Inspection on 12/09/05 for Thomas Knight Care Home

This inspection was carried out on 12th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Thomas Knight Care Home 16/06/08

Thomas Knight Care Home 17/05/07

Thomas Knight Care Home 29/08/06

Thomas Knight Care Home 16/05/06

Thomas Knight Care Home 27/01/06

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Thomas Knight Care Home 1 Beaconsfield Street Blyth Northumberland NE24 2DN Lead Inspector Janet Thompson Announced 12 September 2005 10:00 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 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. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Thomas Knight Care Home Address 1 Beaconsfield Street Blyth Northumberland NE24 2DN 01670 546576 01670 546823 N/A Mr Sewa Singh Gill Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Vacant CRH 54 Category(ies) of DE(E) - Dementia over 65 (36) registration, with number OP - Old Age (18) of places Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection Not Applicable Brief Description of the Service: Thomas Knight is a newly built care home situated in the centre of Blyth. The home is close to local shops and amenities. The accomodation is located on three floors and all rooms are single with ensuite facilities. The ground floor of the home accomodates residents with general nursing needs. The second floor accomodates residents with nursing and mental health needs. The middle floor is currently unoccupied. There are sitting areas and a dining room on each floor. A passenger lift connects all floors, the lift is of a type not usually found in care homes and its approval is still under discussion with the fire department. The gardens are located to the front and side of the home. They are very small. The garden at the front is not suitable for use by those residents with any degree of confusion as it leads directly onto the main road. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the first inspection of the home since registration. Two inspectors were present at this inspection. The registered manager of the home has left. The deputy manager, Suzanne Jones, is acting as the manager. She had done so for one week prior to the inspection. There were a number of serious concerns, some of which required immediate attention, identified at the inspection. The provider agreed to stop admissions to the home. The inspectors asked the Fire Officer and the Nurse Specialist from the Health Protection Agency to visit, which they did the following week. Verbal feedback from these professionals confirms that they had serious concerns regarding the facilities and practices within the home. The Environmental Health Officer has made a later visit and the CSCI have carried out a further monitoring visit. A strategy meeting has been held at the home involving all agencies. The Proprietor has cooperated with the Commission. The Acting Manager and staff were very cooperative throughout the inspections. What the service does well: What has improved since the last inspection? The service has not previously been inspected. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 6 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. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and3. Prospective service users did not have the information they need to make an informed choice about where to live. Service users do not have adequate statements of terms and conditions or contracts for care. Service users needs had been assessed prior to admission. EVIDENCE: The home’s statement of purpose was not up to date and was poorly presented with inadequate print. There was no information on accommodation, available services, and the number of beds, fees or categories of care. The terms and conditions document bore no resemblance to the documents that were actually being issued to residents. The acting manager has to type out residency contracts from home and modify another home’s documents. The document being used did not meet requirements in that it was not up to date and failed to specify: : The room number to be occupied : Overall care and services covered by the fees : Fees payable Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 9 : Additional services to be paid for : Rights and obligations Residency agreements were in place for the Local Authority funded residents. Evidence of satisfactory, well written pre-admission assessments by the senior nurses was seen. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 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 standard(s) 7, 8 and 9. Service users health, personal and social care needs are not set out adequately in care plans. Service users health care needs are not fully met. The home’s procedures for dealing with medication do not protect service users. EVIDENCE: Four care plans were examined and case tracked. Three were for physically dependant residents and one was for someone more physically able but with complex mental health needs. Generally the assessments within the care plans were very good, they provided comprehensive information. This was not always followed up with an action plan of care. The section entitled “daily notes on care” acts as the care plan unless there are other issues to consider. The inspector concluded that this is not adequate because it does not provide enough information regarding specific care needs. Core care plans and risk management plans were in place for issues such as falls and weight loss, relatives had not signed their agreement to these. The care plan for the more able resident was very scant, there was little instruction on managing behaviour. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 11 None of the care plans showed good planning in relation to social care. There was good evidence in the care plans of the involvement of other health professionals. Multidisciplinary input was well recorded. Telephone calls with health professionals were also recorded. This is good practice and demonstrates that staff act in the best interests of the residents in their care. Staff stated, and records confirmed that all residents on the second floor were incontinent and at least three required absolute total care. Most of the remaining residents required a high degree of input from the staff because of confusion or behaviour patterns. All residents were bathed once in the week. The staff on duty stated that they do not have time to do baths more often though they did think some residents would benefit from this. The residents did look reasonably clean. This is to the credit of the staff. A requirement has been made regarding the review of staffing