Care Home: John Kirk House

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What the care home does well Residents reported that they liked living at the home and that staff were responsive to their individual needs. Residents were supported to take part in fulfilling activities and to access local leisure and shopping facilities, and other community amenities. The individuality of the residents was recognised by staff, including cultural needs. The staff group responded well to meeting the varied needs of the residents, in accordance to different disabilities and physical and health care needs. What has improved since the last inspection? Ten requirements were issued at the previous inspection; five of these requirements were met at this inspection visit. The service evidenced that reviews were being regularly conducted and the individual residents` plans contained `health care plans`. The service demonstrated that the medication refrigerator temperature was being recorded daily and a valid public liability insurance certificate was produced. A satisfactory and varied supply of fruit was available throughout the inspection visits. Recommendations were met regarding the provision of pictorial complaints guides for residents, documentation that references have been verified and the reviewing of staffing levels to meet flexible working with residents. What the care home could do better: Three requirements have been repeated, which relate to medication practices. The service needs to review its systems for enabling residents to manage their own medication, and a more vigilant approach needs to be undertaken for checking expiry dates on medications. The service also needs to ensure that staff (and self-medicating residents) has clearly specified instructions for applying prescribed topical creams and lotions. Requirements for the refurbishment of the communal areas of the home and for the clear marking of opening dates on food have been repeated. A new requirement has been issued for the service to repair the garden shed. Recommendations have been issued for residents to be provided with a Sanctuary Care contract (including pictorial style contract) and to provide information at residents meetings regarding whether issues have been actioned. CARE HOME ADULTS 18-65 John Kirk House 25 Pearl Close Beckton London E6 5QY Lead Inspector Sarah Greaves Unannounced Inspection 31 January and 8 February 2008 12 pm st th John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 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 John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service John Kirk House Address 25 Pearl Close Beckton London E6 5QY 020 7511 6636 020 7511 9013 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) www.sanctuary-care.co.uk Sanctuary Care Ltd Care Home 14 Category(ies) of Learning disability (14) registration, with number of places John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can accommodate one named service user over the age of 65 years 1st September 2006 Date of last inspection Brief Description of the Service: John Kirk House is a registered care home for fourteen people with learning disabilities. Sanctuary Care manages the home, which is a voluntary sector provider of care services. John Kirk House is situated in Beckton, within easy reach of local buses, an underground station, a large supermarket and other amenities. The care home is divided into four separate living units; two of these units are located on the ground floor and two units are on the first floor (accessible by stairs). The premises contain a flat occupied by one person; this part of the building is not required to be registered by the CSCI. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that people who use the service experience good quality outcomes. This unannounced key inspection was conducted over two days. The inspector commenced the inspection on Friday 31st January and returned to complete the inspection on February. The second inspection date was undertaken in order to meet more of the residents and obtain their views regarding the service. During the inspection visits, information was obtained through speaking to residents, staff and the manager, as well as reading care plans, checking staff files (for recruitment procedures, training and development, and supervision), touring the premises and looking at the arrangements for managing the medication needs of the residents. The inspector checked the service’s compliance with the ten requirements and five recommendations issued at the previous inspection. What the service does well: What has improved since the last inspection? Ten requirements were issued at the previous inspection; five of these requirements were met at this inspection visit. The service evidenced that reviews were being regularly conducted and the individual residents’ plans contained ‘health care plans’. The service demonstrated that the medication refrigerator temperature was being recorded daily and a valid public liability John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 6 insurance certificate was produced. A satisfactory and varied supply of fruit was available throughout the inspection visits. Recommendations were met regarding the provision of pictorial complaints guides for residents, documentation that references have been verified and the reviewing of staffing levels to meet flexible working with residents. 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. The summary of this inspection report can be made available in other formats on request. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 7 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 John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of prospective residents (and their representatives) were addressed in a supportive manner through the provision of clear information about the service, good assessments and opportunities to make informed decisions as to whether to move in. However, the service must ensure that prospective and current residents are provided with valid and resident focused contracts. EVIDENCE: The inspector found that a new manager had been appointed since the last inspection. The manager had updated the Statement of Purpose and the Service Users’ Guide in order to reflect this change at the service. At the time of this inspection there were twelve residents living at the care home, although the service can accommodate fourteen people. There had been no new admissions since the last inspection, hence the inspector was unable to gather new evidence regarding the arrangements that the service conducted in order to support a prospective resident to view the care home and move in for a trial period. However, it has been noted at previous inspections that prospective residents have received a thorough assessment of their needs prior John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 9 to moving in, which has included assessments by external social care and health care professionals, visits by senior staff at the care home to prospective residents at their current residence, liaison with family members and other representatives, and opportunities for the prospective resident to visit John Kirk House. A recommendation was issued in the previous inspection report for the service to develop pictorial style contracts for residents. The inspector also noted at this inspection visit that residents still had contracts issued by the former provider of the service rather than new contracts stating that the provider is Sanctuary Care. The manager had been in post for a month at the time of this inspection and was aware that this recommendation had not been addressed. This recommendation will be repeated in this report with a timescale for action. