Inspection on 21/05/08 for Kingsleigh

This inspection was carried out on 21st May 2008.

CSCI found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kingsleigh 12/05/09

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Kingsleigh 78 Berrow Road Burnham-on-Sea Somerset TA8 2HJ Lead Inspector Jane Poole Unannounced Inspection 21st May 2008 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kingsleigh DS0000071263.V361453.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. Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsleigh Address 78 Berrow Road Burnham-on-Sea Somerset TA8 2HJ 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) 01278 792768 01278 783825 Angels (Kingsleigh) Ltd Samantha Oatway Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Kingsleigh DS0000071263.V361453.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 can be accommodated is 23. First Inspection. Date of last inspection Brief Description of the Service: Kingsleigh is registered with the Commission for Social Care Inspection to provide care to up to 23 people over the age of 65 who require personal care. Nursing care is not provided. The home is a large, older style property located in a residential area of Burnham on Sea. Accommodation is arranged over two floors with a passenger lift between. All communal areas are located on the ground floor. The home has been owned by Angels (Kingsleigh) ltd since December 2007. The registered manager is Samantha Oatway. Fees at the home range from £390.00 to £470.00 Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 5 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. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. This inspection was carried out over a one day period. The inspector was able to spend time talking with people living and working at the home and able to observe care practices. The inspector was given unrestricted access to all parts of the home and all records requested were made available. Before the inspection 3 completed questionnaires were received from staff, 3 from relatives and one from a person living at the home. 2 relatives were spoken on the phone before the inspection. The manager completed an Annual Quality Assurance Assessment prior to this inspection. The following is a brief summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: Kingsleigh provides a comfortable environment for the people who live there. There is a relaxed atmosphere and people spoken to said that they were able to make choices about when they got up, when they went to bed and how they spent their day. The inspector observed that people moved freely around the home and were able to spend time alone or the company of others. The recruitment practices in the home are good and appropriate checks are carried out before new staff begin work. Staff spoken to, and observed, during the inspection were well motivated and competent in their roles. People living at the home were complimentary about the staff describing them as very kind. People living at the home are assisted to access healthcare professionals in line with their individual needs. One person said that they had been very well cared for by staff when they had been unwell. Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 6 The inspector was invited to have lunch with people living at the home. Lunch was a very relaxed and sociable occasion and people were able to make choices about the food that they ate and portion sizes. To help people stay in touch with friends and family, visitors are welcome at all reasonable times. What has improved since the last inspection? What they could do better: Although the home offers opportunities for people to visit before deciding to move in some people are unable to do so. One person, who had recently moved in, felt that they had not received enough information to make an informed choice. Another person said that it would have been nice to see pictures of the home before they moved in. The home carries out pre admission assessments but these are very basic and do not identify specific needs or demonstrate how the home will meet needs. Care plans are not fully reflective of peoples changing needs and in some instances do not give clear guidelines to enable staff to deliver appropriate care. There is no evidence that people living at the home are involved in the creation or review of care plans. Staff spoken to raised some concerns about staffing levels at the weekend when neither the manager or deputy are on the premises. The manager needs to review staffing levels to ensure that they are sufficient to meet the needs of people and promote safe working practices. The registered manager is new in post and needs to explore ways of being more visible in the home and give a clearer sense of leadership and direction. Medication administration practices are generally good but the manager should ensure that there are protocols are in place for the use of ‘as required’ medication and that creams and lotions are appropriately dated. Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kingsleigh DS0000071263.V361453.R01.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 Kingsleigh DS0000071263.V361453.R01.