CARE HOME ADULTS 18-65
Kingston House 43 Woodfield Park Drive Leigh On Sea Essex SS9 1LN Lead Inspector
Patricia Stanton Key Unannounced Inspection 4th July 2006 10:00 Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 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 DS0000036988.V296072.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 Adults 18-65. 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 DS0000036988.V296072.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Kingston House Address 43 Woodfield Park Drive Leigh On Sea Essex SS9 1LN 01702 712022 01702 712544 kingston.house@achuk.com kingston@consensushealthcare.org Consensus Healthcare Limited 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) Manager post vacant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 22nd February 2006 Brief Description of the Service: Kingston House is situated in a residential area of Leigh on Sea, Essex in close proximity to the town centre, local amenities, shops, pubs, clubs and sea front. The home provides care to a wide range of residents of various age groups from both genders. The home can accommodate up to eight residents with a learning disability comfortably although registered for nine. The house has good-sized single bedrooms on the three floors, all with en-suite facilities, plus one communal area and garden. The home does not have a private room for residents to entertain families/friends in private and is in need of redecoration. The home provides transport to take residents out. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The routine unannounced inspection too place on the 4th July 2007. Records and documents were looked at, including the previous requirements and recommendations from the last inspection. As part of the inspection process pre inspection questionnaires were sent out to the acting manager, residents and their relatives but at the time of publishing the report only feedback was received from the acting manager. Details of which are included in the report. Time was spent in the lounge, office, kitchen and garden chatting to three residents, three staff members and the acting manager taking note of the residents’ daily routine. The area manager was spoken to by telephone following inspection regarding the decline in standard of care at the home and outcomes for residents, which have not been met. The inspector would like to thank residents, staff, the acting manager and area manager for their time and cooperation. What the service does well: What has improved since the last inspection?
Consensus Care have recently appointed a new area manager who has visited the home and completed a regulation 26 report that identifies some areas of weakness for action. The home now ensures fire checks and evacuation in the home are completed weekly with response times. Regulation 37 notifications have been completed and sent to the CSCI regarding serious incidents. Two residents meeting and one senior staff meeting have taken place with records of minutes. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 6 What they could do better:
The homes accommodation is in need of some redecoration and refurbishment. The home could seek the advice of fire offices to improve fire exits, and lighting outside the home to improve security and safety. An appropriate combination lock could be used on the homes back garden gate to enable easier access in the event of a fire. Weekly fire test could also include the different times of day for fire drills. The home could arrange to have the laundry room made larger to enable proper ventilation and sluicing with extra space made available to allow residents to participate in daily living skills as part of their independence. The home could reduce registration numbers to only eight residents, as the home does not have sufficient communal or private space for nine residents. The acting manager has not consulted with guests, their relatives and staff to seek their views and develop a quality assurance system to monitor and progress the service. The homes care plans do not guide staff in delivering good quality care to residents or reflect residents’ changing needs and progress, as they had not been updated by the homes acting manager of reviewed since April 05. Care plans could include behaviour monitoring formats to help professionals monitor progress of residents. Activities in the home for residents could be improved and personalised to ensure residents participate in personal interest and more days out to motivate and widen their social skills, taking risks as part of their daily lives. The acting manager could make more use of the local community to ensure residents mix with people of their own age. The acting manager could ensure all televisions in the home are working properly. Communication between staff could be improved as this has deteriorated since the last inspection and staff have ongoing issues regarding roles, job descriptions, pay and the management delegation. The acting manager could have more residents and staff meetings to help improve communication and review and maintain care plans, medication and personal risk assessments. The acting manager could become more involved with residents day-to-day life. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 7 The home could employ a domestic once a week to carry out spring-cleaning duties including cleaning ceiling lights, windows, kitchen cupboards, window seals, and skirting boards ensuring staff are not taken away too long from caring for residents. The acting manager could benefit from more training in management skills and receive more regular supervision from consensus health care. Staff would benefit from training in restraint challenging behaviour. The home could reduce the number of agency staff used in the home, as they do not have such a good understanding of residents needs. The acting manager could evidence that agency staff have appropriate checks to ensure residents are kept safe. All visitors to the home should be asked to sign in and out of the premises to keep residents safe. The acting manager could send a copy of the action plan prepared following 26 visits to the CSCI. 