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Inspection on 21/11/05 for Kingfisher House Residential and Nursing Home

Also see our care home review for Kingfisher House Residential and Nursing Home for more information

This inspection was carried out on 21st November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

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

What has improved since the last inspection?

Two of the five requirements from the last inspection have been actioned. None of the fire doors were wedged open and lighting in bedrooms has been reviewed to ensure residents who like to read have sufficient lighting. Further work has been undertaken to encourage staff to use the evaluation section at the bottom of each component to record their observations rather than using the general progress notes. Since the last inspection a new special needs (Dementia) unit has opened for 29 residents. Currently there are only 8 places in use until additional staff have been recruited. The accommodation is excellent and thought has been given to the use of colours to help residents become familiar with areas of the building.

CARE HOMES FOR OLDER PEOPLE Kingfisher House Residential and Nursing Home St Fabians Close Newmarket Suffolk CB8 0EJ Lead Inspector Anna Rogers Unannounced Inspection 21st November 2005 09:45 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 House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 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 House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kingfisher House Residential and Nursing Home Address St Fabians Close Newmarket Suffolk CB8 0EJ 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) 01638 669919 01638 669929 Four Seasons Homes No 4 Limited Post Vacant Care Home 91 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (33), Old age, not falling within any other of places category (62) Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th July 2005 Brief Description of the Service: Kingfisher House, Newmarket, is part of Four Seasons Health Care. The house is purpose built to provide nursing and residential care for a maximum of 62 older people. Kingfisher House has two floors with a shaft lift accessing the first floor. The home has a lounge on each floor, a smoking room and a laundry room situated on the ground floor. Both floors have separate dining rooms, which are available for service users to eat their meals. There are 58 single bedrooms and four shared rooms each having the advantage of an en suite toilet and wash basin, shared bathrooms are situated on each floor. A new unit (Spillers) was opened in September 2005 and provides an additional 29 places for people who have dementia. The layout is similar to Kingfisher House in that there are bedrooms and communal areas on both floors. There is a vertical passenger lift for use between the two floors. Currently only the ground floor is in use with 8 residents. Meals are transported from the main kitchen. There is a separate staff team consisting of senior carers and care assistants. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken on a weekday over 6 hours starting at 09.45. Since the last inspection a new manager has been appointed but an application to register with The Commission for Social Care Inspection (CSCI) remains outstanding. During this inspection discussions were held with residents both in communal areas of the home and in their bedrooms. Discussions were also held with the two trained nurses who were leading the shifts (on the ground and first floor) in Kingfisher House. The senior carer in Spillers was spoken with and 4 of the residents were seen. Two relatives were spoken with briefly in Spillers. A number of records relating to the care of residents were seen and also records relating to the recruitment and deployment of staff. A group of care staff were spoken with during the inspection as well as individual discussions with staff. The Commission for Social Care Inspection (CSCI) has received an anonymous complaint, which identified concerns about staffing levels and supervision of residents in Spillers. These concerns were investigated during this inspection. Further comment is made under the staffing section of this report. The elements of the complaint could not be substantiated but action is required. The reader of this report may wish to read this in conjunction with the report of the announced inspection, which took place on the 27th July 2005. What the service does well: What has improved since the last inspection? Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 6 Two of the five requirements from the last inspection have been actioned. None of the fire doors were wedged open and lighting in bedrooms has been reviewed to ensure residents who like to read have sufficient lighting. Further work has been undertaken to encourage staff to use the evaluation section at the bottom of each component to record their observations rather than using the general progress notes. Since the last inspection a new special needs (Dementia) unit has opened for 29 residents. Currently there are only 8 places in use until additional staff have been recruited. The accommodation is excellent and thought has been given to the use of colours to help residents become familiar with areas of the building. What they could do better: There is a need to ensure assessment of needs documentation is completed. Care plans which are developed from the assessment must demonstrate how needs are to be met. There continues to be a problem with nursing staff signing the Medication Administration Records (MAR) sheets when medication has been given. Action taken from the last inspection for staff to undertake regular audits to identify any deficits is clearly not effective as this inspection again found gaps in the records. Residents who either choose to eat in their bedrooms or require assistance with eating must be provided with hot meals and these meals must be covered. The catering staff should be aware of residents with specialist dietary needs and ensure that these needs are met. There is a need to ensure that staff rotas accurately reflect the duties being undertaken and that any changes are recorded. The recruitment of staff from overseas needs to ensure that the members of staff have a satisfactory understanding of the English language to enable them to communicate with residents but also to be able to understand safety procedures that are in place. The induction-training programme undertaken by this group of staff, which is assessed by the manager, must be available for inspection. Fire doors should be routinely checked to ensure they are closing properly as it was noted that two fire doors were left half open which in effect nullifies the fire prevention system in that area of the building. It is clear that the manager wants care plans to be a working document but resident’s personal records must be stored in a secure location within the home rather than in a corridor that is open to everybody. The decision to leave the complete file in residents bedrooms in Spillers unit should be reviewed as some of the contents are not duplicated elsewhere. