Inspection on 19/05/06 for Kingston House

This inspection was carried out on 19th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 House 08/05/07

Kingston House 30/11/05

Kingston House 28/04/05

Kingston House 08/12/04

Kingston House 13/05/04

Kingston House 19/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Kingston House 7 Kings Road Clacton On Sea Essex CO15 1BG Lead Inspector Gaynor Elvin Key Unannounced Inspection 19th May 2006 10:00 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 House DS0000017863.V296315.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 House DS0000017863.V296315.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingston House Address 7 Kings Road Clacton On Sea Essex CO15 1BG 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) 01255 473513 01255 473513 Mrs Marie F Baya Mrs Marie F Baya Care Home 11 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (11) of places Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 11 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 11 persons) The total number of service users accommodated in the home must not exceed 11 persons Once a room accommodating two service users becomes a single occupancy it shall remain so, and the total number of service users accommodated will become 9. 30th November 2005 Date of last inspection Brief Description of the Service: The home is a detached house located in a pleasant, quiet residential area of the seaside town of Clacton on Sea, Essex. It is situated within walking distance to the town centre, local amenities and the sea front. Accommodation is provided on both the ground floor and the first floor; a passenger lift provides access to the upper floor for those service users with mobility difficulties. The home is well equipped to meet the needs of the current service user group and provides the appropriate aids and equipment to assist service users with limited mobility. The home has a large well-maintained garden with a ramp access from the lounge. Seating is provided in the garden. The home currently provides two shared bedrooms, once a room accommodating two service users becomes a single occupancy, consideration will be given for it to remain so. This is in line with the homes changed focus of care and to enable an environment more conducive to meet the assessed needs of current and potential service users with varying levels of dementia. Mrs Marie Fran Bayer, who is also the Registered Manager, owns the home. Mrs Bayer also lives the majority of the time at the home, in private accommodation on the second floor. The home provides written information about the service to prospective service users. Fees for this home, at the time of the inspection, ranged from £398.00 - £450.00 per week. Dry cleaning, hairdressing and chiropody are an additional cost. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on 19th May 2006, over six and half hours, carried out by two inspectors. All of the Key National Minimum Standards (NMS) for Older People and the intended outcomes were assessed in relation to this service during the inspection. The inspection process included discussion with the Registered Manager, two carers, two residents and one relative; examination of a sample of staff and residents records, supporting documentation and other records required to be kept in the home; direct and indirect observation, as well as pre inspection records. The inspector was invited to have lunch and would like to thank the cook and staff for their hospitality. Due to cognitive impairment and disorientation to time and place discussion with the majority of residents with regard to care delivery was difficult, however observation of body language, expression and interaction between the residents and the staff, demonstrated that the residents were comfortable and relaxed at Kingston House. What the service does well: What has improved since the last inspection? What they could do better: The home would benefit from the implementation of a training and development plan for staff individually and for the team as a whole, with a focus to develop skills and awareness of staff in different areas of dementia Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 6 care and general good practice guidance in the provision of a specialist dementia care service. Progress is required to develop a quality assurance and monitoring system to look at care practice and outcomes for residents with a focus on the quality of life for people with dementia. 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. Kingston House DS0000017863.V296315.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 House DS0000017863.V296315.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. Pre admission assessment records contained determine a prospective service user’s needs. sufficient information to The home does not provide intermediate care and therefore Standard 6 is not relevant to this service. EVIDENCE: Unplanned admissions were avoided. A sample of residents’ files examined contained thorough assessments of needs, including social, psychological, health and spiritual needs; providing sufficient introductory information from which the home could determine whether they could meet the needs identified and commence an individualised plan of care. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. Residents’ were looked after well in respect of their health and personal care needs. Care plans were person centred and clearly detailed the care and support required by each resident. Policies and procedures for medication management were adhered to ensuring the safe administration of medication to residents. Residents are assured that at the time of their death their needs and wishes are treated with sensitivity and respect. EVIDENCE: Staff engaged positively with each individual and demonstrated a good relationship with the residents they were supporting, treating them with dignity and respect. