Inspection on 02/11/05 for Magnolia House

This inspection was carried out on 2nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Magnolia House 14/09/07

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Magnolia House Cripple Street Maidstone Kent ME15 6BA Lead Inspector Lynnette Gajjar Announced Inspection 2nd November 2005 09:30 Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 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 Magnolia House DS0000065344.V249006.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Magnolia House Address Cripple Street Maidstone Kent ME15 6BA 01622 747677 01622 741140 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) CareTech Community Services (No.2) Ltd Miss Geraldine Cunningham Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st July 2005 Brief Description of the Service: Magnolia House provides accommodation and personal care for six younger adults with a learning disability. The home is owned by Caretech Community Services Ltd, which is very well established and provides a number of services in various parts of the country. Magnolia House is located in a Residential area of Maidstone and is within easy reach of the town centre, which is some two miles distant. It is close to shops, pubs, public transport and other usual town amenities. The home was first registered on 1st July 1999 and consists of a two-storey building. Magnolia House has six single bedrooms, three of which have en-suite facilities. There is a generously proportioned lounge/dining room with a patio door leading to the patio and a large garden area. A small area in the grounds and roadside car parking is available to the front of the house. The home employs care staff, working a roster, which gives 24-hour cover. The home also provides a part-time maintenance person/gardener but does not employ specific staff for catering and domestic duties Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 09:30am until 16:45pm. The home currently has six residents and has no vacancies. The visit was spent talking directly with both residents privately and collectively; four care staff and the registered manager. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service in the report. Some judgements about quality of life and choices were taken from direct conversation with residents and observation followed by discussion with care staff and evidencing records held at the home. Additional information was obtained through receipt of the manager’s preinspection questionnaire, a tour of the premises and conducting a case tracking exercise, by reading the files and care plans of the two Residents and two care staff, as well as some policies and records maintained by the home. Documentation was on the whole in good order and the recommendations from the previous inspection are being implemented through the homes action plan. Due to the last report being delayed due to staff illness the action plan is still in progress. Questionnaires feedback was also received from a 4 relatives, 2 care managers and 2 health and social care professionals. Overall relatives and professionals are very satisfied with the service received. Some comments received included: “I have just discharged the client I was working with there but I found the staff team very proactive and supportive in addressing this lady’s needs, which are becoming increasingly complex” “I would like to say that in my opinion (name of Resident) always appears happy when I visit her. I have not had any reason to complain about the staff, they are efficient and polite.” “In our regular visits to see (name of Resident) the staff are always helpful and friendly, which gives us confidence in the home.” Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Resident’s lifestyle and living space would be greatly improved through dividing doors between the current open planned living/dining areas. Offering opportunity for different activities and option of privacy/ quiet area away from other activities. Residents would feel safer and able to carry out activities with adequate staffing numbers to meet their needs. Current 1:1 demands that are not funded are restricting others choices and potential risk of abuse from behaviours exhibited. Through the refurbishment and repair to the kitchen and units, residents would be guaranteed a safe and comfortable meal preparation and cooking facility. Current case file records/system can be easier to access by putting the basic core information, risk assessments, individual support requirements and Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 7 recording sheets in one section of the large corporate file format. Enhancing staff records made, direct care time and reduce duplication of records. The service users guide can be made much more accessible and understood by residents through a combination of the written word, widget symbols system, object referencing and photographs. 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. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 Residents and their families are given all the information they need to make an informed choice about whether to live at Magnolia House. EVIDENCE: The home has a Statement of Purpose and a Residents Guide, which as been amended since the last inspection. This gives detailed information about the home and the service provided. Minor areas were discussed to enhance this further. Both documents have been converted to ‘Widget symbol’ format but on discussion current residents still did not easily understand this. Options to develop this format into a simpler format using photographs and object referencing, and clip art were discussed and the involvement of residents to develop this into a working document they understood and were part of. The home has not had any new admissions to assess the practical process recently. The home has clear policies and guidance including assessments by staff, trial visits and working with families, professionals and the individual prior to a decision being made to move into the home. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 The health, social and personal care needs of residents are encouraged offering regular contact with specialists and external professionals. Residents are treated with genuine respect and dignity by support staff. EVIDENCE: The current care plan files holds a lot of information that is a large system that is cumbersome and time-consuming to record and follow. This current case files and then six monthly files and archived files. Residents and staff would benefit from this being reviewed to aid simpler access and recording. So that daily used direct care information/recording is separate to general case file records/letters. Records seen today also indicated duplication in what was recorded, as writing in various sections. For example Dentist visit today was recorded on handover sheet, daily record for the resident and then on their dentist record. One entry to the dentist record and note on the hand over sheet to see this section would be suffice. Residents’ care needs could be better reflected through more detailed daily notes, rather than tick box systems. Regular reviews are taking place in house and with placing authorities. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 11 Residents talked fondly and with familiarity to care staff on duty today and were able to instantly name their allocated key-worker. Residents are encouraged to make choices. Where residents are unable to make informed judgements staff are supportive and caring. Staff continue to work with residents at risk of potential physical abuse resulting from the behaviour of one individual. Full reviews are in hand with the placing authority and alternative residential care being explored. Three services have visited to assess the resident but all indicating that 1:1 support will be needed. The organisation have agreed the home cannot meet their needs as no 1:1 support is funded although they have put this in place and notice is being served on this placement. One resident is at risk of self-harm. Staff continue to work hard to ensure that this happens as little as possible, although more staff would reduce the risks further. Records are stored securely and residents. The manager and senior staff are keen to develop care plans further to be more photographic and object reference formats understood by the individual. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Community links are personal and activities outside of the home are encouraged to individual’s choice and promote personal relationships. However due to insufficient staffing, opportunities for social, educational and recreational experiences are limited. The food prepared and provided is of good quality and served in accordance with residents’ own personal preferences. EVIDENCE: A residents’ behaviour continues to require extra 1 to 1 support as identified during the previous three inspections. The quality of life and opportunities of the other residents have suffered as a result of this. Residents are not able to go out or use the kitchen as much as they used to, as there are not enough staff to make them safe. Residents are supported towards independent living skills and also have the opportunity for personal, emotional and social development. Residents are treated as individuals who have different interests and aspirations. Activities and development opportunities are provided accordingly. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 13 Residents are offered activities such as swimming, sensory time, aromatherapy, gardening and keep fit. At the time of inspection, residents were pursuing their own interests within the home. Videos and board games are available and in use today. Residents are very much part of the local community and attend local pubs and church clubs. A resident confirmed regular contact with their direct and extended family through home visits and outings. Written feedback from relatives was received (included within the summary section). Residents’ relatives and friends are invited to join in activities within the home. Residents enjoy privacy in their rooms and staff respect this. Bathrooms, toilets and individuals’ rooms are lockable. Residents are involved in shopping and cooking wherever possible. They can choose what they eat. Residents’ nutritional needs are monitored and special diets are provided where necessary. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,20 Intimate and personal care needs are attended to in a dignified manner and the physical and emotional health of individuals is promoted. Safe medication practices are followed but will be further enhanced through clear PRN guidance for individuals. EVIDENCE: Staff are clearly aware as to the type and nature of the support required for individual’s personal and intimate care needs. Every effort is made to maintain privacy and dignity when people are being supported with bathing, washing and dressing. Staff have a good understanding of the preferred routines of each resident. New medication storage has been implemented for medication requiring refrigeration to comply with regulations. Staff have all received training and were confident of the system in place with regards the storage and administration of medicines. Some records were assessed, with no errors noted. Further development of PRN guidelines would ensure consistent safe administration within clear set triggers and action to be taken. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The home operates in an open manner, with a clear complaint procedure. Residents are at risk from potential abuse due to individual behaviours and limited staffing levels to managed this. EVIDENCE: Residents feel they are listened to and their views, concerns and complaints are taken seriously and acted upon by staff and the manager. Written information about how to complain is provided for residents and their representatives. Due to the nature of some resident’s communication limitations they are heavily reliant of relative and advocates raising concerns on their behalf. Both residents and staff are not fully protected from potential abuse by the procedures in place within the home. Occasional physical abuse and self-harm result from the behaviour of an individual. Staff work hard to ensure that this happens as little as possible, although more staff would reduce the risks further. Notice is being served for the one placement. There are currently no adult protection investigations at the home. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Residents have sufficient facilities to meet their current needs with minor alterations that would benefit further safe and comfortable kitchen and laundry. EVIDENCE: The building fits in with the local community and has a style and atmosphere that meets individuals’ needs. Residents are able to go access most areas of the home but due to current issues of safety restriction of access are in place for the kitchen. Residents continue to be at risk by broken kitchen cupboard doors, and unit sides, which are an infection control hazard. The hob unit is set very low requiring staff and residents to stand in a ‘stooped over’ position whilst cooking. Promoting poor posture. The kitchen units are a dark wood, dark red tiles, that are in need of an upgrade to offer safer environment, better lit and good food hygiene standards. The grounds are extensive and pleasant. Resident’s benefit from living in a clean, comfortable and homely environment. Adequate recreational, dining, toilet, bathing and individual accommodation are available to residents. They are able to meet their visitors in private in the office. Whilst not ideal, this is available if residents don’t want to use their rooms. Consideration to installing partition doors between the open planned Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 17 dining area and lounge would offer and alternative but also allow for separate leisure activities in tow rooms. Residents showed the inspector to their own rooms, which are on the ground and first floor. Residents clearly like their rooms, which are highly personalised. They discussed enjoying choosing the colour schemes and how their furniture should be arranged. Furnishings are suitable for residents’ individual needs. Advice from the Kent and Medway infection control unit would further enhance procedures in place at the home for infection control, particularly regarding the laundry room. Some improvements have been made regarding soiled laundry but there continues to be no separate hand-washing sink available. Contact has already been made regarding management of MRSA and guidelines are in place as required. A hoist is available for use when bathing for residents who need it. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,36 The number of staff provided does not meet residents’ needs. A motivated and committed staff team supports residents. EVIDENCE: Staff continue to show a good understanding of residents’ needs and the homes philosophy and values. Resident’s continue to benefit from good support and interaction. Residents continue to be protected by the homes commitment to staff training and development with ongoing training courses since the last inspection. As identified in previous three inspections, the number of staff provided does not meet residents’ needs. A resident’s behaviour continues to require extra 1 to 1 support that is not funded by the placing authority. The manager has worked hard with the placing authority to address this and three other services have visited to assess for placement at their home. All identified they will require 1:1 staffing. Due to the ongoing concern the organisation have agreed to serve notice on this placement, as they cannot meet the individuals care needs within the current staffing structure. The quality of life of the other residents has suffered as a result of the staff allocation. Residents continue not to be able to go out or use the kitchen as much as they used to, as there are not enough staff to make them safe. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 19 Staff support residents with cooking, cleaning and laundry tasks wherever possible. No ancillary staff are employed by the home. Time was spent with a new staff member who detailed a thorough recruitment process, induction and training before she started in post. “Everyone has been so welcoming, nothing is too much or them, even though I keep asking questions, I feel very supported by the manger and staff team.” Staff received regular supervision with their line manager, from records seen and discussion with staff. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Through a motivated manager, there is leadership and support systems being implemented, to enable the management of the home to develop and grow good care practice, and so reduce the potential risk to residents. EVIDENCE: The registered manager is aware of their responsibilities and through this visit evidenced the motivation and commitment to develop services to meet the needs of the residents and a good understanding of the limitations currently facing the home in meeting everybody’s needs. Residents showed good interaction and familiarity with the manager and being able to approach them throughout the visit with confidence. The company requires the manager to work with the direct care of residents for two days a week. This requires regular monitoring and review by the organisation to ensure management responsibilities are maintained satisfactorily. House meetings take place to involve residents in day-to-day activities but also planning future events as a group or as individuals. The company also Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 21 undertakes monitoring visits and reports are submitted to the commission as required. There is an open and inclusive atmosphere in the home. Residents feel comfortable chatting and spending time with staff and the inspector. Some radiators are not guarded, due to the nature of the service and care needs this should be risk assessed and priority given to high-risk areas for installation of radiator guards or low temperature surface radiators. As detailed through the report food hygiene and infection control issues require addressing in relation to the kitchen and laundry facilities. Fire safety records showed maintenance is undertaken as required, with regular drills. All equipment is maintained required and signed as completed by the manager. A sample of records was accessed to verify this. Staff had a god understanding of accident/incident process and the manager was fully aware of regulation 37 notifications process. Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 2 3 X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 2 3 2 LIFESTYLES Standard No Score 11 3 12 2 13 2 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 X X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Magnolia House Score 3 X 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 X DS0000065344.V249006.R01.S.doc Version 5.0 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA9YA9 Regulation Requirement Timescale for action 31/01/06 13(4)(b)(c) The registered person shall ensure that any activities in which residents participate are so far as reasonably practicable free from avoidable risks; and unnecessary risks to the health and safety of residents are identified and so far as possible eliminated. In that, the risk to both staff and residents of physical abuse resulting from the behaviour of a individual must be reduced. The risk of self-harm for one resident must be reduced. In that, all radiators must be guarded or low surface temperature. In that, broken and missing cupboard doors in the kitchen must be replaced. Work must be complete by timescale date. (This requirement has been Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 24 2 YA12YA13Y A14YA33 18(1)(a) repeated from previous inspections on 21st Juy 2005 and 15th December 2004.) The registered person shall, having regard to the size of the care home and the number and needs of residents, ensure that at all times suitably qualified, competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of residents. In that, staffing levels must be sufficient to meet the needs of residents. This must be complete by timescale date (This requirement has been repeated from previous inspection on 26th May,21ST July 2005 and 15th December 2004.) The registered person shall make arrangements, by training staff or by other measures, to prevent residents being harmed or suffering abuse or being placed at risk of harm or abuse. In that, the risk to both staff and residents of physical abuse resulting from the behaviour of one individual must be reduced. The risk of self-harm for one resident must be reduced. This must be complete by timescale date (This requirement has been repeated from previous inspection on 21st July 2005 and 15th December 2004.) The registered person shall make suitable arrangements to prevent DS0000065344.V249006.R01.S.doc 31/01/06 3 YA23 13(6) 31/01/06 4 YA30 13(3) 31/03/06 Magnolia House Version 5.0 Page 25 infection, toxic conditions and the spread of infection at the care home. In that, the sink in the laundry room must not be used for both soiled items and hand washing. In that kitchen units are replace where damaged and broken cracked surfaces identified This must be complete by timescale date (This requirement has been repeated from previous inspection on 21st July 2005 and 15th December 2004.). 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 YA1 Good Practice Recommendations It was recommended that both the Residents’ Guide reviewed to a format that is presented that is easily understood by the current residents. Such as combining photographs, object referencing rather than just the written word and widget system. It was recommended that residents’ daily notes should be written in more detail of the care and support given and less reliant of tick box representation. It is strongly recommended that the current case file system is reviewed to have all daily working documents relating to direct care plan, risk assessments and daily records are together and aide ease of access from nondaily used documents and current duplication. Records and documents held in the office including on the walls are stored securely when office is used as visitors room and personal information is kept confidential. It is recommended that Residents in long-term placements should have, as part of the basic contract price, the option DS0000065344.V249006.R01.S.doc Version 5.0 Page 26 2 3 YA6 YA6 3 4 YA10 YA14 Magnolia House of a minimum seven-day annual holiday. In that, this continues to be under discussion at director level in conjunction with the fee price for the home. It was indicated that some residents go on holiday but funded this themselves. (This recommendation has been repeated from previous inspection on 21 July 2005, 17th March, 26th May and 15th December 2004.) It is strongly recommended that the low working surface of the cooking hob is assessed and appropriate action taken due to the poor posture and stooping required by staff and residents when cooking. It recommended that consideration be given to refubishing the kitchen with lighter units and decoration to enhance the facilities and redesign of current layout/surface height to meet the needs of current residents. It is recommended that there should be a designated private area for visitors. In that, the office continues to double as a visitors’ room and partition doors be installed between the lounge / dining area offering two smaller areas in such circumstances. (This recommendation has been repeated from previous inspection on 17th March, 26th May and 15th December 2004.) It is strongly recommended that an infection control audit be requested from Kent and Medway infection control unit of the home current prcedures and protocols. Particularly in relation to the laundry and kitchen. It was recommended that the manager’s shifts for direct care of residents should be reviewed to ensure that sufficient hours were provided for the management of the home. In that, the company continues to require the manager to work on shift with the direct care of residents for two days per week, with the remaining three for managerial duties. (This recommendation has been repeated from previous inspection on 21st July 2005, 26th May and 15th December 2004.) It is recommended that the organisation considers developing a portfolio of the trainers used to provide the DS0000065344.V249006.R01.S.doc Version 5.0 Page 27 5 YA24 6 YA24 7 YA28 8 YA30 9 YA37 10 YA41 Magnolia House 11 YA40 rolling programme of in-house training. Detailing their background ,experience and qualification /competancies to run the specific training courses and keep with the training prpgramme. It is recommended that the area manager should complete their stated intention of developing the home’s policies and procedures using pictorial form and Makaton in order to involve residents. In that, a member of staff said that the home continued to be in the process of developing policies and procedures using alternative forms of communication. Not assessed on this occasion (This recommendation has been repeated from previous inspection on 17th March 2004, 26th May and 15th December 2004.) Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Magnolia House DS0000065344.V249006.R01.S.doc Version 5.0 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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