Inspection on 31/05/06 for Kingstone House

This inspection was carried out on 31st May 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingstone House 21/10/09

Kingstone House 29/11/07

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 Kingstone 121 London Road Burgess Hill West Sussex RH15 8LU Lead Inspector Mrs M McCourt Unannounced Inspection 31st May 2006 09:30 Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 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 Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 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. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kingstone Address 121 London Road Burgess Hill West Sussex RH15 8LU 01444 245063 01444 245063 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) Evesleigh Care Homes Limited Mrs Anna Theresa McGowan Care Home 20 Category(ies) of Learning disability (20), Learning disability over registration, with number 65 years of age (20) of places Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of service users accommodated should not exceed 20 at any one time. New registration Date of last inspection Brief Description of the Service: Kingstone House is a care home registered to accommodate up to twenty Service Users with learning disabilities. The Registered Provider is Evesleigh Care Homes Ltd and the Registered Manager is Anna McGowan. The current weekly charge is between £850.00 and £1,188.07. This information was provided by the manager at inspection. Additional charges are made for personal items, such as; toiletries, chiropody, hairdressing, activities, transport and so on, with Service Users asked to contribute towards holidays; the amount requested dependent on their means and the type of holiday taken. The home is made up of three detached properties located next door to each other. Kingstone house has the capacity to accommodate twelve people, Cleveland House comprises of three 2-bed independent apartments, each with their own kitchen, sitting/dining room and bathroom and to the rear of these two properties is The Lodge which houses two self-contained flats. All of the accommodation is situated a short walk from Burgess Hill’s town centre, and therefore is accessible to all community facilities, including rail and bus stations. Each resident has their own bedroom complete with en suite toilet facilities, some with showers. In addition there is also a large walk-in shower on the ground floor of Kingstone House. Kitchens, dining rooms and lounge areas are well maintained and decorated to a high standard. The home is also in the process of developing an activity room at Kingstone House. External grounds are enclosed for security purposes and consist of a tarmac area and a small lawn with seating. The Service Users Guide and Statement of Purpose, which incorporates inspection reports, are both located at the home and are accessible to Service Users, staff, relatives and anyone else interested in the service. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection was undertaken by one Inspector on Wednesday 31st May 2006 and lasted a total of seven hours. Pre-inspection planning took approximately two days. A full tour of the building took place and included the observation of Health and Safety matters, hygiene issues, decorative order and a general overview of the atmosphere created within the home. Three staff members, four residents, the Registered Manager, the deputy manager and the Responsible Individual were spoken to at the time of inspection. Case tracking was carried out by examination of relevant records and information held on the staff and residents spoken with during the course of the inspection. Policies and procedures were examined both prior to the inspection, received with the pre-inspection document, and during the site visit. What the service does well: What has improved since the last inspection? The home does provide a good level of care for Service Users, although at this inspection it was not possible to highlight any one standard that has improved. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 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. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 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 Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 The outcome for Service Users was found to be good. Service Users are consulted about where they choose to live prior to moving, and are confident that the home will meet their individual needs. Individual contracts for Service Users are in place and have been signed by both the Service User, or representative and the manager of the home. EVIDENCE: The home has an admissions/referral procedure and a Trial Visits Policy in place. The procedure states the process to be followed when considering a Service User’s placement, and includes; tea visits, overnight and weekend stays, followed by reviews to confirm the appropriateness of the placement. It was not stated on the document when it was last reviewed. Discussion with staff revealed that several people had been considered for the vacancies at the home, and the company recently held an open day to generate interest. Two contracts were looked at. Both were found to contain fees and were signed by the Service Users. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 9 Statement of Purpose and Service Users Guide were in place at the home and accessible to interested parties. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 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 and 9 The outcome for Service Users was found to be good. Service Users needs and personal goals are reflected in their care plans, although the plans should be reviewed on a more regular basis. Service Users are assisted to make decisions about their own lives, which includes taking responsible risks. Risk assessments need to be kept up-todate in order to be effective. EVIDENCE: The Inspector examined two personal files for Service Users. Care plans and risk assessments are located in separate folders. Care plans cover issues such as behaviour, although at least two care plans looked at had not been reviewed since last year. Risk assessments for three Service Users had over run their review dates also. Risks identified included; scalding, sexual abuse, road safety, epilepsy and escaping from a moving car. Monthly review reports have been carried out regularly. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 11 The Service Users’ meeting agenda was on the wall in the dining area. It was advertising the next meeting on 9th June and topics for discussion were holidays, day trips out and any worries or concerns. Meetings are held regularly, almost every month. Subjects discussed include seasonal matters (Christmas, Easter, etc), holidays, activities, money and so on. Keyworkers advocate for those Service Users who cannot speak for themselves. A missing persons form, detailing all relevant information about the individual was in place on personal files. The Inspector spoke with several Service Users in order to obtain their views on life at Kingstone. Staff support Service Users to make decisions about their lives and to accept risks as part of achieving an independent lifestyle. Two Service Users spoken with confirmed that they go out on a daily basis, into Burgess Hill town centre for a cup of tea, or fish and chips. Earlier in the day the Inspector had seen them walking into the town. One Service User currently living at the home is having difficulty obtaining written records of identification. The Registered Manager said that she does hold details of an advocacy agency, but currently the Service User involved does not have a named advocate. The Inspector was of the opinion that independent advocacy should be sought soon to ensure independent support it provided. Staff files looked at did contain a confidentiality contract. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 12 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): 12, 13, 15, 16 and 17. The outcome for Service Users was found to be good. Service Users have opportunities for personal development. Service Users are able to take part in a range of appropriate activities within the local community. Service Users are supported with family relationships and guided to develop personal friendships. Meals are varied and nutritious. EVIDENCE: The Inspector spoke with several Service Users in order to obtain their views on life at the home. Staff support Service Users to make decisions about their lives and to accept risks as part of achieving an independent lifestyle. Some of the Service Users who live at the Kingstone are very capable in their abilities and therefore able to make decisions on the activities they take part in. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 13 During the inspection, two of the Service Users returned from a shopping trip to the nearby town centre. They told the Inspector that they go out nearly every day to the shops or for something to eat. Service Users are given the choice on whether they wish to go on holiday or not. Some of the residents are planning a holiday away, whilst two have chosen to stay at home and partake in several day trips to places of interest instead. All the Service Users spoken with are aware of the keyworker system in place and would know who to complain to if they wanted to. There were positive comments about the food, with residents telling the Inspector that they really like the food at Kingstone, especially the roast dinners. A picture menu is used in the dining area to help Service Users understand what meals are on offer. This was seen by the Inspector to be a good example of a communication aid. That evening ham, egg and chips was planned for the evening meal, and two Service Users told the Inspector how they were looking forward to this meal. A large activity board is on display in the office showing various activities, such as; swimming, cookery, Millstone (a rural day centre), shopping, household chores and so on. The Service Users’ meeting agenda was on the wall in the dining area. It was advertising the next meeting on 9th June and topics for discussion were holidays, day trips out and any worries or concerns. It was noted during the course of the inspection that Service Users living at the home are often called by terms of endearment rather than their proper names. There is no reference or agreement to alternative names being used in individual files and therefore the Inspector was of the opinion that unless otherwise stated, Service Users should be called by their preferred choice of name. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 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 and 20. The outcome for Service Users was found to be adequate. Service Users receive personal support in an appropriate manner and suited to individual need. The home is able to provide physical and emotional care to individuals. A review of medication administration, storage and recording procedures must take place. EVIDENCE: Two personal files were examined by the Inspector and included; funeral wishes, behaviour charts, sleep charts, weight charts, personal profiles, activity timetables and daily care notes. Care plans are in place for various activities and are reviewed, although not as regularly as they should be. Risk assessments are in place for activities such as; cooking, road safety, travelling in a car, seizures and so on. These are also reviewed, but again had over-run their review dates. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 15 Assessments from placing authorities were seen from West Sussex County Council and Surrey County Council. Monthly reports are compiled, checking that individual health and wellbeing is monitored. Medication is stored in a locked cupboard. There were some signature gaps on MAR sheets and several discrepancies in the storage of the medicines. A number of prescribed creams had no pharmacy label on the tube or the box. This was also the case for PRN paracetamol that had also not been audited. A prescription of Lorazepam had not been booked in and there was no identifying label on it. Cough medicine, Lactulose and surgical spirit liquids had all been opened but not dated. For two lots of prescribed medication there was a discrepancy between the quantity recorded and the actual amount held. One ointment prescribed on 7.12.04 should have been discarded. The Registered Manager told the Inspector that there is currently no reviewing system in place. The registered provider must ensure that appropriate steps are taken to remedy this situation and a requirement has been made in respect of this. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 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 and 23. The outcome for Service Users was found to be good. Procedures are in place to ensure complaints are dealt with appropriately. Systems are in place to protect Service Users from abuse, neglect and selfharm. EVIDENCE: The Commission has not received any complaints in respect of this service. The complaints policy and procedure were both available, although it was noted that the policy refers to the National Care Standards Commission instead of the Commission for Social Care Inspection. The PIQ completed by the Registered Manager states that there have been no complaints registered at the home. The complaints log at the home contains one entry and this was dealt with in an appropriate manner and found to be unsubstantiated. Records examined during the inspection demonstrated that ¾ of the staff team have received training in recognising signs of abuse and how to report any concern. Staff and Service Users spoken with confirmed that they would speak to the manager if they had any concerns or problems. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 17 Training records looked at during the inspection demonstrated that staff do receive Adult Abuse training and are aware of how to recognise signs of abuse. A missing persons policy is in place with details of the individual concerned. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 18 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, 25, 26, 27, 28, 29 and 30. The outcome for Service Users was found to be adequate. Whilst Service Users live in a comfortable and safe environment, the home would benefit from a maintenance and renewal programme. Infection control and food hygiene guidelines are in need of review by people qualified to do so. Service Users bedrooms suit their needs and promote independence. EVIDENCE: The Inspector conducted a tour of the premises, which started at Kingstone House. The Inspector looked at some rooms that were occupied, with permission, and all of those that were vacant. One Service User showed me her very pink room, which had been decorated to suit her colour preferences. She had two fish in a fish tank and was very happy to show them to the Inspector. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 19 Another bedroom looked at was quite musty smelling and the carpet was stained with urine. Staff told the Inspector that they were going to hire an industrial cleaner for it. The inspector queried whether a more permanent solution should be sought, such as changing the floor covering. The home is currently working with staff from the Martyn Long Centre, and together they are working to support the Service User with some behavioural problems. Aside from these issues, the room and the toilet were in need of redecorating and the staff said that it was next on the list to be improved. The toilet in particular lacked ambience and was musty. The sink also needed cleaning. The fire door leading from the room was open. Although it was thought that the Service User herself probably opened it, the Inspector considered it a security risk. In addition, a window in the room was dusty and had cobwebs on it. The Inspector also noticed that there was a large gap around the edge of the window frame, where it does not close properly. There was a draught coming through the gap, despite it being a mild day. The shower room on the ground floor is a walk in wet room. On the day of inspection this smelled very mouldy and damp. On closer examination, it had black mould patches all round the top of the door area. In addition the flooring has come away from the wall in two separate places, allowing water in. The bathroom/toilet on the ground floor also had no toilet paper in it. It is also in need of re-decoration. The paintwork was stained with greasy marks and the