Inspection on 01/10/07 for Kingland House

This inspection was carried out on 1st October 2007.

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

Kingland House 18/01/08

Kingland House 21/06/06

Kingland House 24/10/05

Kingland House 06/06/05

Kingland House 27/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Kingland House 30 Kingland Road Poole Dorset BH15 1TP Lead Inspector Jo Palmer Key Unannounced Inspection 1st October 2007 10:00 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 Kingland House DS0000060603.V351826.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. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingland House Address 30 Kingland Road Poole Dorset BH15 1TP 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) 01202 675411 Buckland Care Ltd ****Post Vacant**** Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who may be accommodated is 33. 21st June 2006 Date of last inspection Brief Description of the Service: Kingland House is a care home registered to provide accommodation and care to a maximum of 33 older people. It is situated within Poole Town centre and is close to local shops and public transport services. There are views of nearby Poole Park with its picturesque lake and level walks. The home has off-road parking for 6 cars; on-road parking is available but local restrictions apply. Resident accommodation is on the ground and first floors. The home has been extended since the last inspection (June 2006) to increase numbers from 22 to 33 and to improve standards, the home has been tastefully refurbished and each room now has en-suite facilities. To the rear of the home is a garden which was, at the time of inspection, being landscaped to provide better outside space for service users. During 2004 the home was registered to Buckland Care Limited, which owns a number of other care homes in the south west of England. The general manager of the company is Mrs Pownall. There is currently no registered manager at Kingland House although a person Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 5 appointed has assumed this role, her registration with the Commission is not yet at application stage. Current fees are £398 to £550. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choos.aspx Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 1st October 2007; Jo Palmer was the inspector who carried out this unannounced visit. There is currently no registered manager for Kingland House, the person currently responsible for the day to day running of the home was present during the inspection who, although not registered with the Commission, is referred to throughout this report as ‘the manager’. Linda Pownell (Responsible Individual for Buckland Care Limited) attended briefly during the inspection and staff at the home were available for discussion and assisted with the inspection process. The main purpose of the inspection was to check that the residents living in the home were safe and properly cared for and to review progress in meeting requirements and recommendations made at the previous inspection. The inspectors were made to feel welcome in the home throughout the visit. Six service users and four members of staff (including the manager) were spoken with, the inspector took a tour of the premises and examined relevant records were along with some of the homes policies and procedures. Part of the home’s routine was observed and some service users were seen to be enjoying afternoon activities. The Commission for Social Care Inspection sends questionnaires to service users, their relatives, staff and visiting professionals in order to obtain feedback about the services provided, an Annual Quality Assurance Assessment (AQAA) is also sent for completion by the manager/responsible person, at the time of inspection, no surveys had been returned and the AQAA had not been completed. What the service does well: Residents are not admitted to Kingland House until their needs have been assessed and they have been assured in writing that the home is able to meet those needs; all residents are issued with a contract detailing the terms and conditions of residency. Residents can be assured that medication systems are well managed in the home. It was also evident from talking with residents that they feel they are treated respectfully and their dignity is upheld by care practices. There is a good programme of activities in the home although this is not necessarily tailored to meet the individual social needs of residents; resident’s Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 7 family and friends are able to visit. Meal times in the home provide a social occasion and the food is generally enjoyed by residents. Complaints processes are in place which ensure that any concerns or complaints raised by residents or their representatives are investigated and responded to in reasonable time-scales to the complainants satisfaction. The recent upgrading of the premises has resulted in residents being able to live in comfortable, clean surroundings with their own belongings around them in their rooms. Communal areas of the home have been attractively refurbished and provide comfortable seating areas for residents and their visitors. What has improved since the last inspection? What they could do better: Assessment of need and care planning systems require attention. Any care planning documentation that is in place is not available for staff reference to ensure they have clear instruction on how individual need is to be met and how each resident is to apply preferences and direction over their own lives. Adult protection procedures are in place although are not up to date concerning relevant information for staff to act upon should any incidents of abuse or neglect be suspected. Staffing levels need consideration with respect to the added number of residents since the homes extension and in relation to the assessed day and night care needs of residents accommodated. Staff recruitment practices need reviewing to ensure that all staff are employed safely and are considered suitable to work with vulnerable people. Staff training programmes need to be organised around the training needs of staff in relation to the residents they are caring for as well as the statutory training in respect of health and safety issues. Buckland Care Ltd must submit an application for registration of a manager for the home who can take day to day responsibility for its operation. Quality assurance systems need to be in place to ensure the views of residents, staff and other stakeholders can be heard and acted upon. The Annual Quality Assurance Assessment required by the Commission must be completed. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 8 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. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 9 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 Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 10 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): 2, 3 and 4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The admissions procedure ensures that assessments are undertaken to ensure that only residents whose needs can be met by the home are offered places there. Residents are informed of the assessment findings in writing and are sent a copy of the homes contract and statement of terms and conditions of residency. EVIDENCE: Records relating to the admission process for two residents were examined, these demonstrated that both residents had been assessed prior to admission and both had received written confirmation that the home they were entering was able to meet their needs. Both files also contained copies of the residents single assessment documentation and one had an assessment undertaken by social services where the local authority was assisting with funding Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 11 arrangements. Both files contained signed copies of the home’s contract detailing the terms and conditions of residency, in one instance the contract was signed by the resident, in the other, the resident’s next of kin had signed, power of attorney details were held. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 12 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 poor This judgement has been made using available evidence including a visit to this service. There are no systems in place to ensure care staff have up to date detail of each residents assessed health and personal care needs and how these are to be met. Medication systems are generally well managed and safe storage facilities protect residents from harm. Residents spoken with confirmed they are treated with respect and their dignity is upheld by staff practices EVIDENCE: Four sets of resident care files were examined. Care files are held in the home’s office whilst daily records are kept securely in the home’s dining room Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 13 where staff can access them to write their daily reports. A communication book is also used by staff to record messages for other shifts and for the manager. Care files examined for four residents demonstrated that from initial assessment, care needs are identified. There is however, no action plan produced for staff to follow in order that these needs may be met. The inspector acknowledges that the manager, who has been in post since June 2007 is preparing to change the care planning system, however, the current results are an unwieldy, unworkable system that gives no instruction for staff. Different care planning documentation was in use and it was not clear which were current and none were adequately completed using information from assessment. For example, a resident with a nutritional assessment raising concern instructed that the persons weight be monitored, it had also been identified on this persons pre-admission assessment that weight loss had been an issue – there was no recorded weight for this person and no evidence of monitoring. A Waterlow assessment had been completed identifying that the resident was at some risk (of pressure ulcers) there was no associated action plan. The inspector sat with staff and listened to the two o’ clock shift handover, it was evident that care routines took place for which there were no clear written assessments or instruction; catheter care, diabetes and wound care were discussed relating to various residents. The inspector asked staff about the care plans they followed for these residents and was directed to the daily records, which staff called ‘care plans’ although they did acknowledge that the ‘main files’ were kept in the office to which they did not have easy access. In discussion with staff about diabetes, it was evident that they had all had previous experience in other care settings working with, or attending training seminars about this condition, they did not however have up to date information about the resident they were caring for along with instruction on action to take in the event of the resident having hypo/hyperglycaemic attacks. Staff at handover also discussed one residents wound care; it was evident that this persons dressing was for a superficial wound only although again, no plan of care was available detailing for staff what topical applications (if any) should be applied, what dressing, the frequency of changes, how or if this resident should be bathed etc. Daily records are written by care staff following each shift, these records are used to record any significant changes or events for the resident, examination of a selection of these records found them to be written respectfully and articulately. Medication in the home is stored securely and safely. Medication administration records (MAR) are generally well maintained although a few gaps in recording were noted thereby not indicating whether the resident had received their prescribed medication or not. Medications are issued to the home following prescription in 28 day dispensing packs from the supplying pharmacist; those medicines not supplied in this manner but in their original containers, are not issued for the same 28 day period making audit of medicines difficult in the Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 14 absence of a recorded start date. Some shop bought paracetamol was held in the medicines trolley, these were not prescribed for any particular resident and were unmarked. The home keeps a controlled drugs register, the medicine administration record for one resident receiving one of these prescribed substances showed a gap in recording where it was not indicated whether the medicine had been given, omitted or spoilt. The controlled drugs register and number of tablets held audited correctly. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 15 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 adequate This judgement has been made using available evidence including a visit to this service. The absence of up to date care planning documentation for service users leaves staff without formalised action plans to follow in order that each service users assessed needs in relation to social, cultural, religious and recreational activities are met, this also limits evidence that residents are able to exercise choice and control over their lives. Family and friends are able to visit at any time. Meals in the home are generally well accepted by residents who confirmed their dietary needs are met. EVIDENCE: Kingland House provides organised activities such as ball games, exercises, bingo and quizzes. There are also occasional entertainers and monthly trips out to places of interest. Information about the week’s activities is displayed on a board in the dining area although this is written in very small type and is not readily visible to residents. On the afternoon of the inspection, some residents Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 16 were observed enjoying a game of bingo, an activities co-ordinator is employed. Some recently updated care files demonstrate that the resident and their family have been involved in providing information about the persons social history, most did not and there was little evidence that in everyday planning, social care arrangements are tailored to meet individual need, three of the six residents spoken with stated that they spent most of their time in their rooms, one was able to confirm that this was out of choice. A visitor’s book in the entrance hall indicated that many people visit the home to see their relatives who are resident. Residents spoken with confirmed that friends and family are able to visit and sometimes take them out. Meals are provided from a central kitchen, the kitchen, food supplies and records of food provided were not examined. Care plans associated with nutritional assessments were not available for staff reference in order that individual nutritional requirements could be met. Two residents spoken with stated that the food was ‘alright’; two said it could be better, two were unable to comment. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 17 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 adequate This judgement has been made using available evidence including a visit to this service. Since the last inspection, any complaints received have been managed appropriately. Adult protection procedures need to be updated. EVIDENCE: A complaints file was reviewed, this evidenced that two complaints have been received since the last inspection, both had been resolved. The manager had responded to the complainant, in writing outlining her findings having looked into the matters raised, the manager confirmed that this had been done within the allotted time-scale outlined in the complaints procedure although one response letter was not dated. An adult protection procedure is in place for staff reference, this however does not refer the reader to the local authority guidance ‘No Secrets’ which outlines the process to be followed should any suspicions of abuse arise. The homes procedure also refers to obtaining the resident’s consent to reporting such suspicions. Whilst all residents wishes should be respected, it must be pointed out to them that such instances cannot go unreported as other residents must be protected from the person behind the incident. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 18 Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 19 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, 20, 21, 22, 23, 24, and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents live in a clean, comfortable, safe and well-maintained environment, which has been upgraded to ensure it best meets their needs. EVIDENCE: Recent extension work at the home has resulted in an increase in numbers from 22 to 33 and extensive refurbishment. The home is clean with no unpleasant odours and has been equipped with necessary adaptations to meet resident mobility needs such as ramps, grab rails, a lift, wider doors and new furnishings. In those resident rooms that were visited it was evident that they are able to personalise their surroundings with pictures, knick-knacks and small items of furniture from home. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 20 All rooms have en-suite facilities and assisted bathrooms are sited around the home. It has been recommended that shared bathrooms are more comfortable with provision of hooks and shelves for the resident to hang their towels, clean clothing and place their toiletries. One well equipped shower room was seen to have a quantity of the homes clean laundry placed in the wash hand basin. In this shower room there were no paper towel dispensers or anti-bacterial soap for staff in order to prevent any cross infection. Many residents require the use of wheelchairs or walking aids to get around the home, however, when these residents are using the communal lounge, their mobility aids are kept in the corridor partially blocking access, a staff member agreed that storage for such items was limited. Residents spoken with who were able to comment confirmed that improvements to the home had been for the better and that they were comfortable in their surroundings with required space to meet their needs. Radiators in the home were covered with low surface temperature covers to prevent accidental scalding and hot water outlets tested were not of excessive temperatures. All areas of the home visited were clean and well maintained. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 21 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 poor This judgement has been made using available evidence including a visit to this service. The absence of up to date care planning documentation for service users leaves the home with little to base its required staffing numbers upon. Recruitment practice in the home needs reviewing The absence of up to date care planning documentation for service users results in staff training not being tailored to meet their individual needs. Mandatory training requirements are met. EVIDENCE: In discussion with staff, it was evident that staff rota’s do not reflect actual numbers of staff on duty. Rotas examined for the week of the inspection showed there to be four care staff each morning, four each afternoon and two each night. The manager stated that there were five on each day shift. Discussion with staff evidenced that there were three staff on each day shift and two at night with an extra carer in the evening from 5pm until 10pm to ‘help get residents to bed’. In addition to care staff, there are domestic and catering staff and the manager present in the home during the daytime. Overall resident dependencies have not been measured and individual Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 22 assessments and care plans for residents do not give a clear indication of actual need. Discussion with staff, observation and listening to the shift handover report, it was evident that there are several residents who require high levels of care particularly with regard moving and handling and one immobile resident was seen being moved from wheelchair to lounge chair by one member of staff. Six staff files were examined, of these, four had commenced employment at Kingland House on 1st September 2007. All four new staff had been put forward for, or had already completed the home’s induction and foundation training programme, which is run over four days. Topics covered include health and safety, fire safety, food hygiene and infection control; person centred care, abuse, the Mental Capacity Act, bereavement and communication; first aid and manual handling. An external trainer has been appointed by the manager to run these study days. Some training certificates were held on file for some of the staff who had attended training events and courses during previous employment, one file examined demonstrated that the staff member had completed an NVQ 3 in care. It has been recommended that a training matrix is produced showing all staffs training and qualifications and when their date for renewal is due. Two further recommendations of the last inspection have been repeated, as these were not examined during this visit. Of the six files examined, it was evident that a recruitment process is in place, however, some anomalies were noted. All applicants complete an application form, attend for interview and are subject to Criminal Records Bureau checks. Before being offered a position, references are sought. It was noted however that some staff had not properly completed the application with regard to employment history; there were gaps in employment that had not been explored at interview or explained by the applicant. Some references received had not been verified, for example, one staff member had provided two referees whose responses were both written in the same typeface, were not on headed paper and were not signed by the referee. One reference was received and accepted by the home for one staff member from a person not identified on the application as a referee and for this staff member, the most recent employer reference was for a period of employment dated between 2001 and 2003. On another staff file one reference was received from a person who had ‘known the applicant for 15 years’ although the application form did not acknowledge this period of time in the UK. One recruitment file did not hold evidence of the applicants work permit or visa. All staff files indicated that the Terms and Conditions of Employment had been issued; none of these had been signed as accepted by the employee. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 23 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): 31, 32, 33, 35, 37 and 38 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. There is no registered manager at Kingland House to take responsibility for the day to day running of the service in the best interests of service users. Quality Assurance programmes are in their infancy leaving service users, staff and other stakeholders not able to have their views on the service heard or acted upon. The Annual Quality Assurance Assessment required by the Commission had not been completed. Service users confirmed that their financial interests are protected. Health and safety policies and procedures are in place and reviewed although are not strictly adhered to by management practices in the home. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 24 EVIDENCE: Kingland House has been without a registered manager since January 2007 and whilst Buckland Care Ltd have made an appointment to the post, the registration is currently on hold, pending suitable references; when these are received Buckland Care will decide whether to proceed with the application to the Commission for this person’s registration. Prior to this inspection the home was sent an annual quality assurance assessment (AQAA), which they were requested to submit to the Commission for Social Care Inspection to identify what the home feels they do well and set out their plans for improvement over the next twelve months. The AQAA was not completed and returned to inform this inspection or to demonstrate the home’s annual development plan. However, a development plan was seen that had been produced by Buckland Care Ltd, this was held in the policy file. Records relating to any money held on behalf of residents by the home were not examined although in speaking to residents, those that were able to confirm that they were able to manage their own affairs with the help of their families were satisfied with the arrangements. It was evident that the manager has spent a substantial amount of time reviewing records although, as noted during this inspection, improvements still need to be made in many areas, particularly resident care records and recruitment records. The staff rota also needs attention to ensure it accurately reflects who is on duty at any given time in the home. The Fire Risk Assessment held on file was not dated although it was evidently out of date as it identified persons at risk – named residents who were no longer resident at the home. A policy for infection control is in place, this is accompanied by the Department of Health guidance ‘Essential Steps to Safe clean Care’, the manager confirmed that although the guidance was available, the assessment had not been carried out. The home’s accident reporting procedure is clear and accident reports held comply with data protection legislation. It was evident from a review of accident reports that over the last three months (July – September 07) a substantial number of accidents had occurred at night; there was no audit of accidents in the home to establish cause, prevention methods etc. There are two staff members on duty at night with 33 residents to care for. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 25 Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 26 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 3 1 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 1 3 3 2 1 3 3 X 1 STAFFING Standard No Score 27 1 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 3 2 X 3 X 1 1 Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 27 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 OP7 Regulation 17 Requirement A comprehensive care plan must be recorded for each resident. These must include all aspects of care detailing assessed need during both day and night hours. (Repeated Previous timescales of 01/08/05-01/12/05-21/07/06 not met) Enforcement Action may be taken. Information gained at preadmission assessment must be used to formulate an effective plan of care. (Repeated previous timescale of 21/07/06 not met). Enforcement Action may be taken Care plans must be reviewed regularly in consultation with service users and evidence must be documented. Repeated previous timescale of 26/11/06 not met). Enforcement Action may be taken Risk assessments must identify specific risks and detail what action needs to be taken to minimise harm. (Repeated DS0000060603.V351826.R01.S.doc Timescale for action 26/11/07 2. OP3 4 26/11/07 3. OP7 15 26/11/07 4. OP7 13 26/11/07 Kingland House Version 5.2 Page 28 5. OP7 12 previous timescale of 21/07/06 and 26/10.06 not met). Enforcement Action may be taken Staff must have access to up to date, reviewed action plans in order to deliver the care needed as assessed. The registered persons must demonstrate that they have consulted service users and their supporters about their individual social and cultural interests and make arrangements for them to engage in individual, social and community activities. Service users must be consulted about the programme of activities arranged by the home, which must then provide planned social care that meets assessed need. This requirement is repeated from the last inspection. Meals must be provided to residents that meet their nutritional requirements based on individual assessment of need. Adult protection procedures must be held in line with local authority guidance ‘No Secrets’ and must refer staff to the process of whistle blowing. Such procedures must not leave staff to rely on a victims consent in order to report any such incidents. Adequate storage space must be provided for mobility aids in order to keep corridors free from obstruction. In line with the home’s procedures for infection control, anti-bacterial soap and disposable towels must be provided for staff use in each DS0000060603.V351826.R01.S.doc 26/11/07 6. OP12 16 26/11/07 7 OP15 16 26/11/07 8 OP18 13 26/11/07 9 OP22 23 26/11/07 10 OP26 16 26/11/07 Kingland House Version 5.2 Page 29 11 OP27 18 12 OP29 19 13 OP31 8 14 OP33 24 15 16 OP37 OP38 17 13 area where personal care is given. There must be sufficient numbers of staff on duty at all times to meet resident’s assessed care needs. Recruitment processes must be robust to ensure the safety of service users. Any gaps in an applicant’s employment history must be explored and references must be verified. All staff appointed from overseas must have a valid work permit and visa. Buckland Care Ltd must submit an application for a manager to be registered with the Commission for Social Care inspection in respect of this home. The registered persons must complete the AQAA and return it to the Commission to demonstrate the business’ annual development plan and plan for improvement. Records held in the home must be up to date and accurate. The registered persons must undertake an audit of accidents in the home and act upon the results. 26/11/07 26/11/07 26/11/07 26/11/07 26/11/07 26/11/07 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 Where medicines are supplied in their original containers, the container should be marked with the date the container was opened in order to facilitate effective audit. DS0000060603.V351826.R01.S.doc Version 5.2 Page 30 Kingland House 2. OP9 3 4 5 6 7 8 OP21 OP28 OP29 OP30 OP30 OP38 Shop bought medicines (homely remedies) should only be provided for service users following assessment and should only be used for the service user for whom it was bought. Any such medicines must be named for the person who is to use it. Bathrooms and shower rooms should be provided with hooks, shelves or other space for residents to leave their towels, clothes and toiletries whilst using the room. A minimum ratio of 50 of care staff should have the NVQ level 2 awards in care or equivalent by the extended date of 2006.(Repeated from previous inspection). A signed copy of the home’s Terms and Conditions of Employment should be held on staff files to indicate their acceptance of the contract. In order to meet the needs of the resident group all relevant staff should receive training in dementia awareness. (Repeated from previous inspection). A training matrix should be produced to ensure the manager is able to see, at a glance, when statutory training courses become due. As the Department of Health guidance ‘Essential Steps…’ are in place, it is recommended that the assessment tool is used to effect good hygiene procedures. Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Kingland House DS0000060603.V351826.R01.S.doc Version 5.2 Page 32 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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