Inspection on 13/03/06 for Kineton Manor

This inspection was carried out on 13th March 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

Kineton Manor 31/10/08

Kineton Manor 18/02/08

Kineton Manor 01/02/07

Kineton Manor 09/08/05

Kineton Manor 15/12/04

Kineton Manor 11/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Kineton Manor Manor Lane Kineton Warwickshire CV35 0JT Lead Inspector Sandra Wade Unannounced Inspection 13th March 2006 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 Kineton Manor DS0000004398.V286430.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. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kineton Manor Address Manor Lane Kineton Warwickshire CV35 0JT 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) 01926 641739 01926 642220 Mr Ken Inglefield Mr Edward Graham O`Rourke Dr Paula Philippa du Rand Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th August 2005 Brief Description of the Service: Kineton Manor is a large converted manor house situated in the village of Kineton and is close to the village amenities. It is set in its own extensive grounds with an outlook onto open fields. The home is surrounded by well kept gardens and a large lawned area. The home is registered to provide personal and nursing care for 42 elderly service users. Ample car parking is available to the rear of the home. The service user accommodation is provided on two floors with 31 single ensuite rooms and 5 ensuite shared rooms. There are two lounges and one dining area. A lift is available to access all floors. The current proprietors Mr Inglefield and Mr O’Rourke have owned the home for the past 15 years. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection to Kineton Manor and took place between the hours of 9.00am and 4.40pm. The inspection process was carried out with support from both the manager and Senior Sister of the home. The inspection included the examination of records including care plan records, discussions with services users and staff, a review of policies and procedures of the home and a tour of the building. It was evident that some areas of the home were in the process of being redecorated. On arrival to the home it was noted that some of the residents were around in the communal areas but others were in their rooms. Staff were busy attending to the residents. What the service does well: What has improved since the last inspection? Since the last inspection the home have purchased a new hoist and some digital weighing scales to help support staff in caring for the residents. At the time of inspection, areas of the home were in the process of being redecorated. This includes redecoration of the lounge and corridors, which are to have new carpets. The manager advised that each year three rooms are completely refurbished and they were just about to start doing this for this year. Tiling has been done in the showers and some of the toilets and hand wash basins have been changed to improve the environment for the residents. New commodes have been purchased for residents to have in their rooms and all exits from the home now have had ramps fitted to support those residents who have limited mobility. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 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. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 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 Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 Prospective service users are provided with information about the home to enable them to make an informed choice about whether to stay at the home. Each resident is provided with a Statement of Terms and Conditions regarding the home but payment methods for the fees are not clear. Service users know that their needs have been discussed prior to their placement being agreed by the home and receive written confirmation of this. EVIDENCE: Since the last inspection the manager has taken action to review and revise the Statement of Purpose and Service User Guide. Minor amendments were suggested to ensure these documents fully reflect the care home standards and regulations. These included the provision of a detailed room sizes schedule and confirmation of the arrangements in place to enable regular consultation with service users on how the home is managed other than Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 9 resident surveys. sizes. The manager has subsequently provided details of room There is a detailed Statement of Terms and Conditions given to residents upon their admission. It was noted that this was not fully clear in confirming the method of payment of fees. The manager writes to residents following their assessment to confirm their placement at the home. It was advised that the wording of this letter is reviewed to ensure this fully reflects the commitment by the home to meet the residents assessed needs as stipulated in the Care Home Regulations. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9, 10 Individual resident care plans are in place but they do not demonstrate that staff are meeting residents needs consistently. Medication systems are in need of review so that staff can demonstrate medications are being administered safely. Service users are mostly treated with respect and their right to privacy is upheld. EVIDENCE: At the time of inspection there were 40 residents in the home. Residents looked well presented and well cared for and stated they liked the home. One resident said that they had been in the home a while and they felt Kineton Manor was “a nice place”. One resident confirmed that staff helped them to get up each morning and that staff were very “helpful” and “good” and if they wanted anything they only had to ring the bell. Another resident said “it is excellent here”. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 11 Since the last inspection care plans have been reviewed and those seen had been completed with sufficient information to confirm care needs and staff actions required to address these. Records included information on past medical histories, social hobbies and activities, preferences of times for getting up in the morning and going to bed and detailed records on care needs. Care plans had been evaluated on a monthly basis to establish any changes in care needs. The daily records did not give a full picture of the care given in relation to the care needs identified and no night records had been completed to confirm care given or any monitoring and observation that had taken place. A review of medication was carried out to confirm that issues raised at the last inspection had been addressed. Medications are provided to the home by a dispensing GP and since the last inspection the home have taken action to devise their own computer generated Medication Administration Records (MARs). The manager