walls are badly scuffed. There was a lot of dust on the radiator and dirt behind the toilet and sink. In addition, the taps to the sink did not show which was hot or cold because the top to the hot tap was missing and the other one had no colour symbol on it, despite a sign alerting people to the water being very hot. The room smelled musty and the bin was not working. The kitchen door leading through into the corridor is constantly banging as staff and Service Users go in and out. It is very distracting and annoying. The Registered Manager said that the issue is being addressed. The maintenance person is due to fit door closers onto several of the doors within the home where there is a repeat of this problem. Examination of the fridge found all food to be labelled. However, staff were not following the storage guidelines displayed beside the fridge. Eggs were being kept on the 3rd shelf down, not the top as stated on the guidelines. In addition raw meat is supposed to be stored on the shelf above the salad draw. The Inspector was of the opinion that this is not good practice. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 20 On inspection of the laundry room, a complicated system of colour coding has been implemented, which is very difficult to remember. This was proved moments later when one of the cloths that should have been used for the toilet was in fact being used in the kitchen, around the sink area. It was confirmed to the Inspector that the system is not user friendly and therefore it should be reviewed immediately. The mop and bucket system was also difficult to understand, with three different colours of mop to be used in two different coloured buckets. However, the Inspector pointed out that putting the blue mop in the red bucket was no different to using the red mop, which was also supposed to only go into the red bucket. The Registered Manager and deputy manager agreed to review this system. The remaining rooms empty rooms in Kingstone were bright, clean and well maintained. One of the empty rooms is being transformed into an activity room and is in the process of being decorated. In Cleveland House all rooms are vacant. They were all seen to be clean, tidy and bright. A fire testing log book was seen and has not been filled in since 2004. The Lodge consists of two self-contained flats. These are empty also. On the day of inspection they were seen to be nicely decorated, bright and cheerful with modern fixtures and fittings. The deputy manager told the Inspector that there is no renewal and maintenance programme in use currently. During the tour of the building the Inspector identified an issue regarding one of the residents who puts lots of toilet tissue into the toilet, resulting in the toilet becoming blocked at times. In order to rectify this, staff had adopted a system of withholding toilet tissue until the Service User requested it. The Inspector was of the opinion that whilst the situation is a difficult one to address, it is not appropriate or acceptable to deny basic toiletries as a way of dealing with the issue and the matter must be reviewed. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 21 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): 32, 34 and 35. The outcome for Service Users was found to be good. A competent and qualified staff team is appropriately trained to meet the individual needs of Service Users. Recruitment policies and procedures are in place and sufficient to ensure Service Users are protected from harm. EVIDENCE: Training records demonstrated that all staff had undertaken a wide range of training from induction through to National Vocational Qualifications level 2 & 3. Training in Health & Safety topics had been undertaken at induction and updated as required. Specific training in topics relevant to the needs of the service users had also been undertaken. Members of staff confirmed that this training had been provided and that updates in Health & Safety topics are forthcoming. The staffing policy states that it can guarantee a ratio of two staff to four Service Users. The Inspector discussed this with the Registered Manager, as although it is possible to meet these numbers whilst the home only has seven Service Users, would the ratios be sustainable if the service was at full Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 22 capacity? The Registered Manager said that she didn’t think the company would be able to honour this guarantee, and that there are times now when there are only two staff working with the seven Service Users. If this is the case, then the policy needs to be re-written. The Inspector examined two sets of staff files. Training records show that staff are offered a wide range of training from induction through to NVQ level 3. Training includes Health & Safety, Manual Handling, Physical Intervention, Diabetes, Autism, Makaton, Adult Protection, Fire, Report Writing, Food Hygiene, 1st Aid, Epilepsy, Medication and Challenging Behaviour. During the inspection it came to the Inspector’s attention that one of the Service Users was admitted to hospital several weeks earlier after suddenly not being able to weight bear. The hospital was planning to discharge her, but staff are unable to care for her until they have had appropriate training in using a hoist, which she is going to have to use regularly. The Registered Manager is working hard to ensure staff are equipped with the correct training in order to assist this particular Service User. Recruitment records demonstrate that the Registered