CARE HOMES FOR OLDER PEOPLE
Kington Court Health and Social Care Centre Victoria Road Kington Herefordshire HR5 3BX Lead Inspector
Sandra J Bromige Unannounced Inspection 18th February 2006 9:45 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 Kington Court Health and Social Care Centre DS0000066097.V283939.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 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. Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Kington Court Health and Social Care Centre Address Victoria Road Kington Herefordshire HR5 3BX 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) 01453 546746 01453 544218 Blanchworth Care Ltd Mrs Thembelihle Claries Nzama Care Home 48 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (37), of places Physical disability over 65 years of age (3), Terminally ill (1), Terminally ill over 65 years of age (1) Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The Registered Manager`s span of management control is limited to the registered care home facility only. The minimum staffing levels to be maintained for Unit 1 (Eardisley), with 16 places for older persons requiring personal care to include a maximum of 6 dementia places (DE/E) must be 360 separately rostered care hours per week. The minimum staffing levels to be maintained for Unit 2 (Logan Jack & Staunton Wings), with 32 places for care with nursing to include a maximum of 3 physical disability (PD), 1 terminal illness (TI) , 1 terminal illness (TI/E) and 27 older persons (OP) must be 981 separately rostered care hours per week. All care staff employed to provide care for service users, with dementia and as part of the Home`s mandatory training, must begin NVQ Level 2, Unit CLI & W2 within the first 6 months of employment. 3. 4. Date of last inspection Brief Description of the Service: Kington Court is a care home providing personal care and accommodation for 16 older people, 12 Intermediate care places, 8 older people and 4 for people under the age of 65 and 20 nursing places for older people. In total it is registered to accommodate 48 residents. It is owned by Blanchworth Care Ltd. The Home is located on the outskirts of a small market town of Kington, close to shops, and other amenities. The Home was purpose built and opened in June 2003 and consists of a twostory building, which was built to provide a Health & Social Care centre for the town and surrounding rural area. The care home facilities are entirely situated on the first floor of the building with the exception of a lounge/dining area that is downstairs. The care home is divided into three units; Eardisley (personal care), Logan Jack (Intermediate) and Staunton Wing (nursing). The Home offers 46 single rooms, and one double room, all with en-suite toilet and shower facilities. There is a passenger and a service lift provided. The Home has gardens at the rear and to the side of the building that are accessible via the ground floor lounge/dining area or outside via an entrance off the care parking area. Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by two inspectors over 5.75 hours on Saturday 18th February 2006. Information has been obtained through observation of parts of the premises and care practice. Some residents’ records and staff training records were seen. A number of residents’, visitors and staff were spoken with including the manager (designate) who was on duty. Comment cards were sent to the Home for distribution to residents and relatives in July 2005. There were no comment cards on display at the entrance to the Home for relatives and visitors to pick up and complete. Only one comment card has been received from one relative and none from any residents. Comment cards have been sent out to visiting professionals to the Home. Too few comment cards have been received to date to be able to draw any general conclusion from this exercise. A follow up pharmacy inspection was carried out in December 2005 by the Pharmacy Inspector and a report sent to the owner. This is available to the public upon request. The requirements and recommendation from this report have been actioned by the Home. An incident regarding adult protection has taken place since the last inspection. This is being investigated by the local multi-agencies for the Protection of Vulnerable Adults with the full co-operation of the owner of the Home. Since the last inspection, the owner has investigated the complaint about the staffing levels on Staunton Wing. The outcome was that the complaint was upheld. The Commission wrote to the owner requiring them to ensure that there are sufficient staff on duty at all times to ensure that the residents are not placed at risk. The Commission has received five notifications since the last inspection informing of staff shortages on an identified shift. Two of the occasions took place on Christmas Day and New Years Day, the last occasion being 9th January 2006. None have been received since that date. What the service does well:
The Home is clean and well maintained. Staff are welcoming, helpful, jolly and pleasant towards visitors to the Home. Residents said that the staff are ‘all very nice, very obliging’, ‘very friendly’ and ‘very kind’. Residents indicated that they liked it at the Home. Residents seen all appeared comfortable, they were well dressed, their clothes were clean and nicely laundered and their hair was tidy, glasses clean and men
Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 6 were cleanly shaven. Hot and cold drinks were available to residents throughout the day. Staff are aware of the care needs of the residents. The food looked and smelt very appetising. Residents said that the food is ‘very nice’ and ‘the staff come round with a choice’. Meetings are held in the Home for residents to attend to enable them to give feedback on the service. These meetings are chaired by someone independent to the Home and are not attended by any staff from the Home. What has improved since the last inspection? What they could do better:
