Inspection on 19/09/06 for Kingston Residential Care Home

This inspection was carried out on 19th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 20 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingston Residential Care Home 01/06/07

Kingston Residential Care Home 08/11/05

Kingston Residential Care Home 18/07/05

Kingston Residential Care Home 25/09/04

Kingston Residential Care Home 19/04/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Kingston Residential Care Home 27-31 Westbrook Road Margate Kent CT9 5AU Lead Inspector Clair Brown Unannounced Inspection 19 & 25 September 2006 10:30 th th Kingston Residential Care Home DS0000023485.V317641.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 Residential Care Home DS0000023485.V317641.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 Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingston Residential Care Home Address 27-31 Westbrook Road Margate Kent CT9 5AU 01843 292412 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) info@craegmoor.co.uk Parkcare Homes Limited Mrs Joanne Jeavons Care Home 21 Category(ies) of Learning disability (21), Physical disability (7) registration, with number of places Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th November 2005 Brief Description of the Service: Kingston provides residential accommodation and care for adults with differing degrees of learning disability. The service users may have an additional physical disability. The Home, owned by a large Company, is a Victorian terraced property on three floors. It is situated in a residential area of the seaside town of Margate and is within walking distance of all local amenities, including the seafront and local shops. There is on road parking to the front of the property. The Home provides 24-hour staff cover, including staff on wake-duty at night. There is always a senior member of staff on duty or on call, to deal with any queries or emergencies. The health care needs of the residents are met by the local primary health care team. The fees are: £767.13 to £1,364.44 per week. Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection consisted of an unannounced visit to the home on 19th & 25th September by one inspector the duration of the visit was 8 hours. The inspection takes account of information received from a variety of sources including written information from the registered providers, service users, staff and general practitioners. The previously made requirements and recommendation from other inspections were inspected and all key standards. Comment cards were completed sent to the service users & GP’s, no service users responded and only 1 GP completed the survey. The inspector spent time observing the interactions between service users and the care staff. A tour of the premises was conducted. Documents and records were seen and service users files were case tracked. What the service does well: What has improved since the last inspection? Staff were interacting with service users and the home was seen to be clean. The home continues to undergo refurbishment resulting in the communal rooms (lounges) being redecorated and new carpet laid. The fire signs have been produced in pictorial format and appropriately situated to assist service users in the event of a fire. Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 6 What they could do better: 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 Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 7 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 Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 25 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The contract fails to provide service users with clear details of the terms and conditions of living at the home and what services they will receive. Prospective service users have their needs fully assessed and recorded prior to admission to the home. EVIDENCE: The most recently admitted service users file was case-tracked, this included a pre-admission assessment conducted by the registered manager and other documentary evidence of her then gaining further information about the service users needs from relevant parties prior to admission. The file also contained the copy of the service user contract which fails to inform them of their rights and what services the home provides for the fees paid and what is not included in the fees. Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users files provide the majority of the information required to provide care to meet service users needs. Service users are supported to make choices and decisions about their life. Confidential information is stored securely. EVIDENCE: Two service users files were case-tracked, both contained care plans, including specific sections on challenging behaviour. These records identified a variety of care needs that were quite holistic in the areas covered, however these still did not contain all of the service users needs or provide sufficient instructions on how to meet them, for example some of the service users require hoists and other movement and handling equipment, although this need is clearly recorded in the care plan it does not inform the reader of what type of hoist is used, what size of sling and specifics about equipment. The care-plans for challenging behaviours do not include possible triggers to behaviours and Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 10 appropriate actions to take in the event of these behaviours. A care plan summary has been produced which is kept in service users bedrooms to ensure staff have access to this information when providing the care. There was limited evidence available in the care plan & records to demonstrate that service users are supported with decision making processes about their care, although the registered manager was able to provide information about current circumstances where a service user is being supported whilst making life changing decisions. For 11 of the 12 service users the registered provider is the appointee for managing their finances the remaining service users’ family is appointee. The home does have service user meetings and the cook explained how she is able to meet with service users to discuss the menu and the preferences. Records were seen to be stored appropriately. Kingston Residential Care Home DS0000023485.V317641.