Inspection on 04/06/08 for Kilkenny Residential Care Home

This inspection was carried out on 4th June 2008.

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

Kilkenny Residential Care Home 27/05/09

Kilkenny Residential Care Home 08/05/07

Kilkenny Residential Care Home 27/06/06

Kilkenny Residential Care Home 05/01/06

Kilkenny Residential Care Home 23/08/05

Kilkenny Residential Care Home 03/02/05

Kilkenny Residential Care Home 20/07/04

Kilkenny Residential Care Home 26/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Kilkenny Residential Care Home 6 Third Avenue Frinton On Sea Essex CO13 9EG Lead Inspector Francesca Halliday Unannounced Inspection 4th June 2008 09:00 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 Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kilkenny Residential Care Home Address 6 Third Avenue Frinton On Sea Essex CO13 9EG 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) 01255 672253 F/P 01255 672253 Mr Rajalingum Valaydon Mrs Christine Joan Emmamdeen, Mr Mamode Farouk Emmamdeen Mr Rajalingum Valaydon Mrs Teresa Rosaline Jones Care Home 11 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (11), Old age, not falling within any other of places category (11) Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 11 persons) Persons of either sex, aged 65 years or over, who require care by reason of dementia (not to exceed 11 persons) One person, under the age of 65 years, who requires care by reason of dementia, whose name was made known to the Commission in April 2005 The total number of service users accommodated in the home must not exceed 11 persons 8th May 2007 Date of last inspection Brief Description of the Service: Kilkenny is situated in a residential area on the outskirts of Frinton on Sea town centre, close to the sea front and within walking distance of all local amenities. The home has two shared rooms and seven single rooms. Five bedrooms have an en-suite bath or shower and all have an en-suite toilet and washbasin. Bedrooms upstairs can be accessed by means of a chairlift. There is a hardstanding area at the front of the home, with space for two or three cars. There is an enclosed, paved garden at the rear of the property. The home provides care for 11 older people, aged over 65 years, some of whom have dementia. The weekly charge for a room at the time of inspection in June 2008 was between £375.00 and £430.00 per week. Additional charges were made for private chiropody, visits to day centres, manicures, hairdressing, toiletries, newspapers and confectionary. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means that people who use this service experience adequate quality outcomes. This key inspection was carried out on 4th June 2008 and a short visit on 24th June 2008 concluded the inspection. The term resident is used throughout the report to refer to people who live in the home and the term “we” refers to the Commission for Social Care Inspection. Both the registered managers were present throughout the inspection. We spoke with four members of staff including the managers and with four residents during the inspection. We spoke with one relative who was visiting at the time of inspection. We contacted one of the home’s GPs following the inspection and spoke with a social worker who was visiting at the time of inspection. We received three surveys from relatives and information from the surveys has been included within the report where appropriate. We carried out a tour of the premises and sampled the records held in the home. We also looked at the annual quality assurance assessment (AQAA) completed by the managers. What the service does well: What has improved since the last inspection? One resident told us that they appreciated “the lovely new bath” that had been installed. The paved area in the garden had been levelled and made safer for residents. The activities for residents have been improved by the employment of a drama therapist who attended the home once a week. Residents’ interests, hobbies and preferences in relation to activities were now being recorded, with information provided by the residents and relatives when appropriate. This enabled staff to provide activities particularly suited to the current residents. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 7 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 Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3, 5 (standard 6 not applicable) Quality in this outcome area is good. Prospective residents can be assured that their needs will be assessed before moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a range of information about the home for prospective residents, their family and friends or representatives. The managers confirmed that they always carried out an assessment before accepting a new admission, in order to ensure that the home could meet the prospective residents’ needs. In the home’s annual quality assurance assessment (AQAA) the managers stated that they encouraged relatives to visit and invited prospective residents to spend a day in the home to meet existing residents, whenever possible, before making any decision about admission. All new residents were offered a trial period of four to six weeks. One relative told us that they had visited the home and they and the prospective resident had been given a range of information before making a decision about the home. