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Inspection on 28/10/08 for Kingfisher Court Care Home

Also see our care home review for Kingfisher Court Care Home for more information

This inspection was carried out on 28th October 2008.

CSCI found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Full assessments of needs are completed before people move into the home. Visitors told us they always felt welcome at the home and there was a choice of where to sit with their relatives. People were enjoying their meals during this inspection and there was a picture menu on each dining table to give everyone clear information about the choice of meal available. The complaints procedure is clear and people`s concerns and views are listened to. A comments and suggestions box is situated in the reception area. There are clear signs around the home to help people locate facilities and rooms. Some bedroom doors are decorated with knockers and letterboxes to resemble front doors of individual homes.Staff receive updated training and 70% of them have achieved the National Vocational Qualification at level 2 in Care. The manager has regular meetings with people who live at the home and relatives. Questionnaires are also used to gain people`s views.

What has improved since the last inspection?

A new manager, Nora Gazely has commenced at the home since the last inspection and has been assessed and registered with the Commission. Care planning is developing and directions are given about actions staff need to take to meet needs. A new activities worker has been appointed. People told us that their meals had improved a lot recently and there was always a choice. Some improvements have been made to the building. The dining room had been enlarged using space that was previously a "smoking room" and one of the small sitting rooms is now available for those that choose to smoke. An open tea making area had been made into a private quiet room as an alternative place for people to sit.

What the care home could do better:

Care plans must be updated when needs change. This is so that all staff have clear information about what actions to take to meet people`s changing needs. Care staff should follow the system that is in place to monitor when prescribed creams are applied. This is to ensure people receive all medications as prescribed to promote their health. The cubicle toilets should be replaced with more private facilities and all toilet and bathroom doors must be lockable. This is to promote privacy and dignity for people and new toilet facilities should be accessible by wheelchair users and those that need care assistance. Updated training in Safeguarding Adults must be provided to staff. This is to ensure staff are fully aware of action needed within local area procedures to safeguard people from abuse at all times.Sufficient heating and ventilation must be provided in all parts of the home, so that people are always warm enough wherever they choose to sit. The double glazed windows that have ineffective seals should be replaced. The right hand rail on the main stairs must be replaced. This is to provide assistance to people using the stairs and to promote health and safety. The risks caused by wall heaters must be assessed and sufficient action must be taken to reduce the surface temperature in order to eliminate risks of burns to people that may fall against them.