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. JUDGEMENT – we looked at outcomes for the following standard(s): 11 12 13 14 15 16 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are supported to participate in activities of their choice and to attend further education. Service users are supported in their personal relationships and to maintain contact with friends & relatives. A nutritionally balanced diet is provided, ensuring those with specialist dietary needs are met, however choice of food on a daily basis is limited and not supported by regular assessments. EVIDENCE: The diversity of the needs of the service users has an impact on the range of activities available and providing those appropriate to their abilities. Some service users have individual timetables for their daily activities and others are generally available to all, these include Music Man, Exercise for All, attending college and day centre. Some service users have not been awarded places at college this year. Service users are also supported to develop independent living skills, by using the skills kitchen for learning to make drinks and cooking Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 12 meals although the area appeared as though it was not in regular use, this area of personal development was not always linked to the care plan. The service users pay for their week’s annual holiday but the company pays half of the staff wages. The registered manager was able to demonstrate through discussion how they are supporting a service user who has a relationship with a service user at another care home and have expressed a wish to marry. The learning disability team, family and health care professional have been involved in providing support and advice to the couple, as well as ensuring that both parties are able to understand and consent to future plans. The cook was able to demonstrate that the home provides for those with special dietary needs, she has written details of every service users preferences and special requirements. The cook meets regularly with service users to find out what they would like on the menu. She was enthusiastic and passionate about the quality of the food provided and showed the inspector how she makes everything from fresh and does not use processed food. Therefore when service users expressed a wish to have chicken nuggets the cook made them with fresh produce. The food budget has been reduced to compensate for the cooks over spend last year. Currently no second option is provided (although omelettes and salads available) but cook stated she found this difficult with the constraints of the budget. The home does not have a nutritional assessment tool to monitor the service users nutritional status. Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 21 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home monitors health needs but these are not supported by health assessments. Medications practices are unsafe and potentially place service users at risk. Plans are being made for the care needs of the ageing service users. Staff do not respect the privacy & dignity of the service users. EVIDENCE: A carer was showing the inspector around the building, the carer would consistently open the bedroom door & then knock on the door. On one occasion the door was opened wide to a bedroom to reveal a service user sitting on the commode with one carer standing with the service user in the bedroom, neither of the staff reacted in anyway, nothing was said by the carer in the room about closing the door and no acknowledgement from the carer conducting the tour to the fact the lady was being exposed to the public whilst using the commode. The inspector had to request for the door to be closed to maintain some dignity & privacy for the lady. Service users who require Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 14 continence aids privacy and dignity is not maintained as these were seen to be left out on the bedroom floor. The service users files provided evidence that that the home works closely with the learning disability team and health care professionals to meet their healthcare needs. These are well documented and show that there is ongoing monitoring of the service users general health status. However, the home is not using assessment tools for monitoring skin integrity and nutrition (nutrition - standard 17). A medication audit was conducted with a member of staff. This raised a number of serious concerns relating to practice and storage. The home carries an excessive amount of medication for the service users resulting in some of it having expired. Other medication was found with no prescription label on it. There was sufficient evidence to question whether service users were receiving all of their prescribed medication, some tablets remained in blister trays despite being signed as given on the MAR chart, the remaining volumes of liquid medicines did not correspond with the volume issued and the quantity that should have been administered and the records. Some of the storage units were not appropriate, and internal and external medicines were being stored together. There is no equipment provided for the safe transportation of medicines around the home. The registered manager discussed the work they are undertaking with the relevant borough to review the needs of one of the elderly service users. It was discussed that moving the service user should be a last resort decision and that the home should work towards meeting their needs if appropriate and possible. Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The procedures for handling allegations of abuse do not protect the service users. EVIDENCE: The home has not received any complaints in the last year and the service users have not responded to the inspection surveys. Staff were seen to interact with service users through out the course of the inspection visit, the service users appeared relaxed and comfortable with their interactions with the staff. The home has a complaints procedure. The homes adult protection policy includes an aide memoir that states the companies internal investigation of any allegation of abuse should be completed before social services are informed, this practice wrong and does not protect the service users. Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 25 26 28 30 Quality in this outcome area is adequate . This judgement has been made using available evidence including a visit to this service. The home has benefited from some refurbishment and the implementation of a maintenance programme. Infection control procedures need improvement. EVIDENCE: The home provides single bedded accommodation for all of the service users. The home is currently registered for 21 service users but only has the capacity to accommodate 17. The 5 vacant bedrooms were locked and were being or due for refurbishment. The home now has a 3 year maintenance programme in place. The communal areas such as the lounges have been decorated and had new carpet laid. The main part of the home was seen to be clean, however some areas such as the laundry and the laundry store room were in a poor state and needed serious attention to be infection control procedures and condition of the environment. The linen and duvets in the linen store were not Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 17 fit for purpose, full of holes and stacked on the floor, the room was dirty had signs of a water leak. The dishwasher in the main kitchen has not worked for over a year. The skills kitchen had a strange odour and appeared as though it hadn’t been used for some time. The clinical waste bins were not stored securely. Bedrooms that had been refurbished were individual and personal, staff had used their knowledge of service users likes and interests to choose the décor of their rooms, one loves Thomas the tank engine and this was reflected in their bedroom. Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32 33 34 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recruitment procedures for employing staff are thorough. There are sufficient numbers of care staff provided to meet the needs of the service users. Staff have not completed adequate training and have not put into practice knowledge and skills gained through training. EVIDENCE: The most recent member of staff employed file was assessed, this provided evidence that the home follows a thorough recruitment procedure, ensuring all of the required checks are obtained prior to them starting work. At the time of the inspection visit only one member of staff (the deputy manager who is on maternity leave) has obtained the NVQ level 2 in care. The registered manager stated that over 50 of the care staff are enrolled on the NVQ training course. There are four care staff on duty during the day with additional 1:1 support provided at times during the week and two waking carers at night. The care staff are also rostered to cover the cleaning duties and cooking at the weekends. The home currently provides care for six service users who user wheelchairs and more that may require two carers for Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 19 transfers and care, therefore it is recommended that the manager monitors the staffing levels and service users needs closely. There was no evidence of a dependency tool in use to assist with this. The training matrix only covers mandatory subjects and confirms that staff have not attended any training relating to caring for those with learning disabilities. The poor practices identified during the course of this inspection visit relating to the administration of medication provides evidence that staff are not always putting into practice the training they have undertaken. Kingston Residential Care Home DS0000023485.V317641.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37 38 39 40 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager has the appropriate skills to meet the demands of the role. The home has only a limited quality assurance programme. The majority of the environmental health & safety checks are satisfactory. EVIDENCE: The manager has previous experience of managing a staff team and has worked with older people and has expertise in fields covering mental health needs and learning disabilities. The manager is also currently in the process of completing the RMA award. The staff were comfortable speaking with the Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 21 inspector and encouraged to be involved in the inspection visit by the registered manager. Hot water temperatures at sinks are not tested and recorded, some hot water is running cold and there is no system to prevent possible scalding. The home has an electrical certificate however it does not have a recommended date for the next test. All other environmental certificates were seen to be in date. The Quality Assurance Process is conducted by an appointed person from the company, they gather information from the home and the Reg 26 visits are conducted by the area manager. Audits are carried out both internally and by head office. However, at the time of the inspection visit, no annual quality assurance has been conducted for this year. None of the processes for quality assurance discussed with the registered manager indicated that the views of those who live at the home are sought. The policies and procedures files showed that these are produced by the company and are generic throughout the business, a number of these are produced for homes providing nursing care and talk of nursing duties, for example the Care of the dying - last offices procedure reads “nurses” and gives incorrect instructions for a care home and it’s staff. Kingston Residential Care Home DS0000023485.V317641.