Care Home: Kingston Care Home

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What the care home does well "One would not choose to live in a nursing home but if one has to, I feel that Kingston Care Home could not be bettered" and "it is very comforting to me to know my relative is in a well run and, in my words, `special` care home" were two comments from relatives or friends of people who live at the home. We think that home has made a lot of progress since we last visited in June 2007 and the quality rating of 2 stars reflects this. The home is well managed and has a staff team who work well together. Feedback about staff was generally very positive. Comments from relatives or friends included "we feel very happy and assured that our relative`s needs are met with very caring even loving staff" and "they show love + care and take pride in personal contacts". What has improved since the last inspection? Medication is well managed and the issues found at the June 2007 inspection have been put right. Mealtimes have been made a much more positive occasion for all involved. We saw some lovely interaction between staff and people who live there at the dining table. The activities programme has been improved and more trips outside of the home are being arranged. The home has been refurbished to a high standard. CARE HOMES FOR OLDER PEOPLE Kingston Care Home Jemmett Close Coombe Road Kingston Surrey KT2 7AJ Lead Inspector Jon Fry Unannounced Inspection 10:05 11 & 26th June 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 Kingston Care Home DS0000068285.V365566.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. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingston Care Home Address Jemmett Close Coombe Road Kingston Surrey KT2 7AJ 020 8547 0498 020 8547 0499 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) Four Seasons (No 9) Limited Mrs Veronica Scates Care Home 67 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0), of places Physical disability over 65 years of age (0) Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 24 service users in the Dementia - over 65 (DE(E)) category 43 service users in either the Old Age (OP) category and/or Physical Disability over 65 years of age (PD(E)) category. Date of last inspection Brief Description of the Service: Kingston Care Home provides nursing and residential care for sixty-seven older people. The home is located opposite Kingston Hospital with good access to public transport. Accommodation is provided over three floors that are served by a passenger lift. All bedrooms are single and en-suite. Kingston Care Home DS0000068285.V365566.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 star. This means the people who use this service experience good quality outcomes. One inspector carried out this unannounced inspection over two days. The inspector used the Short Observational Framework for Inspection (SOFI). This involves an observation of the activity taking place for a small number of people with dementia in a communal area. We spoke with seven people who live there, five relatives or friends of individuals and four staff members. Completed surveys were received from ten relatives or friends and one person who lives at the home. The home sent us an annual quality assurance assessment (AQAA). This is a self-assessment that gave us information on how well outcomes are being met for people using the service. What the service does well: “One would not choose to live in a nursing home but if one has to, I feel that Kingston Care Home could not be bettered” and “it is very comforting to me to know my relative is in a well run and, in my words, ‘special’ care home” were two comments from relatives or friends of people who live at the home. We think that home has made a lot of progress since we last visited in June 2007 and the quality rating of 2 stars reflects this. The home is well managed and has a staff team who work well together. Feedback about staff was generally very positive. Comments from relatives or friends included “we feel very happy and assured that our relative’s needs are met with very caring even loving staff” and “they show love care and take pride in personal contacts”. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is available to people about the service. Assessments are completed before people move in and these are kept under review. EVIDENCE: 70 of relatives or friends said that they ‘always’ got enough information about the home to make a decision about using it. 20 of people said ‘usually’ and 10 said ‘sometimes’. Good information about the service provided is available to people in a written guide and this is available in large print if requested. We have again recommended that other formats be looked at for the guide. Photographs of Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 9 the home, key members of staff and local places may help the guide to be much more user friendly. Assessments are carried out to make sure that the needs of people coming to live there can be met. We saw that these were all completed by staff and the information used to inform the persons care plan. The home uses an organisational assessment format and this gives space for staff to record additional notes about each area of need. The documents we looked at sometimes lacked detailed information about the individual and were ‘tick box’. We have recommended that the service keeps looking at how good quality information could be captured at this stage especially around the person’s life, their preferences and the things they are still able to do. Relatives or friends of individuals could be given questionnaires as part of the assessment process to help gather information if needed. Equality and Diversity issues could be looked at to make sure that assessments properly address issues like sexual orientation. It is recommended that good practice documents such as the CSCI Equality and Diversity prompts and the Age Concern publication ‘The whole of me…” be used to look at this important area. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are well maintained but could still be made more person centred. People’s health needs are met well. Arrangements for the handling, storage and administration of medication are good. EVIDENCE: “I’m well looked after to a certain degree”, “some things are good and some are bad” and “I do and I don’t” were comments from the people we spoke to. 60 of relatives or friends said that the home ‘always’ met the needs of the person they knew. 40 said ‘usually’. Comments included “I am happy – they are comfortable and well looked after”, “They look after my relative very well” and “I think they care for the people in the home”. Another person said “generally good but I have to keep an eye on things” whilst another individual reported that “little things are sometimes overlooked”. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 11 We looked at three care plans and saw that these do give some good information and are reviewed regularly but are sometimes still too general in describing the care the person needs. One care plan had some very good person centred information saying that staff need to spend time with the individual using touch to comfort them. Another care plan about recreational needs gave some very specific information about what the person liked to do and the daily newspaper to be provided for them. We have recommended that the home continue developing the care plans to be more individual. Some plans still contain very general statements like “give a wash daily’ or ‘complete shower / bath weekly’. All staff need to make sure that the plan says exactly how the support is to be delivered and to specify who is doing this, where this is happening and when. As stated previously, we saw that care plans are regularly reviewed but some evaluations written by staff are repetitive saying things like ‘remains confused’ or ‘no change in condition”. It’s important that both daily notes and monthly evaluations be used positively to make sure that care plans are up to date and relevant. We also saw some repetition in the notes made by staff and this should be discussed to make sure that good quality information is being recorded. It is recommended that the home look at developing life storybooks with the people living there and these could then be shared with others in the home. This may also help staff to relate to people as individuals and encourage more interaction. Staff may also wish to develop their own life storybooks as part of this process. Risk assessments are completed well and kept under review. This makes sure that areas such as risk of falls, developing pressure sores and nutritional intake are looked at regularly. “Medical and personal care is well looked after”, “they keep me informed of my relatives condition” and “my relative was ill recently in the evening – they rang me to tell me what was going on” were comments from relatives or friends of individuals about the health care provided. We saw that good records are kept of appointments and that people’s weights are being regularly monitored. We looked at medication in two units and saw that this area is managed well by staff. Administration records are up to date and items stored properly and securely. This is an improvement from the June 2007 inspection. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers a good range of activities although this area could still be developed particularly for people with dementia. People living at the home generally enjoy the food provided to them and the mealtime experience has been much improved for them. EVIDENCE: “The manager arranges superb entertainments suitable for elderly people”, “I would like to see more stimulating activities – rather than sitting watching TV and sleeping – something to keep their minds alert”, “need more to do” and “not enough going on” were comments from relatives or friends of people living there. We saw that there is a good weekly programme of activities and this is displayed throughout the home. The activities available now include a weekly trip outside of the home to places like Richmond Park. In–house activities Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 13 include social clubs, visiting entertainers, 1-1 sessions, movies and reminiscence. We think that there needs to be more activity and stimulation on each floor. These should not be part of a structured programme but focus on occupation and engagement for the people there. Our SOFI observation showed good levels of engagement with the majority of people sitting in a lounge area but also showed that there was not much for staff to actually do with people. Some staff were very natural in interacting with people whilst others would clearly benefit from having things to do with people to help engagement. As discussed later in this report, lounges and hallways need to be full of items that can be used to engage people and provide occupation. This is very important for people who have dementia and will help staff positively engage with people. Care staff must not rely on the home’s activity co-ordinator to arrange sessions but instead try to have things going on constantly on each floor to provide activity based care. We saw that televisions were usually on all day in lounges but people were very rarely watching them. This should be discussed within the staff team and perhaps these sets could be kept switched off unless people living there request otherwise. Staff could also experiment with bringing items they no longer use from home or getting items from charity shops very cheaply. Hats, jewellery, spectacle frames, material remnants, full bookshelves, soft toys, dolls, tools and household items should all be tried. People who live there said “the food is ok – perfectly adequate”, “the food is very good”, “some food is