Inspection on 14/12/05 for Kingswood House

This inspection was carried out on 14th December 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Kingswood House 24/04/08

Kingswood House 30/04/07

Kingswood House 09/06/06

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Kingswood House Mays Hill Road Shortlands Bromley Kent BR2 0HY Lead Inspector Wendy Owen Unannounced Inspection 10:00 14 December 2005 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kingswood House Address Mays Hill Road Shortlands Bromley Kent BR2 0HY 020 8460 0273 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) Shaw healthcare Ltd ** Post Vacant *** Care Home 41 Category(ies) of Dementia - over 65 years of age (15), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (25) Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 12 of the 25 places designated OP are for those receiving rehabilitative care. 8th June 2005 Date of last inspection Brief Description of the Service: Kingswood House is one of 6 homes which from April 1 2005 have seen a change in the registered provider, Shaw Healthcare. The organsiation has a number of residential and nursing homes throughgout the UK and has its organisational headquarters in South Wales. Kingswood House is a large purpose built care home situated in a quiet residential area on the outskirts of Bromley. The Home provides twenty-four hour care to a maximum of 41 service users. It has been developed over the last few years into a respite and rehabilitation unit, providing care to elderly service users and a small number who have a diagnosis of dementia. This year has seen the closure of the rehabilitation unit. Discussions are currently being held as to the future of the unit between the Local Authority and Shaw Healthcare. Residents placed in the home are admitted via the social services departments or case of rehabilitation unit, via the PCT. The accommodation at Kingswood is set on three floors on three separate units. Each unit has private and communal accommodation. The main kitchen and laundry are on the ground floor, which also comprises the main offices.The Home’s kitchen provides a catering service to another residential Care Home in the area. The building itself is owned by the London Borough of Bromley, which means the Home has to approach the landlord for issues relating to the premises and the grounds. Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over two half days, on 8/12/05 and 14/12/05. Day one of the inspection was undertaken by the Pharmacy Inspector and day two by the Care Inspector. The inspections included viewing of records; observations of staff practices, a tour of the home, and discussions with staff. This inspection also includes details relating to previous visits made on 31/7/05 and 1/11/05. What the service does well: What has improved since the last inspection? What they could do better: Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 6 Medication practices still require further improvement to ensure service users are fully protected. Care plans were extremely poor and together with the lack of assessments, place service users potentially at risk. The soap dispensers in core locations must be refilled to ensure risk of cross infection is minimised. Activities need to be more consistently provided and there is a need for improvement in some of the maintenance and redecoration. The staffing numbers for the day and night must be reviewed which must also take into consideration the particular needs of the respite service. Recruitment practices must be improved and the core training provided needs to ensure this includes monitoring of staff to ensure they are competent. 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. Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 & 6 The admission practices do not provide enough information on which to base a decision to admit service users to ensure they care are cared for appropriately. EVIDENCE: The organisation has good pre-admission procedures. However, it is evident that these are not being followed by the home. The procedures require an assessment of the prospective service user prior to admission. Whilst this occurs, the files of the last two service users admitted had no record of the assessments taking place. They contained a very basic referral provided by the Care Manager but little else. This does not give staff the information to enable them to care for the service users or develop care plans reflecting the care they require. This standard was also inspected during a visit of 31/07/05 with the same findings and a requirement raised during this time. (See requirement 1) During the pre-admission service users may view the home, although the choice for service users is restricted due to the block contract of the Local Authority. Since the last inspection last inspection the intermediate care unit has closed leaving the rooms vacant until decisions are made how best they may be used. Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Care plans and medication practices and procedures do not contain the information and guidance for care staff to understand service users needs, provide adequate care, support or promote the health, safety and well-being of service users, placing service users potentially at risk. EVIDENCE: The Pharmacy Inspector undertook an inspection of the medication procedures on 8/12/05 as part of the inspection process. The home had not updated the policies and procedures for medicines as required by the previous inspection although apparently this was in progress. No daily audits of MAR charts were seen and it was not clear that these were still being done. Records of receipt were available for most medicines, and records of disposal of medicines were good. The home was using a mixture of computer generated administration charts and hand written charts. The hand written charts were much clearer than those seen at the previous inspection, but the charts were not initialled to show that they had been checked by a second person for Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 10 accuracy. Some medicines were found in the drug trolley that were not entered onto the administration records. Morning doses had not been signed for one service user although they had been administered. Where variable doses were prescribed, the amount actually administered was not recorded. Some service users had two charts but they were not marked “1 of 2” and “2 of 2”. The rehab beds had moved to another site and this unit was not being used at the time of inspection, although the refrigerator and CD cupboard in the medicine room of this unit were being used. The home was using a mixture of monitored dosage systems and traditional bottles where there was insufficient time to obtain medicines in the monitored dosage system from Boots. Digital thermometers had been obtained but these did not measure minimum and maximum temperatures and the probes were sited in the ice boxes of the refrigerators rather than in the main refrigerator compartment. Photographs were not available for all service users. On the day of inspection the morning medicine round had been completed when the inspector arrived at 10.15. There had been no training on medicines since the last inspection. Polices and procedures relating to medicines were currently being reviewed as required by the previous inspection. (See requirements 2,3, 4 & 5) The inspection of June 2005 highlighted the need for the home to provide a designated person responsible to the oversee the respite admissions together with a review of the respite procedures. There has been some improvement in the procedures and a Deputy Manager has been in place to support the Area Manager in managing the home. However, there is still much improvement required, especially relating to the staffing levels and the workload of support staff. Please see the comments relating t staffing levels. Care plans were extremely poor and in some cases non-existent. This is not surprising considering the lack of assessments. One service user’s risk assessment highlighted high risk of pressure sores but no action or intervention recorded by the home; two service users’ file contained no care plan at all developed by the home and another did not detail any MRSA or interventions required despite all the equipment and resources in the individual’s room and evidence that they may have had MRSA previously. Daily records for one showed a hospital appointment but nothing in the care plan to detail why treatment was needed and another detailed DN visits but no care plan to support the reason for the intervention. There was no record of the home weighing service users on admissions. The inspector has been informed that the organisation is reviewing the care plan system in light of the special needs of the respite service. However, these issues have been brought up at the previous inspection and there has been no improvement to date. Vital core information has not been recorded to enable staff to provide the care required and may present risks to service users or inappropriate care. These standards were also inspected during a visit of 31/07/05 with similar findings. Requirements were raised at this time. (See requirement 6 & 7) Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 11 A previous night-time visit found the home relaxed with service users asleep and bedrooms doors closed to ensure their privacy. There are no double rooms. During this inspection staff were observed undertaking personal care tasks discreetly and with respect to the individual’s dignity. However, one room had clearly on display, equipment required to undertake personal care for someone with MRSA. This does not respect the dignity or privacy if the service user, especially as there was no evidence that the service user still had this infection. (See recommendation 1) Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 13 Activities are not provided consistently to ensure service users are stimulated on a regular basis. EVIDENCE: The home has an Activity Co-ordinator who works in the home Monday-Friday. The daily records showed little evidence of activities taking place with one file recording nothing on the activities since July 2005. On the day of the inspection the Activity Co-ordinator was in the process of moving activity items to the dining room on the vacant rehabilitation unit. No activities were taking place and had not been undertaken on the days previously due to sickness. The home must review the time spent on actual involvement in activities with service users rather than other tasks. There must be a record to show the activities provided and service users involved. (See requirement 8) The last inspection suggested the home review the placing of the hot trolley (on the lower ground floor) during the meal times. The hot trolley is located in the small unit kitchen and meals served from there. This meant the service users were left unsupervised at various times. The re-location of the trolley to the dining room area would enable staff to serve, monitor and assist service users. The inspector re-iterated the suggestion and agreed the Deputy Manager assisting in the home at present. (See recommendation 2) Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 13 On both days of the inspection visitors were observed in the home chatting to residents and appearing relaxed. The nature of respite care provision is that both carer and cared for have a break and therefore the regular visiting of family members is not as it would be for those residents in permanent placements. Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home has improved its complaints system and there is some evidence that service users views are listened to and acted upon. EVIDENCE: Since the last inspection there has been some improvement in the recording of the complaints. Those viewed recorded the investigation, action taken and outcome. There is a need to ensure that the investigations are completed within the required timescale. The Commission has not received any complaints regarding the home over recent months. Previous visits to the home have provided evidence of how the home protects service users. The organisation has clear guidelines and procedures which must be followed when any incident or allegation is raised. There is evidence that these procedures have been followed and appropriate agencies informed. However, there is some evidence to suggest that staff would benefit from the time to read and fully understand these procedures. Staff are provided with adult protection training during induction Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23, 24,25, 26 The standard of environment is satisfactory providing a attractive and homely place to live. Further improvements and monitoring will enhance the quality of life for service users and ensure potential risks are minimised. EVIDENCE: The interior of the home looked adequately maintained and decorated, although some of the communal lounges and dining rooms are in need of decoration and the vacant rehabilitation unit needs to be redecorated and made more homely, prior to further admissions to the unit. One of the toilets also needs the light fixture repaired or replaced and the pipe-work in another also requires boxing in. (See requirement 9). The inspector noted the changes made in the reception area, which now provides comfy furniture and is arranged to make a warm and welcoming area for visitors. Most of the bedrooms were of a good size and were well furnished and contained the furniture needed for residents in the home for short- term care. Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 16 The home was clean and free of odours, although there is a need to ensure the toilets soap dispensers are replenished, when empty. A relative informed the Pharmacy Inspector, on the day of her inspection, that a WC had no soap in the dispenser. A few days later, during this inspection, the dispenser remained empty. The domestic assistants were asked immediately to replenish the dispenser and did so. This was also true of the laundry room. There must be a system in place for ensuring these basic tasks take place. (See requirement 10) The laundry area equipment is suitable to the needs of the home and handwashing facilities in place. However, as stated above, there was no soap in the dispenser. Many items in the laundry lacked the names of the residents whilst some of the clothing was named the service users had since returned home. (See recommendation 3) Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Staffing levels must be reviewed and permanent support and senior staff recruited to provide a consistent standard of care. EVIDENCE: At the time of the inspection there were nine service users on the dementia unit and eleven on the physical frail unit. The roster for the week commencing 11/12/05 showed five support staff and a team leader on duty during the day shift and one senior and two support staff at night. The last visit which was undertaken at night required the home to increase its staffing at night due to the lay out of the home, the visits during June and July 2005 also raised this as a concern. Requirements were raised at these times. This has not been done. There is still a high number of agency staff used, especially senior staff. The inspector also found the staff rosters difficult to interpret, especially asoften there were names missing. Discussions with staff on the ground floor unit highlighted the continuing issues of the workload of staff, in relation to the respite care admissions and discharges. The unit has two support staff with a Team Leader “floating”. The lack of a laundry assistant on many days also contributes to the increased workload. During respite admissions and discharge days, staff must not only care for the current clients but also undertake the checks required for the transferring of service users either into or out of the home. Previous reports have detailed these issues and required changes in the staffing. These changes have not occurred. The inspector understands that the Area Manager has reviewed the staffing levels required but the organisation has not yet Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 18 agreed these. The visit undertaken on 31/7/05 highlighted concerns regarding staffing where a number of staff had not arrived for their shift at the allotted time and the current staff leaving their completed shift. This left the home at risk with reduced staff numbers and also no allocated time for a handover of the previous shift. A member of staff spoken to during this inspection showed very little understanding or knowledge of their job role despite having had induction training. (See requirement 13) The home has a care staff team of twenty-eight care staff with fifteen having achieved NVQ 2 (three of these have now achieved NVQ 3). The Deputy Manager has achieved NVQ 4 in Care, the Joseph Rowntree qualification and is now undertaking the Registered Managers Award. Discussions with permanent staff showed that the standard of training has improved since the new organisation took over. Specifically, core training, such as moving and handling; health and