currently orders medications so that a monthly supply is received for each resident. It was clear from MARs that medications given had been signed for and records had been appropriately coded for those residents who had refused their medication. A new system for recording incoming medication had been set up but some of the records were not up-to-date and it was therefore not possible to undertake an audit of medications received, given and remaining to ensure these were correct. Controlled drugs were found to be stored appropriately and effectively managed. Not all medications contained prescribing labels. This included Asasantin Retard and paracetamol. It was noted during the tour of the home that various creams are being stored in resident’s rooms without prescribing labels. All medications prescribed must contain labels and any creams not prescribed should be agreed and confirmed in a homely remedies policy. Some of the information recorded on the MARs did not reflect what was on the prescribing label of the medication. This included Furosemide 40mg tablets which on the box stated “one every day”. On the MAR it stated “alternate mornings”, a member of staff said that the frequency had been changed but records had not been updated accordingly. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 12 During the inspection residents were treated with respect but one resident said that night staff did not answer their call bell or they had to wait a long time for it to be answered. This person also said that night staff slammed doors and would put the light on when entering bedrooms. Another comment made was that choices of male/female gender when bathing had not been made clear to the resident. A resident with a hearing aid confirmed that staff did clean this and check the batteries so they could effectively communicate. The manager stated that all residents when admitted are asked if they want a lock on their door and if any resident stated they wanted a lock this would be arranged. The manager stated that no resident to-date had requested this. Kineton Manor DS0000004398.V286430.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): 13,14 Service users are able to maintain contact with family and friends as they wish. Systems are in place, which enable residents to exercise some choice and control over their lives. EVIDENCE: The Statement of Purpose and Service User Guide documents giving details of the care and services provided by the home confirm that visitors are welcome at any time. Staff stated that visitors usually come between the hours of 10.30am and 7.30pm. The front door to the home is not kept locked so there are no restrictions to the residents being able to leave the home. A hairdressing service is provided and residents are able to participate in exercises provided by “mobility plus” twice a week if they wish. Other community links include persons who provide arts and crafts sessions, singers and fashion sales. Church services are provided on alternate Wednesdays. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 14 Care plan files confirm resident choices in regard to times they get up and go to bed and whether they prefer baths or showers. All rooms at Kineton Manor have walk in showers as an en-suite facility. Choices of food are evident on menus provided and residents can choose to have their meals in their rooms if they wish. Residents can bring in their personal possessions to furnish their rooms providing the items fit without removing any necessary items already in the room. A resident who offered to show the inspector their room had various personal possessions and photographs in their room and confirmed they were happy with the facilities provided. Kineton Manor DS0000004398.V286430.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, 18 Systems are in place to ensure any complaints or allegations of abuse received are listened to and referred for investigation as appropriate. EVIDENCE: Since the last inspection the home have received one verbal complaint regarding staff attitude. At the time of inspection this matter was in the process of being investigated. No complaints have been received by the Commission for this home. A policy is in place in regard to Abuse so that staff know how to identify this and know their responsibilities in regard to reporting this to senior staff. A member of staff spoken to confirmed that statements would be obtained and an investigation carried out. The Warwickshire Adult Protection Policy confirms that once abuse has been confirmed by the home this must be reported to Social Services to enable decisions to be made on how this is to be investigated. The home need to ensure that any procedures in place reflect this. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 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 the following standard(s): 19, 21,25,26, Service users live in a pleasant environment, which has been well maintained. Some actions are required to the environment to confirm residents live in safe surroundings. EVIDENCE: Kineton Manor is a period building, which is set in 8 acres of land with countryside views. There are 31 en-suite bedrooms and 5 double rooms, which also have en-suite facilities. There are two lounges, a dining room and a library and the home is accessible to wheelchairs. In addition to en-suite facilities there are also four wheelchair accessible toilets on the ground floor and three on the first floor. Rooms have been decorated to a high standard and the manager confirmed there is an ongoing decoration programme for the home. It was observed during the inspection that various areas of the home were in the process of being decorated. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 17 One of the rooms was noted to have a dent in the wall and the walls were paint scuffed and there were also screw holes in the wall. It was suggested that this room was one of those due to be decorated. The dining room had been laid with 26 places but there were 40 residents in home, staff confirmed that a number of residents require assistance to eat and therefore do not use the dining room. In one bedroom it was noted that one of the curtains had come off the hook and a cleaning product was being stored in the room. All chemicals should be kept in a locked location when not in use. One resident said that their toilet seat was a bit low which meant they sat down with a bump. The manager confirmed that there are raised toilet seats available and these were observed in some areas within the home. The manager agreed to follow up this matter. In some of the bedrooms the water was tested and was found to be very hot. Some of the residents who occupy these rooms are mobile and therefore able to use their hot water facilities. Water temperatures are regulated on the baths but not