Manager follows a robust recruitment procedure. The two files looked at contained two written references, CRB checks, job descriptions, a confidentiality agreement, a probationary period and a contract. A displayed supervision planner shows that staff receive regular, planned supervision and issues such as keyworking, personal and general work matters are discussed. Staff spoken with also confirmed that they receive regular supervision and staff meetings are usually held every six to eight weeks. A keyworker system is in place. Service Users spoken with confirmed that they knew who their keyworker was. Staff told me how they help the Service Users with health appointments, activities and personal and/or family relationships. Staff meetings are held every six to eight weeks on average and issues such as training, Health and Safety, maintenance, Service Users and staff issues are discussed. Health professionals can and do attend to give advice. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 23 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, 41 and 42. The outcome for Service Users was found to be adequate. The manager should consider implementing a more specific quality audit tool to improve the home’s ability to self-monitor and develop, ensuring Service Users’ views and those of family and relatives are sought on a regular basis. Health and safety procedures should be reviewed by the Registered Manager, particularly food hygiene and infection control procedures. Accidents and incidents should be reviewed regularly in order to prevent repetition and/or to highlight where further assessments need to be carried out. EVIDENCE: The Registered Manager, Ms Anna McGowan is working toward NVQ level 4 and once completed she will apply to do the Registered Manager’s Award. Ms McGowan has been in post for eighteen months, with six months as the deputy Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 24 manager prior to becoming the RM. She told the Inspector that she has seventeen years experience of working with people with learning disabilities. A survey has just been conducted for Service Users, staff, care managers and next of kin. The results have been compiled and published for the conference held on 2nd May 2006. A copy of the report has been received by the Inspector. There is no other form of quality assurance within the home. Information on storing food within the fridge hygiene was on display, although this had not been followed. The two COSHH cupboards located within Kingstone House were both locked. However, in the laundry room one hazardous product was found up against the washing machine in an empty cupboard. The can is not supposed to be exposed to temperatures of more than 50 c. Policies and procedures are in place, although it was noted from the PIQ that many of these have not been reviewed since 2004. The Registered Manager told the inspector that the Administration Manager has forwarded new policies to the home since recently. These are headed with the name of the new company and have all been reviewed recently. The accident book was looked at and contained nineteen incidents/accidents logged back to July 2005. There were seven incidents of aggression by a Service Users towards staff, eight falls, two burns, one fainting and one banged knee. The Inspector suggested that the Registered Manager implement a reviewing programme to ensure that accidents are monitored in order to see if any of them could be prevented. Records kept in the office are in need of culling and tidying. on files goes back over years and could be archived. Information kept Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 25 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 3 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 3 26 3 27 2 28 3 29 3 30 2 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x 3 x 2 x 3 2 x Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 26 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 YA20 Regulation 13(2) Timescale for action The registered person shall make 31/07/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Requirement 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 Refer to Standard YA16 YA24 YA30 Good Practice Recommendations (16.5) - Staff use Service Users’ preferred form of address, which is recorded in the individual plan. (24.6) - The premises are safe, comfortable, bright, cheerful, airy, clean and free from offensive odours and provide sufficient and suitable light, heat and ventilation. (30.1) – The premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation, published professional guidance and the purpose of the home. (39.6) – Feedback is actively sought from Service Users (with support from independent advocates as appropriate) about services provided through e.g. anonymous user DS0000066070.V290988.R01.S.doc Version 5.1 Page 27 4 YA39 Kingstone 5 YA42 satisfaction questionnaires and individual and group discussion, as well as evidence from records and life plans and informs all planning and review. (42.2) - The Registered Manager ensures safe working practices including: (iv) food hygiene – correct storage and preparation of food to avoid food poisoning and (v) infection control – understanding and practice of measures to prevent spread and of infection and communicable diseases. Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Kingstone DS0000066070.V290988.R01.S.doc Version 5.1 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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