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 10 A sample of resident files was examined. They contained a clear and detailed plan, which gave precise information for care staff on how to meet personal, social and psychological needs, ensuring consistent and structured support. The plans were regularly updated and the necessary action taken to respond to changing needs. They provided evidence of the resident’s choices and preferences with regard to their personal needs, likes and dislikes and preferred terms of address. Individual night care programmes detailed personal preferences and requirements such as time to go to bed, pillows, warmth and hot drinks and how needs were to be met to promote a good night sleep. The care plans identified medication prescribed, however it is recommended to ensure that information relating to the side effects and adverse reactions of medicines being taken by service users is readily available. The homes medicine administration system was inspected. This was a monitored dose system (MDS). Based upon the sample of records inspected the receipt, administration, storage, security and disposal of medication was found to meet National Minimum Standards. Staff responsible for the administration of medication had received training from the local pharmacist, which mainly focuses on the delivery system. The manager was advised to seek accredited training for staff or establish a formal means to assess whether the care worker is sufficiently competent in medication administration including how to recognise and deal with problems in the use of the prescribed medication for the individual including side effects and the use of ‘as required’ medication. From conversations with staff, and information submitted to the Commission with regard to the recent death of a resident, it was evident that the home responded appropriately to the changing needs of the residents and provided all the care and support they were able, in collaboration with the Primary Healthcare multi professional team. A previous request from the deceased resident and family to be cared for at the home was upheld. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area s good. The provision of suitable activities to stimulate social and recreational interests for residents with dementia was adequate. Staff required further training in this area. Visiting arrangements are open and relaxed and family and friends links with the service were strongly encouraged and well developed. Meals provided in this home are of good quality, wholesome and freshly prepared; and mealtimes were a dignified social occasion. EVIDENCE: A fairly regular routine was kept to help residents remember what happens throughout the day. There were some good elements of practice, which included staff’s cheerful and positive attitude. Continual short interactions and constant verbal exchange was observed between staff and residents. Staff gave gentle reminders throughout the day of what was happening next, to give residents some conception of time. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 12 Further development is required to explore various approaches to appropriately engage residents in maintaining and stimulating social and recreational interests, linked to individual needs. Although dementia awareness training attended by staff provided a basic level of understanding of diagnosis and symptoms of dementia related illnesses, this was insufficient to provide detailed knowledge of the needs and therapeutic approaches to care and support for people with varying levels of dementia. This training need was reflected in the observation of well-intentioned staff practice encouraging two residents to participate in a game of dominoes. Each resident had varying cognitive and communication abilities; one who experienced substantial difficulties in word finding, ability to make choices and fine movement, the other resident had reasonable cognitive abilities but was troubled with little memory for events, conversation and people. The game of dominoes was conducted at a faster pace than one that would encourage the resident with higher cognitive needs to fully participate to his optimum ability. Although the interaction was fully enjoyed by the resident, the pace and type of game chosen could possibly promote unnecessary frustration or feelings of failure. The manager confirmed that arrangements were in place to attend church if the residents wished and friends of the church visited the home. The home positively involved relatives in ways appropriate to the needs and circumstances of individual residents and their families. The Manager and staff indicated that the service strongly encouraged family and friendship links and took a partnership approach with family members, which was paramount to caring for people with dementia. Relatives spoken with confirmed that the staff were always welcoming and inclusive and there were no restrictions on visiting. Residents were able to express their individuality by having personal possessions and photographs around them. The main meal was observed to be a happy, social affair, conducted with dignity. The residents and visitors commented positively about the food, which was ‘always good home cooking’. The meal was taken leisurely and unhurried, staff were observed assisting residents with patience and dignity. Good wholesome, freshly prepared home cooking was provided in good quantities. Records of daily dietary intake and monthly weight were maintained to monitor and assess health and well-being. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality outcome in this area is good. Arrangements for responding and acting upon any complaints or concerns were satisfactory. Service users were protected by policies and procedures within the home. EVIDENCE: The home or the CSCI had not received any complaints within the last three years. Residents were observed to be comfortable and at ease with the staff. Relatives spoken with were happy with the care provided by staff in the home and felt able to discuss any concerns openly. An adult protection policy and procedure was in place, including Whistle Blowing, providing information and guidance for staff to follow in response to a suspicion, allegation or evidence of abuse. All staff had received the appropriate training in recognising and protecting vulnerable adults from abuse. Staff treated the service users well and were aware of issues related to protecting vulnerable adults, training and guidance from the adult protection policy and appropriate recruitment procedures enhanced the service users protection. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 & 26 Quality in this outcome area was adequate. The home was well maintained and provided a homely warm and welcoming environment. The service recognises, and plans are in place to address, areas for improvement, particularly with regard to health and safety issues relating to the sluice, laundry and kitchen facilities. EVIDENCE: A full inspection of the premises was not carried out on this occasion. Areas visited presented a homely style and comforting feel about them. Bedrooms reinforced the individual’s identity with personal belongings and photographs. A running redecoration and maintenance programme to further improve the environment and safety for residents was in place and included refurbishment of the kitchen, laundry and sluicing facilities. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 15 Progress had been made to address a previous statutory requirement for the home to provide appropriate sluicing facilities to meet the needs of the service users. Preliminary building plans for the sluice and laundry facilities included consideration of infection control guidance and professional advice from the Environmental Health Officer, ensuring compliance, particularly with regard to the restraints of a relatively small area in an older style building. The home had recently purchased a mechanical sluice with a disinfector programme for the safe handling and disposal of waste materials and control of infection and was awaiting installation following completion of building works. The manager, Mrs Bayer indicated a programme of redecoration was planned for the corridors and communal areas. The planning included consideration of how the design and décor of environments contribute to the well being of service users with dementia. Mrs Bayer was in the process of researching current guidance looking at the use of colour and signage. At the time of inspection the above-mentioned work was not yet complete and will be assessed further within the inspection process. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome based on the evidence provided was adequate. Staffing levels were not calculated against service users’ assessed needs, using a recommended tool, paying particular attention to busy times of the day and changing needs of the residents. Induction and foundation training for new staff did not fully meet Skills for Care requirements. Records relating to staff recruitment were satisfactory. Staff training is not provided in a planned way to ensure that mandatory requirements are met and that all staff receive training in areas pertinent to the residents assessed needs. EVIDENCE: The staff team of fourteen comprise of three whole time equivalent and eleven part time care workers. The staff roster indicated two members of staff were on duty at all times, however there was no evidence to support that the existing numbers of staff were sufficient to support the assessed needs of the current residents, particularly as care staff also undertake cooking and domestic tasks within the home. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 17 The home needs to consider the additional contribution of domestic and catering staff to enable care staff to meet the increasing and changing needs of people with dementia. At the time of inspection, the service had not yet achieved an adequate proportion of carers having attained or commenced a National Vocational Qualification (NVQ) level 2, or a date by which this will be achieved. Five of the fourteen care staff had achieved NVQ level 2. Work permits, issued to two newly recruited care workers from the European Union, indicated previous skills and work experience were accepted as equivalent to NVQ. However records examined did not provide evidence to demonstrate how the service had assessed their competence in meeting residents’ needs. The homes induction arrangements is mainly service focused and although it provided the support new staff required and informed them of the culture of the home, it was not in line with National Training Organisation specification, as highlighted in previous inspection. Discussion with the manager advised that all new staff must be registered on a Skills for Care programme, the newly formed occupational training council for the social care sector, as from September 2006. It was also recommended that existing staff not yet commenced NVQ level 2 in care should be considered for the induction and foundation programme. The files of recently recruited staff were examined during the inspection, all of which contained appropriate levels of documentation in respect of recruitment to promote the protection of residents from abuse. A sample of staff files examined contained reference to training sessions undertaken by individuals during their employment. Mrs Baya is yet to undertake training needs assessment for the staff group as a whole, or an individual assessment and profile of care staff to identify any training needs or gaps in knowledge and skills. Records of annual appraisals reflected the individuals and the managers’ perception of strengths, weaknesses and achievements. To conclude the process these need to be carried forward into a plan for future individual and team development. Whilst it is acknowledged there has been a comprehensive range of basic training accessed from external trainers and the Primary Healthcare Trust, the inspector identified less than half of the staff team had attended. A lapse in mandatory training updates such as infection control and food and hygiene was identified, as well as a need for accredited medication administration training. Further development is required in the training programme to ensure that the basic level of dementia awareness is complimented by further initiatives in Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 18 areas such as communication; nutrition, social inclusion and person centred planning to enhance staff understanding of dementia care. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33, 35, 36 & 38. Quality in this outcome area is good. The Registered Manager is a person of good character and is fit to be in charge of the home. The Registered Manager has a clear vision for improving the service users quality of life but needs to develop a system to monitor and review quality outcomes. Planned formal supervision for staff is not consistent. EVIDENCE: The Registered Manager, Mrs Baya, has operated Kingston House for many years. Mrs Baya is a qualified Registered Nurse in Adult Care and Mental Health and has successfully completed NVQ level 4 in care and management, Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 20 (Registered Managers Award). Unfortunately, the specialist dementia course Mrs Baya had applied to commence, as indicated in the previous inspection report, has been withdrawn due to a lack of resources. Mrs Baya is currently seeking an alternative training course. Mrs Baya, the Proprietor and Registered manager resides at the home for the majority of the time, and there was evidence of good contact during the day and night between the manager and the staff and the residents. Visitors to the home spoken with on this and previous occasions expressed satisfaction with the home and felt welcomed and included in their relatives care. The manager has a hands on approach to managing the home, frequently working alongside the care staff; staff therefore receive ongoing practical supervision through this approach. The staff felt well supported in their roles and confirmed any issues identified were dealt with as they arose. Staff spoken with and staff records confirmed they received formal supervision, which reflected all the elements necessary to support staff in developing and sustaining their working practice, however these need to be more frequent, particularly for newly appointed care staff. A new member of staff had been informally supervised during induction but formal agreed one to one protected time had not yet taken place in the last three months. The manager confirmed that the home does not manage any finances on behalf of residents. The home had still not progressed in addressing quality assurance and quality monitoring systems as required in the last inspection report. The elements of quality assurance were discussed with the manager, who agreed she needed to explore this area further, focusing on the quality of life of people with dementia and looking at the outcomes for the residents. The homes policies and procedures support the health and safety of service users and staff supporting them. The certificates relating to equipment and services to the home were in place and updated as required. As previously mentioned training for staff related to health and safety issues needs to be monitored more closely to ensure mandatory training and update is received by all staff employed. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 21 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 3 8 3 9 3 10 3 11 3 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 X X X X 3 X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 2 X 3 Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 22 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 OP27 Regulation 18 Requirement Timescale for action 01/08/06 2. OP30 12,18 3. OP33 24 4. OP36 18 The Registered Manager must ensure staffing arrangements are appropriate to meet the assessed needs of the service users. Repeat requirement not met within given timescale 01/03/06 The Registered Manager must 01/08/06 ensure all members of new staff receive induction and foundation training to NTO specification within the specified timescales of appointment. Repeat requirement not met within given timescale 01/03/06. The Registered Manager must 01/10/06 establish and maintain a system for reviewing, improving and monitoring the quality of care provided and the outcomes for service users within the care home. Repeat requirement not met within given timescale 01/04/06. The Registered Manager must 01/08/06 ensure that staff supervision is consistently provided. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 23 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. 3. 4. Refer to Standard OP27 OP28 OP30 OP30 Good Practice Recommendations The Registered Manager should consider the additional contribution of domestic staff and a cook. The Registered Manager should ensure a minimum of 50 of the staff team have achieved or have a date to commence NVQ 2. The Registered Manager should ensure that training needs identified through staff supervision and appraisal processes are included in a training programme. The Registered Manager should ensure that staff continually develop their understanding and knowledge of care for people with dementia. Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingston House DS0000017863.V296315.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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