safety and First Aid. Recruitment procedures were inspected with only one new member of staff employed recently. The file viewed was missing essential documentation regarding the checks required. There was no evidence of a Criminal Records Bureau or POVA check. There was no employer’s reference even though employment details, although limited, were recorded on the application form; no interview schedule; and a reference from a guardian, which is not appropriate. The application form was not fully completed and nor were gaps explored. (See requirement 12) Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 38 The lack of Registered Manager does not adequately promote or protect service users health, safety and well-being or provide a basis for continuous improvement in the quality of care. EVIDENCE: The Acting Manager has, since the last inspection, left the home. The home has had no Registered Manager since July 05 and currently the Area Manager is overseeing its management, along with support from a Deputy Manager. The Commission has raised concerns about the length of time the post has been vacant and the increased responsibilities of the Area Manager. This must be addressed as soon as possible. (See requirement) Staff commented on the improved morale over recent months and how supportive and approachable the Deputy Manager has been since she joined the team at Kingswood House. The recent staff meeting also commented positively on the changes made in recent weeks. The requirements raised Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 20 during the inspection of June 05 have now been implemented with safety checks completed regularly. Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 1 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X X Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 Requirement The Registered Person must ensure that service users admitted to the home are fully assessed prior to admission and a record of the assessment maintained by the home. Previous requirement with timescale of 01/09/05 Policies and procedures for leave and for verbal orders are reviewed and revised in line with NMC guidelines. (This was a requirement of the previous two inspections). Current policies are clearly identified and readily available to staff All medicines are listed on administration records including those administered by the district nurse. Directions hand written onto administration records are checked and initialled by a second member of staff (This was a requirement of the previous two inspections). When variable doses are prescribed, the amount actually administered is recorded. (This DS0000063942.V259419.R01.S.doc Timescale for action 01/01/06 2 OP9 13 01/01/06 3 OP9 13 01/01/06 Kingswood House Version 5.0 Page 23 4 OP9 13 5 6 OP9 OP7 13 15 7 OP8 13 8 OP12 16 9 OP19 23 was a requirement of the previous two inspections). Administration records are complete without gaps. (This was a requirement of the previous two inspections). If service users have more than one administration record this is clearly marked at the top of each record sheet. Photographs are available for 01/01/06 each service user. A minimum and maximum thermometer is obtained and positioned correctly in each refrigerator. The minimum, maximum and current temperature is recorded daily. (This was a requirement of the previous two inspections). Staff adherence to policies and 01/03/06 procedures relating to medicines is audited regularly. The Registered Person must 01/02/06 ensure care plans are developed for all service users admitted to the home. The care plans must reflect the needs of the service users. This is an outstanding requirement with the timescale of 01/09/05 expired. The Registered Person must 01/02/06 develop risk assessments for any areas of identified need including pressure care. The risk assessment must record the appropriate action to minimise the risk. This is an outstanding requirement with the previous timescale of 01/09/05 expired. The Registered Person must 01/04/06 ensure that appropriate activities take place for service users and a record of these activities must be made. The Registered Person must 01/04/06 carry out repair and redecoration of the bathroom areas. DS0000063942.V259419.R01.S.doc Version 5.0 Page 24 Kingswood House 10 11 OP26 OP27 13 18 12 OP29 17 13 OP30 18 Specifically, the pipework must be covered and the light fitting fixed. The Registered Person must ensure soap dispensers are refilled when empty. The Registered Person must review the staffing levels and excessive use of agency staff. This is an outstanding requirement with previous timescales expired. The Registered Person must ensure that the required recruitment checks are made prior to employing new staff. The Registered Person must ensure that, at all times suitably qualified, competent and experienced persons are working at the care home. All new staff must receive induction training and have their competency assessed before caring for residents unsupervised. This requirement was not inspected during this inspection. 01/01/06 01/01/06 01/01/06 01/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP10 OP15 Good Practice Recommendations The equipment used for the protection of staff from infection should be kept discreetly in service users’ rooms. The location of the hot trolley on the ground floor should be relocated to provide a more convenient location for the assistance and monitoring of service users. . Service users’ clothing should be clearly labelled. 3 OP10 Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Kingswood House DS0000063942.V259419.R01.S.doc Version 5.0 Page 26 - 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. 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