CARE HOMES FOR OLDER PEOPLE
Kington St Michael Residential Home 81 Kington St Michael Chippenham Wiltshire SN14 6JB Lead Inspector
Elaine Barber Key Unannounced Inspection 18th August 10:20 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 St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Kington St Michael Residential Home Address 81 Kington St Michael Chippenham Wiltshire SN14 6JB 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) 01249 750737 Mr Jitendra Kumar Singh Tirbhowan Mrs Sashtee Teelucksingh-Tirbhowan Mrs Sashtee Teelucksingh-Tirbhowan Care Home 9 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (9), Old age, not falling within any other of places category (9) Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Only the two named male service users in the category DE referred to in the application dated 3rd November 2005 may be accommodated in the home. Once these service users reach the age of 65 the service user category DE will no longer apply. 20th December 2005 Date of last inspection Brief Description of the Service: The home is situated in the village of Kington St Michael in a large building, parts of which date back to 1660. The home is registered for older people and older people who have had a diagnosis of dementia. The home is adjacent to the pub and the village provides many amenities. The home is owned and run by independent providers, Mr and Mrs Tirbhowan. During the waking day there is a minimum of two staff who are involved in cooking and cleaning as well as care. There are two members of staff sleeping in at night. There is a set of steps from the pavement to the front door although there is level access to the rear of the property. All the bedrooms are single accommodation and have en-suite facilities save one, which has its own nearby private toilet. On the ground floor there is a large sitting room, separate dining room, kitchen, toilet, laundry facilities, one of the bedrooms and an office. The first floor is accessed by two sets of stairs, one with a stair lift. To the rear of the home there is a garden with a large level patio. The fees range between £350 and £450 per week. Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection included two visits to the home on 31st July 2006 and 7th September 2006. The visit on 31st July was unannounced. During the visits information was gathered using: • • • • Structured observation Discussion with people who lived in the home Discussion with staff Reading records. The manager provided information prior to the inspection about the running of the home. The judgements contained in this report have been made from all this evidence gathered during the inspection, including the visits. Feedback was given to the provider on 7th September 2006. What the service does well:
Each person’s needs were fully assessed and their health, personal and social care needs were set out in their individual plans to ensure that their needs would be met. Each person had an individual plan and a record of the outcomes that they wished to achieve from living in the home. Risks were assessed and action was identified to manage any risks. Each person also had a manual handling assessment to ensure they were assisted appropriately. A care plan was still being developed for one person who recently moved into the home. Their health care needs were being met. People saw health care professionals such as the GP, district nurse and dentist when they needed to. People were protected by the home’s policies and procedures for dealing with medicines. The pharmacist advised about medication and all medicines were appropriately stored and recorded. People were assisted to take their medication when they required help. Staff knocked on people’s doors and sought permission before entering. Personal care took place in private. People had their own rooms and private toilet facilities. People felt that they were treated with dignity and respect and their right to privacy was upheld. People found that the lifestyle in the home matched their expectations and preferences. There was a range of activities in the home and people took part in them as they chose. There were also outings and recently people had been to Weston-super-Mare. Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 6 People kept in contact with family and friends and representatives of their local community as they wished. People said that they had visits from family members or went to see relatives. Representatives from local community groups visited. People had opportunities to exercise choice and control over their lives. They chose where to spend their time and whether or not to take part in activities. Some people managed their own finances. People had a wholesome appealing and balanced diet served in pleasant surroundings at times convenient to them. People said that they enjoyed the food and they were consulted about the menus. There was a complaints procedure and everybody had been reminded about how to make a complaint. People knew that their concerns would be listened to, taken seriously and acted upon. People said that they were satisfied with the service and had no complaints. There was a policy about abuse and information about the local multi-agency procedures for safeguarding vulnerable adults. Staff had received training about the prevention of abuse. People were protected from abuse. The home was decorated and maintained to a high standard. The communal areas were light and airy. There was a dining room and a separate lounge where people liked to sit and play games or watch television. There were laundry facilities and infection control procedures. The home was clean and hygienic. There were two members of staff on duty at all times. Three of the staff had worked in the home for many years and were familiar with people’s needs. These staff also had National Vocational Qualification level 2 in care. Two new members of staff had been recruited and one had NVQ level 2. A range of training was provided. People’s needs were met by the numbers and skill mix of staff. People benefited from staff who were qualified, trained and familiar with their needs. There was a recruitment policy and this was followed for most staff. On the whole people were supported and protected by the home’s recruitment policy and practices. The manager had an appropriate qualification and experience and kept her training up to date. This ensured that people lived in a home run and managed by a person who was fit to be in charge and of good character. The home was run in people’s best interests. There was a quality assurance system. The manager had conducted a survey of people’s views and written a report of the findings. She had then produced a development plan from the findings and identified several improvements to the service including the redecoration and new carpets.
Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 7 The manager handled small amounts of money on behalf of some people and managed the finances of one person. Appropriate records were kept of all transactions so that people’s financial interests were safeguarded. The health, safety and welfare of service users and staff was promoted and protected. There was a health and safety policy and there was a wide range of health and safety measures. What has improved since the last inspection? 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. Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 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 St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 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): 3 Quality in this outcome area was good. This judgement has been made from evidence gathered during the visit to the home. Each person’s needs were assessed to ensure that these needs would be met. EVIDENCE: The records of three people were consulted. Each person had had an assessment of their needs when they were admitted to the home. One person also had a community care assessment completed by a social worker and another had a summary of their assessment. A third person had information from a district nurse and community psychiatric nurse. Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area was good. This judgement has been made from evidence gathered during the visit to the home. Most people’s health, personal and social care needs were set out in their individual plans to ensure that their needs would be met. A care plan was still being developed for one person who recently moved into the home. Their health care needs were being met. People were protected by the home’s policies and procedures for dealing with medicines. People felt that they were treated with dignity and respect and their right to privacy was upheld. EVIDENCE: The records of three people were read. Two people had care plans including action to meet all the needs identified in standard 3.3. There was a requirement at the previous inspection that care plans should include the
Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 11 outcomes, which people wanted to achieve from their plan. There was a separate sheet recording the aims and outcomes these two people wished to achieve from their plans. The people had signed these sheets to confirm their agreement. The plans included a box to tick to confirm that the person agreed with their plan and they had also signed their plans. Their plans were reviewed once a month. The third person had recently moved into the home. A care plan was being developed for this person and most aspects had been completed. However the section about meeting cultural needs had not been filled in and the manager reported that staff were getting to know these needs slowly. The plan had not yet been signed, the outcomes had not yet been recorded and it was too soon to have a review. Each person also had a preferred daily routine and a manual handling care plan. There were risk assessments, including risks of falling, with action taken to minimise risks. However, one person’s risk assessment was conducted in 2002 and there was no evidence of a review. The care plans included the support that people needed with health care. They also identified that staff were supporting people to manage their own personal and oral care when able including washing, dressing and cleaning teeth. Advice was sought from the district nurse when people were at risk of developing pressure sores. Treatment, specialist equipment and continence aids were also provided by the district nurse. The community psychiatric nurse monitored people’s psychological and mental health. People had opportunities for physical activity and could go for walks. Their nutritional needs were identified in the personal notes and their weight was recorded. People were registered with the local GP. There were records of appointments with the GP, dentist, optician, chiropodist, district nurse and community psychiatric nurse in the personal notes. There was a medication policy. The home used a monitored dosage system, which was kept secure in a locked cupboard. No one administered their own medication. There were records of all medication received into the home, administered and returned to the pharmacist. No controlled medication was prescribed. The GP monitored people’s medication. Since the last inspection the staff had received training about medication. The manager sought advice about medication from the pharmacist. The pharmacist had recently visited and was satisfied with arrangements for storage, recording and disposal of medication. The pharmacist had also conducted an in depth review of each person’s medication and intended to do this annually. Each person was dressed in their own clothes. Care was given in the privacy of people’s bedrooms and the bathrooms. Each person had a single room and each had their own toilet most of which were ensuite. A record of the name each person preferred to be called was recorded in their admission form. Staff knocked on people’s doors and waited for permission before entering people’s Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 12 rooms. Consultation with professionals took place in the privacy of people’s rooms. Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 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, 13, 14, 15 Quality in this outcome area was good. This judgement has been made from evidence gathered during the visits to the home. People found that the lifestyle in the home matched their expectations and preferences. People kept in contact with family and friends and representatives of their local community as they wished. People had opportunities to exercise choice and control over their lives. People had a wholesome appealing and balanced diet served in pleasant surroundings at times convenient to them. EVIDENCE: There were different activities in the home. On one afternoon of the inspection a structured observation took place of people playing skittles in the lounge. People were seen to be enjoying themselves and there was positive contact between staff and people who lived in the home. People moved in and out of the lounge and joined and left the game as they chose. On the second day of inspection some people were playing cards with staff and others were watching
Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 14 television. People said there were trips out and several people had recently been to Weston-super- Mare and enjoyed the visit very much. There was a pleasant garden and people sat out if they chose. Some people had been involved in planting hanging baskets and one person took responsibility for watering them. One person said that they did not like to watch television in the morning but chose to watch it in the afternoon. People said that they kept in contact with their family and friends. One person had been visited by relatives the previous day and another said that they had been out to visit a relative in hospital. Staff reported that other people had visits from their family. There were visits from representatives of groups from the village. People could go out unaccompanied if they chose and were able. People had independent arrangements to manage their finances. Some people’s money was managed by their family and some by solicitors. People managed small amounts of cash independently. Some people had brought items of furniture into their rooms and everyone had brought personal possessions. The provider reported that people were aware that they could access their own records and one person had requested access to their records in order to find a phone number. People chose where to spend their time and during the inspection were observed freely moving around between their rooms and the communal areas. One afternoon during the inspection some people had chosen to watch a particular television programme in the lounge. People were offered three full meals a day; breakfast, lunch and supper. The timing of breakfast was flexible and people had this in their rooms. Lunch was around 12 noon and supper was at 5-30pm and drinks were served throughout the day. There was a further drink and snack at 8-30 pm. Two people also took sandwiches to their rooms in the evening. Nutritional needs were assessed and recorded. Special diets could be catered for, including diabetic and food served took account of any cultural needs. There was a rotating fourweek menu, which showed that a varied and balanced diet was being served. People said that staff asked what meals they liked and included everyone’s preferences in the menu. The dining room table was attractively laid and people had individual napkins. Lunchtime during the inspection was a pleasant social occasion. The food was well prepared and hot. An alternative was offered if someone did not like the planned meal. All the people who were spoken to said that they enjoyed the food. Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 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): 16, 18 Quality in this outcome area was good. This judgement has been made from evidence gathered during the visit to the home. People knew that their concerns would be listened to, taken seriously and acted upon. People were protected from abuse. EVIDENCE: There was a complaints procedure. The manager stated that she had reminded people how to make a complaint. She had put a copy of the complaints policy in the lounge together with a form to complete if anyone had a complaint. There had been no complaints. People who were spoken to were very satisfied with the service and said they had no complaints. There was a policy about abuse, a copy of the Swindon and Wiltshire Protection of Vulnerable Adults Procedure and a copy of the ‘No Secrets’ booklet. There had been no allegations of abuse to record and no staff had been found to be unsuitable to work with vulnerable adults. All staff had received training about the prevention of abuse. Relatives or solicitors managed money on behalf of most people. They gave small amounts of cash to the manager who hands it to the person concerned. There were records of these transactions. The people managed these small
Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 16 amounts of cash themselves. The manager was managing money for one person and records were kept of transactions. Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 17 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, 26 Quality in this outcome area was good. This judgement has been made from evidence gathered during the visit to the home. People lived in a safe and well maintained environment. The home was clean, pleasant and hygienic. EVIDENCE: The home was decorated and maintained to a high standard. Since the last inspection all the shared areas had been repainted and the lounge had been wallpapered. There were new curtains and new carpet had been laid throughout. People said that they liked the new decoration and carpet and that they had been consulted about the colours. Access to the home was via a flight of steps from the pavement. There was a stair lift to the first floor. The owners made it clear to prospective service
Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 18 users that the building was not always accessible to people who may have mobility problems. One person with mobility problems had a downstairs room with their own bathroom. There were no outstanding requirements from the environmental health officer’s or the fire officer’s last inspections. The fire logbook showed that the appropriate checks and tests were being carried out. There was a record of maintenance. The garden was accessible to people who lived in the home. The manager planned to improve the lay out of the garden and replant it. There was no CCTV. Since the last inspection more radiators had been covered following a risk assessment and window restrictors had been fitted. The accommodation was clean and free from odours. The washing machine was sited in a small room in the rear corridor. Laundry was not carried through areas where food is stored, cooked or eaten. There were no hand washing facilities in this room but there was a hand washbasin in the toilet next to it. The walls of the laundry area were painted and easily cleanable. Since the last inspection the carpet on the floor had been replaced by vinyl flooring which was easier to clean. A tumble drier was in the airing cupboard upstairs. There were infection control guidelines. The washing machine had a pre-wash facility and a high temperature programme to meet disinfection standards. People’s clothes were labelled to ensure that their clothes were returned to them. The staff knew which clothes belonged to each person apart from rare occasions when relatives brought in a new item of clothing and did not inform them. Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 19 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 Quality in this outcome area was good. This judgement has been made from evidence gathered during the visits to the home. People’s needs were met by the numbers, and skill mix of staff. People benefited from staff who were qualified, trained and familiar with their needs. On the whole people were supported and protected by the home’s recruitment policy and practices except one member of staff must have a new Criminal Records Bureau check. EVIDENCE: The rota showed that there were two staff on duty at all times and two staff sleeping in. The staff had a multi-purpose role and were involved in meal preparation, cleaning and laundry as well as care. Three members of staff had worked in the home for several years and were familiar with people’s needs. During the observation period of the inspection positive relationships were observed between the staff and people who lived in the home. Staff supported people to play games and anticipated their needs. Over 50 of the staff had an appropriate qualification. Three of the staff had achieved National Vocational Qualification level 2, one had NVQ Level 3 and was working towards Level 4. Two staff were working towards NVQ Level 3.
Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 20 One new member of staff had NVQ level 2 and a second new member of staff was keen to start NVQ. Two new members of staff had been recruited since the last inspection and one member of staff had left. The manager reported that having the new staff had allowed her to change the rotas around and ensure there was an appropriate skill mix of staff on each shift. She said that staffing was more flexible and she could devote more time to management. She and the other proprietor were covering holidays and sickness rather than working on the rota. There was a recruitment procedure and examination of the recruitment records showed that in the main it was being followed. Both members of staff had completed application forms and been interviewed. Two written references had been received for both and one had a criminal records bureau (CRB) check and a protection of vulnerable adults (POVA) check. The other had not had a CRB check or POVA check. The manager said that this person was still working in another care home and had had a CRB check there. She was not aware that CRB checks are not transferable and she said that she would apply for a new one straight away. Neither of the new staff had had supervision yet but supervision sessions were planned. The two new staff had had induction training. Staff had received training in first aid, food hygiene, manual handling and abuse. Copies of certificates were displayed in the corridor. All staff had received training about medication since the last inspection. Training about dementia care and refresher training in first aid and fire safety was planned for the autumn. Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 21 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, 33, 35, 38 Quality in this outcome area was good. This judgement has been made from evidence gathered during the visit to the home. People lived in a home run and managed by a person who was fit to be in charge and of good character. The home was run in people’s best interests. People’s financial interests were safeguarded. The health, safety and welfare of people and staff were promoted and protected. EVIDENCE: The registered manager had a Registered Mental Nursing qualification and was updating her knowledge and skills by undertaking a management course. She
Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 22 also participated in the training provided for staff. Through her qualification and experience she was familiar with conditions and diseases associated with old age. There were clear lines of accountability between the manager and the staff. The manager had undertaken a service user survey within the last year. The survey showed a high level of satisfaction with the care provided. The manager had written a development plan for the home following the survey. The results of this survey had recently been forwarded to the Commission. The views of relatives had also been sought. As part of the development plan the manager had improved the environment by decorating and replacing the carpet. As a result of the survey the home had obtained Freeview in order to give people a wider choice of television programmes. The manager reported that most people’s finances were managed by their families or their solicitor. The family representative handed small amounts of cash to the manager to give to people who looked after the cash themselves. Appropriate records were kept of these transactions. The manager handled money on behalf of one person. They had a detailed financial care plan, which they had agreed and signed. There were records of all transactions signed by both the person and the manager. The manager managed the collecting of the person’s benefits and paying of fees. However, she gave the person their personal allowance to look after themselves. The person asked staff to take them to the post office when they wished to make deposits into their savings account. This was an area of good practice as it provided financial safeguards for the person whilst maintaining their personal autonomy. There was a health and safety policy identifying how the home would comply with relevant legislation. There was a general risk assessment in relation to safe working practices. There were arrangements for the training of staff in moving and handling, fire safety, first aid, food hygiene and health and safety There were COSHH assessments, equipment was regularly serviced, the electrical consumer unit had been replaced, the electrical wiring had been checked and portable appliances were tested annually. The plumbing and electrics were under a service contract. A new central heating boiler was fitted recently and was not yet due for service. There was a fire risk assessment and records of fire safety checks. The fire officer visited last year and was satisfied with the fire safety measures. The environmental health officer had visited in June 2005 and was satisfied with the arrangements in relation to food hygiene. Several requirements were made at the last inspection about health and safety. The environmental health officer had visited again earlier and advised about the health and safety measures. The providers had followed this advise and addressed most of these requirements and had a plan to address the rest. A bath thermometer had been obtained and staff were taking and recording water temperatures before bathing. A new risk assessment had been done
Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 23 about the safety of uncovered radiators. These were being covered according to the level of risk. Most had been covered and the manager planned to cover the rest by December 2006. Window restrictors had been put on all the windows to ensure no-one fell out of a window. A risk assessment had been done about the hot water from taps. Thermostatic valves were being put on taps according to the level of risk. The high risk taps had valves fitted and the manager planned to fit valves to all the taps by December 2006. This would help to ensure that people were not scalded. The worn carpet on the stairs in one person’s living accommodation had been replaced to ensure their safety. Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 24 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 OP29 Regulation 19 Schedule 2, 7b Requirement The member of staff who also works in another home must have a new Criminal Records Bureau check. Timescale for action 31/07/06 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 Risk assessments should be reviewed at regular intervals to ensure that they continue to reflect people’s needs and risks continue to be managed. Kington St Michael Residential Home DS0000028153.V298475.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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