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 X 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 2 27 X 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 3 LIFESTYLES Standard No Score 11 2 12 2 13 2 14 2 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 1 2 1 3 2 3 2 2 X 2 X Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 23 Yes 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. Standard YA5 Regulation 5 Requirement The service user contract needs to include details of what services are provided for the fees paid. That risk assessments continue to be undertaken as care needs are reviewed and activities developed for each service. Previous timescale: 31/12/05 Care plans must identify all of the service users needs, include clear instructions on how to meet those needs, all staff must refer to the care plan, especially when writing the daily reports. Care plans must be regularly reviewed and information from assessments cross-referenced to the care plan. Documentation must record the service users decision-making process and the support provided. Those service users being supported to develop independent living skills and/or have personal goals must be DS0000023485.V317641.R01.S.doc Timescale for action 31/01/07 2. YA2 15 31/01/07 3. YA6 12 13 15 31/01/07 4. YA7 12 13 15 31/01/07 5. YA11 12 13 15 16 31/01/07 Kingston Residential Care Home Version 5.2 Page 24 6. YA14 17 worked towards and supported by recorded evidence. The cost of a week’s annual holiday for the service user must be included in the fees, therefore paid for by the company. All service users must have regular nutritional assessments completed. 30/03/07 7. YA17 12 -16 31/01/07 8. 9. YA18 YA19 10. YA20 A second hot meal option must be provided at the main meal of the day. 12 16 18 Staff must treat service users with respect & dignity at all times. 12 - 16 17 Health care needs must be met, sch 3 including using appropriate health assessments such as skin integrity. 12 - 17 That the dispensing of sch 3 medication is in line with guidelines set by the Royal Pharmaceutical Society. The home must use a safe & secure means of transporting medication around the home. The staff and registered manager must ensure that service users receive all of their prescribed medication. None medication items must not be stored in the medication cupboard. Internal & external medicines must be stored separately. A second medication cupboard must be provided to store the medication appropriately. Records must be kept when medication leave and return to the home for service users social 30/11/06 31/01/07 31/01/07 Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 25 activities. Action must be taken to rectify the excess stock levels of medication and a procedure introduced to prevent reoccurrence. Out of date medication must not be used. The medication room must provide hand-washing facilities and the glass be obscured The adult protection procedure must comply with current legislation & practice. The laundry & linen room must be made fit for purpose. Bed-linen and duvets must be fit for purpose. Infection control procedures must be adhered to in all areas of the home. The registered manager to use an appropriate dependency tool for assessing the dependency levels of the service users. Duty rotas must include staffs name and designation as well as their hours worked. Staff must complete all of the required training course as well as other specialist training relevant to the needs of the service users, including learning disabilities. All staff must have individual training programmes. The quality assurance process must gain the views of those who use the service and other relevant parties. The registered manager must ensure this years quality assurance programme is undertaken and completed. Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 26 11. 12. 13. 14. 15. YA23 YA24 YA26 YA30 YA33 12 13 17 20 23 sch 3 12 13 23 12 13 23 12 13 16 23 17 sch 4 31/01/07 31/01/07 30/11/06 30/11/06 30/11/06 16. YA35 12 13 18 30/03/07 17. YA39 21 22 24 30/03/07 18. YA40 12 13 17 24 The registered manager must review the homes policies & procedures and ensure they are relevant and appropriate to the home and the needs of the service users. The registration certificate to accurately reflect the bed numbers in the home to meet requirements and ensure the full safety of service users. Previous timescale: 31/12/05 Action must be taken to make the door to the cellar safe from possible falls. Action must be taken to regulate, test and record the hot water at all sink, baths and showers, ensuring water is delivered at the required temperature 43’. The registered manager must gain written confirmation of the timescale for the next electrical inspection/test Clinical waste must be stored in accordance with current legislation, the registered manager to contact the environmental health or infection protection agency for clarification. 30/03/07 19. YA41 23 31/01/07 20. YA42 12 13 17 23 sch 3 & 4 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000023485.V317641.R01.S.doc Version 5.2 Page 27 Kingston Residential Care Home 1. 2. Standard YA14 YA20 For the activities programmes to meet the variety of needs, abilities and preferences of the service users. To check with the manufacturers if the medication cupboard complies with legislation for storing controlled drugs. To purchase a new British National Formulary. Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingston Residential Care Home DS0000023485.V317641.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!