on the wash-hand basins, which could present a scald risk to residents. No risk assessments have been developed to identify these risks and show how the home manage these safely. The home was found to be clean and tidy in those areas not being decorated. Residents confirmed that their rooms are cleaned regularly and one resident said “it is a nice place”. A cleaning trolley was being stored in the upstairs bathroom containing various chemical cleaners, which could present a risk to the residents. The home are required to keep chemicals locked away when unattended. There are two washing machines and two driers to cater for all the laundry of the home. The laundry area was viewed and it was evident there is a dirty to clean flow of laundry with the exception of clean washing being dried over a sink that was being used to soak dirty items. Dirty washing and clean washing should be kept in separate areas of the laundry to maintain good infection control practices. There was no specified hand wash sink for staff and no paper towels in the holder for staff to wash and dry their hands to maintain effective hygiene. Disposable aprons were available but gloves could not be located so that staff could maintain effective infection control practices. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28,29, 30 There are occasions when the home are not working to their full nurse establishment, which could impact on the residents care needs being met. Most staff have completed appropriate training to provide effective care to the residents. Further work is required in regard to recruitment practices to ensure residents are fully protected by the homes procedures. EVIDENCE: Since the last inspection the manager has reviewed staffing in regards to the dependency of the residents and has increased the number of carers from eight to nine during the morning. The manager confirmed that in addition to the nine carers there are two nurses available and the manager works in a supernumerary capacity. In the afternoons they aim to have five care assistants and one nurse. There are two waking night carers plus a nurse on each night and there are dedicated staff to complete laundry, cleaning, cooking and maintenance of the garden. The manager had also taken actions to review the requirements made at the last inspection in regard to staff working patterns and the shift patterns have now been reviewed. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 19 The inspector was informed that there are two Senior Sisters and the Senior Carers are divided into 5 zones within the home and are responsible for the residents within these zones. Residents looked well cared for and one said that “it is excellent here”. This resident felt that some staff were more sensitive to the needs of the residents than others. Another resident said that staff were “very helpful”. Another resident said that staff were accessible and they received the support from staff that they needed. A member of staff is now available to provide activities for six hours per week, which is divided into two hour sessions three days per week. The manager advised that they were trialling activities in smaller groups and were trying to encourage residents to participate. On viewing the duty rotas it is evident that on some days the home have been operating with one nurse during the morning but for the majority of time there are two nursing staff available. A member of staff confirmed that the night staff sort the laundry into piles for washing and fold the clothes as required. Since the last inspection further care staff have completed National Vocational Training in Care to help them provide more effective care to the residents. The manager confirmed that this training is ongoing and training records confirmed that at least 50 of staff have now achieved this qualification. Other training completed includes wound care, infection control, palliative care continence and catheter care. Statutory training is being addressed on an ongoing basis but it was not possible to fully confirm that all staff had completed this within the required timescales from records available. Training information for staff is held on individual files. A review of staff files was undertaken to establish recruitment practices in place and to confirm this process was being managed in a manner, which would safeguard the residents. Some staff had been employed from overseas and the manager confirmed they had been employed at the home via an agency. The manager advised that due to them being new to the country, criminal record bureau checks had been applied for from overseas. One of these was noted to be in a foreign language and it was therefore not possible to confirm this was an official document for the member of staff concerned. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 20 Application forms had been completed but not all employment gaps were explained and although references had been provided it was not always clear in what capacity the referee knew the applicant. A birth certificate had been transcribed into English but other documents provided to identify the person had not been transcribed. Any documents provided by the agency should be transcribed as appropriate so that a firm identification process can be completed and the applicant can be deemed as safe to work with vulnerable adults. Kineton Manor DS0000004398.V286430.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): 35,37,38 Systems are in place to ensure resident’s monies are safeguarded. Some actions are required in regard to record keeping to demonstrate that service user best interests are safeguarded. Some actions are required in regard to health and safety to confirm the welfare and safety of residents is protected. EVIDENCE: A review of resident pocket monies was undertaken to ensure these were being managed appropriately. Monies checked were correct and records had been completed to confirm all transactions made. Receipts were available but sometimes these contained items for other residents on the same receipt and it was not clear which item the resident had purchased. Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 22 The inspection process included a review of various records, where actions are required in regard to record keeping, these are detailed in each relevant section within this report. During the tour of the home some health and safety issues were identified for action. In the upstairs corridor it was noted that various items were being stored such as wardrobes, walking frames, a hoist and laundry trolley. The storage of these items meant that the corridor space was reduced which could impact on the effectiveness of resident evacuation in the event of a fire. Door guards are fitted around the home so that doors can be held open safely but the door to the library was being held open with a book, as the door guard was not working. This is not in keeping with fire precautions, as the door would not automatically close in the event of a fire. A full oxygen bottle was found to be stored in an upstairs staff toilet. It was not evident that consideration had been given to the health and safety guidelines in storing this safely. A member of staff confirmed that none of the residents in the home were using oxygen and this was awaiting return. A number of records were viewed to confirm health and safety checks carried out this included:5 Year Electrical Wiring Certificate – 12.12.01 – this stated that there were some remedial works to be carried out and it was not clear from records that these had been carried out. Electrical Portable Appliance Testing – 8.4.2004 – as good practice testing should be carried out annually. Hoist – 14.2.06 Bath Chairs – 22.2.06 Lift Maintenance – 16.1.06 Legionella Risk Assessment – 9.9.05 Fire Risk Assessment – 20.7.04 – this should be reviewed at least annually Door guards – checked 21.1.06 Fire extinguishers – next due for checking in November 2006 Fire Drills 18.2.06 Employers Liability Certificate – next due 26.10.06 Environmental Health visit – 8.4.04 The manager advised there is no gas at this home. Kineton Manor DS0000004398.V286430.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 2 X 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X 2 2 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X 2 2 Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2OP37 Regulation 5 Requirement The Statement of Terms and Conditions for the home must confirm the method of payment of fees. Care plan records (eg daily records) must demonstrate that care needs prescribed are being met. (Outstanding from August 05 inspection). Timescale for action 31/05/06 2 OP7 12,13 31/05/06 Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 25 3 OP9OP37 17(1)(a) Sch 3 The registered person shall make 31/05/06 arrangements for the recording, handling, safe keeping,safe administration and disposal of medicines received into the care home plus a record of all medicines kept in the care home for the service user, and the date on which they were administered to the service user. To comply with the above the manager must ensure:All incoming medications must be recorded on the MAR charts. Start dates and details of medications carried over also need to be indicated on the MARs. All medications must contain appropriate labels. Details of medications recorded on the MARs must reflect accurately what is written on prescribing label of the bottle or box. (Above outstanding from August 05 inspection). 4 OP10 12 The registered person shall make 30/04/06 suitable arrangements to ensure that the care home is conducted in a manner which ensures residents are treated with respect. This in particular applies to resident comments regarding night staff support and bathing (as detailed in the body of this report). Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 26 5 OP25 23,13 The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. Unnecessary risks to the health or safety of service users must be removed. The manager must ensure actions are taken to ensure hot water temperatures in resident areas are managed safely. The manager must develop risk assessments for each resident demonstrating actions to manage the risks of hot water above the recommended safe temperature of 43°C. (Outstanding issue from August 05 inspection) 30/04/06 6 OP26 13 23 Cleaning chemicals must be stored in an appropriate location consistently to prevent any health and safety risks to residents. The manager is to confirm that the home has been inspected to confirm compliance with the Water Supply (Water Fittings) Regulations 1999. A copy of any documentation to confirm this is to be forwarded to the Commission. Staff must have access to hand washing facilities in the laundry to maintain hygiene. A dedicated hand wash basin is to be made available for staff. 30/04/06 Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 27 7 OP27 18 (1)(2) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. The manager must ensure that duty rotas confirm there are sufficient numbers of nursing staff on duty consistently in the mornings to comply with previously agreed staffing levels. (Issue from August 05 inspection) 30/04/06 8 OP29OP37 7,9,19 Schedule2 The manager must ensure that recruitment information is available in English to enable the appropriate recruitment checks to be carried out effectively. Any gaps in employment must be explored with the applicant and explanations recorded as appropriate. 31/05/06 Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 28 9 OP30OP37 18(1)(a) To demonstrate that staff are competent and experienced to work at the care home. The manager is to confirm that all staff have completed the necessary statutory training within the required timescales. It is advised this is confirmed in an at a glance training schedule detailing all staff and dates of training completed and training planned. 31/05/06 10 OP38 13,23 The manager must ensure that the corridor as identified during the inspection is free from obstruction. Doors must not be held open with devices which prevent them closing in the event of a fire. Appropriate procedures must be followed when storing oxygen within the home. The manager is to confirm that works identified on the 5 Year Electrical Wiring Certificate have been carried out. The manager is to confirm a date for Electrical Portable Appliance Testing in the home. The manager is to confirm a date for the Fire Risk Assessment to be reviewed and updated. 30/04/06 Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 29 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 OP18 Good Practice Recommendations The manager is requested to confirm that a reporting procedure is in place in regard to abuse, which reflects the Warwickshire Vulnerable Adults Procedure. The manager is requested to confirm a date for the redecoration of the room as identified during the inspection as in need of decorating. It is advised that a review of those residents requiring raised toilets seats is carried out to ensure these are both available and suitable for the residents. It is recommended that the home review the storage of resident monies in envelopes as money could easily fall out and this is not a secure system. It is also advised that individual receipts are obtained for resident transactions so these can be kept with their records. 2 OP19 3 OP21 4 OP35 Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 30 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Kineton Manor DS0000004398.V286430.R01.S.doc Version 5.1 Page 31 - 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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