Inspection on 05/06/07 for Kingston Care Home

This inspection was carried out on 5th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Kingston Care Home 27/11/06

Similar services:

Queen Elizabeth House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Kingston Care Home Jemmett Close Coombe Road Kingston Surrey KT2 7AJ Lead Inspector Jon Fry Key Unannounced Inspection 5th and 12th June 2007 10:30a 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 Kingston Care Home DS0000068285.V343063.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. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingston Care Home Address Jemmett Close Coombe Road Kingston Surrey KT2 7AJ 020 8547 0498 020 8547 0499 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) Four Seasons (No 9) Limited Mrs Veronica Scates Care Home 67 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0), of places Physical disability over 65 years of age (0) Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 24 service users in the Dementia - over 65 (DE(E)) category 43 service users in either the Old Age (OP) category and/or Physical Disability over 65 years of age (PD(E)) category. 27th November 2006 Date of last inspection Brief Description of the Service: Kingston Care Home provides nursing and residential care for sixty seven older people. The home is situated opposite Kingston Hospital with good access to public transport. Accommodation is provided over three floors that are served by a passenger lift. All bedrooms are single and en-suite. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector who spent twelve hours in the home over two separate visits. The inspector talked individually with eight people living at the home. Four relatives or friends of individuals were also spoken with during the inspection. A number of records were examined and discussions took place with the manager and six staff members. Completed surveys were received from nine people living at the service and six relatives or friends of individuals. What the service does well: What has improved since the last inspection? What they could do better: Medication is generally well managed but there is still room for improvement. The challenge for the home is how to develop the care provided to be more person centred and individualised. Mealtimes in particular could be a much more positive occasion for all involved. The service needs to think creatively as to how this can be done. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 6 Everyone living at the home needs to have a social care plan in place. Care staff need to see the provision of social care and occupation as a very important part of their role. 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. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 7 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 Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 8 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 and 5. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Good information is available to prospective users of the service about the home. Assessments are completed before people move in to make sure that their individual needs can be met. EVIDENCE: “It’s a nice location”, “it’s very well run” and “all in all very good” were some typical comments from people living at the home. Relatives and friends comments included “first class” and “very satisfied”. In surveys, all nine people who use the service said that they had received enough information to make a decision about moving in. One person said that “they showed us around the home and we had tea”. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 9 A user guide is available which contains information about the service provided. This is available in large print if requested. We recommend that other formats are looked at for the guide such as tape or pictures to make sure that it can be used by as many people as possible. We saw that there is an admissions procedure and that assessments are completed prior to anybody moving in. Once an individual comes to live there, a care plan is written based on these assessments. One relative or friend did say that they had been asked to provide written information about their relative but had forgotten to give it back. They reported that this form had never been asked for. It is important that the service looks at how good quality person centred information is gathered within assessments. We looked at assessments completed for three people and saw that some good information had been recorded. This could be improved by looking at the assessments in use and making sure that these help to capture the information needed to allow staff to provide personalised care and support. Five out of nine people who responded in surveys said that they had not received a contract. The service does have written contracts in place which should be provided to people and / or their representatives on admission. It is recommended that the home looks at how it can make contracts more available to the people who live there. Contracts should also made available in large print and other formats as required. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 10 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. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans could be more person centred and better address the health, personal and social care needs of individuals. Arrangements for the handling, storage and administration of medication are generally good but could be improved further. EVIDENCE: Five people who live at the home responded ‘always’ when asked if they received the care and support they needed. Four people said ‘usually’. Three out of the six relatives or friends who sent in surveys said that the home ‘usually’ met the needs of the individual. Two people said ‘always’. One person did not answer this question. One individual commented “pretty good on the basics” but “weaker on the individual approach”. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 11 We looked at the care plans for three people. Each care plan sets out how their needs are to be met, this document is reviewed regularly. The plans could be improved to contain more individual information and to better address social needs. Care plans seen for areas such as personal hygiene included phrases such ‘has weekly bath or shower’ and ‘maintain privacy and dignity’. Staff should review these and make sure that specific person centred information is recorded. For example, does the person like a bath or a shower, which bathroom do they use, what day or time do they prefer and who do they like to help them? Daily notes kept by staff should also be looked at. We saw that some of these contain very repetitive and general statements such as ‘all hygiene needs met’ and ‘skin remains intact’. The manager said that this was due in part to the organisational policy so we have recommended that this be reviewed. Notes kept by staff need to contain good information which can then be used to evaluate and review the care being provided. Risk assessments are completed around areas such as falls, pressure areas and nutrition. We saw that these were generally well completed and kept under review. Staff are trained in manual handling and satisfactory numbers of hoists are available. The service must make sure that enough slings are available in different sizes within each unit and these are kept clean. People who use the hoist on a daily basis must have their own personal slings provided. One relative or friend said that they thought that manual handling practices could be improved. They commented that practices seemed ‘random’ with different staff using different methods. Staff must make sure that they follow the care plan for each person. We saw that these clearly stated the method of transfer for each person and what equipment to use. Seven out of the nine people who completed a survey said that they ‘always’ received the medical support they need. Two people said ‘usually’. Comments included “health matters are dealt with quite quickly” and “the GP comes round regularly”. We saw that good records were kept of any contact with healthcare professionals for each person. We looked at medication records in two units. These were generally kept well but a number of issues were highlighted. These included incorrect storage of items in a fridge and instances where the record of administration had not been signed by staff after a medication had been given. One issue of more serious concern was found where quantities of one medication did not tally with the record kept. This suggested that staff had signed the administration record for a medication on two occasions but had not actually given it to the person. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 12 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. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home offers an good range of activities. There is scope to improve this by making sure there is a full social care plan for each person and involving all staff in delivering this care. Improvements need to be made to make sure that mealtimes are a positive occasion for everybody involved. EVIDENCE: Most people spoken with said that they enjoyed the food offered with comments including “very good”, “good”, “not bad at all” and “the cooks are very good”. One person said that the meals “could be improved” and another individual said “I don’t think much of it”. In completed surveys, four of the nine people said they ‘sometimes’ liked the meals served. Three individuals said ‘usually’ and two people said ‘always’. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 13 We looked at lunch being served in two units. The service should look at how mealtimes can be made a more positive occasion throughout the home and an opportunity for people to talk and interact without being interrupted. Staff need to review when and how the meals are served particularly when many people need assistance to eat. We saw instances of staff standing when supporting individuals to eat and staff members helping two people at the same time. On our first visit to the service, we saw that different menus were displayed in dining rooms and staff spoken to were unsure of which menu was in use. By the second day of inspection, attractive daily menus were put on each table. It is recommended that the menus be presented in more user friendly ways such as large print or pictures and any changes to the menu communicated to the people living there by staff. There is a good range of activities on offer to people living there. The home has one full time activities co-ordinator who works to a weekly schedule which is displayed throughout the home. Activities include social clubs, visiting entertainers, cooking and gardening. We saw the garden area being used by a number of people and film shows put on within different units. Six out of the nine people who completed a survey said that there were ‘usually’ activities that they could take part in. One person said ‘always’, one person said ‘never’ and another individual did not give an answer. Comments included “there are enough activities for me”, “you can have your hair done”, “somewhat limited” and “I’d like to get out more”. Comments from relatives or friends included “able to accommodate successfully individual needs”, “I wonder whether activities could be more frequent” and “more 1-1 visiting for the more isolated residents”. Care staff spoken to said that they did not routinely provide activities and that this was not really their role. We saw a number of missed opportunities where staff were sitting in lounges with people but did not positively chat or interact with them. We saw staff turning down the television on two occasions and putting on music for the people sitting there. This could however be confusing for people and individuals were not asked if they wanted music on. On the second visit, staff had been allocated each day to support the activities person. We have recommended that an additional activities person is employed given the large size of the home. All individuals need to have a social care plan in place and staff should also be much more involved in providing this important care. The activities coordinator could then be more involved in organising and supporting staff to Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 14 deliver activities. This is particularly important for those people who spend a lot of time in their rooms and for individuals with dementia. The organisation should make sure that the home has its own transport to use. This will support more trips out for individuals and allow more spontaneity as the weather allows. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individuals are protected from abuse. Concerns about the care provided are listened to and acted on. EVIDENCE: Records are kept of any concerns or complaints received and we saw that these were very well maintained. The complaints policy and procedure is displayed in the home and is part of the guide for the people living there. Seven of the nine people who completed surveys said that they knew how to make a complaint. One person said ‘no’ and another individual did not answer. Five out of six relatives or friends who completed surveys said they knew how to make a complaint. One person did not answer this question. One relative or friend of a person living at the service said they intended to make a complaint about an issue and “felt confident this would be taken on board”. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 16 Care staff at the home have training that teaches them how to recognise and report abuse. There is an organisational procedure for staff to follow in the event of any allegations being made. The home also raises awareness of abuse amongst friends and relatives and in the local community. An Elder Abuse Awareness day was due to be held at the home with exhibitions and workshops put on. This is commended. Kingston Care Home DS0000068285.V343063.R01.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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home enjoy a comfortable and safe living environment. The home is generally kept clean and well maintained but would benefit from redecoration in some areas. EVIDENCE: People spoken to were happy with the environment. Comments from individuals included “its good”, “my room is ok” and “fine”. A number of people spoke about how the garden had recently been improved by the manager and staff. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 18 Relatives or friends of people living at the service were also appreciative of the work done to improve the garden. Other comments included “the decoration is tired” and “the owners are not willing to spend much”. We saw that the home generally provides a pleasant and well maintained place for people to live. Some areas are in need of updating and re-decoration. We have recommended that the organisation puts a programme in place in the short-term to address this. A number of chairs in the lounge area on the top floor need replacement and a toilet on the first floor needs a new lock. The use of colour and wall murals in the unit for people with dementia is particularly good. Bathrooms and toilets can be easily identified by the people living there. The home was generally clean and hygeinic at the time of this inspection. Seven out of nine people who returned surveys responded ‘usually’ when asked if the home is fresh and clean. Two people said ‘always’. Comments from relatives or friends included “there is a pervasive smell throughout the building”and “better cleaning needed and replacement of carpets”. We saw that there were satisfactory numbers of domestic staff to keep the home hygienic. The service should however look at replacing carpets if they cannot be kept clean and fresh. Kingston Care Home DS0000068285.V343063.R01.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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are generally enough staff on duty to meet the needs of people using the service. People living at the home are protected well by the recruitment procedures. There is a staff training and development programme in place. EVIDENCE: Feedback about the way the staff carried out their duties was generally positive. Comments included “very helpful”, “the staff are kind”, “quite friendly” and “some are very nice and some are not so nice”. Relatives or friends of individuals said “nearly all of them are pleasant in manner and help my relative feel secure” and “staff seem genuinely pleasant and kind”. Three people felt that communication could be an issue at times with care staff coming from so many different cultures. Five people who filled in surveys said that staff were ‘usually’ available when needed. Four other individuals responded ’always’. We saw that staff were very caring and spoke to individuals in a polite and respectful manner. As stated previously, there is scope to look at the role of Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 20 carers and make sure that social and emotional care is seen as an important part of their job. It is recommended that staff teams look at the routines in place and see how they start to move away from task based care to a more person led approach. This may require further training and support from the organisation to support a culture change at the home. One relative or friend commented that they thought the home needed to take “a different approach to care”. Staff are offered training in a number of topics such as manual handling, medication, fire safety, First Aid, and Protection of Vulnerable Adults. Two staff members we spoke to said that they had not received training in dementia care. It is essential that all care staff receive this training. The manager said that she had been running in-house sessions around person centred approaches and that two day dementia training was being rolled out by the organisation. We looked at the recruitment records for four members of staff. These were very well maintained and contained all the necessary checks including Criminal Records Bureau (CRB) checks. Kingston Care Home DS0000068285.V343063.R01.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, 36 and 38. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home that is well run. There are good arrangements to make sure that the health and welfare of people using the service is protected. EVIDENCE: The manager has considerable knowledge and experience of running a care service for older people. Comments from staff about the management of the home included “good” and “they are all nice”. A relative or friend said “the matron is a super leader with wonderful staff”. Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 22 The manager and her deputy are trained in Dementia Care Mapping (DCM) but have not yet been able to use this to evaluate the care provided. The organisation needs to look at using this resource to develop the service. Regular audits are carried to monitor the performance of the home in areas such as accident reports, staff training and Health and Safety. Relatives meetings are held regularly and the ‘Friends of Kingston Care Home’ also take an active part in raising funds and arranging events. A newslatter is produced for the home and meetings also take place on each unit. A system for regular individual staff supervision is in place but needs development to make sure that all full time staff receive this at least six times per year. Health and Safety checks take place to make sure people are kept safe and good records are kept of these. One issue was highlighted where certification was not available to show that an annual Gas Safety check had taken place. The manager stated that this was being addressed by the organisation. Kingston Care Home DS0000068285.V343063.R01.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 3 3 3 X 3 X 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 2 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 3 2 Kingston Care Home DS0000068285.V343063.R01.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 OP7 Regulation 16 (2) (m) (n) 15 (1) Requirement Each person living at the home must have a care plan in place addressing their individual social needs and how these are to be met. This will help to make sure that their social and recreational needs are being met by the service. To make sure that the safety of individuals is protected, a range of slings in suitable sizes must be made available on each unit. These must be kept clean and hygienic at all times. In order to fully protect the health and welfare of people living at the home, medication records must be correctly maintained at all times. Medication must be given as prescribed with full and accurate records kept at all times. (Previous timescale of 27/11/06 not fully met). Timescale for action 01/10/07 2. OP8 23 (2) (n) 01/08/07 3. OP9 13 (2) 01/07/07 Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 25 4. OP15 12 (4) (5) Mealtimes need to be reviewed 01/10/07 to make sure that they are a positive occasion for the individuals living there. This is with regard to ensuring there are always adequate numbers of staff available to assist individuals and looking at the way people receive this assistance. Menus displayed must reflect the food being served. Any changes in menus must be communicated effectively to individuals. Damaged or worn chairs in the 01/10/07 top floor unit need to be repaired or replaced. A lock needs to be fitted in a toilet on the first floor. These improvements will help to make sure that the environment is suitable and safe for those living there. To make sure that individual needs are fully addressed, all staff must receive training in dementia care. All full time care staff must receive supervision with their line manager at least six times per year (pro-rata for part time staff). This will help to make sure that good quality care is being delivered to people living at the home. Certification must be supplied to the CSCI to show that an annual Gas Safety check has taken place. This is important to make sure that the home environment is safe for the people living there. 5. OP19 23 (2) (c) 6. OP30 18 (1) (c) 01/11/07 7. OP36 18 (2) 01/11/07 8. OP38 13 (4) 01/08/07 Kingston Care Home DS0000068285.V343063.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 OP2 Good Practice Recommendations The user guide to the home should be made available in a variety of formats such as audio tape or pictures. It is recommended that the home looks at how contracts are supplied to people living at the home and / or their representatives. This would include making sure that these are in plain english and in alternative formats as required. The assessment format should be reviewed to make sure that good quality person centred information is recorded. This can then be used to inform the care plan from when the individual moves in. The home should look at ways to make the care plans more person centred and better reflect the individual’s life and preferences. The plan in place should direct the care to be person orientated and less task based. Care plans need to give specific information about how the person likes the care and support to be delivered. Daily notes need to be reviewed to make sure that good quality useful information is being recorded. All care staff should be responsible for the provision of social activities. The job of the activities co-ordinator could be changed to be more of an organisational / supporting role for care staff. The organisation should seriously consider employing an additional activities co-ordinator for the home. It is strongly recommended that further training courses be made available to the activities co-ordinator. It is strongly recommended that the home has its own minibus or similar vehicle available. Menus should be presented in user friendly formats such as pictures or large print. Large whiteboards could also be used to present information and any changes. Mealtimes should be made a more positive occasion and Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 27 3. OP3 4. OP7 5. 6. OP7 OP12 7. 8. OP12 OP15 an opportunity for people to interact. Practices such as protected mealtimes, varying numbers of mealtimes, and staff eating with people who live there should be considered seriously by the home. People should only be seated at tables immediately prior to the food being served. A programme of refurbishment / re-decoration should be put in place for the home. It is recommended that all staff working at the home receive mandatory training in dementia care of at least three days in length. The organisation should look at how this training could support culture change within the home. Dementia Care Mapping should take place within the home to look more closely at the care being provided. 9. 10. OP19 OP30 Kingston Care Home DS0000068285.V343063.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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. 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