The sample contract in the Home’s Service User guide and the contracts of residents who need nursing care must be reviewed, as they need to include details about the ‘free nursing care’ payments for residents. All trained nurses particularly on the intermediate care unit must be trained in the setting up and use of syringe drivers by a professionally recognised trainer. This will ensure that they have the skills to set up and use this equipment to keep residents comfortable in the later stages of life. Residents’ and/or their representatives must be consulted about their individual care plans and their agreement sought. Risk assessments for the moving and lifting, falls, diet, skin care and the use of bedrails must be fully Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 7 completed to identify any potential problems and should be reviewed each month or more often if an incident happens to see if the care needs have changed. The risk assessments for the use of bedrails must be further developed to show that the Home has considered all areas of potential risk to the residents and that the equipment is suitable for use with each individual resident and suitable for the type of bed that it is being fitted too. Care plans must be further developed to include how the social and emotional care needs of the resident are being met. The serving and feeding arrangements must be reviewed to ensure that each course of the meal is served hot (where applicable) to each resident. The dessert should not be served at the same time as the main course, so that it remains hot or chilled (as applicable) and it also ensures that there is more supervision of residents by staff when they are eating meals in their bedroom. Staff must ensure that all residents are given a choice of meals and not choose for them according to their known likes and dislikes of food. Staff must have further training about abuse to ensure that local procedures are followed at all times when abuse is suspected. It is strongly recommended that the Herefordshire Adult Protection Co-ordinator be asked to provide this training in the Home for all staff. The numbers of staff provided for the Staunton Wing must be reviewed to ensure that there are sufficient staff at all times to give the care needed by the residents and to ensure the safety of staff. Staff must received regular supervision to ensure that they have the correct skills and knowledge to care for the residents. 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. Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 8 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 Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 9 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): 1, 2 & 4 Residents’ contracts still do not provide clarity of information for prospective and current residents regarding the ‘free nursing care’ payments. Sufficient training is still not being provided for all of the trained staff on the intermediate care unit to ensure that the specialist needs of residents admitted for palliative care will be met by the Home. EVIDENCE: The Service User guide on display at the entrance to the Home is dated March 2005. This is not the most recent version of this document. Three residents contracts were seen during this visit. All of the residents had been living in the Home for over 6 months. The two contracts for the residents in the nursing unit did not contain any information about the payment of the ‘free nursing care’ payments and neither of the contracts had been signed by the resident or their next of kin. Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 10 Recent training has taken place in the Home about the use of syringe drivers by a representative of St. Michaels Hospice. The manager (designate) confirmed that 5 trained nurses attended this training and the cost of the training was funded by the five staff that attended the training. The training records of two trained nurses who also work on the intermediate care unit showed that neither of these nurses have attended any training or training updates for the use of syringe drivers since May 2003 & October 2004 respectively. Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 11 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&9 Social care plans are not in place to show that the individual residents’ social and emotional care needs are being met. Individual risk assessments need to be reviewed on a regular basis to ensure that any potential risks to residents are identified and acted upon. Systems and procedures are in place for the management of medication to ensure residents are not at risk. EVIDENCE: Care records from all three units were seen. recording in the care plans continue to improve. Overall the standard of the Some aspects of the care plans still need to be improved. Care plans need to be reviewed in consultation with the resident and/or their next of kin. If residents are declining to be involved in this review, this should be recorded. There are no social care plans in place. Risk assessments are not all being reviewed each month and are not being routinely reviewed following a fall or incident involving bedrails. It is strongly recommended that risk assessments be reviewed each month, as they are an integral part of the care plan. Bedrail risk assessments do not give clear
Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 12 information to staff about the type and frequency of the checks that they need to make to ensure that they are safe for the individual resident and the compatibility with that type of bed. The Medical Device Agency guidance for the safe use of bedrails is available in the Home, although not all trained staff were aware of this guidance. This was discussed with the manager (designate) at the time of the inspection. A care plan identified that the resident must be weighed each week, but there was no evidence to show that this had been done. Wound charts prescribing treatment to ensure consistency of care are not being used at all times when a wound is identified. There was also no evidence of an identified wound being reviewed according to the instructions on the wound chart. A pharmacy inspection took place in December 2005 and the three requirements and one recommendation from this visit have been implemented. Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 13 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 & 15 The recreational interests and needs of the residents are not being fully explored and recorded to ensure that their social and emotional care needs are being met. A more varied menu is now being provided to enable residents to exercise choice and control over what they eat. EVIDENCE: The Home employs an activity co-ordinator who works Monday to Friday in the Home. There is no one employed to co-ordinate activities in the Home at weekends. The notice boards list activities as follows: - daily – various with the activity co-ordinator, weekly – quiz & arts & crafts, monthly – music/movement & communion. Residents spoken to indicated that they enjoyed the entertainment provided by the activity co-ordinator. On the day of the inspection there were no organised activities taking place in the Home. Residents were observed watching the television, reading the newspaper or enjoying a conversation with their visitors. In the lounge on Staunton Wing the television was on, although the majority of the residents were asleep in their chairs. A visitor arrived to see one lady and they sat talking and enjoying a glass of sherry together. Residents are able to receive visitors at any time, including well-behaved dogs. Visitors were seen throughout the Home visiting residents in the privacy of their bedrooms.
Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 14 Staff reported that they are expecting to be able to use the training room as a second sitting room and dining room for the residents on Eardisley in the next two weeks. As the current dayroom facilities for this unit are split between two floors of the building and pose problems with supervision due to staffing arrangements. Social care plans are not in place for each resident, although some good personal profiles were seen in the residents care plans. Activity logs for individual residents are used. Two care records had no activities recorded since October 2005. The format for displaying the menus has been revised since the last inspection. They are now displayed daily instead of weekly. On the day of the inspection the daily menu was not on display. During the morning of the inspection the cook put on the notice board a copy of the weeks menu, but this was a poor photocopy and difficult to read. On the two nursing units the residents were offered a choice of menu for lunch and dessert that day. On the residential unit only 5 residents were asked for their choice of menu for lunch that day. Staff reported that they only ask some people what they want because sometimes they know people so well they know what they like and dislike. This is poor practice. The serving of meals was observed on all three units. All the main courses and desserts on Staunton Wing come out from the kitchen in a hot trolley preplated and are served by the care staff in the unit. Residents were eating in the dining room, lounge and in their bedrooms. The main course and dessert were served to each resident at the same time, whether they were sat at the dining table, eating in their bedroom or being assisted to eat their lunch. This practice took place on all three units. This is poor practice. The cook serves the main course of the meal from the top of the hot trolley for Logan Jack & Eardisley. The temperature of the food was checked with a thermometer before and during service and the temperature of the main course was satisfactory. The temperature of the hot dessert was not being maintained during service as it was sat on the table in the kitchen and was being served at the same time as the main course with no cover when being transported to the residents’ rooms or the dining room. Residents were observed being assisted to eat in their bedrooms on a one to one basis and in a discreet and sensitive manner. Residents were observed being assisted to eat in the lounge. Staff were assisting two residents, they were sat beside the residents. The two staff were observed talking to each other and they both got up to assist another resident with their lunch. This is not good practice. The majority of residents spoken with indicated that they liked the food served at the Home.
Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 15 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): 18 No progress has been made in the provision of staff training about the local procedures for Protection of Vulnerable Adults to ensure that the correct procedures are followed to protect the people living at the Home from abuse. EVIDENCE: No training has taken place for staff on the local procedures for the Protection of Vulnerable Adults since the last inspection. A recent adult protection incident has taken place in the Home and is being investigated by the multi-agencies. At the outset of this incident, neither the manager (designate) or staff at the headquarters of the organisation followed the local procedures for the Protection of Vulnerable Adults. Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 16 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): None of these standards were assessed. EVIDENCE: Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 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 The deployment and numbers of staff on duty in Staunton Wing are not sufficient, which has the potential to place residents’ and staff at risk. EVIDENCE: On the day of the inspection there were sufficient staff on duty on Eardisley and Logan Jack. On the day of the inspection there were 15 residents on Staunton Wing. On duty was the manager (designate); a second trained nurse and 2 care staff until 1.00pm. The nurse covering the minor injuries unit worked on the unit between 7-8 am and also helped with residents who needed assistance to eat at lunchtime. The two care staff on duty in the morning went off duty at 1.00pm leaving the two trained nurses only on the unit to care for 15 residents until the one carer returned to be on duty at 3.00pm that afternoon. At 3.00pm in the afternoon, neither of the two trained nurses on duty had been able to take a lunch break and when the carer came on at 3.00pm, one of the trained nurses went off for her lunch break, leaving 2 staff on duty on the unit. At 3.00pm the manager (designate) had been unable to take a lunch break and would not be able to until another trained nurse returned to the unit. Poor outcomes were noted during the inspection for the residents as staff did not have sufficient time to spend with the residents providing activities for stimulation and residents were not being supervised in the lounge, as a visitor was observed going to find staff as a resident was asking to be taken to the toilet. None of the residents had access to a call bell to summon assistance from the staff.
Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 18 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): 36 & 38 Care staff are not being individually supervised at regular intervals to ensure that they have the competence and experience to carry out the care needs of the people living at the Home. Procedures have improved since the last inspection in order to promote and safeguard the health, safety and welfare of the people living in the Home. EVIDENCE: The manager (designate) has submitted a registered manager application to the Commission for consideration. This is being processed. It was evident that the manager (designate) was well known by the visitors on Staunton Wing. When the Inspectors asked about staff on duty in the Home that morning, the manager (designate) knew there were three staff on Eardisley but she was not aware of who the staff were. Formalised supervision is not in place for care staff working in the Home.
Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 19 The last inspection report strongly recommended that the bath and shower temperatures are taken prior to immersion of the resident and are recorded as part of the residents care records. The recommendation was made by the Commission as good practice for the protection of the Home in the event of an incident of scalding, as without the temperature being recorded they do not have any documented evidence that staff are checking water temperatures. The Providers action plan states that they do not record water temperatures on residents care records, as their policy does not require this action. Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 20 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 2 2 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 2 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 1 X 3 Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 21 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 OP1 Regulation 5 Requirement Timescale for action 31/03/06 2. OP2 5A 3. OP4 18 4 OP4 18 The Service User guide must be further developed in line with Regulation 5 and Standard 1 to include the information in the contract about ‘free nursing care’ payments. Brought forward amended, timescale of 28/02/05 & 31/12/05 not met. The contract must be reviewed 31/03/06 in line with this Regulation with regard to any nursing contribution paid in respect of nursing care. Timescale of 31/01/05 & 31/12/05 not met All registered nurses must be 31/03/06 trained in the setting up and use of syringe drivers by a professionally recognised trainer. Timescale of 28/02/05 & 31/12/05 partly met. A registered nurse must not be 28/02/06 left in sole charge of the unit, when a syringe driver is in use, until they have received the training required in requirement No. 5. Timescale of 21/11/05 not met.
DS0000066097.V283939.R01.S.doc Version 5.1 Kington Court Health and Social Care Centre Page 22 5 OP7 15 6 OP7 13 7 8 OP7 OP15 15 12, 16 9 OP18 12, 13 10 OP27 18 11 OP36 18 The care plan must be reviewed in consultation with the resident and/or their representative. Timescale of 31/01/06 not met. Risk assessments for the use of bedrails must be reviewed to ensure that all potential risks are being considered. Timescale of 30/11/05 not met. Care plans must show how the social & emotional care needs of the resident are met. Serving and feeding arrangements must be managed to ensure food remains hot. Timescale of 28/02/05 & 31/01/06 partly met. All staff must receive further training and instruction on the recognition, reporting and referral of residents who are suspected of suffering abuse in line with the local procedures for the Protection of Vulnerable Adults. Timescale of 28/02/05 & 31/01/06 not met The staffing levels for Staunton Wing must be reviewed. Timescale of 30/11/06 partly met. Staff must receive regular formalised individual supervision. 31/03/06 31/03/06 31/03/06 28/02/06 31/03/06 28/02/06 30/04/06 Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations It is strongly recommended that individual residents risk assessments for moving and handling, falls, nutrition, skin care and the use of bedrails must be fully completed upon admission and reviewed each month for all residents. The main & dessert course for meals should not be served at the same time, to enable the temperature of the dessert to be maintained prior to being eaten and to ensure that there is more supervision of residents by staff when the residents are eating meals in their bedroom. It is strongly recommended that the Herefordshire Adult Protection co-ordinator should be asked to provide training in the Home on the local procedures for the Protection of Vulnerable Adults. 2. OP15 3 OP18 Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 Kington Court Health and Social Care Centre DS0000066097.V283939.R01.S.doc Version 5.1 Page 25 - 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!