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 9 We looked at two pre-admission assessments for residents who had been admitted since the last inspection. They contained detailed assessments of the residents concerned. These residents did not have dementia. However, the assessment form needed to be expanded to cover a more detailed mental health assessment for prospective residents with dementia. The managers told us that they would expand the assessment to include mental health. Assessments were dated but not always signed. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 Quality in this outcome area is adequate. Residents are satisfied that their health and care needs are met but as the risks to their health and welfare are not always assessed there is a risk that they will not be fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents we spoke with told us that they were happy with the standards of care and the support they received from staff. One resident said “I get on very well here, I’m quite cosy and comfortable”. A relative surveyed told us that the person they visited was “well cared for and all her daily personal care needs are met”. Another relative who responded to our survey said “Staff and owner deal with my mother with dignity and respect and take pride in their care for her. They treat friends and family of the person they care for the same way”. The social worker visiting the home told us that the home were meeting the needs of the resident they were visiting and that staff were providing individualised care. One of the home’s GPs told us that staff reported healthcare concerns promptly and appropriately. Residents who Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 11 needed assistance with personal care were appropriately dressed for the temperature in the home. They were generally very well presented although a couple of residents needed help to clean their nails. We sampled the care records for three residents. There was evidence that both relatives and residents had been involved in providing information about residents’ needs, preferences and interests. The care plans had details of residents’ preferences, abilities and care needs with guidance for staff on how to provide the care. The care plans were dated but not signed. The daily care records were generally brief and needed more evidence that staff were monitoring the care needs identified in the care plans on a daily basis. However, monthly evaluation of care needs was carried out and generally demonstrated good monitoring of residents’ care needs. The daily care records were kept separately from the care plans, which would not encourage staff to regularly access the care plans. The night records were kept separate from the day records and information on all residents was written on the same sheet. This did not conform to the Data Protection Act 1998 requirements. The managers confirmed following the inspection that the day and night records would be combined and that individual residents records would be kept separate. Relatives generally considered that staff kept them informed about residents’ changing health and care needs. A relative told us that the family had been informed when the resident they visited had a fall. However, another relative who was surveyed told us that they had only found out about a resident’s falls when they visited and found that they were bruised. One relative responding to our survey considered that the communication with them would be made “even easier” if the home “adopted email”. Another relative said that they were “consulted about doctor’s visits” each time the resident needed to see a GP. We saw records showing that the GP had been consulted following a resident’s accident. Residents confirmed that they had optical and dental checkups when needed. A chiropodist visited the home on a regular basis and audiology appointments were arranged for residents with hearing problems. Records of checkups and visits were seen. The managers told us that they had “excellent” support from the local GPs and district nurses. They also confirmed that they had access to community mental health nurses when needed. Records of GP’s and district nurses’ visits were made with information on any changes to treatment or care. Residents’ weight was generally recorded monthly although there were only records for eight months for one resident in 2007. Another resident had not been weighed on admission; the managers told us that they had been too frail to be weighed when they had been admitted. However, no nutritional risk assessment had been completed despite the fact that staff told us they had concerns about this resident’s poor appetite. Some risk assessments were seen but this was an area that needed to be developed. Moving and handling assessments had been completed but there were no nutritional risk assessments or assessments Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 12 of the risk of residents developing pressure sores. The home did not have a tool for monitoring residents’ psychological health. This was particularly important for residents with dementia, as there was no method of systematically monitoring their condition, their responses to changes in medication or any periods of challenging behaviour. The medicine administration records we sampled were well completed. One relative who was surveyed told us “drug administration is carried out carefully and precisely”. The home was not storing any controlled drugs (CD) at the time of inspection and did not have a CD cupboard. The managers said that they would investigate the possibility of obtaining a CD cupboard to enable them to store these medicines, in line with current legislation, if any residents were prescribed CDs in the future. Prescription only medicines in residents’ room were not always being