Inspection on 06/06/05 for Kingland House

This inspection was carried out on 6th June 2005.

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 01/10/07

Kingland House 21/06/06

Kingland House 24/10/05

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 Gloria Ashwell Unannounced 6 & 16th June 2005 th 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 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 D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kingland House Address 30 Kingland Road Poole Dorset BH15 1TP 01202 673124 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Buckland Care Limited Mrs Linda Jane Pownall Care Home only 22 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 27th September 2004 Brief Description of the Service: Kingland House is a care home registered to provide accommodation and care to a maximum of 22 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 which has a picturesque lake and level walks. The home offers limited off-road parking; on-road parking is available but local restrictions apply. Resident accommodation is on the ground and first floors. There are 22 single occupancy bedrooms on the ground and first floors, 17 have en-suite facilities (including 8 with showers). To the rear of the home is a well-maintained, attractive garden. 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. The manager of Kingland House is Miss Leanne Buckland. Buckland Care Limited intends to enlarge the home. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was one of the two statutory inspections required in accordance with the Care Standards Act 2000. The previous inspection took place on 27 September 2004; since that inspection no complaints against the home have been received or investigated. The inspection took place over two days; the inspector arrived (unannounced) at 14.30 on 6 June 2005. During that afternoon she spoke to 9 residents, 2 members of staff and the visiting relatives of a resident. The inspector observed staff interaction with service users, the carrying out of routine tasks and toured the premises, departing at 17.00. The inspector left a selection of ‘Comment Cards’ and prepaid envelopes (for return to the Commission) in the entrance hallway of the home. Additional information used to inform the inspection process included formal notifications of events and monthly reports regularly provided to the Commission by the registered provider. As agreed during the visit on 6 June 2005, the inspector returned to the home at 10.00 on 16 June 2005 and together with the manager considered other evidence relating to the National Minimum Standards, as described in this report. During that visit the inspector spoke to an additional two residents. The duration of the inspection (both days combined) was 6 hours and 30 minutes. What the service does well: The home provides good care to residents who are mainly of low and medium levels of dependency, and thereby able to remain actively involved in decisions regarding their lives and activities. Residents are assisted to maintain as much independence as possible and are encouraged to maintain contact with the local community. Meals are appetising and of good quantity and quality. The premises are comfortable, with a lounge, conservatory and a dining room; there are car parking spaces at the front of the house and attractive gardens at the rear. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 6 Staff are kind and helpful to residents. Residents are treated with respect, their privacy is protected and staff understand and meet their needs. Residents feel safe and well cared for. The home provides a good range of social and recreational activities, including regular excursions. Medicines prescribed by doctors are safely stored and carefully administered to residents by staff thereby protecting residents from risks of medicine errors. Residents wishing to do so may store and administer their own prescribed medicines. What has improved since the last inspection? What they could do better: Following pre-admission assessment each proposed resident must be given written confirmation that the home will be able to properly care for them. Care plans must be improved to ensure staff have sufficient information to enable them to provide correct care to each resident. The home must introduce a documented system for identifying and minimising risks to residents prone to falling or other harm. Some improvements to record keeping associated with medicine handling are necessary to ensure that residents continue to receive the correct medicines, that all medicines held in the home are properly accounted for and that adequate precautions are observed when handling prescribed gases. Residents storing and administering their own prescribed medicines should do so in accordance with recorded risk assessment. Some first floor corridor carpet is shabby, bedroom doors are not all fitted with locks of approved type and one bedroom has a defective window glass. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 7 The health and safety of the premises must be assessed for risks and must include consideration of the use of oxygen as a medical gas. 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. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 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 standard(s) 2, 3, 4, 5 & 6 When a new resident moves into the home they are provided with a statement of terms and conditions to ensure they know the fees and what they do and do not cover. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them but the home does not then write to prospective residents confirming the ability to properly care for them. Prospective residents (or their representatives) are encouraged to visit Kingland House in advance of admission to establish their impressions of life at the home and the available accommodation. The home does not provide intermediate care. EVIDENCE: The records of a recently admitted resident were examined and found to include a contract stating statement of terms and conditions of occupancy and details of pre-admission assessment, carried out by the manager when she visited the person in hospital. The prospective resident was at the time unwell Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 10 so on her behalf her daughter visited Kingland House and viewed the available room. Following pre-admission assessment, if the home decides to offer a place to a new resident, they do not write to the person stating that Kingland House will be able to meet their assessed needs; this report contains a related requirement. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 & 10 Care needs are briefly and sometimes inadequately described in a written plan of care, which do not all ensure staff have information necessary to provide correct care to each resident. Care plans have been improved but still omit skin assessment which was a requirement of the last inspection report. Nonetheless, the standard of care is good; residents feel well cared for. Records are kept of all accidents but accidents are not handled in accordance with an established protocol, so there is not a reliable system for identifying and minimising risks to residents prone to falling or other harm. Medicines prescribed by doctors are safely stored and carefully administered to residents by staff, unless the residents have chosen to store and administer their own medicines. Risk assessment has not been recorded for those who self-administer. Some improvements to record keeping associated with medicine handling are necessary to ensure that residents continue to receive the correct medicines, that all medicines held in the home are properly accounted for and adequate safety precautions are taken. No warning signs are displayed where oxygen is stored and used and records have not been kept of staff trained to handle oxygen; the home is not adequately minimising risks associated with this prescribed gas. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 12 Residents are treated with respect, their privacy is protected and staff understand and meet their needs. EVIDENCE: Care records of five residents were examined. Care plans are brief, comprising more a summary of needs than a comprehensive plan of care; the forms used provide insufficient space for details of changes in need and associated care provision. Essential information (including possible deterioration in condition, emergency action to be taken by staff, and details of on-going care needs) was not stated for three residents with special health needs. In discussion with the inspector the manager demonstrated good understanding of the various conditions. Nutritional and ‘moving and handling’ needs are assessed and used to inform the content of care plans, but risks to skin integrity are not separately assessed, although this was a requirement of the last inspection report. Residents and their relatives feel they are properly cared for; comments included “I came here at death’s door…(now) I feel well, I feel cared for…I feel so safe…I always imagined looking after myself until the end, but it’s very comforting to know I can always press the bell…they have so much patience”. Similarly, a recently received letter from a resident’s relative stated “She seems to have settled with you very well…due to the care and attention that she is receiving from you…”. All accidents are recorded, but subsequent actions taken to minimise the risk of recurrence are not always recorded; the home does not have a policy and procedure for accidents and does not periodically audit accidents to identify any trends or patterns (e.g. in time, place, person or activity) and subsequently to introduce measures to reduce the risks. The home uses a monitored dosage system; the dispensing pharmacist provides printed administration charts. The manager said that residents are assessed for their ability to manage their own medicines (at the time of inspection a number were doing this) but there was no written record of these assessments. Records indicated that medicines had been accurately administered but the records must be improved to ensure that residents continue to receive correct medicines and doses, and that the home can properly account for all medicines held. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 13 Medicine administration records (MARs) did not state the allergy status (to medicines) of each resident, handwritten amendments to the printed MARs were not signed and dated, records did not state the amount actually given when a variable dose was prescribed, the reason for as required administration was not always stated on the MAR and there was not a summary of all medicines prescribed for each resident, describing purpose and possible side-effects. A currently accommodated resident regularly uses oxygen, supplied via a concentrator with a spare cylinder also available. The home has a policy for oxygen but has not displayed warning signs for the gas is used and stored and has not recorded the names of staff trained to handle the prescribed gas. The inspector provided to the manager written guidance on these matters. Residents are treated with respect and their privacy and dignity is promoted; staff are kind and considerate, and keen to assist residents. Residents are confident they can receive help when needed; comments included “they do everything they possibly can…couldn’t be more kind and considerate...very understanding…I consider them my friends…”. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 12, 13, 14 & 15 The quality of daily life in the home is good with residents assisted to maintain as much independence as possible. Social and leisure activities are varied and suited to the preference and ability of each resident, thereby ensuring residents do not feel bored or lonely. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals are appetising and of good quantity and quality. Most residents take meals in the dining room, some receive them in their bedrooms. EVIDENCE: The inspector spoke to 11 residents; with one exception they expressed satisfaction with the home, including the range of activities, meal provision, staff and premises. One resident said that the home frequently runs out of particular foodstuffs but discussion with other residents, staff and the manager, and examination of food records did not support this claim. The home employs an activities organiser for 3 days each week. A full programme of activities is available to residents and includes events in the home, trips out and visiting entertainers. Destinations during June include Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 15 Swanage, the New Forest and Compton Acres in Poole. Residents confirmed that they were happy with the level of activities and that routines were flexible. Comments included “They have a lot of outings”, “Very nice entertainments and outings”, “I like to do my own thing…but those that like (organised trips) are enjoying it”. Visitors are welcome at any time and residents can go out of the home whenever they wish, and for as long as they wish. One resident visits a nearby church each week, in the company of Age Concern volunteers. On the ground floor there is a dining room where most residents eat; some prefer to receive meals in their bedrooms. Residents select meals in advance, from a planned menu. During the first visit (on 6 June 2005) the inspector observed the serving of supper; all residents said that food is of good standard, for quality, choice and quantity. The manager said that on 15 June 2005 the food handling arrangements were assessed and found suitable by an Environmental Health Officer. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 16 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 standard(s) 16 & 18 Complaints are managed properly and residents said they are confident their concerns are listened to and taken seriously. The home protects residents from harm and abuse. EVIDENCE: No complaints against the home have been received or investigated since the last inspection. The home has policies and procedures for the protection of residents from abuse or neglect. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 17 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 standard(s) 19, 20, 22, 23, 24, 25 & 26. With the exception of the shabby carpets of sections of first floor corridor and the defective double glazed window of one bedroom, the home is attractive, comfortable and well maintained. The home has been assessed by an Occupational Therapist to ensure it is suitable to meet the various needs of residents. A call system is installed in all residents’ bedrooms and bathrooms enabling them to summon prompt assistance as required. Residents bedrooms are suitably decorated and furnished; many residents have brought items of their own furniture and a number have private telephones installed, thereby enabling them to conduct private conversations and maintain contact with persons outside the home. Bedroom doors are not all fitted with locks of approved type so not all residents are able to key-lock their bedroom doors for privacy, when they temporarily leave the room. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 18 There are pleasant communal use rooms – a lounge, separate dining room and a conservatory lounge, and well maintained gardens to the rear of the home. There is a laundry, used by staff to wash and dry residents’ household linen (towels, sheets etc.) and personal clothing. EVIDENCE: There is a lounge, dining room and conservatory. The conservatory is used as a quiet area whilst the lounge is equipped with a large screen television. These rooms are suitably decorated and appropriately furnished and the home has a cosy and relaxed atmosphere throughout. The home stores hot water at 60C or higher, to prevent risks of Legionella contamination, records are kept of checks to support this method. During November 2004 an occupational therapist assessed the premises and in her report states they are suited to the needs of the residents. A call system is installed in all residents’ bedrooms and bathrooms enabling them to summon prompt assistance as required. Additionally, one resident uses a pendant call system, to ensure it is always within reach. There is an ongoing programme of refurbishment and upgrading. During the visit on 6 June 2005 the inspector noted that one bedroom had a heavily stained carpet; this was made known to the manager and by the time of the second visit on 16 June 2005 the carpet had been replaced. A double glazed window in this bedroom was defective and cloudy from inner condensation and should be replaced or repaired. The manager demonstrated similar prompt efficiency by obtaining expert opinion regarding the safety of a balcony, queried by the inspector during her visit on 6 June 2005. The Manager consulted the Health & safety Executive and was advised that the balcony was acceptable. However, as a precaution against risks of accidental falling the home intends to install a Perspex sheet. Some sections of first floor corridor carpet are discoloured and wrinkled, the manager said arrangements are in hand for these carpets to be replaced. Not all bedroom doors are fitted with locks of appropriate type, for which the resident can hold a key. The manager said that arrangements are underway for suitable locks to be fitted. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 19 Resident’s bedrooms contain a variety of personal belongings; many residents provide items of their own furniture. An inventory of each resident’s personal possessions is recorded. Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 20 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during this inspection. EVIDENCE: Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during this inspection. EVIDENCE: Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 x 3 3 2 2 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 23 YES Are there any outstanding requirements from the last inspection? 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 3 Regulation 14(1)(d) Requirement Following pre-admission assessment, when the home decides to offer a place to a new resident, they must firstly write to the person stating that they will be able to meet their assessed needs. A comprehensive care plan must be recorded for each resident. For each resident there must be a recorded assessment, by a person trained to do so, to identify those who have developed or are at risk of developing, pressure sores and appropriate interventions and outcomes must be recorded in the care plan. Previous timescale of 30/01/05 not met. Warning signs must be displayed wherever oxygen (or other gases) are used and stored. There must be recorded assessment of all residents who self-administer prescribed medicines. The stained and wrinkled first floor corridor carpets must be made good or replaced. Timescale for action 17/07/05 2. 3. 7 8 17 14(1)(a) 01/08/05 01/08/05 4. 5. 9 9 13(2) 13(2) 17/07/05 17/07/05 6. 7. 19 16(2) 01/10/05 Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 24 8. 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 7 8 Good Practice Recommendations Care plan documentation should be amended to provide more space for review outcomes and changes to needs and circumstances. The home should develop and implement a policy and procedure for dealing with accidents, to include periodic audit with evidence of any consequent action taken to reduce identified risks. There should be a written summary of all medicines prescribed for each resident, describing purpose and possible side-effects. When a medicine is prescribed for administration as required the administration record should clearly state the reason for which it is required. The medicine administration records for each resident should clearly state any allergy to medicines, or none known. Handwritten amendments and additions to medicine admnistration records should be signed and dated by the writer, and countersigned by someone who has checked the entry for accuracy. A record should be kept of all staff trained in handling oxygen. Doors to service users private accommodation should be fitted with locks suited to service users capabilities and accessible to staff in emergencies. Service users should be provided with keys unless their risk assessment suggests otherwise. This recommendation was also included in the report of the last inspection. The defective double glazed bedroom window should be repaired or replaced. 3. 4. 5. 6. 9 9 9 9 7. 8. 9 24 9. 25 Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole, Dorset BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingland House D55 S60603 KINGLAND HOUSE V229705 060605 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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