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): 1, 2, 3, 4 & 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People have opportunities to visit the home before deciding to move in but only limited information is given to people who are unable to visit. Pre-admission assessments do not clearly set out the needs of the individual and it is therefore unknown how the decision is reached that the home is appropriate to meet their needs. Intermediate care is not provided. EVIDENCE: People wishing to move to the home are able to visit and spend time at Kingsleigh to make sure it is the right place for them. In addition to full Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 10 residential care the home also offers day care to a small group, which enables people to get to know the home, staff and other people living there. Most people spoken to during the inspection stated that they had not visited the home but had relied on a friend or family member to view the home on their behalf. The inspector viewed the personal file of a person who had recently moved to the home. A pre-admission assessment had been carried out by the manager and was included in the file. The assessment did no clearly outline the needs of the individual or give any details about how the home would meet their individual needs. The inspector met with the person concerned who stated that they had not been able to visit the home before moving in and did not feel that they had received adequate information to assist them to make an informed choice. People who are funding their stay privately receive a contract with the home. Copies of contracts were seen and these clearly stated that the first four weeks of a persons stay is a trial period. People who are being assisted with their fees by the local authority have a financial agreement with the relevant authority. The Statement of Purpose and service user guide sets out what is included in the fee. Kingsleigh DS0000071263.V361453.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, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans do not always give clear information to enable staff to assist people appropriately or to monitor changes in need or dependency. People living at the home are not fully involved in the creation or review of care plans. People have access to healthcare professionals in line with their individual needs. EVIDENCE: Everyone living at the home has a care plan that is kept in their room. As previously stated pre admission assessments provide only minimal information however a further assessment is completed once a person has moved in. Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 12 Three care plans were viewed in detail during this inspection and a further two were looked at briefly. Two of the care plans seen related to people who’s needs had increased significantly but the care plans were not reflective of this. They did not give clear guidance for staff regarding social and mental health needs. One care plan in respect of someone who had diabetes stated that blood sugar levels were to be taken weekly. No further information was given about the persons’ normal range or the action to be taken if readings were above or below normal range. Care plans gave personal details of peoples’ daily routines including their likes, dislikes, faith and cultural needs. There was no evidence in the care plans to state how people had been involved in their creation, review or the setting of goals. Daily records are written about each person but again there was no evidence that people were being fully involved in this. Everyone spoken to stated that the home made arrangements for them to be seen by healthcare professionals. A chiropodist, optician, dentist, GPs and district nurses visit the home on a regular basis. People are regularly weighed and weights are recorded. Those seen showed people were maintaining a stable weight. The home has some pressure relieving equipment for people who are at risk of pressure damage and they liaise appropriately with the district nursing service for advice and support in this area. One person spoken to praised the staff for the way that they had been cared for when they were unwell. People spoken to said that their privacy was respected. People said that they were able to spend time in company or in the privacy of their personal rooms. The inspector observed that care staff assisted people in a dignified manner and interaction was friendly and polite. The home uses a Monitored Dosage System for medication. Medication is administered by senior staff who have received specific training in this area. The inspector viewed the Medication Administration Records (MARs,) these showed that all medication is checked and signed for when it arrives at the home and signed for when administered or refused, this gives a clear audit trail. Some people living at the home are prescribed pain relief on an ‘as required’ basis but there were no protocols in place, on MARs or in care plans, to indicate when these should be given. One person was prescribed pain relief to be given four times a day but signatures showed that this was being administered each morning and on an ‘as required’ basis throughout the rest of the day. Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 13 Some creams and lotions are kept in personal bedrooms and the inspector noted that these had not been dated when opened and no expiry dates had been written. Kingsleigh DS0000071263.V361453.R01.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 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to choose how and where they spend their time. Visitors are welcome at all reasonable times. There is a good variety of food in the home enabling people to make choices. EVIDENCE: People spoken to stated that there are no set times to get up or go to bed. One person said “you can do what you like” another said “ you can carry on your own life.” The inspector noted that people moved freely around the home and were able to choose how they spent their day. Some people spent time in their rooms watching TV or listening to music whilst others socialised in the lounge areas. An activity worker, who arranges group and individual activities, is employed for 4 afternoons a week. The activity worker was away at the time of this Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 15 