CARE HOMES FOR OLDER PEOPLE
Kirkby House Residential Care Home James Holt Avenue Kirkby Knowsley Merseyside L32 5TU Lead Inspector
Mrs Trish Thomas/Lorraine Farrar Unannounced Inspection 11th November 2005 11:00 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 Kirkby House Residential Care Home DS0000062026.V266569.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. Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Kirkby House Residential Care Home Address James Holt Avenue Kirkby Knowsley Merseyside L32 5TU 0151 289 9202 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) Meridian Healthcare Ltd Ms Madeleine Ward Care Home 30 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (20), Physical disability over 65 of places years of age (20) Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 6. The service should employ a suitably qualified and experienced Manager who is registered with the CSCI. Day staffing levels for 10 service users with dementia to be on duty in the ratio of 1:5, in accordance with the Notice of 9/3/04. Services to be provided for one Service User of 55 years or over, within the registered number of 10 DE The service is registered to provide personal care to a maximum of 30 Service Users The service is registered to provide personal care to a maximum of 20 Older People (OP) The service is registered to provide personal care to a maximum of 10 Older People with Dementia DE(E) Date of last inspection Brief Description of the Service: Kirkby House is a care home for 30 older people. The manager of Kirkby House is Mrs. Madeleine Ward and the home is owned by Meridian Healthcare Ltd. Kirkby House is a single storey building surrounded by well-maintained grassed areas and secluded gardens. The home is situated in a residential area of Kirkby, close to bus routes and a train station. Care and accommodation in Kirkby House is provided in three units. General administration, laundry and cooking are carried out centrally, and the manager has over all responsibility. Individual Units are otherwise self-contained, having designated staff, toilet and bathing facilities and lounge/dining areas. The building is suitable for people with a physical disability, providing level access, mobility aids and further communal spaces available to all residents for joint social gatherings. All Service Users are registered with a local G.P. when admitted on a permanent basis. Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The visit was un announced over a four hour period by two inspectors. Methods used during the inspection were, discussion with residents, managers and staff, reading records, direct observation and by touring the premises. What the service does well: What has improved since the last inspection?
The home has improved environmentally as areas of the dementia unit have been refurbished to a very good standard. Residents who commented approved of the changes. The scope of training has improved and the manager has confidence that standards in the home will develop in coming months. The home is registered to provide 10 dementia beds and no out of category admission were noted during this inspection. Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 6 What they could do better:
The manager must establish strategies for consultation with residents who lack capacity, as to their care, health, welfare and daily lives. The manager must provide a care plan which details all personal, social and health care needs and which holds the signatures to ensure that the care delivery is acceptable to the residents /representative. The manager must update care plans to provide sufficient information and guidance to support each individual resident. In meeting these requirements the manager will ensure that the home is managed in a way, which recognizes the limitations on quality of life, which are faced by residents who have dementia, and target services in line with all residents’ changing needs and preferences. The manager must put a system in place to ensure that medication is only stored in the fridge in when necessary. In meeting the standard the manager will ensure that residents’ medication is stored in accordance with pharmacy instructions. The manager must arrange for the medication room to be maintained to a high standard of hygiene. In meeting this standard, the risk of cross contamination will be limited. The manager must ensure that the language written in care plans respects residents’ dignity and that notices displayed in the home do not impinge on residents’ rights to privacy and dignity. In meeting the requirement the manager will ensure that written matter in the home, supports best care practice. The manager must provide a complaints procedure in a format, which residents can easily understand. In meeting the requirement, the manager will ensure that access to the complaints procedure is not limited through residents’ disabilities. The manager must arrange for the menu to be distributed daily to residents and for ongoing consultation as to their meal preferences. In meeting this requirement, residents will have more information and choices available and their levels of satisfaction with meals should improve. The manager must employ domestic staff in order to maintain standards of hygiene throughout the home and reduce pressure on care staff at peak times. In order to ensure that residents’ needs are met, the manager must arrange for staff to be suitably NVQ (or equivalent) qualified. In order to ensure that residents are in safe hands at all times, the manager must obtain two satisfactory written references before a new member of staff starts work in the home. To ensure residents’ health and safety, the manager must arrange for all staff to receive moving and handling training. Also, to ensure the building is safe, the manager must provide CSCI with copies of satisfactory gas and electricity inspection certificates. In order to protect the welfare of residents and staff, the manager must arrange for smoking in the home to be risk assessed regarding fire and ill health to residents and staff who live and work in smoking areas. To ensure a safe audit of controlled drugs held in the home, the manager should arrange for use of a book as opposed to loose sheets of paper for the recording of controlled medication.
Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 7 To ensure that maintenance and equipment standards are maintained, the manager should arrange for a review of kitchen equipment and arrange for repair/replacement as necessary. To ensure that financial transactions are double-checked, and in the best interests of residents and staff, the manager should obtain two signatures for all transactions relating to residents’ personal allowance. 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. Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 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 Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 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 The home was meeting standard 3. Professional and home’s assessments were in place for residents recently admitted Kirkby House. The home does not provide intermediate care and will not be measured against standard 6. EVIDENCE: Written assessments were contained on care files. In addition to professional assessments, the home’s assessment is undertaken and forms the basis of the care plan. There was evidence that a high level of information as to residents’ needs is obtained on admission to Kirkby House. Further work is necessary as to the way in which information is used in planning individual care. Shortfalls were noted under standard 7, as to the level of assessed need addressed in individual care plans (particularly regarding residents’ mental health needs). Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 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 The home was not meeting standard 7. Care plans had been established for all residents but were lacking in detail as to how to meet assessed needs. Care plans did not contain sufficient information for staff to follow when supporting the residents’ health and personal care needs. The home was not meeting standard 8. Staff work in partnership with health professionals and follow through on advice given. Records relating to residents’ health were not fully completed nor had they been reviewed. The home was not meeting standard 9. In general, residents’ prescribed medication was well managed by staff. Shortfalls were observed regarding the storage area. The home was not meeting standard 10. In practice the home was meeting the standard regarding residents’ right to respect and privacy in personal care giving. Shortfalls were noted regarding written material displayed in the home and the written language in care plans. Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 11 EVIDENCE: Standard 7. Each resident has an individual care file, and a number were read. Files contained copies of assessment as to mobility and risk and social work review meetings. Shortfalls were noted in care plans regarding residents’ mental health and general healthcare needs. Examples noted were with regards to pressure care, where support was being given to a resident, (as stated by a member of staff), but had not been recorded in the care plan. Also, on the dementia unit there was limited information as to individual mental health, the support needed and the means of delivery. A number of care plans had not been recently reviewed, either on a monthly basis or more regularly as needs change. On the dementia unit, one resident’s file contained a risk assessment for smoking. There was no assessment regarding the risk of fire or related health and fire risks to fellow residents/staff who share the same lounge. Some of the language written in care plans, were not appropriate and the manager was advised to instruct staff on correct use of language in records, during supervision sessions. Standard 8. There was clear information regarding one resident’s health, however, another plan recorded a resident’s weight on 29/8/05 and stated, “weigh in two weeks.” There was no evidence that staff had done this. Care plans must be updated to provide sufficient information and guidance for staff to follow in supporting the individual. Reviews should also take place on a monthly basis or more often if needed. Standard 9. The medication room is secure but was not clean, the sink and cupboards being dusty. The manager must arrange for this room to be thoroughly cleaned and maintained to the highest standard of cleanliness. There were satisfactory arrangements for the securing of controlled drugs and the audit was checked and found to be correct. It is recommended, as a safety measure that controlled drug stocks are recorded in a book and not on loose sheets of paper. Some drugs had been placed in fridge when this was not necessary as they could be stored at room temperature. Instructions on correct storage temperatures should be included in the home’s medication procedures. Standard 10. One of the bedrooms and a bathroom visited during the inspection had posters and notices displayed, which made the rooms appear institutionalised. The manager should monitor the use of information displayed as insensitive use could breach residents’ right to confidentiality and dignity. Kirkby House Residential Care Home DS0000062026.V266569.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): 12,13,15 The home was meeting standards 12 and 13 but was not meeting standard 15. The lifestyle in the home appeared to be meeting residents’ preferences and expectations, and their visitors are made welcome and left undisturbed. The meal observed during the inspection looked plentiful and appetising but some residents said they were not satisfied with their meals. EVIDENCE: Standard 12. Throughout the duration of this inspection, there were several visitors to the home. A resident explained, and the manager confirmed, that residents’ visitors are welcome to call at all reasonable times. A number of activities are arranged for residents and the manager said that further work is being undertaken by staff to improve the range of leisure activities. There was an aromatherapy session in progress on that day and a Halloween Party had taken place the previous week. Meals are transported to the units on heated trolleys. The meal served on the dementia unit at lunchtime looked appetising and hot and was served to residents seated in the dining area. On commenting on the food, one resident said “The food is lousy, we get mash with everything and I can’t stand it. Other comments included, “all right”, “Good”, “The fish was hard.” One lady said “I can’t remember what I had, but I really enjoyed it.” The manager is advised to distribute the menu and consult with resident as to their meals on a daily basis.
Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 13 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 was not meeting standard 16 regarding the format of the home’s complaints procedure. The content of the complaints procedure is satisfactory and measures have been taken to make the complaints procedure is distributed to residents. The home was meeting standard 18.The home has Adult Protection and Whistle Blowing policies. EVIDENCE: Standard 16. The home has a complaints procedure in place, which advises residents of how to make a complaint. Good practice was noted in that a copy of this procedure is available in all residents’ bedrooms. The complaints procedure is in small print and one resident said, “I can’t see that.” The manager must provide this for each resident, in an appropriate format. Standard 18. The home has Adult Protection and Whistle Blowing policies and provides related training to staff. Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 14 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, 20,21,22,26 The home was meeting all but standards 19 and 26. Kirkby House is a purpose built care home and was meeting residents’ needs in a comfortable and homely way. The home has three self-contained wings, accommodating ten residents on each. One wing has been registered for residents who have dementia. The home provides a variety of shared space and bathrooms positioned to be easily available to residents. Aids and adaptations are in place to help residents with their mobility. Some of the kitchen equipment was not in working order. Standard 26. The building was clean and well organised in most of the areas visited. The medication room did not meet the standards of hygiene observed in other areas of the home. EVIDENCE: The home is generally well maintained internally and externally. The cook said that some kitchen equipment was not working. The kitchen equipment should be reviewed and replacements provided as necessary. There are three lounge/dining areas (one on each unit). Smoking is permitted within designated areas.
Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 15 There is a large garden surrounding the building, which residents said they use in summer months. There are two small courtyard gardens, which are planted and have seating and tables for residents’ use. There are sufficient bathrooms and toilets located throughout the home. Bedrooms are not en-suite but do have wash hand basins. A number of aids and adaptations are available throughout the building, including assisted baths, grab rails and call bells. The dementia unit has recently been partially refurbished to a very good standard. A resident spoken with on this unit said that their bedroom has been newly decorated and they were “pleased with it.” The manager said that there are plans in place for the home to undergo a major refurbishment in the next twelve months. At the present time, parts of the home are looking “tired” and in need of decoration. The home was clean and well organised in areas visited, other than the medication room, which must in future be maintained to the highest standards of hygiene. Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 16 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. The home was not meeting the standards, for the reasons stated below. The manager and staff are working towards improvements in this aspect of service regarding training and staff recruitment. EVIDENCE: The staff rosters were satisfactory with regards to care staffing levels. Shortfalls were noted in ancillary staffing support. The home employs and laundry assistant for three days a week, but care staff were working extra hours to cover domestic hours until the domestic post is filled. A member of care staff said that bed change days are difficult, providing extra domestic duties in addition to care responsibilities. She said that office (management) staff will support if asked, but this is not always possible. The residents were complimentary in their comments towards staff saying, “We get on very well with them.” “They are very good.” The home was not meeting 50 NVQ training levels. The manager said some staff had moved on and the percentage had dropped, but training was continuing with existing staff and a number were awaiting final certification. An improvement was noted in the range of training on offer, which includes dementia training, managing challenging behaviour in addition to Protection of Vulnerable Adults and ongoing mandatory training. Several staff files were read and these showed that staff undertake training in areas appropriate to their work, including Basic Food Hygiene, Continence, and Health & Safety. The manager said that all new staff undertake a set induction course, and this was confirmed by a new member of staff.
Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 17 This staff member had not received moving and handling training and this must be arranged, and for all staff who need it. The home has a good recruitment policy, which includes completion of application form, recorded interview, taking up references and Criminal Records Bureau clearances. A newly appointed staff member confirmed the process verbally and records of this were in evidence. One file inspected contained only one written reference and the manager said that she had obtained a second verbal reference. In order to ensure the protection of residents, the manager must in future obtain two written references before a new member of staff takes up their post. Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 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): 31,33,35,38 The home was meeting standards 31 and 33. Morale amongst management staff was high, as they feel supported by the providers in their training and in moving standards in the home forward. There appears to be a strong staff team and an “open door” management style. The home was not meeting standards 35 and 38. There is a system in place to secure residents’ personal allowance held in the home. A safety measure is recommended, regarding the accounting system. Not all health and safety certification was available at the time of inspection and shortfalls were noted in risk assessments related to smoking. EVIDENCE: The manager said that she is well supported by Meridian Healthcare and has confidence in the commitment towards improving standards in the home. Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 19 She now feels part of a wider team of managers and has attended recent team building events. Residents, visitors and staff appeared comfortable in approaching the manager and there was a pleasant atmosphere in the home. The home holds residents’ personal allowances and one account was checked and the amount held balanced with the records. The manager is advised to obtain two signatures to all such transactions, that is, the resident or representative and a member of staff or two members of staff. Records and certificates relating to health & safety were examined. The home has satisfactory records for small electrical appliances; fire testing and training, water temperatures and checks for bath hoists. In July 05, Meridian Healthcare had carried out a detailed health & safety audit. The home was provided with an assessment and action plan for risk areas identified. The electrical certificate, which was seen during the inspection, dated November 04, states “unsatisfactory”. The required landlord’s gas certificate was not available. The manager must provide CSCI with copies of the up to date satisfactory certification for electricity and gas supplies in the home. There was no evidence that risks of ill health and fire had been assessed in relation to residents and staff who live and work in smoking areas. Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 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 3 X X X X 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 3 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 X 2 3 3 3 X X X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 1 Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 21 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 OP7 Regulation 12 Requirement The manager must establish strategies for consultation with residents who lack capacity, as to their care, health, welfare and daily lives. The manager must provide a care plan which details all personal, social and health care needs and which holds the signatures to ensure that the care delivery is acceptable to the residents /representative. Outstanding from the last inspection, extended time limit given. The manager must update care plans to provide sufficient information and guidance to support each individual resident. The manager must put a system in place to ensure that medication is only stored in the fridge in accordance with the pharmacy instructions. The manager must ensure that the language written in care plans respects residents’ dignity and that notices displayed in the home do not impinge on
DS0000062026.V266569.R01.S.doc Timescale for action 07/02/06 2. OP7 15 07/02/06 3. OP7 15 07/02/06 4. OP9 13 07/02/06 5. OP10 12(4) 07/02/06 Kirkby House Residential Care Home Version 5.0 Page 22 6. OP16 22 7. OP15 16 8. OP26 13 9. 10. 11. OP27 OP28 OP29 18 18 19 12. 13. OP38 OP38 13 13 14. OP38 13 residents’ rights to privacy and dignity. The manager must provide a complaints procedure in a format which residents can easily understand. The manager must arrange for the menu to be distributed daily to residents and for ongoing consultation as to their meal preferences. The manager must arrange for the medication room to be maintained to a high standard of hygiene. The manager must employ domestic staff. The manager must ensure that staff are suitably NVQ (or equivalent) qualified. The manager must obtain two satisfactory written references before a new member of staff starts work in the home. The manager must arrange for all staff to receive moving and handling training. The manager must provide CSCI with copies of satisfactory gas and electricity inspection certificates. The manager must arrange for smoking in the home to be risk assessed regarding fire and ill health in relation to residents and staff. 07/02/06 07/01/06 10/11/05 07/02/06 02/04/06 10/11/05 07/02/06 07/02/06 07/02/06 Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 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. 2. 3. Refer to Standard OP9 OP19 OP35 Good Practice Recommendations The manager should arrange for use of a book as opposed to loose sheets of paper for the recording of controlled medication. The manager should arrange for a review of kitchen equipment and arrange for repair/replacement as necessary. The manager should obtain two signatures for all transactions relating to residents’ personal allowance. Kirkby House Residential Care Home DS0000062026.V266569.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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