CARE HOMES FOR OLDER PEOPLE
Kilkenny Residential Care Home 6 Third Avenue Frinton On Sea Essex CO13 9EG Lead Inspector
Marion Angold Unannounced 23rd August Final 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. Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Kilkenny Residential Care Home Address 6 Third Avenue Frinton On Sea Essex CO13 9EG 01255 672253 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) Mr Rajalingum Valaydon, Mrs Denise Valaydon Mrs Christine Emmamdeen, Mr Mamode Emmamdeen Mr Rajalingum Valaydon Mrs Denise Valaydon Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Dementia - over 65 years of age (6) Dementia (1) Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 11 persons). 2. Six persons, over the age of 65 years, who require care by reason of dementia, whose names have been made known to the Comission. 3. One person, under the age of 65 years, who requires care by reason of dementia, whose name was made known to the Comission in April 2005. 4. The total number of service users accommodated in the home must not exceed 11 persons. Date of last inspection 3 February 2005 Brief Description of the Service: The Kilkenny is situated on the outskirts of Frinton town centre, close to the sea front and within walking distance of all local amenities. Bedrooms upstairs can be accessed by means of a chairlift. There is a car parking and seating area at the front and an enclosed, paved garden at the rear. The home provides care for 11 older people, aged over 65 years. An application by the provider to vary the registration category to include service users with a dementia is being progressed in conjunction with this inspection. Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 10.40 and 17.10 hours with the assistance of the registered manager and deputy manager. The inspection focussed very much on the views of service users, eight of whom spoke with the inspector about their experience of living at The Kilkenny. The inspector was also pleased to hear the views of two people visiting their relatives. All comments received showed satisfaction with the care provided and the home’s suitability for meeting the needs of residents. Two staff spoke with the inspector about their roles and recent developments in the home, demonstrating the benefits of recent training. Of the 18 Standards inspected, 15 were met and 3 consisted of minor shortfalls. This represents considerable progress since the last inspection. It was particularly encouraging to note good practice developments in relation to the care of residents with dementia. What the service does well:
Residents recently entering The Kilkenny had been thoroughly assessed and reassured that the home would be able to meet their needs. All comments from residents and visitors confirmed their satisfaction with the standard of care provided. The family atmosphere and friendliness of the home was mentioned by a number of people. One service user said, ‘People are very kind here, that’s what I like about it’. Two service users discussing the attributes of the home were emphatic that they had no complaints and no suggestions to make things even better. Residents, who were not necessarily able to verbalise their views about the service, conveyed by their tone and body language a sense of well being. Two service users mentioned ‘food’ when listing what they thought was good about the home. One person said they had never had a bad meal. They were aware that the menu was displayed on the notice board. Another person said they were satisfied with the content and timing of meals and that, if they wanted something different from the menu, they only had to ask. A flexible approach to menus and routines generally was evidenced during this inspection. The Kilkenny offered a pleasant environment, which was clean, comfortable, homely and fit for purpose. Plans for its ongoing maintenance were in hand.
Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 6 Suitable arrangements were in place for meeting residents’ health care needs and handling any money they were holding for safe keeping. What has improved since the last inspection? What they could do better:
Information provided for existing and prospective residents in the Statement of Purpose and Service Users Guide could be more clearly written. In their present form, they did not reflect the quality of care being provided by the home. Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 7 The inspector observed staff entering a resident’s room without knocking. Staff should be aware that this compromises people’s privacy. Although the inspector heard two references to a downstairs bedroom being used occasionally as a visitors’ room, the manager and deputy manager said that this practice had been discontinued some time ago. 66 of service users / their representatives responded positively to the matter of choice of menu. Discussion took place with management about ways of enabling all service users to make informed choices and contribute to menu planning. It was suggested that the television might be used more constructively, staff helping service users to choose programmes, which particularly interested them, and turning off the set, if nobody appeared to be watching. Whilst it was encouraging to see most people eating lunch together, it was recommended that the home ensure that they have capacity for all residents to participate in lunch at a dining table. Not all the radiators in the home had guards or low temperature surfaces. Risk assessments should be carried out and appropriate action taken to ensure residents’ safety. Staff supervision was taking place but not as often as necessary and the records sampled suggested potential for discussion of a broader range of issues relevant to the individual’s roles, responsibilities and development. 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. Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 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 Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 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) 1, 3 and 4 Information provided for prospective service users was comprehensive but could be written with greater clarity. Service users recently entering the home had been thoroughly assessed and reassured that the home would meet their needs. EVIDENCE: The Statement of Purpose and Service Users Guide had been reviewed on 1 May 2005. Although these documents met the requirements for content, they needed to be more carefully edited for accuracy and clarity. In their present form they did not reflect the quality of care being provided by the home. Records and discussions with management evidenced multi-disciplinary and family involvement in service users’ admissions, and detailed, holistic preadmission assessments undertaken by the home, which included individual profiles. The home was caring for six service users with dementia at the time of inspection, three of whom had been admitted as a condition of the home’s
Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 10 registration, as part of a planned and incremental approach to the home being registered as a care home specifically for people with dementia. Discussion took place with management during the inspection about the manager’s proposal to retain the option of accommodating people without dementia. Evidence from this inspection, including care plans, environmental changes, staff training and awareness, showed that the home had made considerable progress in the area of dementia care. Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 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 standard(s) 7, 8 and 10 Service users benefited from a person-centred approach to care planning. The home was attentive to service users’ health care needs. Some situations occurring in the home had compromised service users’ privacy. EVIDENCE: Three care plans and accompanying risk assessments were sampled. Care plans were holistic, showed understanding of the needs of people with dementia and contained appropriate instructions to staff. Risk assessments were relevant to the individual and working documents, as evidenced by a new entry, following the person’s fall. Monthly evaluations contained updated comment on a range of identified needs. The Community Mental Health Team had been involved in placements and reviews, where appropriate. A relative spoke of being consulted and a sense of being involved by the home. Discussion with management and individual records evidenced appropriate action by the home to promote service users’ health. One service user indicated that medical help had been sought for them on a number of
Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 12 occasions and an appointment made on their behalf with the dentist. A mental health checklist, and records of health related contacts and periodic weight monitoring were included in each care plan. Care plans also included detail of the dosage, indication, side effects and method of taking all prescribed medication. It was reported that the home’s recent consultation with the GP about one person’s drowsiness and unsteadiness had led to their medication being reduced. A visitor indicated that their relative’s challenging behaviour was well managed by the home. Two members of staff entered a service user’s room without knocking during the inspection. Although the service user said they did not mind this, such practice compromised their privacy and might cause anxiety and discomfort to other service users. The inspector received two indications that a bedroom, situated near the front door, was occasionally used for visitors. Again the occupant stated that they had no objection to this arrangement and management gave their assurance that, to their knowledge, this had not happened for some time. The deputy manager advised that plans to introduce a new service user into a shared room were discussed with the residents concerned or the people representing them. The new occupant had requested a shared room and it was reported that a good outcome had been achieved from the arrangement. Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 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 standard(s) 12, 14 and 15 The home was developing a person-centred approach to lifestyle and activities, and making a concerted effort to increase individual choice. Service users enjoyed balanced meals in a congenial setting. EVIDENCE: Two staff were working as part-time activity coordinators, each for 4 hours a week over a total of 4 days. On the day of inspection, 5 service users were making cakes, seated round the kitchen table. The activity had been greeted enthusiastically and service users given opportunity to choose what they would bake at each weekly session. It was the only time one person came out of their room, apart from meals. After the cooking session, 3 service users were taken for a walk along the seafront. Activities and outings had been linked to people’s interests and care plans. For example, one service user was being supported to continue swimming. They had also been taken to a community event because they loved animals and on a car ride for the purpose of triggering their memory of a particular location. One person visiting their relative commended the level of stimulation provided by the home and mentioned the intermittent presence of a child (living with
Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 14 resident staff) as being particularly positive for residents. One service user also spoke enthusiastically about being able to entertain the child. The activity coordinator on duty during the inspection described a personcentred approach to activities. They had based individual programmes on information from families, social workers, care plans and talking with service users directly. Routines in the home were found to be fairly flexible. For example, one service user had chosen to have breakfast in their dressing gown, others remained in their rooms if they chose. People were observed moving freely about the home and being engaged in conversation by staff in their vicinity. Lunch was served to fit in with the morning’s activities, very much on family lines. Service users confirmed they could get up and go to bed when they liked. One service user had an advocate, with whom the home had been working closely. Information about the local advocacy service was displayed but it was reported that all other service users had family or other representatives to support them. The home was acting as appointee for one person, in consultation with their solicitor and friend. The deputy manager explained that the home catered for service users on family lines. Menu alternatives were not routinely prepared but they attempted to involve everyone in menu planning and cater for individual dislikes and preferences, as documented in individual care plans. The deputy manager reported that they also carefully monitored any change in service users’ eating patterns and preferences and made appropriate adjustments in consultation with the individuals concerned. 66 of service users / their representatives responded positively to the matter of choice of menu. Two service users speaking with the inspector mentioned ‘food’ when listing what they thought was good about the home. One person said they had never had a bad meal. They were aware that the menu was displayed on the notice board. Another person said they were satisfied with the content and timing of meals and that, if they wanted something different from the menu, they only had to ask. Discussion took place with management about ways of increasing service users’ ability to make informed choices and contributions to menu planning. Some service users had lunch at the dining table, others remained in their chairs with small tables in front of them. The atmosphere was relaxed and congenial. Although management indicated that rarely more than six service users would choose to eat at the dining table, it only had capacity for eight people and, as the home was registered for eleven residents, this had potential for some not being able to participate in a meal round the table.
Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 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 standard(s) 16 The home had reminded service users of their right to complain. EVIDENCE: The complaints procedure, contained in the Service Users Guide, covered the necessary points. However, the manager and deputy manager reported that, as only 66 of service users / their representatives surveyed had responded in the affirmative about knowing whom to approach if they were not happy, they had drawn the complaints procedure to people’s attention. One service user said, ‘If I had any concerns, the people who run it would soon put me right. They are very nice people. People are very kind here, that’s what I like about it.’ Another person said, ‘Living here works, because of the sort of people who are here. Some have children of their own.’ One of the relatives commented favourably on the family atmosphere in the home. Two service users mentioned ‘friendliness’ among its positive attributes. They were emphatic that they had no complaints and no suggestions to make things even better. Service users, who were not necessarily able to verbalise their views about the service showed signs of well being. One person used words such as ‘kindness’ and appeared to be trying to convey satisfaction. Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 and 24 The home was clean, comfortable, homely and fit for purpose. EVIDENCE: Some improvements to the back garden were in evidence, including areas of grass and simple flower tubs. Service users were making use of garden table and chairs to sit in the sunshine. Outside and interior decoration was planned and a contractor was present on the day of inspection, giving a quotation. The deputy manager stated that service users and their families had been informed of plans to decorate the lounge and of contingency plans for the 2 to 3 days this would take. Records evidenced that fire checks were being carried out routinely. The fire safety officer’s annual inspection was due. The deputy manager confirmed that recommendations from their previous report had been addressed. Some of the lounge chairs, formerly along the wall, had been re-grouped round the television. The TV was on most of the day in both the main lounge and
Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 17 quiet room. One service user stated that they did not mind the TV being on; it did not interfere with them because they could go into their room. Management indicated that the television was not usually on all day, being switched off, for example, when other activities were taking place. However, it was suggested that, to provide a contrast for everyone, the TV might be switched off anyway, if nobody appeared to be taking an interest. Three bedrooms were inspected and found to be spacious, comfortable and suitably furnished. Bedside lamps had been introduced to supplement ceiling strip lighting. Aids to mobility in one person’s en suite were found to suit them. Screening was available in the shared room. All occupants had a lockable facility in their rooms but individual care plans sampled contained disclaimers or risk assessments in relation to locks on bedroom doors. An additional stair / chair lift had been installed since the last inspection, so that all parts of the home were accessible. Not all the radiators in the home had guards or low temperature surfaces. Separate risk assessments should be carried out and appropriate action taken. The home was clean and fresh in all areas inspected. Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 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 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) 27 and 30 Staff were employed in sufficient numbers to meet the existing needs of service users. They were also receiving appropriate training for their roles. EVIDENCE: Management reported that no new staff had been recruited since the last inspection, although two existing staff had taken on the role of activities coordinators, providing an additional 8 hours or care per week. This allowed for a minimum of two care staff to be on duty throughout the day, with additional support from management, particularly with meal preparation, and 10 hours of domestic cover a week. One member of staff reported that 5 service users were fairly independent with personal care, needing only occasional support or prompting, and were also able to take themselves to bed. The manager stated that dependency levels of the newer service users were considerably lower than those of the residents they had replaced and the inspector’s observations supported this. Night cover included one person awake, supported by two asleep in the flat at the top of the house. One service user said they were aware that a carer was on duty at night but they had never needed to call on them. All staff had attended a day course entitled, ‘Activities and Meaningful Occupation for people with Dementia’. The home was also subscribing to the Journal of Dementia care to keep abreast with new developments in the field. The value of these developments was reflected in the examples of good practice, commented on under the relevant sections of this report. Recent
Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 19 health and safety training had included a course on infection control at Chelmsford College, moving and handling and, for senior staff and managers, a refresher course on medication. All staff were shortly to attend a course on loss and bereavement. Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 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 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) 33, 35 and 36 The home had made a number of positive changes in the course of preparing to become a home specialising in dementia care. Suitable arrangements were in place for handling service users’ money. Staff supervision was taking place but not as often as necessary. EVIDENCE: Annual user satisfaction questionnaires had generated mostly positive responses and the management had taken appropriate action to address the two issues they had raised. They had extended their survey to a couple of stakeholders and discussion took place with management about broadening their sample and perpetuating the cycle of planning, action and review. The manager’s development plan covered structural changes, activities and staff training and all these areas had been progressed since the last inspection. The manager and deputy manager had made genuine efforts to implement the
Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 21 requirements and recommendations from the last inspection report and develop their service for people with dementia. The home’s system for recording its involvement with service users’ personal money was found to be satisfactory. In most cases, the individual’s family or solicitor deposited money with the home to cover outgoings such as chiropody, toiletries and day centre attendance. These representatives signed an appropriate entry in the records and the home retained the receipts. The balance of money being held for safe keeping by the home was checked for one service user against the record and found to be accurate. Staff supervision records were sampled. It was encouraging to see that both parties had signed them. However, they evidenced a recent pattern of 3 supervisions per year, instead of 6. The manager indicated that supervision usually lasted about 45 minutes but the brevity of some of the records did not suggest that in depth discussion of the individual’s role and development had taken place. Recent records evidenced that management had introduced a reward system for exceptional service. Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 x x x 3 x x STAFFING Standard No Score 27 3 28 x 29 x 30 3 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 3 x 3 2 x x Kilkenny Residential Care Home I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 23 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. 2. Standard 10 36 Regulation 12 (4) (a) 18 (2) Requirement The registered person must ensure that staff respect the privacy of service users rooms. The registered person must ensure that staff are appropriately supervised. Timescale for action 9 September 2005 30 September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 1 Good Practice Recommendations The registered person should edit the Statement of Purpose and Service Users Guide to remove typing and grammatical errors and present the information in a manner, which is easier to follow. It is recommended that the registered person make it possible for all service users to eat their meals at a dining table and develop ways of increasing everyones involvement in menu planning. It is recommended that the registered person make more constructive use of the television and only leave it on if people are showing interest. The registered person should review their risk assessments for unguarded radiators and take any necessary action before winter.
I56 I05 S17862 Kilkenny V217445 UI230805 Stage 4.doc Version 1.40 Page 24 2. 15, 20 3. 4. 20 25 Kilkenny Residential Care Home Commission for Social Care Inspection 1st Floor Fairfax House Causton Road Colchester CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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