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assured that their individual and holistic needs will be addressed through the care planning process, which recognises their entitlement to make choices, take balanced risks and be protected from risks that would impact upon their safety and welfare. EVIDENCE: A requirement was issued in the previous inspection report for the service to ensure that the care plans clearly documented that these documents were being regularly reviewed. The inspector read four care plans and noted that the care plan objectives were being reviewed every six months, in addition to residents receiving annual reviews by their placing authorities. The inspector had previously discussed concerns regarding the format of the care plans, identifying the need for a more streamlined and precise style, as the current John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 11 system appeared outdated. The manager confirmed that the service provider has developed a new care planning system, which was being printed for distribution at the time of this inspection. The inspector had already had an opportunity to look at the new care planning system and shared the manager’s opinion that the new system will enable staff to demonstrate their understanding of the residents needs in a more effective and organised manner. The inspector spoke to several residents and found that they were supported to make choices about their lives. At the time of this inspection, the service had drawn up specific guidelines for one resident to address a health care need, which had been produced with input from the resident, health care professionals and day centre staff. The resident was able to explain to the inspector why this guidance had been developed and confirmed that they had been fully consulted. The inspector noted that the care home provided a service to people with very different needs in regard to their learning disabilities and physical care needs; hence it was acknowledged that not all of the residents were in a position to clearly articulate their wishes and aspirations. However, the care plans for more dependent residents demonstrated that staff closely observed residents in order to understand which activities they enjoyed and responded well to, so that people could be offered meaningful and fulfilling choices. The inspector looked at the minutes for the residents meetings. The frequency of the meetings had been commented upon through the monthly unannounced monitoring visits by the regional manager (the meetings had not consistently been held each month); the inspector also observed that the minutes did not always evidence if the requests of the residents had been addressed (for example, if residents asked for a specific outing or the purchase of recreational equipment). Via discussion with the manager, it was noted that the importance of conducting these meetings every month was understood. Each care plan viewed at this inspection contained risk assessments, which appeared relevant to the individual needs of the residents and were regularly reviewed. It is acknowledged that new risk assessments will be produced when the service transfers to the new care planning system. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to enjoy fulfilling activities within their home and in the community. Important relationships are promoted, and the nutritional needs of the residents are met through consultation, choice and any required support. EVIDENCE: Via the reading of the care plans and the residents’ meetings minutes, and through speaking to residents and staff, the inspector found that people were offered a varied programme of activities to meet their cultural, social and therapeutic interests. Several of the residents attended local day centres and clubs and other residents participated in leisure activities that also addressed their health care needs (for example, swimming and hydrotherapy). Some of the residents had requested a trip to Blackpool, which took place, and other John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 13 residents went to a holiday centre with a day centre club. The service organised entertainments such as trips to banger racing and the cinema, pub lunches and parties, as well as bringing in entertainers and celebrating birthdays and cultural events. The care plans also evidenced that residents were supported with trips to local shopping centres, although some residents were able to shop independently in accordance to their risk assessments for travelling on public transport and managing their finances. One of the residents described his contact with family members; the resident chose to make visits as this met the specific health needs of the relatives. The service offered flexible visiting arrangements and supported residents to attend family occasions such as weddings or a special event at a place of worship. This evidenced that staff have established good relationships with relatives and demonstrate an understanding of the importance of enabling residents to take part in events that reflect their role within their family and/or their wishes to participate in their cultural traditions. As previously stated in this report, the service provides care to people with significantly different needs due to their individual learning disabilities and health care needs. This was discussed with the manager; for example, a couple of the residents would be able to progress to living in more independent settings. The inspector observed some good examples of how the service recognised the rights of the residents, such as encouraging people to work with their social workers towards new objectives (applicable to the more independent residents) and supporting other residents to become involved in household tasks for their laundry or tidying their rooms. A recommendation was issued in the previous inspection report for the service to make sure that there was an adequate supply of fresh fruit throughout the day; it was noted that this recommendation had been addressed. The inspector looked at the food supplies and the menu plans, which demonstrated that there was