levels on this floor. Medication was inspected throughout the home. The main storage for medication is on the middle floor. The excess drugs and the trolleys from each floor are stored here. This means that every time the nurse wants access to any item of medication she needs to leave the floor that she is working on and come to the middle floor. There are clinical rooms on each floor. A requirement has been made to give consideration to the storage of medication in these rooms. The medication storage cupboard on the middle floor was full. It is inadequate in size for the amount of residents currently in the home and will not cope with any increase in occupancy. Medication administration records were checked. There were a lot of omissions to the recording of drugs on the ground floor. The acting manager confirmed that there is not a system for auditing the medication, checking on recording and ascertaining if the numbers of drugs are correct. She undertook to start an audit system as a priority. The nurses currently share the task of medication ordering, this has resulted in some confusion in the past. The inspector recommended that one or two people take responsibility for the ordering and disposal of drugs. The nurse had undertaken medications training but reported that the course content had been too simplistic and not relevant. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 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 standard(s) These standards were not assessed at this inspection. EVIDENCE: Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 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 standard(s) 16 and 18 Service users are confident that their complaints will be listened to and acted upon. Service users are not adequately protected from abuse. EVIDENCE: One complaint was recorded in the complaints log. This was a complaint known to the Inspectors as the CSCI had been involved in monitoring this. The complaint is currently in the final stages of being resolved. Two of the senior staff were scheduled to attend external training in adult protection. Otherwise the only other training had been provided to those carers who had undertaken the original TOPSS induction. This is not enough. All staff left in charge of a shift should receive external training regarding Adult Protection. All additional staff, including ancillary staff, should receive training in the recognition of abuse and whistle blowing. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 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 standard(s) 19, 20, 22, 25 and 26. Service users do not live in a safe, well-maintained environment. Service users do not have access to safe indoor and outdoor facilities. Service users do not always have the specialist equipment they require. The home is not clean or hygienic. EVIDENCE: Staff advised that the lack of regular maintenance input was leading to a backlog of items for repair and attention. This was confirmed from the home’s records of requests made to head office and observations of the premises. Examples included a bedroom call bell not working since 13.8.05 and three emergency lights on one floor not working since 8.8.05. Questions were raised about the adequacy of the home’s ventilation system and staff advised that batteries were not installed in the extractor fans. Several expelair were observed not to be working. Several issues were identified that impacted on the safety and welfare of residents in relation to health and control of infection. These were: Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 15 There were several carpets that were stained. Carpet cleaning machines were of a domestic type not suitable for use in a care home. Waste bins in the home were not adequate for use in a care home. Several were small and flimsy with hand operated lids. All bins should be foot operated. Clinical waste bins were used for the collection of ordinary waste. Some clinical waste bins were full of used continence pads. This resulted in offensive odours in bathrooms. Waste bins should be emptied as soon as they are full. Water in staff hand washbasins was too hot meaning that staff were not able to practice good hand washing techniques. There was not always paper towels and liquid soap available for staff hand washing. In some cases inappropriate antiseptic hand wash was in use. Clean linen, pads, wipes and gloves were stored on top of dirty linen sacks. This was because there were not any linen trolleys provided. Soiled linen was not appropriately dealt with either by the carers and laundry staff. There were no alginate bags available to put soiled linen in. There was not any cleaning equipment available on the second floor with which to deal with immediate issues. Baths and showers were not cleaned immediately after use. These were marked with what appeared to be faeces. Sluice disinfector machines were on each floor. The one on the ground floor did not work. Cleaners mops were noted to be grubby, there did not appear to be a routine of cleaning or disposal of these. These issues have been discussed with the specialist nurse from the Health Protection Agency who is following up any progress in this area. Further safety issues were identified as follows: One of the windows had fallen from it’s casing and was taped in with adhesive tape. The windows on all floors could be opened to an extent where residents could fall through. All windows must be secured so that their opening width is restricted. There is a small garden at the side of the building, which is designated as the means of exit from the Fire collection point. The gate to this was blocked with Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 16 a bolt. This meant that, in the event of a fire, residents would be trapped in close proximity to the building. The lounge designated as a smoker’s area did not have any mechanical ventilation of a means of calling a nurse. All doors were wedged open with chocks. Permission for this should to be gained from the Fire Officer. Food, cutlery and crockery were stored on open view in all of the dining rooms. There are not any designated storage areas in these rooms. The fuse cover at the back of the sluice on the second floor was broken. One stair well was obstructed with a vacuum cleaner, a trolley and a pushbike. The Fire Officer addressed some of these issues during his visit to the home. Further issues identified in the premises were: There were only two adjustable nursing beds. These should be provided for all residents requiring nursing care with priority given to those spending a lot of time in bed, those with complex moving and handling needs and those residents of high dependency. The kitchen was inadequately equipped with domestic equipment. There was no food mixer or processor. There were inadequate amounts of crockery, cutlery, tea-pots and milk jugs. There were not enough storage shelves in any storeroom, particularly the linen room and hairdressing room. Towels and linen in these areas were stored on chairs or over boxes. The sinks in the hairdressing room were too low, residents were unable to use them. Hairdressing was taking place in the sluice room. This is not acceptable. The payphone provided for resident use did not work as there was not any socket to plug it in. There were not enough shower chairs. One shower chair was shared on each floor. There should be one chair per shower. There were not any privacy nets at any windows. The pavement and some by the storage rooms of shops opposite overlooked some bedrooms. There was a strong smell of drains in bedroom 52 and in the toilet opposite. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The numbers and skill mix of staff on duty did not meet service users needs. Service users are not in safe hands at all times. Service users are not protected by the home’s recruitment procedures. Staff are not trained to do their job nor assessed as competent. EVIDENCE: Seven staff were on leave at the same time and this was causing serious shortages and unavoidable use of agency staff. Cook was on holiday and the kitchen assistant was in charge of catering with support from agency staff. It was common for only one person to be working in the kitchen and this is insufficient for the number of residents. There was only one domestic on duty each day for the whole home and the care assistants were being used to assist with cleaning duties. Only one laundry person is employed in the laundry and provides cover over five days. There is no regular maintenance input and staff call head office when repairs are needed. On the Dementia unit one RMN is employed for three nights with agency nurse cover for the other nights. Two carers support the night nurse and on some occasions these are both agency staff. It was identified that new night carers were commencing work at the home without any supernumerary time. Two part-time and one agency RMN cover this unit during the day and are supported by three carers. Regular nurse cover was better on the general unit with support from two carers at night and three during the day. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 18 Agency staff were being used for twelve shifts during the week of the inspection. One staff member had recently been employed in the laundry. She had not received training in moving and handling, infection control or COSHH. She had not been provided with a uniform of protective clothing and was wearing a borrowed uniform from a friend within another organisation. The acting manager was unsure of the NVQ status of the care and ancillary staff. Staff recruitment was ongoing and the acting manager confirmed that she sometimes had to interview alone. Shortfalls in the observed recruitment records included: : No evidence of original qualifications : Other than photographs no evidence of identification : No interview records : No terms and conditions : No reference to relevant clinical update or additional qualifications : Lack of professional references and references from previous employers. (References seen were from personal friends and work colleagues). There were no performance reviews and none of the staff have received formal supervision. As yet staff have no contracts of employment or any terms and conditions. The acting manager has been given blank documents and told to complete and issue them. The staff register was not fully up to date. There was good evidence of the nurse’s registration details. There are no training records for any of the staff despite the satisfactory induction that was given to staff employed when the home opened. There was no evidence of induction for a carer who had commenced in August and the inspector was advised that the TOPSS induction arrangement in place at registration had ceased. There had been no dementia care training. The deputy manager had managed to formulate a staff-training plan, which had not yet commenced. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 35, 36, 37 and 38. Service users financial interests are not safeguarded. Staff are not appropriately supervised. Service users are not safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are not protected. EVIDENCE: The senior staff were experiencing serious inconvenience in the absence of a printer and were having to print essential items on their personal home equipment. Also staff were seen struggling to change the ink in the photocopier. It was identified that the Acting Manager requires more administrative support to address the backlog of serious concerns identified at this inspection. This should include adequate equipment to do the job. There should not be any need for staff to use their own personal equipment. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 20 The arrangements for safekeeping of resident’s personal monies were examined. Only one audit had been carried out since the home opened. Evidence was found of a resident who had bought her own waterproof mattress and pillow cover. These items should be purchased by the home. The storage of valuables such as jewellery was inadequately recorded. No petty cash had been provided since 5th September 2005 and there was only £2:87 in the kitty for any financial emergency!! In the absence of suitable lockers staff were leaving their bags and valuables in insecure areas around the home. The home has two fire trainers however training was not up to date with only two night staff reportedly having attended. Written evidence of their attendance was reported as lost. The written fire risk assessment seen at registration was unobtainable. It was confirmed that the fire alarm had not been tested since 30th June 2005. There was no record of any checks on the emergency lighting system since registration. There was no evidence available of any Regulation 26 monthly visits by the homeowner. The acting manager did not know how many of the staff have up to date first aid qualifications or whether the ‘acting’ cook had received suitable food hygiene training. There were no performance reviews and none of the staff have received formal supervision. The incidence of accidents appeared high with 32 resident accidents recorded since 1st August 2005. There is no incidence audit in place. Many records were inadequately detailed with no record of what residents had fallen from, the time of the incident, how they were found and recovered and whether bed safety rails were in use. Four staff accidents had occurred and three of these had resulted in back injuries. This section should also take account of issues previously mentioned relating to lack of staff training, health and safety issues and lack of proper working equipment. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 1 1 x 2 x x 2 1 STAFFING Standard No Score 27 1 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 x x x 2 1 1 1 1 Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 22 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. 2. Standard op1 op2 Regulation 4 4, 5, 6 Requirement The Statement of purpose must be reviewed to ensure that all details within it are correct. Residents should be issued with a contract that covers all areas identified by this standard. The terms and conditions of residency must be reviewed to ensure that they are accurate and up to date. Care plans must be reviewed to ensure that all aspects of physical, mental and social needs are addressed. There must be clear action plans for each assessment. Residents or their representative must sign their agreement to care plans and risk assessments. Bathing routines must be reviewed to the bathing of some residents more frequently. More storage cupboards must be provided for the storage of medication. Nurses should be reminded of their professional responsibilities Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 23 Timescale for action 1.12.05 1.12.05. 3. op7 15 1.12.05 4. op8 12(1) 13(3) 13(2)(3)( 6) 1.12.05 5. op9 op30 1.12.05 regarding the recording of medication. A medication audit must take place on a regular basis. Staff must adequate training in regards to medication. This includes any care staff who may be asked to countersign controlled drugs. Provide qualified staff with external training in the management of adult abuse. Provide all staff with training in abuse and whistle blowing. Provide evidence that all identified maintenace issues are addressed. Ensure residents have access to hair washing sinks by lowering them. Provide extra shelving in all storage areas. Repair expelairs. Repair broken fuse socket. Investigate and put right the cause of the drain smell. Ensure all windows are in working order. Fix window restrictors to all windows. Ensure that kitchen equipment is of suitable design for industrial use. Provide more crockery and cutlery. Ensure that the garden gate can be opened. B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc 6. op18 13(6) 1.1.06 7. op19 16, 13(4), 23 1.12.05 8. op20 23 Immediate Page 24 Thomas Knight Care Home Version 1.40 Seek the advice of Fire Officer regading the use of the smokers lounge and door chocks. Ensure that emergency exits, including stairwells, are free from obstruction at all times. Provide some storage equipment in dining rooms or remove all items. Provide privacy nets at bedroom windows. Provide residents with a working pay telephone. Provide adjustable beds to those requiring nursing care. Each shower unit should be provided with its own shower chair. Review the maintenance of emergency lights and confirm that they are all in working order. Provide industrial type bins that are foot operated. Ensure that all hot water is delivered at below 43oC. Provide disposable towels and liquid soap to all sink units. Provide each floor with a trolley for the transportation of clean linen. Provide a similar trolley in laundry. Provide a dirty linen skip for use in laundry. Provide alginate bags. Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 25 1.12.05 9. op22 23 1.1.06 10. op25 23 Immediate 11. op26 op38 13(3)(4) 1.12.05 Ensure that cleaning equipment is provided on each floor. Provide an industrial carpet cleaning machine. Review the cleaning schedule and the roles and responsibilities of staff as regards cleaning. Ensure that all items such as baths and shower chairs are included. Ensure that all sluice machines are maintained in working order. Devise a programme of cleaning and disposal of mop heads. 12. op27 op38 18 Conduct an urgent review of staffing. Take acount of comments made by the Health Protection and Environmental Health Units. Provide laundry staff to cover seven days per week until 4pm each day. Provide a qualified Cook seven days per week. Provide three full time domestics. Provide two care staff on every night shift on the second floor. All staff should TOPPS induction training. Staff recruitment should be reviewed to include all of the areas identified in this section. Immediate 1.12.05 13. 14. op28 op29 18 18 1.12.05 1.12.05 15. op30 op38 18 Provide staff with terms and conditions of employment as well as contracts. Ensure that all staff have 1.12.05 statutory training. B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 26 Thomas Knight Care Home Train staff in Dementia care and the management of medication. Provide a training plan that takes acount of assessed training needs of all staff. The Provide must provide the 1.12.05 CSCI with a business plan taking account of the issues raised in this report. Review the amount of petty cash available in the home. Provide a refund of money to the service user who paid for a mattress cover. Reorganise the recording system to ensure proper recording and audit of service users finances. Commence a programme of formal staff supervision. Provide suitable equipment with which to produce documents and keep records. Provide an increase in the amount of administrative support. Conduct a review of accidents within the home and demonstrate monitoring of these. Review the moving and handling techniques within the home. Provide staff with secure storage facilities for valuables. Ensure that Fire prevention tests checks and training are up to date. 16. op34 25 17. op35 12 13(6) 20.10.05 18. 19. op36 op37 18(2) 12(5) 18(1) 1.12.05 20.10.05 20. op38 13(4) 23(3) 1.12.05 Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard op9 op27 Good Practice Recommendations Provide medication storage on all floors. Provide one nurse and two care staff to each floor throughout the night. Provide one staff member on the second floor throughout the day. 50 of home staff should be qualified to NVQ level 2 by end of 2005. 3. 4. op28 Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 28 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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 Thomas Knight Care Home B53-B03 S60989 ThomasKnight V237736 120905 Stage4.doc Version 1.40 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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