Care Home: Keswick

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What the care home does well Prospective residents are only admitted to the home following a detailed needs assessment in order to establish if assessed needs can be met. The care planning process is good and resident`s needs and preferences are outlined in well maintained care plans, which are person centred. The activity arrangements provide residents with a varied programme of recreational activities on individual units or in the day centre. The nutritional needs of resident`s are met and the chef/manager plans a varied and wholesome menu, which received good feedback and positive comments during the inspection. The organisation is very committed to the training and development of staff and individual staff profiles are in place. Staff recruitment procedures are robust, and protect the residents. The home is well maintained, clean and hygienic. Resident`s accommodation is arranged over seven units providing homely and comfortable living space. There is also a large lounge on the ground floor which is used as the day centre, and for home functions and gatherings. A large garden provided relaxation, and garden activities for the both day centre clients, and home residents. The home is well managed in the best interests of the residents and the health, safety, and wellbeing of the staff and residents are observed and protected. What has improved since the last inspection? The requirements and recommendations made as an outcome of the last inspection have been met. All care plans are now reviewed regularly reflecting the changing needs of residents. These plans also include risk assessments for residents at risk of developing pressure sores. Records are stored in a secure place when not in use. Staff employment records include all the required documentation. A fire risk assessment was undertaken and advice sought on the policy of leaving fire doors open. Arrangements for formal staff supervision have been reviewed and this is now recorded as required. Weight fluctuation is managed and recorded. CARE HOMES FOR OLDER PEOPLE Keswick Keswick Eastwick Park Road Great Bookham Surrey KT23 3ND Lead Inspector Mary Williamson Unannounced Inspection 10:00 12 August 2008 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Keswick Address Keswick Eastwick Park Road Great Bookham Surrey KT23 3ND 01372 456134 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) shona.bradbury@anchor.org.uk www.anchor.org.uk Anchor Trust Ms Shona Bradbury Care Home 51 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (51), of places Physical disability over 65 years of age (10) Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Of the 51 Residents accommodated, up to 15 may fall within the category DE(E). Of the 51 service users accommodated, up to 10 may fall within the category PD(E). 13th August 2007 Date of last inspection Brief Description of the Service: Keswick is a care home providing personal care for older people. Anchor Trust, a non-profit making national care provider, operates the home, which is situated in a quiet residential area in the village of Great Bookham. The high street is nearby where there is a small range of shops and other amenities. The home is adjacent to a health centre and junior school. Accommodation at the home is arranged in seven residential living units. Each has six to eight single occupancy bedrooms, a communal lounge/dining room with open plan kitchenette, bathroom and toilet facilities. The two-storey building is wheelchair accessible throughout with passenger and wheelchair platform lift provision. A large lounge/dining room on the ground floor is used for activities and social functions organised by the home. Anchor Trust operates a day centre service for older people living in the community in this lounge during the week. People living in the home have an ‘open invitation’ to join in the day centre activities at any time. A spacious conservatory overlooks the home’s attractive garden. There is a furnished patio, lawns, mature trees, shrubs and flowers. Access to an enclosed garden is through the lounge of one of the residential units. The main entrance lobby is light and airy with a reception desk and a seating area. Car parking spaces are provided to the front and side of the property. Fees charges are £649 per week Keswick DS0000013691.V369181.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 a two star rating. This means that people living in this service experience good quality outcomes. This was the first site visit of a key inspection and was unannounced. Mary Williamson, Regulation Inspector undertook the inspection. The deputy manage facilitated the commencement of the inspection and she was relieved after two hours by the home manager. A tour of the premises was undertaken and records relating to the care of the residents and the management of the home were examined. It was possible to meet and talk with residents to gain their views and experiences about living in the home. It was also possible to meet and talk with the staff in duty and get some feedback about how they find working in the home and explore some of the training they had received. Lunch was observed being served and various activities were noted. The term ‘residents’ is used in this report when referring to people who use this service, as their expressed wish. The CSCI would like to thank the residents, staff and management team for their assistance, hospitality and input throughout the inspection process. What the service does well: Prospective residents are only admitted to the home following a detailed needs assessment in order to establish if assessed needs can be met. The care planning process is good and resident’s needs and preferences are outlined in well maintained care plans, which are person centred. The activity arrangements provide residents with a varied programme of recreational activities on individual units or in the day centre. The nutritional needs of resident’s are met and the chef/manager plans a varied and wholesome menu, which received good feedback and positive comments during the inspection. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 6 The organisation is very committed to the training and development of staff and individual staff profiles are in place. Staff recruitment procedures are robust, and protect the residents. The home is well maintained, clean and hygienic. Resident’s accommodation is arranged over seven units providing homely and comfortable living space. There is also a large lounge on the ground floor which is used as the day centre, and for home functions and gatherings. A large garden provided relaxation, and garden activities for the both day centre clients, and home residents. The home is well managed in the best interests of the residents and the health, safety, and wellbeing of the staff and residents are observed and protected. What has improved since the last inspection? The requirements and recommendations made as an outcome of the last inspection have been met. All care plans are now reviewed regularly reflecting the changing needs of residents. These plans also include risk assessments for residents at risk of developing pressure sores. Records are stored in a secure place when not in use. Staff employment records include all the required documentation. A fire risk assessment was undertaken and advice sought on the policy of leaving fire doors open. Arrangements for formal staff supervision have been reviewed and this is now recorded as required. Weight fluctuation is managed and recorded. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 7 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. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, and 6 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents and their relatives have access to sufficient information to help them choose to live in this care home. All residents have a needs assessment in place prior to admission. Individual contracts of occupancy are in place. The home does not provide intermediate care. EVIDENCE: The home has a statement of purpose and residents guide in place. A copy of this is available to all prospective residents and their relatives prior to admission in order that they have the information necessary to help them choose the home of their choice. This is also available in audio tape format. Two residents stated that their family had access t this information which they shared with them before choosing Keswick. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 10 Individual needs assessment are in place. These are undertaken by the home manager or a senior experienced member of staff, in order to establish if the home will be able to meet the specific individual needs highlighted in the assessment. Anchor has its own assessment tool which is comprehensive and a good working document. A pre admission needs assessment was sampled from each unit and these were informative and reviewed to meet changing needs of the residents. Contracts of occupancy are in place. The contracts seen include the accommodation offered, the support provide, and the amount, frequency and method of fees payable. Contracts are signed by the resident or a designated representative, and includes a four week mutual trial period. Intermediate care is not provided. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individual care needs are outlined in well maintained care plans. Appropriate arrangements are in place to meet resident’s health care needs. The medication policy in place protects residents living in the home, and privacy and dignity is observed. EVIDENCE: Care plans have greatly improved since the last inspection. These are person centred and based on the needs assessments. Residents are involved in the development of their care plan as much as possible. Information is also used from relatives, health care professionals and any other relevant reports. A care plan was sampled on each unit and found to be well maintained. These include daily living activities and goals, a range of risk assessments, care objectives and how these are to be achieved. These are signed by the person completing the care plan and by the resident or a designated representative. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 12 Anchor Trust has a system in place whereby a team leader is delegated responsibility for one outcome area. A named team leader has responsibility for the maintenance of care plans, and coordinating reviews of care. Relatives are also encouraged to take an active part in this process. All residents are registered with a local GP who visits the home on request. There is also good district nurse support who will advise on pressure area care, monitor pain relief, undertake dressings, take blood samples for investigation and administer flu vaccines. There is also a chiropody service provided by the NHS or privately if required. Arrangements can be made for residents to see the dentist and optician. The continent adviser visits the home and specialist aids, and pressure relieving equipment is provided when necessary. Specialist input can be accessed by the GP. The home has a medication policy in place that protects residents living in the home. All staff who administers medication are familiar with this policy. The medication is supplied to the home by Boots the chemist, who also undertake audits of medication and staff training. There is also a corporate training procedure in place for staff prior to being assessed as competent to undertake medication administration. Each unit has a trolley from which daily medication is administered. There is also a central medication room for stock and the storage of controlled medication. The medication recording charts (MAR) were seen and are well maintained. Medication is checked daily by a senior staff and any discrepancies recorded. A team leader has overall responsibility for the ordering, receiving, returning, and maintaining audit trails of medication within the home. Privacy and dignity is observed and residents are able to receive personal care in private. Facilities are also available for residents to receive visitors in private, and keys can be provided for bedroom doors on request. Staff were observed to be polite and caring, and interact with residents in a respectful and professional manner. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The activity programme in place meets the individual and collective needs of the residents. Nutritional needs of residents are being met and there are good links with relatives and the local community. EVIDENCE: It was possible to talk with the activities coordinator and the manager of the day unit at length and gain some feedback on how activities are arranged in the home. Activities are provided on individual units usually in the afternoons and include word games, card games, bingo, music, gentle exercise, and videos. Residents from individual units are invited to join in activities in the day unit, which is run for non residents in the main lounge on the ground floor. Various outings are arranged for example visits to Wisley gardens, the theatre, and other local attractions. Events like cheese and wine evenings, coffee mornings, evening concerts, and garden parties are organised and friends and family usually attend. Special occasions and birthdays are celebrated. The home benefits from large well maintained gardens. Residents stated that they enjoy outdoor garden activities. For example residents have planted pots Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 14 of vegetables, and flower baskets. There are various themed areas where residents may sit including a reminiscence corner and a memorial garden. Family and community links are maintained, and visitors are welcome in the home at any reasonable time. Relatives can participate in care reviews and arrange to have a meal with a resident if they wish. A resident stated that she looked forward to having visitors and going home. Community links are maintained and residents may go shopping locally, or visit the park. Spiritual needs are supported and visits from various clergy are encouraged and can be arranged on request. The vicar from the local church visits regularly and provides a Holy Communion Service in the home. The catering arrangements in the home are satisfactory. There is a new chef/ manager in post and a deputy chef is expected to commence employment two weeks from the inspection. The chef is responsible for planning the menus which are balanced, varied and take into account the needs and choice of residents. The chef stated that he had met with the residents to gain some feedback on the standard of the catering and listen to suggestions. Lunch was observed being serves in the dining rooms on various units. Residents were relaxed and appeared to be enjoying their food in an unhurried atmosphere. One resident stated that “the food is very good here” and another “we get lovely food” and “it’s like home from home”. The kitchen was visited and was clean and orderly. All the required documentation was in place regarding food hygiene. The kitchen assistant on duty needed her food hygiene training updated. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are able to express their concerns and have access to a robust, effective, complaints procedure since the last inspection. They are safeguarded from abuse and have their rights protected. EVIDENCE: The complaints procedure is included in the resident’s guide which all residents and their relatives have access to. There is also a leaflet located in the reception area titled ‘Compliments, Concerns, and Complaints’. This enables residents and non residents to complete this form expressing their views about the home at any time. These forms can also be completed anonymously. Information is also provided on this form on how to contact the CSCI with concerns. There is a complaints log maintained and there has been one formal complaint received in the home since the last inspection which was managed effectively using the complaints procedure. Minor concerns and irritations are also recorded. The CSCI has not received any complaints since the last inspection. The home has a safeguarding procedure in place. All staff undertake training in this procedure during their period of induction. This is mandatory training Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 16 and is repeated annually. During discussion with staff it was obvious that they were aware of this procedure and felt confident that if they reported an incident of abuse it would be managed according to procedure. There is a copy of Surrey’s Multi Agency Policies and Procedures on Safeguarding Vulnerable Adults in place and all senior staff have attended training in these procedures and this has been cascaded throughout the staff team. There have been no safeguarding referrals under these procedures since the last inspection. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, and 26. The people who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is suitable for its stated purpose. Residents live in a clean, safe, and well maintained environment that meets their individual and collective needs. EVIDENCE: A tour of the premises was undertaken. Accommodation is arranged over seven units each with its own lounge and dining area for six to eight residents. There is also a large lounge located on the ground floor which is used for day care and home functions and activities. Individual bedrooms are well decorated and furnished and provide residents with comfortable private space. All bedrooms are fitted with wash hand basins. Some residents invited the inspector to view their rooms all of which have been personalised to reflect individual personalities. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 18 The home is clean and hygienic and a team of five cleaning staff maintain this standard of cleanliness throughout the week. There is a control of infection policy in place and all staff have undertaken training on infection control. The main laundry is located on the ground floor and there are two smaller laundries situated on two of the units. The home has a vacancy for a laundry person to work in the home for sixteen hours a week. This is currently been overseen by the care staff. A discussion took place between the inspector, the home manager, and the projects manager regarding the benefits of having a laundry assistant in post and it is anticipated that this post will be recruited to by September 2009. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30. The people who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by the number and skill mix of staff employed in the home. Recruitment practice and commitment to staff training protect the residents living in the home. EVIDENCE: There is a stable core staff team working in Keswick and the staff on duty during the inspection were competent and were observed undertaking their duties in a professional and confident manner. The staff team includes five team leaders, one care assistant working on each unit and two additional carers to provide support on various units as required. In addition to the care team the home employs a chef, two kitchen assistants, a team of cleaners, maintenance staff, an administrator, a receptionist, two activities coordinators, and a day care manager. A deputy chef and a laundry assistant have been recruited to commence employment in August and September respectfully. Individual staff training profiles are in place. All staff undertake the Anchor Trust BTEC certificated induction programme. During discussion with the staff on duty they were able to confirm some of the training undertaken and how this applies to their care roles. The home has a team leader responsible for back care training who is also an NVQ assessor. National Vocational Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 20 Qualification training is ongoing and the inspector was informed that progress is being made to meet the required workforce training targets. There is a year planner on the manager’s office wall outlining all the training available and when staff are due to undertake this training. The recruitment procedure in place is robust and protects the residents. Three staff employment files were seen. These are well maintained and contain all the required documentation relating to employment legislation, including two written references, an employment history and a Criminal Records Bureau (CRB) disclosure. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is managed in the best interest of the residents. Financial procedures in place protect residents, and the health, safety and wellbeing of staff and residents are observed and promoted. EVIDENCE: On the day of the inspection the home was functioning well with all staff undertaking their duties and responsibilities in a confident and professional manner. One of the deputy managers on duty participated in the commencement of the inspection and introduced the inspector the residents in the home and the staff on duty. The registered manager has recently been Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 22 reallocated to new project within the organisation. A new home manager had been appointed the previous day, who had been undertaking managerial duties in the home for several weeks prior to her appointment. It was possible to meet the new manager and her line manager who both arrived in the home following an organisational management meeting and stayed for the duration of the inspection. The new manager has worked with Anchor Trust for several years and is in the process of completing her Registered Managers Award (RMA). The organisation now intends to proceed with an application to register the manager with the CSCI. There are two deputy managers in post with considerable experience between them, and carry out various roles for example assessment of NVQ, supervision, and recruitment. Systems are in place for monitoring quality assurance. Regulation 26 visits are undertaken monthly and reports retained in the home for information. Residents complete a pre review questionnaire which is discussed with them at their review. Annual quality review questionnaires are sent to residents, relatives, and other stakeholders and feedback analysed and acted upon. Regular audits of care plans, medication, and cleanliness are undertaken. Health and safety audits are undertaken and the home has successfully achieved the “Safe site award” from the organisation. Residents meetings are held monthly on a different unite each month providing all residents with the opportunity to attend and air their views. The chef also meets regularly with residents to monitor catering arrangements and seek feedback about the food offered. Resident’s financial interests are safeguarded by the procedures in place. The AQAA indicated that no staff act as appointee for residents and only small personal accounts are managed by the administrator for hairdressing, and sundries. The health, safety, and welfare of residents are observed and promoted. Risk assessments are in place for all identified risks and safe working practice. All staff undertake health and safety training and this is updated annually or when new procedures are introduced. The organisation has a wide and varied range of health and safety policies and procedures in place some of which were sampled during the inspection. A full fire risk assessment has been undertaken on the building and fire safety is observed. Accidents and incidents are recorded, reported accordingly, and acted upon. Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Keswick DS0000013691.V369181.R01.S.doc Version 5.2 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!