kept in a locked drawer as required. This could pose a potential risk to residents with dementia. We observed the medicine cupboard with the keys in the lock with no staff member in attendance. It is potentially very dangerous to leave an unlocked medicine cupboard unattended, particularly as there were mobile residents with dementia in the home. The managers confirmed, in the annual quality assurance assessment, that all residents’ had had their medication reviewed by their GP this year. Some opened eye drops were being stored in the medicine cupboard. One had no prescription label and two others had a date of opening some months previously; none were safe for continued use. The manager said that they had been brought in by a resident and were not currently used. She took steps during the inspection to ensure that they could not be used again. Some medicines that had a short shelf life once opened did not have a date of opening on them. This might result in medicines being given to residents beyond the time that they were safe to be used. It was not possible to correctly audit the medicines that were not stored in monitored dosage systems, as the amount recorded as brought forward did not include the medicines that had not been used the previous month. It was therefore not possible to assess whether residents had received all their prescribed medicines. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15 Quality in this outcome area is good. Residents can expect to be offered a range of social activities and to be provided with a nutritious diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Activities in the home had been improved since the last inspection as a drama therapist now visited the home for between one and one and a half hours each week. Staff considered that residents had really benefited from this input. One resident said that they enjoyed the music sessions. The home also had a part time activity coordinator who worked three or four one and a half hour sessions each week. Details of residents’ hobbies, interests and preferences were recorded. The activity records showed that residents had one to one sessions with staff as well as activities. Although one resident who preferred to spend more time in their room told us that it was “a bit boring here”. The activities included pottery sessions, games, hand and leg massages and some outings to local shops, cafes and a garden centre. One resident visited the local swimming pool each week. A relative told us that staff “help residents celebrate their birthdays by throwing small parties”. The lounge had music Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 14 playing loudly as well as the television being on. This would have been very disorientating for residents with dementia who were in the lounge. Residents told us that they could choose when they got up and went to bed and where they spent their day. They said that staff gave them any assistance they needed but encouraged them to retain their independence. A few residents chose to have all their meals in their rooms. Some residents spoken with said that they liked to be as independent as possible. One resident told us “I like fending for myself, I’m my own boss”. Residents we spoke with were generally very happy with the food served although one resident told us that the standard of food varied. The food we saw at lunchtime looked nutritious. Choices were available at all mealtimes and residents could have alternatives if they did not like what was on the menu. Cooked breakfasts were available for residents who wanted them. Staff told us that residents were asked about their preferences at each mealtime rather than the day before as some of the residents had short-term memory problems or some degree of dementia. A relative confirmed that staff asked residents about their preferences and told us “the food is very good and there is a choice”. Another relative told us that staff prompted residents to drink plenty of fluids. The kitchen looked clean and well organised. Some of the food in the freezers did not have a date label to enable staff to monitor the use by date and ensure that the food was within the safe period for it to be eaten. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16, 18 Quality in this outcome area is good. Residents can be confident that their concerns will be promptly addressed and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure was on display in the home. Residents we spoke with told us that they had not had any complaints. The majority of relatives surveyed and spoken with were aware of how to make a complaint. A relative told us that they had an “excellent response” to any concerns raised. The managers told us that they had not had any complaints and that any minor concerns were sorted out immediately. We have not received any complaints about the service since the last inspection. In the AQAA the managers stated that staff were regularly reminded about being aware of the signs of possible abuse, the signs to look for and who to report it to. The home had a policy in place for safeguarding vulnerable adults. The majority of staff had received safeguarding training and further training had been arranged. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 26 Quality in this outcome area is poor. Residents live in a clean and comfortable home but cannot be confident that the environment is safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents rooms were generally well personalised to their individual preferences. The home had a lounge with a dining area and a separate quiet room with a small dining table. This room was used for residents who wanted to be away from the noise of the television and was also used for meetings with relatives and visiting professionals. Rooms seen had a lockable drawer for residents to keep valuables, money or medicines. The paving in the back garden had been levelled and a new bath had been installed in one resident’s en-suite since the last inspection. There was garden furniture for use in good weather and the managers said that an additional parasol was being purchased. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 17 The home had a number of unguarded radiators and a few windows on the first floor without restrictors. This was of particular concern as a number of the residents in the home had some form of dementia. A fire door in one resident’s room on the first floor led out onto a fire escape. The door was not alarmed and therefore posed a potential risk to mobile residents with dementia. The managers confirmed that they would take prompt action to address these issues. Portable ramps had been purchased since the last inspection in order to improve access into and out of the home for residents and wheelchair users. However, exits, with doors open that residents could access, were seen without a ramp in place. The portable ramps relied on staff moving them and still did not create a safe and level exit for residents or wheelchair users wishing to go out independently. On the day of this unannounced inspection the home was clean and there were no unpleasant odours in the home. One resident told us that the home was “lovely and clean”. Residents told us that the home provided a good laundry service. Clothes seen looked well laundered. The home did not have a supply of red dissolvable bags for the handling of foul linen. The managers said that they would investigate whether the bags could be used on the hottest cycle of a domestic washing machine, as they did not have a washing machine with a sluice cycle. There were numerous toiletries in residents’ rooms and the communal bathroom. This would pose a potential risk to residents with dementia. No risk assessments had been carried out of the suitability of their storage in relation to the current residents in the home. There were bars of soap in a number of communal areas, which could potentially lead to cross infection. Bars of soap should only be used by one resident and not shared by other residents or used by staff as they can cause cross infection amongst a vulnerable group of people. There were no liquid soap or paper hand towels for staff to use in residents’ rooms. This would not enable staff to carry out good infection control practices when they were providing personal care. The managers confirmed that liquid soap and paper hand towels for staff use would be put in residents’ rooms and that steps would be taken to put all toiletries out of sight. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29, 30 Quality in this outcome area is poor. Residents are supported by an adequate number of staff but the lack of training means that their safety cannot be assured. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a very stable workforce. The managers stated that the majority of staff had been working in the home for fifteen years or more. There was a minimum of two care staff on during the day and one carer at night with one carer sleeping in. Staffing was at an adequate level for the dependency of residents. There were ten residents in the home at the time of inspection. None of the residents needed the assistance of two staff with their care and none of the residents had challenging behaviour. The managers confirmed that staff no longer worked a night duty followed by a day duty. We looked at four staff records. There was evidence that all had received a criminal records bureau (CRB) check. Two references were on file for staff who had been recruited more recently but only one reference was on file for staff who had been recruited more than ten years ago. The managers told us that they would ensure that proof of identity, for example a copy of staff’s birth certificate or passport would be kept on file. No new staff had been recruited since the last inspection. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 19 Staff training was difficult to assess as the records were not in date order and there was no summary of the overall training completed by each member of staff. Three staff files seen had no record of any moving and handling training, one had no record of the training since 1998 and two had no record of the training since 2004. The managers confirmed that four staff had undertaken National Vocational Qualification (NVQ) at level 2 and two staff had also completed level 3. Further training had been booked on dementia and challenging behaviour for nine staff although they said that they did not have any problems with challenging behaviour at the time of inspection. Eight staff had completed a course on palliative care at NVQ level 3. Further training in infection control, safeguarding of vulnerable adults, moving and handling, health and safety and risk assessment was booked. A number of the care staff had recently completed food hygiene and first aid training. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36, 38 Quality in this outcome area is adequate. Residents benefit from clear leadership in the home but the lack of risk assessments potentially puts them at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had two registered managers, one of whom was also one of the registered providers. They shared the management responsibilities and worked alongside the carers on a daily basis. One of the managers had completed the registered manager’s award and NVQ at level 4. The other manager had completed the assessor’s award. The GP we spoke with described the home as “well organised”. However, there was a lack of risk Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 21 assessments relating to aspects of care and to the environment that potentially put residents at risk The managers said that they tried to have an open culture within the home and encouraged residents and relatives to come forward with any changes that could improve standards in the home. Relatives said that the managers were very responsive to any concerns raised. The home sent out surveys to residents and relatives once a year. The dispensing pharmacist carried out audits of the medication. The managers were able to monitor standards in the home as they carried out care alongside the carers. The annual quality assurance assessment demonstrated that the managers were constantly reviewing care and services provided and were trying to improve standards within the home. We looked at the systems in place for residents’ personal monies. The balances checked were correct and receipts were available for all transactions. Staff we spoke with confirmed that they had supervision every two months and the records confirmed this. Staff were not receiving a formal appraisal but the managers said that in future once a year instead of supervision an appraisal would be carried out for all staff. There were systems in place for the maintenance and servicing of equipment. Water temperatures were not being checked on a regular basis as staff were relying on the thermostats to control temperatures at water outlets used by residents. However, thermostats are not always reliable and checks need to be carried out to protect vulnerable people particularly residents with dementia. Water temperatures were not checked during the inspection. The fire safety officer had visited and no requirements had been made. The home had completed a fire risk assessment. The accident records seen were well completed. Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 3 17 X 18 3 1 X X X X X 1 2 STAFFING Standard No Score 27 3 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 2 Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard 1. OP8 Regulation 14 Requirement Staff must ensure that all aspects of care are risk assessed, monitored and action taken when necessary. For example the risk of pressure sores and malnutrition and the assessment of residents’ psychological health. Staff must ensure that the medicine cupboard is always locked and prescription only medicines are kept locked up when staff are not administering the medicines, so that residents are not put at potential risk. Staff must ensure that medicines with a short shelf life when opened have a date on first use, so that medicines are not given to residents beyond the time that they are safe to use. Staff must ensure that medicines left over from the previous month are recorded on the medicine administration record, in order that a check can be made on whether residents have received all their prescribed medicines. Timescale for action 01/07/08 2. OP9 13(2) 04/06/08 Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 24 3. OP25 13(4) Risk assessments must be carried out and appropriate action taken to minimise the risk of residents being injured by hot radiators. Risk assessments must be carried out and appropriate action taken to minimise the risk to residents posed by open access from a fire door on the first floor, which leads to the fire escape. All exits of the home must be made level so that residents and wheelchair users can use them independently and safely. This requirement had a timescale of 02/07/07 and has only been met in part. Staff must ensure that toiletries are stored safely and do not pose a risk to residents with dementia. Staff must ensure the safe handling of foul linen in order to reduce the risk of cross infection to staff and potentially to residents. Bars of soap must only be used by individual residents as they pose a risk of cross infection in a vulnerable group of residents. All staff must undertake moving and handling training on a regular basis in order to reduce the risk of accidents to themselves and to vulnerable residents. The temperature of all water outlets used by residents must be tested on a regular basis in order to ensure that the temperatures remain within the safe range and do not pose a risk to residents. 01/09/08 4. OP19 13(4) 01/07/08 5. OP19 13(4) 01/08/08 6. OP26 13(3) 01/07/08 7. OP30 13(5) 01/08/08 8. OP38 13(4) 01/07/08 Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 25 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 OP3 Good Practice Recommendations The pre-admission assessment should be expanded to cover mental health issues in order that residents with dementia can be fully assessed as to the suitability of the home prior to admission. Staff should ensure that food in the freezer is date labelled in order to ensure that residents are not given food beyond the time that it is safe to eat. The home should consider purchasing a washing machine with a sluice cycle in order that foul linen can be appropriately laundered and the risk of cross infection to staff and potentially to residents can be reduced. 2. OP15 3. OP26 Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kilkenny Residential Care Home DS0000017862.V365927.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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