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 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 House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, (Standard 6 does not apply to this service). New residents can expect their needs to be assessed prior to their admission to the home but they cannot be assured that the formats used will be completed. EVIDENCE: Three assessments were inspected, one of a resident admitted in 2002, one admitted to Kingfisher in October 2005 and one resident admitted to Spillers in October 2005. All three files contained an assessment of need, which included the criteria set down in 3.3 of this standard. However not all elements of the assessment had been completed. For example the assessment of the resident admitted in 2002 clearly identified his needs including medical condition, mobility, which was assessed as very poor, nutrition and continence but the social assessment dated 9.1.2001 had not been completed. The dependency rating had been completed and a general risk assessment relating to mobility identified no risks, which contradicts the initial assessment. The assessment of pressure sore rating was assessed as very high risk, which also contradicts the general mobility risk assessment. There was also insufficient information about how the residents skin care was to be monitored to prevent a pressure area developing. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 10 The second resident’s assessment was detailed and identified the resident’s needs. The resident has a pressure sore on their heel and there was a clear wound assessment including the length, breadth and depth and also detailed information, which demonstrates the wound, is monitored. Risk assessments were in place although the resident is incontinent of urine but the continence assessment had not been completed. The social assessment was also incomplete. The placing authority had provided the third resident’s assessment of need. There was also an admission assessment undertaken by the home. The social assessment, which includes personal habits and routines, was incomplete. The moving and handling assessment was not completed, the cognitive assessment had not been signed or dated. There was evidence that a referral for psychiatric services has been followed up. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9 Residents can expect that their care plan will set out their needs but greater detail should identify how the needs will be addressed. Residents cannot Administration and recording of medicines is ineffective. EVIDENCE: Three care plans were examined. The care plan format is divided into separate components of care to reflect the individual sections identified in the assessment of need. There is space on each component for staff to evaluate how the need is being addressed. There is also a progress sheet for staff to record general areas of progress not necessarily related to the care plan. From the sample seen it was evident that staff are using the evaluation of care section at the bottom of each component, which is a development from the last inspection when these observations were being entered on the general progress notes. Generally the components of the care plans indicate how the need is to be met with the exception of one for a resident with dementia. Their care plan identifies the need to establish eating and sleeping patterns but there is no detail of how this is to be achieved. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 12 The monthly assessment of this resident also identifies that the resident “becomes very distressed, needs someone with her all the time” but again there is no detail of how this is to be addressed. On another care plan medical problems are identified and the monthly review shows this is a long-standing problem with a score of 5 recorded. However it was noted that these medical problems have reduced from 5 to 0 in one month with no explanation of how or why the scoring has been reduced so dramatically. As noted at the last inspection the care plan agreement by resident and/or relatives has not been signed. There was evidence that care plans are reviewed monthly. The home uses a Monitored Dosage System (MDS) and trained nurses are responsible for the ordering, storage, administration and disposal of unused medication. There has been a continual problem with The Medication Administration Records (MAR) sheets having unexplained gaps including no signature of anyone administering medication and no explanations for this. It was noted at this inspection that although there were less gaps the problem continues. There was evidence that one of the two registered nurses on duty had recorded where the gaps were and confirmed they were intending to follow this up with the relevant staff (all of who were bank staff). On the day of this inspection one resident’s medication record indicated they had not been given any of their prescribed medication on the 19th November although the blister packs were empty. Another residents record indicated they had missed their teatime medication on the 16th November. There were also gaps in medication prescribed as required for a resident on the 18th November. The record indicated that they usually refused the medication at certain times but the record did not confirm this had occurred on this day. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 15 Residents can expect that they will be supported to make choices about how they spend their time at the home. Residents can expect to be provided with a varied diet but those with specialist needs cannot be assured that their dietary needs will be addressed and that they will have a hot meal. EVIDENCE: The inspector spoke with six residents individually in their bedrooms and others were spoken with in the communal areas of the home. Generally residents were very complimentary about the staff team. They cited how responsive staff were if they called them. One resident said nothing was too much trouble for the staff and they were generally cheerful. All of the residents spoken to in their bedrooms said they preferred to spend time in their rooms with some making a decision to join other residents for meals while some preferred to have their meals served in their room. Residents also said that staff were respectful of their privacy when bathing and are encouraged to maintain their independence and undertake personal care but with support from staff. Residents have a choice to join in activities if they wish to. Personal preferences are recorded on care plans. As noted at the last inspection there Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 14 is a need to recruit an Activities Co-ordinator to the vacant post. This post remains vacant. One of the care staff has arranged some in-house activities. It was noted that in the last three weeks they worked an additional 12 hours on one week but on the other two weeks have worked their usual contract care hours. Activities for residents in the special needs unit (Spillers) were not examined in detail during this inspection but there was no evidence that organised activities takes place but one resident was taken to have their haircut at a local barber’s shop. The majority of residents spoken with were complimentary about the food provided and said the food was good and their was a reasonable choice. However one resident who is unable to swallow bread said they were offered sandwiches or cup a soup routinely for tea and has taken to having tins of soup bought for them. They also need to monitor the intake of sugar and said that although they were offered their choice of a cold drink (Cranberry Juice) they again were buying their own as the drink offered was not low calorie. Residents have a choice where they eat and some require assistance with feeding. It was noted that meals taken to bedrooms were not covered. The inspector noted that three puréed meals were left uncovered on a side table in the dining room for approximately 5 minutes while the inspector was present (and it was not known how long they had been there before this) waiting for a member of staff to take to the residents in their bedroom. One resident was being assisted in the dining room and it was noted that the member of staff engaged in conversation with them and was heard to tell the resident what they were having. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 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 Residents can expect that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: The Commission for Social Care Inspection (CSCI) has received an anonymous complaint about staffing levels in Spillers and also the safety of residents in Spillers. The home does have a complaints policy and procedure. Residents spoken with said if they had a complaint they would either mention it to one of the staff or speak to their relatives. The record of complaints maintained by the manager shows that since the last inspection two complaints have been made by residents about the attitude of two members of staff (25th October and 28th October). In both cases the members of staff left before the complaint was fully investigated. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 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, 25 Residents can expect to live in an attractive environment that is well maintained. EVIDENCE: As noted at previous inspections Kingfisher House is an attractive and wellmaintained home. Since the last inspection an additional 29-bedded unit Spillers) has opened although at the time of this inspection only 8 residents were using the ground floor accommodation. The main door leading into Spillers has a security keypad but is not alarmed. Other exit doors are alarmed. All the windows have window locks and window restrictors to limit the opening. However one resident has managed to find the key to their window and after locking themselves in their bedroom on the ground floor (which can be accessed by staff) they managed to get through the narrow side window using a chair to stand on, climb over a gate and catch a bus to Cambridge where they were found near their relatives home. This was discussed with the manager who said staff quickly noticed the resident had gone missing (about 20 minutes) when they went to check the Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 17 resident who had gone to “lie down after lunch” in their bedroom and after the premises and local area was searched the police were informed. The resident was returned to the home unharmed. The second element of the recently received complaint said, “that the talk of the home was that the person was not noticed to be missing for 4 hours”. The inspector could not find any evidence to substantiate this. It was evident from discussion with the manager and staff working in the unit that action has been taken to reduce the opportunity for a similar incident to occur again. It was noted during the tour of Kingfisher that the fire doors leading from the back stairs into a lobby and then into the unit were both only half closed. It was noted at the last inspection that one resident felt the lighting in their bedroom was not sufficient for them to read and this was brought to the attention of the manager. From discussion with residents during this inspection it is evident that they were satisfied with the lighting in their rooms. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 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): 27,29 Residents in Kingfisher can expect there to be sufficient staff on duty to meet their needs but this cannot be guaranteed in Spillers. EVIDENCE: The rotas for Kingfisher were seen and these corresponded to the staff on duty. The rotas show that there is a minimum of 5 staff on each floor in the mornings and four on each floor during the afternoon. The manager confirmed that they were looking to reduce the number of long days i.e. 7.30 – 21.30 to one day a week for all staff. At night the manager confirmed that there are two waking care staff and a registered nurse on each floor in Kingfisher and two waking care staff in Spillers. Discussion with residents confirmed the availability of staff and as already noted they were complimentary about the response times. Staff spoken with are clearly aware of their duties and from observation it was clear that they worked well together and they were overheard arranging between themselves who would work together to support residents requiring 2:1 support to go to the toilet before lunch. The rota in Spillers showed that for 8 residents there were 2 staff on each shift. An element of an anonymous complaint was in relation to staffing levels in Spillers. The complainant referred to a specific day in November when it is alleged that there was only one member of staff on duty for 8/9 residents and that the member of staff command of the English language was “virtually non existent”. The inspector checked the rota for the identified day and found that Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 19 there were two staff on each of the early and late shifts but that the rota did not correspond to the timesheets. On the day in question none of the overseas staff were scheduled to be on shift in Spillers. Therefore the complaint is not upheld for that particular day. However on the day of this inspection two staff were scheduled to be working the late shift and it was noted that one of the staff had arranged to take a resident to the local shop for a haircut, which in theory left one member of staff with the remaining seven residents. The recruitment of overseas staff is undertaken by an overseas agency. The recruitment files of the three staff currently employed at the home were inspected. All three members of staff have had limited experience of working with older people. There was evidence that appropriate checks had been undertaken. The interview checklist was on file for each and on two specific mention was made for the workers English to improve. There was evidence that two of the workers are currently attending English classes locally. The induction programmes for the three workers were not available on file and in discussion with one worker who was appointed in June it was evident they were not familiar with the booklet used. It was also concerning that when the inspector asked them what they would do in the event of the fire alarm going off the worker assumed it would be a practice only. Discussion with care staff indicated that staff morale is very low with a number of staff considering whether to look for other jobs. The inspector was shown written details of staff grievances that are to be sent to the area manager. A senior member of staff has been suspended which has caused a lot of anger toward the manager. It was concerning that when talking with residents they commented on the unrest in the staff team. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 Resident’s storage of records does not safeguard service users interests and rights. EVIDENCE: It was noted at the last inspection residents records are stored on a shelf in the corridor, allowing access to individual’s personal information to anyone visiting the home. Personal records should be stored in a secure place within the home. In Spillers the residents file is kept in each of the resident’s bedroom. The new manager wants the care plan to be used as a working document and feels that staff would refer to it if it were available in the bedroom. However as some of the documentation is not duplicated elsewhere there is a concern that should the resident dispose of the information there is no back up system. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 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 2 X X n/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X 3 X STAFFING Standard No Score 27 2 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 2 X Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 22 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 2. Standard OP3 OP9 Regulation 14 1 & 14.2 13.2 Requirement The Assessment of need documentation must be completed. The Registered Person must ensure that the administration of medicines policy and procedure is adhered to. MAR sheets must be completed to confirm medication has been administered. This is a repeated outstanding requirement Residents must be provided with appropriate food to meet their dietary needs and requirements. Residents requiring assisting with eating must be provided with meals maintained to a reasonable temperature and all meals covered while taking to bedrooms. Staff rotas must accurately reflect who is working on which shifts Staffing levels in Spillers must be reviewed to ensure there is sufficient staff on duty to ensure residents individual needs are met. Timescale for action 02/12/05 02/12/05 3. 4. OP15 OP15 16.2 (i) 16 2 (j) 02/12/05 02/12/05 5. 6. OP27 OP27 18 1 (a) 18.1 (a) 02/12/05 16/12/05 Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 23 7. OP28 18.1( c ) i (i) 19 (5) (b) 8. OP29 9. 10. OP37 OP38 17.(1).(b) 23. (4) (a) New staff must be provided with an induction that is recorded and the record available for inspection. Staff employed must have the communication skills to support residents and understand the safety procedures. Residents personal records must be stored in a secure place. Fire doors must work effectively 02/12/05 30/11/05 02/12/05 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP37 Good Practice Recommendations Care plans should detail how identified needs are to be met. The decision to keep resident’s entire file in their bedroom (Spillers) should be reviewed to ensure records are kept safe. Kingfisher House Residential and Nursing Home DS0000024427.V267491.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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. 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