a wide choice of food that reflected the preferences and cultural needs of the residents. The service offered different choices for cereals, snacks and beverages, including healthy options. Some of the residents were supported at meal times, which was conducted in accordance to guidance provided by speech and language therapists (to address difficulties in swallowing). On the first day of the inspection, the inspector noted that the individual food records for the residents that needed support were not being consistently completed with sufficient detail although this was remedied on the second day of the inspection. The inspector and manager found twenty tubs of margarine stored in the small refrigerator in a unit kitchen for four residents. It appeared that this refrigerator was inappropriately being used for general storage purposes rather than its intended use as a facility for the residents to store varied supplies from the main kitchen, and their own purchases or food items provided by John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 14 visitors. It was also noted that staff used this refrigerator to store their own food; the inspector suggested the provision of a separate staff refrigerator. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although the service demonstrated good practices to meet the personal and health care needs of the residents, a more robust approach needs to be taken to ensure that medication is safely managed. EVIDENCE: The care plans demonstrated that the personal care needs of the residents were clearly identified and addressed. One of the resident’ s informed the inspector of how staff offered flexibility with the time that the resident had a daily shower and responded to a preference to be supported by a person of the same gender; this approach was witnessed during the inspection. Via discussions with the manager and staff, and through looking at four care plans, the inspector was satisfied that the service responded promptly to any health concerns. All of the residents were registered with local health practitioners (such as doctors and dentists) and staff supported people to John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 16 attend hospital and clinic appointments). The care plans evidenced that residents received other support as required to address specific needs, such as input from district nurses, psychologists, and speech and language therapists. A requirement for all of the residents to complete health care plans had been met. One of the residents was in hospital at the time of this inspection and was being visited regularly by staff. Three requirements were issued in the previous inspection report for regarding the service’s management of residents’ medication. A requirement was issued for the service to ensure that all expired medication was disposed of, including the medications for residents that were self-medicating. It was noted at this inspection that a prescribed topical cream (Betnovate ointment) had been dispensed on the 23/10/07 and needed to be disposed of within four weeks of opening; however, the service had not recorded the date of opening so it could not be accurately established if the medication was valid or not. A requirement was issued for the service to ensure that respiratory inhalers that had been issued to residents were safely stored (for example, the bedroom of the individual should be kept locked and/or the inhaler stored in a lockable facility). The inspector and the manager checked upon the storage arrangements for a resident that self-medicated; the door to the bedroom was open and three different medications (two bottles of tablets and a respiratory inhaler) were found in a plastic container next to the bed. The manager was advised to temporarily suspend the arrangements for this resident to selfmedicate until these issues were addressed. A requirement was issued for the service to ensure that there were clearly recorded guidelines for the administration of prescribed topical creams. The inspector found four prescribed topical creams had been left in a communal bathroom; these were brought back to the resident’s bedroom during the inspection. It was noted that two of the creams did not have specific guidelines for administration on the pharmacy labels and this information was not recorded on the medication administration records. The inspector found a prescribed jar of thickening granules for adding to beverages left in a prominent position in the kitchen. The three requirements relating to medication practices have been repeated in this report. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assured that they will be listened to and protected through the service’s procedures and staff training. EVIDENCE: The service produced a comprehensive complaints procedure, as well as a pictorial complaints guide for the residents. No concerns were identified regarding the service’s management of complaints. Residents expressed that they felt able to approach staff with their concerns. The Adult Protection policy was written in accordance to Department of Health guidelines. Staff had received training from the Newham Safeguarding Adults Team and training delivered by the service provider. There had been one Adult Protection allegation since the last inspection, which was thoroughly investigated by the service and the local authority. The inspector attended a meeting regarding the allegation, which was also attended by the relative of the resident that made the allegation. The issues that arose were indicative of the need for the service to have a permanent manager in place to resolve any staff issues as opposed to inappropriate care of the resident, which should now be resolved through the appointment of a permanent manager. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although residents are supported to enjoy individualised bedrooms, the service needs to improve upon the appearance and comfort of the communal areas. EVIDENCE: A requirement was issued in the previous inspection report for the service to refurbish the communal lounges and kitchens; this requirement had not been met. Via discussion with the manager, the inspector was informed that this work is planned for this year. The requirement has been repeated with a new timescale for completion. The inspector observed that there were areas for improvement with the environment, particularly the need to create more homely bathrooms and toilets. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 19 The inspector was invited to view some of the bedrooms by the residents. There was good evidence of residents being supported to individualise their own rooms in accordance to their preferences and interests. The premises were found to be clean and free from any offensive odours, apart from an odour in one bedroom visited by the inspector and the manager. It was acknowledged that this was likely to be a temporary concern and the manager was requested to investigate and resolve this finding. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service demonstrated that the needs of the residents were met through appropriate staff training and safe recruitment; however, an annual training plan needs to be finalised so that staff are clear about their on-going development. EVIDENCE: The inspector requested to view a copy of the service’s annual training plan on the first day of this inspection. This document was not produced although the manager was able to evidence that work was being undertaken to formulate this plan. As previously stated within this report, the manager was very newly in post following an extended period without a manager. The inspector has noted that other approaches have been taken to address the training and development needs of staff such as meetings. Via the checking of staff files the inspector found that staff were accessing mandatory training and the service was booking training from a National Health Service organisation (such as meeting the needs of older people with Down’s syndrome, conflict John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 21 management and challenging behaviour, and supervision/appraisal training for senior staff. A recommendation was issued for the service to review its staffing levels so that the service was adequately covered when staff took residents out. This recommendation has been deleted following a check of the staffing rota and discussion with the manager. The inspector looked at three staff files; recruitment had been undertaken in accordance with the stipulations of the National Minimum Standards. A recommendation was issued in the previous inspection report for the service to evidence that all references have been checked (for example, documentation recorded that referees have been telephoned in order to verify the authenticity of the reference); this recommendation has been deleted. The manager stated that the service would be recruiting new staff, as there were three support worker vacancies and one vacancy for domestic staff. Staff received induction training and opportunities to undertake National Vocational Qualifications in Care. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although newly in post, the manager demonstrated that measures were being undertaken to provide residents with an effective and responsive service. A more robust approach must be undertaken to ensure that the safety of the residents is consistently met. EVIDENCE: The manager demonstrated that she had conducted meetings with staff, including a meeting with the night staff. The minutes of these meetings demonstrated that there were plans to introduce new ideas and developments that would benefit the residents and promote an improved working John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 23 environment for staff. The manager had previously worked with people with learning disabilities, although this was her first experience of managing a care home. The manager confirmed that she will be applying for registration with the Commission for Social Care Inspection and will be starting the Registered Managers Award in March 2008. On the first day of this inspection two residents were attending a Sanctuary Care quality assurance meeting in Hampshire, accompanied by two members of staff. This group met every six weeks. The inspector read the person-in – charge monthly monitoring reports, which evidenced that the views of the residents were being sought. It was noted that the residents’ monthly meetings had not been occurring every month but this was now being addressed. Discussions with residents indicated that they felt that their views about the service were listened to. A requirement was issued in the previous inspection report for the service to evidence that valid public liability insurance was in place; this requirement was met. A requirement for the service to demonstrate the daily recording of the medication refrigerator temperature was also met. The inspector checked the following health and safety records, which were found to be satisfactory: (1) electrical installations check by a competent person (2) portable electrical appliances testing (3) refrigerator and freezer temperatures (4) professional maintenance of fire equipment (5) first aid boxes and (6) weekly monitoring of the fire alarms. A requirement was issued for the service to ensure that opened food items were marked with the date of opening; however, it was noted that staff were not checking non-refrigerated food items for expiry dates (for example, tomato ketchup that needed to be disposed of within six weeks of opening had not been marked with the date of opening and the date for disposal). The inspector found that the garden shed had missing windows and did not lock properly, which presented a potential safety risk as it was used for the storage of paints and gardening tools. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 Standard No Score 1 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 X 3 X X 2 X John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 25 YES 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 Regulation YA20 13(2) Requirement The Registered Person must ensure that all expired medications are disposed of, including the medications of selfadministering residents. This is a repeated requirement. 2. YA20 13(2) The Registered Person must ensure the safe storage of prescribed respiratory inhalers. This applies to all medications that residents self-administer. This is a repeated requirement. The Registered Person must ensure that there are clearly recorded guidelines for the administration of prescribed topical creams and lotions. This is a repeated requirement. The Registered Person must ensure the refurbishment of the DS0000067464.V354120.R01.S.doc Timescale for action 15/04/08 15/04/08 3. YA20 13(2) 15/04/08 4. YA28 23(2) 31/08/08 John Kirk House Version 5.2 Page 26 small communal lounges and kitchens. This must also include bathrooms and toilets. This is a repeated requirement. The Registered Person must ensure that opened food items are labelled with the date of opening. This is a repeated requirement. The Registered Person must ensure that the garden shed is repaired, including the provision of a lock. 5. YA42 13(4)(c) 15/04/08 6. YA42 13 (4) (c) 15/05/08 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 YA5 Good Practice Recommendations The Registered Manager should develop pictorial contracts. This is a repeated recommendation to be met by 30/10/08. 2. 3. YA5 YA7 Residents should be provided with a contract from Sanctuary Care. The minutes for the residents meetings should record whether items have been actioned from previous meetings. John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 John Kirk House DS0000067464.V354120.R01.S.doc Version 5.2 Page 28 - 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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