inspection. The inspector noted that one member of the care staff team spent time in the lounge encouraging people to join in a game and quiz. Some visiting entertainers are booked for the forthcoming year and the diary for this is displayed in the hall. People spoken to were happy with the level of activity in the home. A hairdresser visits the home on a regular basis and members of the church visit two people. People said that they are able to have visitors at anytime and that friends and family are always made welcome. There is a four-week menu in the home, which is displayed by the kitchen. This shows that there is always a choice of three options for the main meal. The inspector was invited to have lunch with people living at the home. The meal was a sociable occasion with people chatting and enjoying each others company. The main course is served plated and vegetables and condiments are made available on all tables. Staff assisted people to make choices about vegetables and portion size. Cold drinks were served with the meal and hot drinks were available afterwards. The inspector observed that people ate well and there was very little food wasted. Kingsleigh DS0000071263.V361453.R01.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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems and practices minimise the risk of abuse to people living in the home. EVIDENCE: The home has policies and procedures about making a complaint, recognising and reporting abuse and whistle blowing. Staff undertake training in recognising abuse as part of their induction training and many have recently received further training in the protection of vulnerable adults. Everyone who completed a questionnaire prior to the inspection said that they knew how to make a complaint. All staff said that they knew what to do if someone had concerns about the home. The complaints procedure is displayed in the main entrance hall. No complaints have been made to the home or the Commission for Social Care Inspection since the home was registered in January. During the inspection it was observed that people living at the home have unrestricted access to their personal rooms and all communal areas. People Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 17 spoken to stated that they would be comfortable to approach a member of staff if they had any concerns about their care. The inspector viewed the recruitment files of the three most recently appointed members of staff, these gave evidence of a robust recruitment procedure. References had been received and appropriate checks carried out before people began work. There is evidence that the home takes all allegations of abuse seriously and appropriate measures have been taken to ensure that people living at the home are protected. Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 18 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, 24 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Kingsleigh provides a comfortable environment for the people who live there. EVIDENCE: The home is located in a residential area of Burnham on Sea. All areas are fitted with a fire detection and call bell system. There are 8 bedrooms on the ground floor and 13 on the first floor. There is a passenger lift to the first floor. 6 bedrooms have en suite facilities and there is a bathroom on each floor for communal use. All bedrooms have wash-basins. The inspector viewed a selection of bedrooms. The majority have now been redecorated and refurbished. All rooms seen were clean and fresh. People Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 19 living at the home are able to bring personal possessions and small items of furniture with them to the home. This gives bedrooms an individual feel. Communal seating areas are located on the ground floor and are accessible to all. There is a dining room and two lounges, that can be made into one large room. All rooms are comfortably furnished. To the front of the house is an enclosed garden area with seating. Various aids and adaptations have been put in place to encourage people to maintain independent movement around the home. Both communal bathrooms have assisted bathing facilities. Bathrooms are tired looking and would benefit from redecoration. Alcohol gel and hand-washing facilities are available throughout the home to minimise the spread of infection. All areas seen were clean and fresh. The laundry was not viewed at this inspection. People spoken to were happy with the facilities offered and the standard of cleanliness in the home. Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home are well motivated and competent. Staffing levels need to be reviewed, to ensure that they adequately meet the needs of the people who live at the home. Recruitment procedures are robust and minimise the risk of abuse to people. EVIDENCE: The home employs 18 care staff and 8 staff in non-care roles. 13 members of the care staff team (72 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. Other staff are working towards the award. (Figures taken from Annual Quality Assurance Assessment.) The manager gave copies of duty rotas to the inspector. These show that there are 4 care staff on duty between 8am and 12 noon, between 12 and 2pm there are 3 staff, this drops to 2 between 2pm and 5 pm when it rises to 3. Overnight there are two waking night staff. During the week (Monday to Friday) the manager and deputy are also available in the home during the day. Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 21 3 members of staff completed surveys prior to this inspection. To the question “Are there enough staff to meet the individual needs of service users?” 