Inspection on 15/05/07 for Kingscourt Nursing Home

This inspection was carried out on 15th May 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

Kingscourt Nursing Home 20/07/06

Kingscourt Nursing Home 13/12/05

Kingscourt Nursing Home 13/07/05

Kingscourt Nursing Home 14/02/05

Kingscourt Nursing Home 20/05/04

Kingscourt Nursing Home 26/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Kingscourt Nursing Home 12 Newton Lane Hoole Chester Cheshire CH2 3RB Lead Inspector Wendy Smith Unannounced Inspection 15th May 2007 9:30 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 Kingscourt Nursing Home DS0000018722.V332831.R02.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. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingscourt Nursing Home Address 12 Newton Lane Hoole Chester Cheshire CH2 3RB 01244 313201 01244 350133 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) Springcare (Kingscourt) Limited Lindsey Elizabeth Unsworth Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 37 service users in the category OP (Old age, not falling within any other category) Date of last inspection 8th September 2006 Brief Description of the Service: Kingscourt Nursing Home is a purpose built three storey property set in its own grounds on the outskirts of Chester city centre and close to local amenities in Hoole. The home provides care for up to 37 older people, some of whom require nursing care. It is convenient for the local bus service. The current weekly fees are from £425 to £435. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on 15th May 2007 and took five hours. Two inspectors carried out the visit, one being a pharmacist inspector who was checking whether requirements about the handling of medicines, made following her visit in September 2006, had been addressed. A second visit, to speak with the manager took place on 24th May 2007. The home had 34 residents, 25 of whom were receiving nursing care; all were older people. A tour of the building, including all communal areas and bedrooms, was completed. A sample of records was looked at and time was spent in conversation with the assistant area manager, residents and staff. Some of the information contained in this report inspection questionnaire that was completed by the Comments cards were provided for residents, visitors to give their views of the home. One was returned by completed by GPs who visit the home. is taken from the preassistant area manager. and visiting professionals a relative and three were What the service does well: People interested in coming to live at Kingscourt have a full assessment to ensure that the home will suit their needs. All of the residents spoken with expressed their satisfaction with their care. They considered that the staff were lovely and gave them the assistance that they needed. The comments card completed by a relative contained very positive comments about the home: the staff are very helpful to my mother and fully understand her needs, I have been very impressed with the level of care and attention. The care plans showed that residents get regular visits from doctors and other health professionals including optician and chiropodist. The GPs who returned comments cards were all satisfied with the care provided. The home employs an activities organiser for 26 hours a week. The activities organiser was a care assistant at Kingscourt for 16 years and knows the residents well. Each week she provides some group activities and a trip out in the minibus every Wednesday. She also spends one to one time with residents and takes some residents out shopping. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 6 Relatives and friends can visit at any reasonable time and a relative commented: my wife and I are always offered a cup of tea, we are made to feel very welcome. The standard of meals provided is consistently good and residents confirmed that this remains so. Both of the cooks have worked at the home for a considerable length of time. Complaints are fully addressed and there are established policies and procedures for the protection of vulnerable adults. Residents have a comfortable, clean and safe environment and most areas have been upgraded over the last two years. What has improved since the last inspection? What they could do better: Care plans need to improve so that they provide a more holistic view of each resident as an individual. There should be more detailed information regarding wound care to show whether the treatment being given is effective. Bedrails should only be used when necessary for the safety of a resident. Whenever bedrails are used there must be a risk assessment that is kept under review, and the rails must be fitted safely to prevent any risk of entrapment. The manager needs to increase the frequency and depth of the auditing of medicines and associated records to immediately identify and document errors and take steps to prevent their recurrence. Some bedrooms are still in need of upgrading to provide a more pleasant environment for their occupants. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 7 The ground floor bathroom should be improved to provide a better environment for residents who need assistance with bathing or with accessing the toilet. Enough staff must be provided at all times of day and night to ensure that the needs of the residents can be met in full. Female residents must always have the choice to receive personal care from female staff only. More staff need to achieve a national vocational qualification in care to ensure that there is a well-qualified team. Recruitment procedures must be followed rigorously to ensure the protection of residents. New staff must receive induction training to ensure that they are safe and competent to provide care to residents. The problem with retention of care staff should be investigated because the constant changes do not give continuity for residents. Training records should demonstrate that all staff are up to date with mandatory training to ensure the safety of staff and residents. The manager must return to working in the home as soon as possible to provide leadership for the staff and ensure that management tasks are carried out. If the manager is absent from the home for more than four weeks the Commission for Social Care Inspection must be notified. Regular fire drills must be held to ensure that all staff know what action to take in the case of a fire. 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. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People interested in coming to live at Kingscourt have a full assessment to ensure that the home will suit their needs. EVIDENCE: On 15th May 2007, 34 residents were living at Kingscourt and a new resident was going to be admitted at the end of the week. The assistant area manager had been to assess this person and had completed a pre-admission assessment to identify her needs. The lady had also been to look around the home and had chosen which room she would like. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 10 Of the current residents, 25 were receiving nursing care and nine receiving personal care. Information provided before the visit indicated that six residents have dementia. One of these people was presenting some challenges to staff in meeting her needs. Her doctor had requested a visit from a community psychiatric nurse and this visit had taken place although there was no information about what advice the nurse had given. Kingscourt does not provide intermediate care. Kingscourt Nursing Home DS0000018722.V332831.R02.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, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ care needs are identified in their care plans but not always in sufficient detail. Residents were happy with the way that they are treated by the staff. Residents’ health is at risk from poor medicine practice. EVIDENCE: Each resident has a care plan which contains an assessment of their needs, a plan of how their needs will be met, and a record of the care that has been given to them. A sample of four care plans was looked at. One care plan had been well completed by the assistant area manager, the other three contained little detail about the individual from which to form a holistic picture of the person. Recent care plan audits carried out by the company’s area management team had also highlighted shortcomings in the documentation. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 12 One resident had a pressure sore on her heel. This had been first identified in November 2006 but the size of the ulcer was not recorded until February 2007 and thereafter was only recorded spasmodically. There was no photographic record. Evidence in the care plan indicated that the wound was now almost completely healed so the outcome for the resident had been good, however the recording was poor. A significant number of residents had bedrails fitted to their beds. In one room there appeared to be only one rail. Some of the rails were fitted too far from the head of the bed leaving a gap where the head or neck might be trapped. One of the care plans looked at contained a risk assessment for the use of bedrails and a consent form signed by a relative, however these were not dated and there was no evidence of any review taking place to see whether the rails were still the best way to keep this person safe. All of the residents spoken with expressed their satisfaction with their care. They considered that the staff were lovely and gave them the assistance that they needed. A comments card completed by a relative contained very positive comments about the home: the staff are very helpful to my mother and fully understand her needs, I have been very impressed with the level of care and attention. The care plans showed that residents got regular visits from doctors and other health professionals including optician and chiropodist, and three doctors who completed comments cards all indicated that they were satisfied with the care that their patients receive at Kingscourt.. The temperature of the drug storage room and the medicine fridge was a lot higher than that recommended on the medicine labels. This may affect the quality of the residents’ medicines. The homely remedies were kept in a cupboard above the fridge and they felt warm. Also the cough linctus had date expired and the paracetamol tablets did not have a container or label to show where they had come from. There were also some solutions used to set the blood sugar machine that had date expired. This could affect the accuracy of the machine. There were a number of influenza vaccines, and emergency adrenaline provided with them, still in the fridge from last autumn. Many were out of date and none would be in date for next autumn. All this shows that the home does not have a system to check regularly that residents’ medicines are fit to use. There were three instances of residents not being given medicines to the prescribed directions. Records of warfarin did not always show what dose should be given or the dose given. There was one record of more paracetamol than the recommended dose being given. The manager confirmed that this had been given to a member of staff and not to a resident. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 13 There was a book to record giving residents homely remedies. The very recent entries were fine but others did not add up. There was one record of a resident being given more paracetamol than recommended in one dose that could be a risk to the resident’s health. Records of prescribed medicines still had problems. This was identified within the home’s quality assurance audit of 30/04/07. The CSCI pharmacist found two unclear handwritten instructions, four medicines where the dose given was not always recorded, nine unexplained gaps in the records of giving medicines and two omitted records of receipt of medicines. The home has started a system to record the quantity held of those medicines not kept in the calendar packs. This is not always done properly. For example, a resident was given a dose of medicine on the morning of the inspection but the quantity left was recorded the same as that on the previous day. The home manages its controlled drugs well. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The social needs of residents are catered for and a good standard of meals is provided. EVIDENCE: Most residents spend their day in the lounge, but some prefer to stay in their own room. The lounge has now been divided into two smaller sitting areas and residents spoken with were very happy with the new arrangements. One resident said that it was quieter and made it easier to have a conversation. There is also a conservatory at the back of the home and two residents were sitting in the conservatory as well as others who were having their hair done by the hairdresser. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 15 The home employs an activities organiser for 26 hours a week. The activities organiser was a care assistant at Kingscourt for 16 years and knows the residents well. Each week she provides some group activities and a trip out in the minibus every Wednesday. She also spends one to one time with residents and takes some residents out shopping. She has an allocated budget for activities but also fundraises. The activities organiser keeps a record of what events have taken place in a diary. Relatives and friends can visit at any reasonable time and a relative commented: my wife and I are always offered a cup of tea, we are made to feel very welcome. Residents are given the choice to have breakfast in their bedroom and this reduced the rush for residents to get up and dressed in a morning. However residents can also choose to go the dining room for breakfast. The standard of meals provided is consistently good and residents confirmed this. Both of the cooks have worked at the home for a considerable length of time. There are new chairs and some new tables in the dining room. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are fully addressed and there are established policies and procedures for the protection of vulnerable adults. EVIDENCE: Information received prior to the visit indicated that the home had received seven complaints since the last inspection. Details of these complaints were recorded in a complaints folder. The records showed that complaints had been investigated and responded to in writing according to the home’s complaints procedure. There are company policies and procedures for the protection of vulnerable adults and these were reviewed in August 2006. A number of training sessions have been held for staff to ensure that they are aware of abuse issues. It was not clear from the records whether every member of staff had attended but certainly most had. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have a comfortable, clean and safe environment and most areas have been upgraded over the last two years. EVIDENCE: The home changed ownership in 2005 and substantial investment has been made by the new owner to improve the accommodation. Most of the bedrooms have been refurbished, however there are a small number that remain below standard including some old furniture that has dangerous sharp edges, some poor carpets and some washbasins that have cracks in them and need replacement. The manager said that the intention is to refurbish one bedroom each month and all will be completed by the end of this year. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 18 The lounge has been divided into two smaller sitting areas and has been redecorated. This has been a great improvement both in appearance and in the choice it affords for residents. There are also some new chairs and an overall improvement in cleanliness and tidiness. There are new chairs in the dining room and some of the tables have been replaced. An area of the flooring in the dining room is in need of repair. The bathroom on the ground floor is very small and has a low ceiling that is oppressive. There is little space for a hoist to be used for any residents who need it either to access the bath or the toilet. The manager said that an application has been made for a grant to carry out the improvement work. The home had a maintenance person but he has recently left. The assistant area manager said that an area maintenance team would provide cover until a new maintenance person can be recruited. A resident spoken with said that her room was kept ‘spotlessly clean’ and a relative commented that his mother’s bedroom and toilet are ‘always spick and span’. An odour of urine was noticed in two bedrooms but not in any communal areas. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 19 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. There are not always enough staff to ensure that the needs of residents can be met in full and few of the care staff have a qualification in care. Recruitment and induction procedures are not applied consistently for the protection of residents. EVIDENCE: The home employs seven nurses, 16 care staff and 13 ancillary staff. For the second consecutive year there has been a high turnover of care staff. Only three have a national vocational qualification in care but six are working towards a qualification. Some days there is only one nurse on duty throughout the day but on other days there are three nurses between 8 am and 4 pm. The duty rota showed that some days there are only four staff rota’d to work in a morning, three in an afternoon and three in an evening, whilst on other days there are seven staff in a morning with five in the afternoon and evening. The assistant area manager said that shortfalls are covered by agency carers but this was not always recorded on the rota and a member of staff spoken with said that they were sometimes short-staffed. A nurse spoken with said that she phones the agency if she considers that there are not enough staff. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 20 The number of staff on night duty has been reduced to two care staff and one nurse, there were previously three care staff and one nurse. This was discussed with the manager who explained that the number of staff had been reduced when there were only 27 people living at the home but should now be increased as the occupancy has increased. The manager said that she would ensure that this was done as soon as possible. Three of the five care assistants working on night duty are male. This will cause a difficulty for any female residents who are not comfortable with a male carer providing personal care for them. The personnel files for six staff recruited after the last inspection were looked at. No record of a Criminal Records Bureau disclosure could be found for two of them, however the manager felt certain that these had been received. One person had no written references. According to the records, only two of the six had completed the company’s full induction training. The registration for one of the nurses had expired in April 2007 and there was no record to show that she had renewed her registration. The company employs two trainers and one of these people was visiting Kingscourt on 15th May 2007, however she was unable to spend time with the carer she had come to see as the staff said they were too busy. Training records showed that Fire Safety, Moving and Handling, Abuse, Food Hygiene, Health and Safety and First Aid training had been provided for the staff over recent months, however it was not clear from the records whether all staff were up to date with statutory training. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Management systems are in place to ensure that the home is run in the best interests of residents, but the manager has been absent from the home for several weeks. There was little evidence of consultation with stakeholders to find out their views. EVIDENCE: The manager was away from the home on a training course on 15th May 2007. The staff rota did not record when the home manager would be on duty and no-one in the home seemed to know. After several attempts to contact the manager she confirmed that she was currently working in another home owned by the same company and did not know when she would be returning to Kingscourt. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 22 A meeting was arranged for 24th May 2007 and the manager was able to confirm that she had been asked to cover another home from March 2007, initially for a period of two weeks, but would be returning to work full-time at Kingscourt at the end of the month. The company that owns the home has quality assurance processes to ensure that the home is run in the best interests of the residents. Unannounced visits, required by regulation 26 of the Care Homes Regulations, are carried out monthly by the area manager or the assistant area manager. The area team also carries out audits of care plans and medicines. A weekly progress report to head office includes details of any complaints, accidents and pressure sores. There were no records of any recent meetings for residents, relatives or staff. The manager confirmed that she holds bi-monthly meetings for staff and for residents and these would be recommenced as soon as she returns to Kingscourt. Small amounts of personal spending money are in safekeeping for most residents but other than this there is no involvement with residents’ finances. Good records of all transactions are kept, and residents’ money is in individual envelopes. This is mainly used for hairdressing, newspapers and small items of shopping. The hairdresser provides individual receipts. Information received prior to the visit indicated that six residents have a Power of Attorney arrangement. Staff receive the required training in health and safety. The home’s maintenance person was also the fire trainer for the company. He carries out a series of weekly and monthly health and safety checks which include a weekly fire alarm test, and monthly emergency lighting and extinguisher examination. The records showed that equipment is tested and serviced regularly and this was up to date. There has been no Fire Drill since December 2006. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 23 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 2 8 3 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 Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 1 28 1 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X X 2 x Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 24 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 OP9 Regulation 13(2) Timescale for action Ensure that staff give medicines 25/05/07 at the right dose and number of times a day as instructed by the doctor so that residents’ health is not at risk. (Requirement not met within timescales 20/07/06 and 08/09/06). Ensure that staff make records 25/05/07 showing the date, quantity and the initials of staff receiving medicines, the date, dose given and initials of staff giving medicines and the date, quantity and the initials of staff putting medicines for destruction so that the audit trail can be followed to show that residents have had their medicines properly. (Requirement not met within timescales 20/07/06 and 08/09/06). Requirement 2 OP9 13(2) Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 25 3 OP9 13(2) 4 OP9 13(2) 5 OP9 13(2) 6 OP38 13(4)(c) 13(7) Ensure that when printed instructions are not provided with medicines that staff handwrite all the details from the medicine label onto the record sheet, that these are checked by a second person and that both sign the record and that a separate record of receipt is made as in requirement 3. This is so that staff have clear instructions how to give residents’ medicines (Requirements not met within timescales 20/07/06 and 08/09/06). Ensure that a complete check of all medicines and medicinal products is carried out each month so that all medicines unfit for use or no longer required are removed for disposal. This ensures that no resident is given a medicine unfit for use. (Requirements not met within timescales 20/07/06 and 08/09/06). Ensure that residents do not run out of prescribed medicines and if there are supply problems the doctor must be contacted without delay to prescribe an effective substitute. This is to make sure that there are no breaks in residents’ treatment that may harm their health (Requirements not met within timescales 20/07/06 and 08/09/06). Bedrails should only be used when necessary for the safety of a resident. Whenever bedrails are used there must be a risk assessment that is kept under review, and the rails must be fitted safely to prevent any risk of entrapment. DS0000018722.V332831.R02.S.doc 25/05/07 25/05/07 25/05/07 25/05/07 Kingscourt Nursing Home Version 5.2 Page 26 7 OP27 18(1)(a) 8 OP10 12(3) 9 10 OP29 OP30 19 18 11 OP31 8(1) 12 OP38 23(4)(e) Enough staff must be provided at all times of day and night to ensure that the needs of the residents can be met in full. Female residents must always have the choice to receive personal care from female staff only. Recruitment procedures must be followed rigorously to ensure the protection of residents. New staff must receive induction training to ensure that they are safe and competent to provide care to residents. The must be a manager working at the home to provide leadership for the staff and ensure that management duties are carried out. Regular fire drills must be held to ensure that all staff know what action to take in the case of a fire. 25/05/07 25/05/07 25/05/07 25/05/07 25/05/07 25/05/07 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 OP7 Good Practice Recommendations Care plans need to improve so that they provide a more holistic view of each resident as an individual and contain more detailed information in areas such as wound care to show whether the treatment is effective. Improve the ground floor bathroom to provide a better environment for residents who need assistance with bathing or with accessing the toilet. Refurbish the remainder of the bedrooms so that all residents have a bedroom of a good standard. More staff need to achieve a national vocational qualification in care to ensure that there is a well-qualified team. DS0000018722.V332831.R02.S.doc Version 5.2 Page 27 2 3 4 OP19 OP19 OP28 Kingscourt Nursing Home 5 6 7 OP27 OP30 OP33 The problem with retention of care staff needs to be investigated to provide continuity for residents. Training records should demonstrate that all staff are up to date with mandatory training to ensure the safety of staff and residents. The views of staff, service users and their representatives should be sought to inform the quality assurance process. Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Kingscourt Nursing Home DS0000018722.V332831.R02.S.doc Version 5.2 Page 29 - 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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