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 DS0000036988.V296072.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3, Residents and relatives have the relevant information to make a choice about the home prior to admission but residents’ individual aspirations are not always met in relation to care planning and recreation. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this home. EVIDENCE: The home has a pictorial format service users guide for residents, which includes photos of staff/residents with details of how to complain but this needs to be updated with management and staff changes. Residents appear to enjoy fulfilling activities in the home and community with the support of staff who encourage them but these are limited. Residents in the home do not have the opportunity for many personal interests days out or annual holidays. Many residents attend educational schools/colleges and enjoy time in the community. Activity plans could be more varied and individualised. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10. Care plans do not reflect residents changing needs. Residents need to take more risks as part of an independent lifestyle and recreational activities offered in the home are limited. Personal files are not stored securely in the homes office. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this home. EVIDENCE: Care plans examined were outdated and did not include all aspects of residents care needs including the changing needs in respect of health, social, emotional, self help, behavioural assessments and personalised risk assessments. Goal plans introduced in the home were not completed with goals achieved but staff had recorded residents personal interests and preferences on admission. The home stores personal files in a secure office but the files are not in a locked cabinet. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16.17 Residents have limited access to the community and leisure activities. Social contact with family and friends is good. Residents are able to develop personal skills and interests in the home and have their needs respected in relation to daily life skills. Residents’ rights are respected. The home provides adequate good quality food for residents. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this home. EVIDENCE: The acting manager and key workers do not arrange activities for the individual residents as only one staff member had been allocated coordination of this work and therefore personal interest and days out were limited. Residents have only had one day trip out this year to the zoo and have limited activities in the community. No annual holiday had been arranged at the time of inspection. One resident who enjoyed dancing went to club each week where he could dance but the range of activities was limited. His rights to choose an alternative dress styles are respected by the home.
Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 12 Minutes of house meeting evidenced residents’ wishes in relation to holidays and with the preference to go only with permanent staff rather than agency staff who do they do not know them so well. The home has some recreational activities in the home for residents such as a bike for one, music, dancing, TV, DVDs, jigsaw, colouring plus a very sandpit which is used as a paddling pool but this can only accommodate one resident at a time. The home’s TV is in need of attention and the inspector was informed two residents TVs in their rooms had poor pictures. Staff are however very keen to take residents out and stated they would like to take them out more. One staff member stated, “This can only be done if sufficient staff are on duty”. Staff stated there was confusion re funding for activities and the acting manager supported residents to go out but the deputy manager was more cost conscious and reluctant to fund some outings. Some residents at Kingstone House are more physically active and younger than others and need to be encouraged to take more risk to help them become more confident and independent. The home is decorated to a poor standard and attention needs to be given to the laundry room which is too small, inaccessible and too warm in summer months. The temperature at inspection was very warm as there is no ventilation and no appropriate sluicing facilities. The inspector was informed the tumble dryer frequently overheats due to lack of ventilation. The homes lounge; hallways and bathroom were in need of urgent redecoration and refurbishment. Some residents appeared to have developed socially and one resident who had been seen at previous inspections appeared to have developed in confidence and verbal skills. Other resident’s behavioural patterns appeared to have improved since the last inspection but the home does not keep records of behaviour to monitor progress. The home at inspection was clean and tidy and staff were observed to carry out spring-cleaning duties in the kitchen which took them away from caring for residents. One agency staff member was on duty observing residents while permanent staff cleaned. The homes staff are expected to carry out all cleaning in the home including windows, skirting boards and light fitting. Residents need to be encouraged more by staff to develop daily living skills and participate in cooking and cleaning their rooms. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 13 Since the last inspection the CSCI has received two anonymous complaints regarding the acting manager. The CSCI had requested the registered provider investigate the complaints but at the time of inspection no response had been received although the acting manager stated the investigation had taken place. At inspection food stocks were adequate and off good quality. The fridge contained healthy snacks and fresh fruit.. Residents appeared healthy and well nourished although one resident had lost weight due to a suspected medical condition which was being investigated by a medical professional. Residents stated they enjoyed the food and liked to eat outside in the garden. The home had installed a gazebo and table and chairs in the garden for residents. During inspection residents enjoyed freshly made rolls and drinks. Menus examined appeared varied and nutritious. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,21 Residents receive personal support and appropriate health care but plans are not updated and reviewed by the homes management. Records for ageing, illness and death need to be updated. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this home. EVIDENCE: At inspection all residents appeared happy and healthy. Care plans confirmed residents receive appropriate health care from medical professionals including speech and mental health professionals with appropriate medication changes to improve health outcomes. Consents from significant others were seen on file for staff to administer first aid and homely remedies. Residents receive personal support from staff and at inspection communication beween staff and residents were mutually respectful and caring. Core staff have a good knowledge of residents and appear kind and caring. The home operates a key working system but no evidence was seen in one file of any one to one key working sessions with staff. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 15 One file examined contained a doctor’s letter, which stated, “There is no baseline assessment recorded by the home to show and compare levels of deterioration in the patients mental health and behaviour. Although staff claimed deterioration had occurred in the last six months there was no evidence in his care plan.” The acting manager does not carry out monthly reviews of care plans, risk assessment or medication audits in the home and stated Boots pharmacy complete twice-yearly audits of medication. The area manager was spoken to after inspection and advised about the concerns regarding care plans, job descriptions, management and staff roles and was advised these were currently being addressed. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Residents are consulted and protected from abuse and neglect. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this home. EVIDENCE: Staff have training in protection of vulnerable adults (POVA). However staff need training in learning disabilities, autism, restraint and challenging behaviour management as the home currently accommodates some residents’ with these conditions. The CSCI has received two anonymous complaints since the last inspection regarding the acting manager which was being investigated by the registered provider and one complaint at the home from a neighbour, however this had been addressed but not been responded to by the acting manager at the time of inspection in line with the homes polices and procedures. The acting manager stated she was to follow up the complaint in the very near future. There was no evidence on the file of any outcome. Records of incidents and accidents were examined and all incidents in the home had been recorded appropriately. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,28,30 The home is registered to accommodate 9 residents but has only sufficient communal and private space for 8. Residents live in a clean environment, which is safe and decorated to a fair standard. There is no private room for residents to entertain relatives and friends and repairs take too long. Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this home. EVIDENCE: The home was clean, comfortable but not welcoming, bright or homely. Since the last inspection the homes’ premises have declined in décor and now in need of urgent refurbishment. The inspector spoke to the acting manager and registered provider following inspection regarding the very small laundry and option of changing registration to accommodate 8 residents to allow for a second communal room for accommodated residents who are of wide age range. The home does not have an appropriate sensory room or private interview area for residents who may wish to speak to relatives and friends in private. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 18 The homes acting manager has not produced a suitable maintenance and renewal programme as recommended at the last inspection. One staff member stated “the homes’ oven was out off order for three months after Christmas before it was repaired. The acting manager takes too long to do things.” However a new handy man has been employed to carry out work two days a week in the home. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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. Staff are competent and trained to meet residents needs but need further training and clarity in their roles and responsibilities. Quality in this outcome is good. This judgement has been made using available evidence including a visit to this home. EVIDENCE: Staff appeared to meet the needs of residents accommodated. The number of staff on duty appeared sufficient to meet residents’ needs and the staff rota matched the numbers of staff on duty. The home has only one full time vacancy but the acting manager stated these hours are used to employ agency staff. At the time of inspection one agency staff member was on duty and the inspector requested evidence of his suitable employment checks but these were not available. The acting manager was advised to seek all verification checks of all agency staff employed in the home prior to employment. There was some confusion over staff roles and responsibilities as the home employs an assistant and deputy manager. These issues were being looked at by the homes area manager and identified in the last regulation 26 report. It was noted residents were very relaxed with the core staff team on duty who had a good knowledge of residents’ needs.
Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,40,42,43. An acting manager runs the home to ensure residents’ needs are met but the home has not progressed since the last inspection and managerial duties were not complete. The homes premises could be made more secure and safe in regard to fire regulations. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this home. EVIDENCE: The acting manager has not progressed the home since the last inspection. Many management roles had not been completed or had allocated to other staff members and not followed up. . The area manager is currently working with the staff and acting manager to address these issues. The acting manager had not received supervision until recently and therefore not further training needs identified. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 21 Some staff was unhappy with the approach of the acting manager and her lack of hands on approach to residents. It was observed the acting manager did not accompany residents on days out or work with residents very much, but remained in the homes office. Staff stated they are able to approach the manager and give their views and opinions about care but stated “changes are seldom implemented unless they do it themselves.” Staff morale appeared had declined since the last inspection and staff spoken to stated although there were ongoing issues they worked well as a team together to meet residents’ needs. The lounge has a patio door which cannot be locked at night because it is a fire door and staff felt this compromised the security of the home plus the garden has fire exit stairs without appropriate non slip treads and lighting. The garden gate is locked by padlock and key, which may compromise emergency evacuation in the event of a fire. The acting manager was advised to purchase a combination lock for the garden gate as soon as possible and seek advice from the fire department regarding the fire exit and stairs. Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 2 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 LIFESTYLES Standard No Score 11 2 12 3 13 2 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 X 2 2 X 2 2 X 2 2 Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA1 YA6 Regulation 5 24 Requirement The service users guide should be updated to include changes in staffing and management. The acting manager must ensure care plans reflect the changing needs of residents and are reviewed monthly. Residents have more opportunity for personal development and friendships in the community. The home with the inclusion of residents must offer them the opportunity for more organised days out/annual holiday. Regular one to one key working sessions should be evidenced in care plans. The acting manager must update individuals’ wishes in relation to illness, death and dying. The homes premises must be kept in good state of repair, reasonably decorated and refurbished to a good standard. This is repeat requirement. Timescale 1/12/05 and 01/06/06 not met. The home must provide adequate comfortable spacious communal and private areas for
DS0000036988.V296072.R01.S.doc Timescale for action 01/09/06 01/09/06 3 4 YA11 16 2 (n) (m) 16 2 (n) (m) 15 15 2 (b) 23(2) 01/09/06 01/10/06 YA13 5 6 7 YA18 YA21 YA24 01/09/06 01/09/06 01/09/06 8 YA28 23 2 (e) 01/10/06 Kingston House Version 5.2 Page 24 residents. 9 YA39 39 The acting manager must seek the views and opinions of residents their relatives and other significant others and complete a quality assurance and monitoring report to demonstrate how the service is to progress. A copy of the report should be sent to the CSCI. This is repeat requirement Timescale 01/06/06 not met. A fire log must be kept with weekly drills; times of fire drills and appropriate maintenance work to ensure the home is safe and secure. This relates to fire exits, lighting and metal fire exit stairs in the garden. The homes policies and procedures must be followed when dealing with any complaints in the home. The acting manager must receive adequate supervision and training to help improve the running of the home. 01/09/06 10 YA42 23 (4) 01/03/07 11 YA40 22 01/09/06 12 YA43 9 01/09/06 Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA9 Good Practice Recommendations Risk assessments should be updated for residents with regard to one to one care, behaviour management and activities outside the home. This is a repeat recommendation. The home should provide more recreational activities in the home for residents, which include staff participation. This is a repeat recommendation. The home should arrange regular residents meeting to seek their views and opinions with regard to choice and activities. This is a repeat recommendation. A copy of the last inspection should be displayed in the home for residents, staff, visiting professionals and their relatives to see. The home should produce a maintenance and renewal programme for the home. A copy of which should be sent to the CSCI. This is a repeat recommendation. The home could employ a domestic to clean difficult areas in the home including high ceilings, windows and paintwork. Staff should receive training in restraint, challenging behaviour, autism and learning disabilities. The acting manager should spend more time interacting and working alongside residents. Residents must be able to take risk as part of their independent lifestyle. This refers to ensuring residents are given the opportunity to try new skills according to their age and wishes. Staff and managers roles and job descriptions must be made clear. 2. 3. YA12 YA22 4. 5. YA23 YA24 6 7 8 9 YA30 YA35 YA43 YA9 10 YA31 Kingston House DS0000036988.V296072.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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