2 people answered USUALLY and one person said SOMETIMES. One person commented that weekend staffing levels were poor. One member of staff commented on weekend staffing levels during the inspection. The rotas show that on Saturday and Sunday staffing levels are the same as during the week but neither the manager, or deputy, is available in the home. This means that at weekends there are only two members of staff on duty during the afternoon. Staff were happy with the training opportunities available to them. Care staff have received training in health and safety issues such as moving and handling and fire safety. Staff have also received training in the Protection of Vulnerable Adults and the Mental Capacity Act. All new staff undertake a 12 week induction programme. 3 staff recruitment files were viewed at this inspection all contained all information required to ensure a robust recruitment process and minimise the risk of abuse to people living at the home. Staff observed, and spoken to, during the inspection were competent and well motivated. People said that staff were helpful and kind. One person said that the staff at the home were “very, very, very kind.” Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager does not give a clear sense of direction or leadership to the home. All areas of the home are adequately maintained and equipment is regularly tested and serviced. EVIDENCE: The registered manager of the home is Samantha Oatway. She has been involved with the home for approximately 4 years and was registered as manager in March this year. She has no formal qualification in care or Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 23 management but is currently studying towards the Registered Managers Award (NVQ level 4) and has registered for NVQ level 4 in care. Staff spoken to during the inspection stated that the manager was not very visible in the home and did not work alongside them. There are records to show that staff receive task focussed supervision on a regular basis. All these supervision sessions are undertaken by the deputy manager. The manager stated that she plans to carry out appraisals with all staff in the coming month. Minutes of the latest staff meeting showed that meetings are an opportunity to share information rather than seek views and suggestions. Due to the location of the managers office, on the second floor, she is not able to observe care practices and not easily available to people living in the home. This was discussed during the inspection. The home does not act as a power of attorney or financial appointee for anyone living at the home. Small amounts of personal allowance are kept on behalf of some people. These monies were sampled and records kept correlated with monies held. The home sends out quality assurance surveys to people living at the home and their relatives. The inspector viewed the returned surveys, which were mainly positive. Some areas that people felt could be improved were highlighted and there is evidence that the manager is addressing these. The manager and inspector discussed the possibly of sending surveys to other interested parties including local professionals. All records requested by the inspector were made available; all were well maintained. Some records are kept securely in the managers’ office others are kept in the carers area which is also a walk through to two bedrooms. Records in the carers area are not securely stored and a white board on the wall gives some personal information about people living at the home. The home is generally well maintained and all equipment is regularly tested and serviced. All accidents in the home are recorded. Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 24 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 2 3 2 1 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 Standard No Score 16 3 17 x 18 3 3 3 2 3 x 3 x 3 STAFFING Standard No Score 27 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 3 x 3 2 2 3 Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A 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 OP3 OP4 Regulation 14 (1) Requirement The registered manager must ensure that comprehensive pre admission assessments are carried out and demonstrate how the home will meet individual needs. Care plans must give clear guidelines to enable staff to give appropriate care to individuals and to monitor healthcare needs. Care plans must be drawn up and reviewed in consultation with people living at the home or their representative. The manager must review staffing levels in the home to ensure they are sufficient to meet the needs of individuals and promote safe working practices. The registered manager must give clear leadership and direction to the home The registered manager must ensure that all confidential records are appropriately stored. Timescale for action 22/06/08 2 OP7 15 (1) (2) 22/06/08 3 OP27 18 (1) [a] 30/07/08 4 5 OP31 OP32 OP37 10 (1) 17 (3) 30/07/08 22/06/08 Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 26 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 OP1 OP9 Good Practice Recommendations The registered manager should ensure that prospective service users receive sufficient information about the home to assist them to make a decision about moving in. Protocols should be in place for people who receive medication on an ‘as required’ basis. These protocols should inform staff when it is appropriate to administer these medications, especially when people are unable to ask for medication. Prescribed creams and lotions should be dated when opened to ensure that they are not used after their expiry dates. Bathrooms should be refurbished and up graded. 3 4 OP9 OP21 Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Kingsleigh DS0000071263.V361453.R01.S.doc Version 5.2 Page 28 - 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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