for employment at the home are referred to Occupational Health in the event that a health condition is declared on the pre-employment questionnaire. It is good practice for two people to sign to show that they have been involved in the handling of resident monies transactions. The signatures should be recorded in the DS0000013691.V290366.R01.S.doc Version 5.1 Page 26 3 OP35 Keswick 4 OP38 spaces specifically provided on the resident monies record sheet. It is recommended that all staff are requested to sign to show that they have read and understood the fire procedures in the home. Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Keswick DS0000013691.V290366.R01.S.doc Version 5.1 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!