CARE HOMES FOR OLDER PEOPLE
Kingland House 30 Kingland Road Poole Dorset BH15 1TP Lead Inspector
Jo Palmer Key Unannounced Inspection 18th January 2008 1.15 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.V357350.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.V357350.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.V357350.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. 1st October 2007 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.V357350.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.V357350.R01.S.doc Version 5.2 Page 6 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.
This unannounced inspection took place on the afternoon of 18th January 2008; this was the second key inspection in the home’s annual inspection schedule, the purpose being to measure improvements and progress in meeting requirements of the last visit in October 2007. Since the last inspection, the person referred to as the manager has left employment, a new manager has been appointed who had been working at the home for the seven weeks leading up to this visit. An application for registration with the Commission for Registered Manager will be made within the month. This person is responsible for the day to day running of the home and was present during the inspection. As stated, the purpose of the inspection was to review progress in meeting requirements made at the previous inspection. One resident and four staff members were spoken with and the inspector visited some areas of the premises and examined relevant records. Following requirements of the previous inspection, the manager sent an ‘Improvement Plan’ to the Commission; this was used to direct this visit. For information on other of the key standards that this inspection has not concerned itself with, please refer to the inspection report dated 1st October 2007. What the service does well:
Of the areas inspected it is now evident that although not yet finalised, care recording systems are improved and now detail residents’ needs in relation to areas of assessed need although some further work needs to be undertaken to ensure the assessments are comprehensive. Social care arrangements remain the same with a level of activities provided by the home’s activity co-ordinator although since the last inspection, an audit has been carried out identifying individual resident’s requirements in relation to their preferred level of recreational activity. The following areas were not inspected during this visit although there were no reasons to suspect that standards had fallen, the last report dated 1st October 2007 should be read in conjunction with this report but it was reported that: Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 7 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 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?
The last inspection resulted in 16 requirements being made where standards had fallen and where the home was in breach of the Care Homes Regulations 2001. The following areas have been improved although the new manager acknowledges that there is still further work to be done: Seven requirements concerning assessments, care planning, re-assessments and reviews, social care planning and consultation and risk assessments in relation to specific areas of health care have been addressed, some in more depth than others. The new manager has revised the documentation associated with assessments and care delivery and has started a review of each residents needs. The adult protection procedure has been re-written in accordance with local authority and Department of Health guidelines Wheelchairs and mobility aids are now appropriately stored. Staff, residents and visitors now have access to appropriate hand washing facilities around the home. Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 8 Kingland House a recurrently recruiting for a third member of night staff having reviewed the home’s accident audit and listened to staff views. An AQAA has been completed demonstrating the home’s plans for improvement. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request.
Kingland House DS0000060603.V357350.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.V357350.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): 3 (standard 6 is not applicable) 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. EVIDENCE: Records relating to the admission process were examined for a resident recently admitted to the home. The manager has reviewed the assessment format since the last inspection and it was evident that all aspects of the persons health and welfare needs are considered and that needs are identified prior to the person moving to the home. This process is carried out in order that the resident and the home can be confident that the staff have the skills, abilities and qualifications to meet the needs of the resident. Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7&8 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Resident’s health and welfare needs are recorded in updated and reviewed care plans that give an overview of needs as indicators from which to plan the delivery of care. EVIDENCE: Several requirements were made at the last inspection concerning the care planning process and its efficiency in identifying and meeting resident’s health and welfare needs. The new manager has introduced a new format on which to record care needs from assessment and on which to direct care staff how these needs are to be met. Kingland House is registered for 33 residents and at the time of this visit, 27 were living at the home; it is recognised that in order to effectively re-assess all resident’s needs and write functional care plans takes time, the manager plans to have this task completed by 31st January 2008. Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 12 The inspector reviewed care plans for four residents living at the home, one of which was a recent admission. The new format for care planning provides information under headings relating to health, personal care, mobility, skin condition, diet, etc. where a history in relation to these aspects of the persons welfare is provided (using information from assessment ie: history of falls or whether the persons skin is vulnerable and their abilities in relation to maintaining their own personal care routines) and then a description of their current needs. This is the section providing staff with the information needed to direct care delivery, it was clear, concise and related to the area of need as assessed. However, it is necessary for the methodology of assessment to be identified and that they have been carried out by persons qualified to do so, for instance, in relation to moving and handling, an occupational therapist should be involved, for nutrition, a dietician and for skin care, the tissue viability nurse from the local PCT can be contacted. Processes that can also be used would include care pathway assessments for continence, mobility, nutrition, dementia etc to evidence and identify the basis for assessment. Some of the assessments and care plans were not dated and did not evidence the residents, or their representatives (as appropriate) consultation in the process. These issues were discussed with the manager who was aware of the need to develop the recording system further but who is currently concerned with getting concise, up to date information available for staff to follow in order that basic levels of care needs can be met. Requirements of the last inspection concerning risk assessments for managing the healthcare of a resident in relation to diabetes and nutrition are no longer of concern as the resident concerned has since left the home; the manager is aware of the need to have accurate, concise care plans in place with instruction for staff should these issues arise with any future resident. Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14 Quality in this outcome area was assessed as good. This judgement has been made using available evidence including a visit to this service. Residents social and recreational care arrangements have been considered and care planning documentation is starting to address this. EVIDENCE: It was evident that work being carried out on assessment and care planning documentation is beginning to address individual residents needs in relation to social, cultural and recreational needs. It was also evident from a brief tour of some areas of the home that arts and craft type activities are enjoyed by residents and that staff were present with residents in the lounge area of the home engaged in individual and group discussions. The manager has carried out an audit of social care needs in the home which addresses each individual residents preferences by name identifying what level of activity or occupation the resident would like to engage in. A review of this audit identified that residents like to enjoy activities such as reading, puzzles and games, watching television, listening to music and going out on trips. This information needs to be transposed to individual care plans so that the delivery
Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 14 of social care can be incorporated into the residents daily routine and in order that re-assessments can be made should a residents abilities or needs change in relation to their chosen lifestyles. Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adult protection policies are now in place and outline correct procedures. EVIDENCE: A requirement of the last inspection relating to the contents of the home’s adult protection procedures has been addressed, the procedure has been rewritten and now reflects the guidance provided by the Department of Health and Local authority in their protocol on the Protection of Vulnerable Adults. The manager confirmed that six staff have completed POVA training and a further eight are booked to attend the course. Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, and 26 at the inspection 1st October 2007 when Quality in this outcome area was assessed as good. This judgement has been made using available evidence including a visit to this service. The last inspection of Kingland House resulted in the judgement that: Residents live in a clean, comfortable, safe and well-maintained environment, which has been upgraded to ensure it best meets their needs. Accommodation was not assessed during this visit although a brief tour of some areas of the home resulted in this judgement remaining unchanged. EVIDENCE: The lounge area, dining room, one of the bedrooms and a bathroom were visited during this inspection, all areas remain clean and well maintained. A requirement of the last inspection has been addressed in relation to storage of wheelchairs and mobility aids, a designated area has been made and notices to staff about safe storage are in place.
Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 17 The manager confirmed that all bathrooms, toilets and staff areas have appropriate hand washing facilities, one bathroom visited was noted to contain anti-bacterial soap and disposable towels, alcohol based hand rubs are available also for staff and visitors in the home. On the morning of the inspection, an incident had occurred where a resident’s bedroom had been flooded as a tap had been left to run on the first floor; this incident had been swiftly managed; the resident had been relocated to another room after quick consultation with his care manager and the room was dried out with appropriate equipment; the manager confirmed that it would not be used again until the electrical fittings had been tested and it was properly aired. Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident assessments have been reviewed enabling a better picture of required staffing numbers; an accident audit has also resulted in a review of night time staffing needs. Training is provided to staff in order that they have the skills and are competent to do their jobs. Safe staff recruitment practice is used. EVIDENCE: A requirement of the last inspection is in the process of being addressed in relation to staffing numbers; the manager confirmed that the staff rotas have been organised to provide 5 care staff each morning, 4 each afternoon and 3 each night. Although the night post is not yet filled; Buckland Care Ltd has started the recruitment process for this post. A review of rotas confirmed the above staffing numbers and that additionally, the home’s deputy manager and manager are in the home, available for resident care and administration during various full time shifts throughout the week. Four staff spoken with also confirmed that additional staff are now available on each shift. The manager confirmed that a previous senior carer has been given the post of deputy manager since the last inspection. Four staff files were examined, the manager has re-organised these since being in post. Each file held appropriate recruitment documentation including
Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 19 application forms, references, CRB and POVA checks and any papers relating to visas and work permits as required. The manager confirmed that in reviewing staff files, the information highlighted in the previous inspection report had not been found and that all staff had appropriate references that had been verified. The last inspection examined staff training records and no concerns were noted as information was held on staff files indicating that many of the statutory courses had been attended. The manager confirmed during this inspection that although some training has been undertaken by staff, not all had attended the necessary courses to ensure their skills and knowledge remain up-dated. The manager presented a training matrix evidencing that appropriate levels of training and courses have now been attended or are booked for staff to attend shortly. The training matrix shows that the majority of staff have now attended courses on health and safety, moving and handling, first aid, infection control, food hygiene, COSHH and fire. Seven staff have been trained in medication management and a further five are booked. The ratio of staff trained to NVQ level 2 or equivalent was not assessed. Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 and 33 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although not yet registered, the manager of Kingland House has reviewed some of the poor practices highlighted in the previous inspection report. Quality Assurance programmes are in their infancy although are being developed to incorporate the views of the residents and reviews of service delivery. The Annual Quality Assurance Assessment required by the Commission has been completed (on December 2007) providing a reasonable picture of the current situation within the service and demonstrating how it is planning to improve. Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 21 EVIDENCE: The last inspection reported that Kingland House has been without a registered manager since January 2007 and that Buckland Care Ltd had made an appointment to the post. This appointment was not successful with that manager leaving after the last inspection. A new manager is now in post and although not yet registered with the Commission, confirmed that the application to register would be submitted within the month. The requirement remains on the report until such an application is submitted Discussion with four staff members confirmed that circumstances in the home have improved for the better since the new managers appointment and that she was more accessible and approachable. The AQAA sent to the home prior to the last inspection had not been returned at that time, this has been sent since and it demonstrates the home’s aims although some information was limited in respect of the areas where evidence should be provided about what the service does well and where it needs to improve. However, since the AQAA was returned and the new manager has taken up post, additional audits have been undertaken, care documentation has been improved, staffing levels have increased and training programmes have been organised. Not assessed during this visit in its entirety, standard 38 was reviewed in relation to accident reporting in the home, the last inspection made a requirement in respect of this. Evidence was available during this visit that an audit of accidents in the home had been carried out which identifies patterns or trends, ‘peak’ periods for accidents has been during the night. The manager confirmed that an additional member of staff was to be employed on the night shift and a review of residents’ care files (who had had falls during the night) demonstrated that risk assessments were in place with appropriate action identified for staff to take to reduce or eliminate these risks. Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 x 18 3 3 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X X X X 3 Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 12 Requirement Staff must have access to up to date, reviewed action plans in order to deliver the care needed as assessed. This requirement is repeated for the second time as although care plans are being reviewed, they are not yet available to staff as working documents. The time-scale given is the home’s own identified from the improvement plan following the last inspection. Care plans must be based on measured assessment of need by persons qualified to undertake such assessments or on verified assessment tools in order that effective reviews can be carried out. 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. This requirement is repeated for the second time as although a manager is now in place, an application has not yet been submitted
DS0000060603.V357350.R01.S.doc Timescale for action 31/01/08 2. OP7 14 29/02/08 3. OP31 8 29/02/08 Kingland House Version 5.2 Page 24 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. This was not assessed during this visit, the recommendation remains for consideration at the next inspection 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. This was not assessed during this visit, the recommendation remains for consideration at the next inspection It is recommended that information from the ‘Activities Audit’ is used to inform the care planning process. 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. This was not assessed during this visit, the recommendation remains for consideration at the next inspection 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). This was not assessed during this visit, the recommendation remains for consideration at the next 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. This was not assessed during this visit, the recommendation remains for consideration at the next inspection 2. OP9 3. 4 OP12 OP21 5 OP28 6 OP29 Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 25 7 OP30 In order to meet the needs of the resident group all relevant staff should receive training in dementia awareness. This was not assessed during this visit, the recommendation remains for consideration at the next inspection Information from the completed AQAA and the home’s internal audits on quality should be contained inn a report that is available to residents and other stakeholders to demonstrate the home’s ethos of openness and transparency in all areas of its operation. 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. This was not assessed during this visit, the recommendation remains for consideration at the next inspection 8. OP33 8 OP38 Kingland House DS0000060603.V357350.R01.S.doc Version 5.2 Page 26 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
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