CARE HOMES FOR OLDER PEOPLE Kingfisher Court Care Home The Spinney Sturgeon Avenue Clifton Nottingham NG11 8HE Lead Inspector Meryl Bailey Unannounced Inspection 28th October 2008 10:45 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 Kingfisher Court Care Home DS0000002206.V372956.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. Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingfisher Court Care Home Address The Spinney Sturgeon Avenue Clifton Nottingham NG11 8HE 0115 940 5031 0115 984 7071 kingfisher_court@hotmail.co.uk 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) Tawnylodge Limited Nora Gazely Care Home 40 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (40) of places Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No one falling within category OP may be admitted into Kingfisher Court where there are 40 persons of category OP already accommodated within this home. No one falling within category DE(E) may be admitted into Kingfisher Court where there is 1 person of category DE(E) already accommodated within this home. No person to be admitted to Kingfisher Court in categories OP or DE(E) when 40 persons in total of these categories/combined categories are already accommodated in this home. Please see changes on the latest Registration Certificate issued after this current inspection Date of last inspection 1st November 2007 Brief Description of the Service: Kingfisher Court is a purpose built care home offering accommodation for up to 40 older people and an application has been made to provide a service to people with dementia. The accommodation is situated over two floors with stairs and a passenger lift providing independent access for service users. Kingfisher Court is situated on the edge of Clifton housing estate providing easy access to a range of local facilities including public transport links. There is a nature reserve to the rear of the property giving a pleasant outlook and a car park to the side and rear of the property. The fees for Kingfisher Court range from £285 to £427 Kingfisher Court Care Home DS0000002206.V372956.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 1 star. This means the people who use this service experience adequate quality outcomes. The inspection visit was unannounced and involved one inspector, though another inspector was present on the same day to assess the suitability of providing a service for people with Dementia. Inspections focus on outcomes for people that use the service. In order to do this the main method of inspection used was ‘case tracking’ which meant four people were selected and their care was tracked through discussion with them and with staff. We looked at their care records and observed how staff worked with them in practice. A tour of the premises took place to assess environmental standards and a sample of staff records were also looked at to make sure checks were carried out on staff before they started working at the home. We have taken account of all the information we have received about the home since the last inspection. This includes information given in support of the application to register the service for people with dementia. Services are now required to fill in a document called an Annual Quality Assurance Assessment (AQAA) in which the registered manager identifies from their own quality monitoring what the service does well at and what they need to improve on. The AQAA form was returned before the site visit and was used to plan the site visit and to support judgements made in this report. What the service does well: Full assessments of needs are completed before people move into the home. Visitors told us they always felt welcome at the home and there was a choice of where to sit with their relatives. People were enjoying their meals during this inspection and there was a picture menu on each dining table to give everyone clear information about the choice of meal available. The complaints procedure is clear and people’s concerns and views are listened to. A comments and suggestions box is situated in the reception area. There are clear signs around the home to help people locate facilities and rooms. Some bedroom doors are decorated with knockers and letterboxes to resemble front doors of individual homes. Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 6 Staff receive updated training and 70 of them have achieved the National Vocational Qualification at level 2 in Care. The manager has regular meetings with people who live at the home and relatives. Questionnaires are also used to gain people’s views. What has improved since the last inspection? What they could do better: Care plans must be updated when needs change. This is so that all staff have clear information about what actions to take to meet people’s changing needs. Care staff should follow the system that is in place to monitor when prescribed creams are applied. This is to ensure people receive all medications as prescribed to promote their health. The cubicle toilets should be replaced with more private facilities and all toilet and bathroom doors must be lockable. This is to promote privacy and dignity for people and new toilet facilities should be accessible by wheelchair users and those that need care assistance. Updated training in Safeguarding Adults must be provided to staff. This is to ensure staff are fully aware of action needed within local area procedures to safeguard people from abuse at all times. Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 7 Sufficient heating and ventilation must be provided in all parts of the home, so that people are always warm enough wherever they choose to sit. The double glazed windows that have ineffective seals should be replaced. The right hand rail on the main stairs must be replaced. This is to provide assistance to people using the stairs and to promote health and safety. The risks caused by wall heaters must be assessed and sufficient action must be taken to reduce the surface temperature in order to eliminate risks of burns to people that may fall against them. 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. Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be assured their needs are assessed before they move into the home. EVIDENCE: Full assessments of needs were on the four files we sampled. Use had been made of the Shared Nottingham Assessment Profile. These assessments had been completed before people moved into the home. Kingfisher Court Care Home DS0000002206.V372956.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): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care planning is developing, but where written plans are not up to date there is a risk that changing needs will not be met. Prescribed treatment with creams is not guaranteed, but medication is otherwise handled safely. EVIDENCE: The four care plans we looked at in detail varied in the amount of information and the way they were written. The person concerned had signed each one and each had a photograph. One was for someone who had been at the home for two years. It was very brief, but included actions to be taken. Two others contained more information and gave staff more direction about what actions they need to take to meet needs. The fourth one was very clear. There was a 24-hour plan of care and further detailed plans that were person centred with pictures. This one was recently prepared and not reviewed yet. The others had been reviewed and the changes needed were written on a review sheet, but the plans themselves had not been updated. The manager said that the new design of care plan was going to be used with everyone. Some of the Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 11 people we spoke with said they knew there were care plans and they were satisfied with the way care staff helped them with personal care. In discussions with care staff they were able to demonstrate that they knew individuals’ needs. There were records of visits from doctors, district nurses and other health professionals. People we spoke with said they had visits from doctors when they requested it. There were clear records in the daily notes for one person where paramedics had attended almost immediately following a fall. There were weight charts for some people and records showing that dieticians had been involved. There were treatment sheets for staff to record when people had bed rest and when prescribed creams were applied. However, these were not completed regularly and it was not clear if the creams were always applied. Medication was otherwise very well organised. Storage was secure and records were fully completed with the exception of prescribed creams. We observed a member of staff giving medication to some people and appropriate procedures were followed. People told us the staff treated them well, “ They’re very helpful when I need help.” One person described help with bathing in a way that demonstrated full respect was given. On files we saw signed forms clarifying if people wanted to have a key for their bedroom door. However, we noticed not all toilet and bathroom doors were lockable and the arrangement of the cubicle toilets shows a lack of respect for privacy (see also the Environment section). Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are made to meet needs relating to activities and people are empowered by being given clear information about meals and choices. EVIDENCE: We met a newly appointed activities worker, who had not yet commenced work, but was enthusiastic about providing suitable stimulating activities. This person is very experienced in working with people who have dementia and a suitable budget has been provided. The manager said that, meanwhile, care staff were providing activities. We saw one care assistant using a soft ball in an activity with people in the large lounge. Visitors told us they always felt welcome at the home and there was a choice of where to sit with their relatives. We observed the lunchtime meal and found people enjoying their meals. People told us that their meals had improved a lot recently and there was always a choice. There was a picture menu on each dining table. Some people required help with eating and this was given by care assistants sitting Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 13 next to them. Food was prepared in the kitchen next to the dining room. Some new items had been purchased for the kitchen, such as potato tumble peeler and a mixer, but refrigeration space was limited to one fridge, flooring was damaged and the kitchen units were not fitted to the walls. In the reception area there was a notice board and leaflets giving information about the advocacy service provided by Age Concern and other information about Dementia. Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate action is taken following any concerns and complaints people have. EVIDENCE: We looked at information about one complaint that had been received at the home and this had been fully investigated with the action taken written down clearly by the manager. The procedure that people need to follow if they want to complain was on a notice board with pictures. A comments and suggestions box was also situated in reception. Some staff had received training in Safeguarding Adults in the past, some within their National Vocational Qualification courses. The manager told us she had recently surveyed staff using a questionnaire and realised they needed more training in this area. The staff we spoke with showed understanding of what was meant by Safeguarding Adults and said they would report any suspicions or concerns to the manager. People’s money was looked after securely and records showed that two people check amounts and sign the record for each transaction. Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Changes are currently being made to the premises to make it comfortable and safe for everyone. EVIDENCE: The shared areas of the home included a large dining room, conservatory, large lounge and three smaller sitting rooms. Several changes had been made since the last inspection. The dining room had been enlarged using space that was previously a “smoking room” and one of the small sitting rooms is now available for those that choose to smoke. An open tea making area had been made into a private quiet room as an alternative place for people to sit. A large window into the room had been replaced with a notice board that provided some clear information to people. On the day of the visit a family of four were visiting their relative and were enjoying the privacy of this room. The Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 16 room had been fitted with comfortable furnishings and décor. All shared sitting areas were maintained and clean. There was a newly fitted bathroom and a new walk in shower room. Another bathroom was about to be refitted, but was left unlocked with tools lying around on the floor. On finding this the representative for the provider company immediately arranged for this room to be locked to protect people living in the home. One toilet had been refitted, but there were two sets of toilets that were partitioned cubicles. These were not easily accessible by wheelchair users and those that need the assistance of carers. Staff told us that if they assisted the cubicle doors could not be closed. This type of facility does not provide full privacy. There were handrails in corridors, but these were only on one side. The upper floor is accessible by a passenger lift and wide staircase. One person had fallen on the stairs and plans were being made to reduce the risk of this happening again (see standard 38). We saw a sample of bedrooms and these appeared comfortable and well equipped. On some there were photographs so that people could distinguish there own rooms and some were decorated with knockers and letter boxes to resemble front doors of individual homes. The seals on some double glazed windows were not effective allowing condensation to build up and obscure the view and these needed attention. Some visitors and two people living at the home were asked about the building and all said they had noticed recent improvements. They also said that it was always kept clean. One person, who preferred to sit in the conservatory, said that it was cold there. Blankets were provided to people. There were covered heaters in the conservatory. In other parts of the home heaters were found very hot to touch (see standard 38). Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are met by a sufficient number of trained staff. EVIDENCE: There were five care staff, including the deputy manager, during the day and three at night currently caring for 36 people. Staff were easy to find and at lunch time there were sufficient to help those who needed assistance with eating. Staff told us that the night staff started helping people to get up in the morning from about 5.30am if people requested to get up. The day staff commenced at 7am and the night staff stayed until 8am so that there were sufficient staff to help everyone with washing, dressing and breakfast. Some people told us they had plenty of help if they wanted it. The manager informed us that 70 of the care staff had achieved the National Vocational Qualification at level 2 in Care. Some have already moved on to level 3. Staffing records included references to completed checks through the Criminal Records Bureau and two satisfactory written references being obtained before people started work at the home. Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 18 The sample of staffing records that we looked at contained notes of regular 1:1 supervision of staff and records together with certificates of a range of training completed since the last inspection. These included: Dementia care training, Moving and Handling, Food Hygiene, Falls prevention, Health and Safety and conversational skills. A new member of staff had completed induction training. Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and action is ongoing to promote the health and safety of people that live there. EVIDENCE: Nora Gazely has been manager at the home for eight months. We have assessed her fitness and can confirm she is fit to manage this care home. The manager completed the Annual Quality Assurance Assessment form at the end of August 2008. This was comprehensive and gave us all the information we asked for. Within the form, the manager described regular meetings with residents and relatives and the use of questionnaires to gain people’s views. We saw the minutes of the last meeting held on 21 October 2008, which was Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 20 attended by five people living at the home and three relatives. In this meeting they had discussed arrangements for a Christmas Fête and party, a clothes sale to be held in November and a Cabaret evening for Christmas. As reported under standard 18, people’s money was looked after securely and records showed that staff followed procedures with two people checking amounts and signing the record for each transaction. The upper floor is accessible by a passenger lift and wide staircase. We noticed that the handrail on one side was not easy to grip. We spoke to one person who had fallen on the stairs. We saw the accident record of the incident, which showed that appropriate emergency medical help was sought. Since the inspection the company that owns the home sent us a written plan to: • Fit a magnetic closer on the door at the top of the stairs. • Fit alarm on the door at the top of the stairs. • Fit a gate at the bottom of the stairs (4th step up) to deter people from going up the stairs alone. • Replace handrails on the main stairs. The first three of these changes have now been made. In parts of the home the heaters were found very hot to touch and these should be assessed to ensure sufficient action is taken to reduce risks to people that may fall against them. Otherwise, there was evidence that action was taken to promote health and safety within the home. There were records of regular checks made on water temperatures and wall mounted water heaters had been removed from individual bedrooms since the last inspection. Staffing records contained evidence that staff were trained in safe working topics and fire safety. The fire plan was posted on a corridor wall. We also saw that portable electrical appliances had labels showing they had been tested. Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 21 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 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 2 2 X 2 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP8 Regulation 15 Requirement Care plans must be updated when reviews indicate changes are needed. This is so that all staff have clear information about what actions to take to meet changing needs. Provide updated training to staff in Safeguarding Adults. This is to ensure staff are fully aware of action needed within local area procedures to safeguard people from abuse at all times. Provide sufficient heating and ventilation in all parts of the home, so that people are always warm enough wherever they choose to sit. Replace the right hand rail on the main stairs. This is to provide assistance to people using the stairs and to promote health and safety. Assess the risks caused by wall heaters and ensure sufficient action is taken to reduce the surface temperature in order to eliminate risks of burns to people that may fall against them. Timescale for action 31/12/08 2. OP18 13(6) 31/12/08 3. OP19 23(2)(p) 31/12/08 5. OP38 13(4)(c) 31/12/08 6. OP38 13(4)(c) 31/12/08 Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations Train staff to follow the system that is in place to monitor when prescribed creams are applied. This is to ensure people receive all medications as prescribed to promote their health. Replace the cubicle toilets with more private facilities and ensure all toilet and bathroom doors are lockable. This is to promote privacy and dignity for people. Provide toilets that are fully accessible by wheelchair users and those requiring assistance. Replace the double glazed windows that have ineffective seals. 2. 3. 4. OP10 OP21 OP19 Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 24 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 Kingfisher Court Care Home DS0000002206.V372956.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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