nice, some is ghastly” and “too many potatoes – not enough greens”. “My relative enjoys the food”, “good and plentiful food” and “the food is getting better – they need good old fashioned cooking” were comments from relatives or friends of individuals. We saw that mealtimes have been very much improved since our visit in 2007. The layout of the dining room has been changed to be more homely and the meal times we saw were much more relaxed occasions. Staff helping people were less focused on getting people to eat and more on making the experience more pleasurable. Other staff now come to help at lunchtime and we saw a domestic member of staff interacting very positively with the people living there. Further ideas to develop could include using cloth napkins rather than paper ones, picture menus and staff wearing cloth aprons instead of the blue plastic ones. Staff members eating alongside the people who live there would also help to make the occasion more like home. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 14 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 using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are protected from abuse. Concerns about the care provided are listened to and acted on. EVIDENCE: In surveys, 90 of relatives or friends said that they knew who to go to if they had a complaint. 10 said they could not remember. Comments from relatives or friends included “we would go and see the manager” and “any problems, I’ll speak to the manager”. A complaints procedure is in place and this is included within the guide for people who live there. As talked about previously, it is recommended that this be made available in other formats. It would be good to have pictures of the manager or other senior staff so people can see who to go to if they are unhappy. We saw that good records are kept of concerns or complaints and these show what action has been taken by the service. Care staff at the home receive training that teaches them how to recognise and report abuse as part of their induction. There is an organisational Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 15 procedure for staff to follow in the event of any allegations being made. We saw that the home was co-operating with the Local Authority in investigating some Safeguarding issues at the time of this inspection. The manager spoke about how difficult this could be for staff and that sometimes the home felt labelled even when investigations find there are no issues or problems. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 16 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, 21, 22 and 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home enjoy a well maintained, comfortable and safe living environment EVIDENCE: A relative or friend commented “the refurbishment has brightened it up”. A person who lives there said “I have a lovely room”. The home has been fully refurbished and is a very comfortable place for people to live. The top floor hallways are decorated with pictures of famous people that may provide stimulation and interest to the people who live there. Pictures of toilets or baths are displayed on doors to help people find them Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 17 more easily. Individual bedrooms are personalised and provide comfortable places for people to spend time. We have recommended that staff now look at how the environment can be made more homely and also provide stimulation particularly for people with dementia. Things to consider include lots more items in the lounges, memory boxes by bedroom doors and more points of interest in the hallways. Occupational items could include dressing tables, workbenches, typewriters, hat stands, rummage boxes and boxes of soft toys / dolls. Other points for discussion within the staff team could be around why there needs to be visitor’s toilets in the home. This may reinforce a ‘them and us’ impression and take away from the fact that is ‘home’ for individuals. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 18 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. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are generally happy with the care they receive. Staff recruitment practices and training are of a good standard. EVIDENCE: “The staff are very adequate indeed”, “the staff treat me nicely – they soon get told if they don’t”, “staff are wonderful” and “staff on the whole are very good” were comments from people who live there. One person said “some staff are too young – cheeky”. Relatives or friends of people said “nice staff”, “the staff are very efficient, knowledgeable and very caring and compassionate”, “the staff are very caring and generally take good care of the residents” and “at times they seem to go further than expected - majority of staff are willing to help and they have a good sense of humour”. Other comments included “need more trained staff” and “I feel the lack of fluency in English is a difficulty which we have to tolerate but can be frustrating for residents and relatives alike”. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 19 One relative or friend said “Staff is a varied group. Some individuals, especially those in charge, are competent and conscientious. Some can be vague and appear uninvolved. They are mostly kindly however”. As in the comment above, the staff we saw came across as generally very caring and spoke to individuals in a polite and respectful manner. We saw two staff in particular who worked in a very person centred way making sure that people were given time and using touch to comfort people who were distressed. We also saw a senior staff member spending time with a person very skilfully reassuring them and using their knowledge of the persons family and background to help in this. This is the good practice that the home needs to role model for everybody working there. There are still some staff who tend to stand off, are ‘uninvolved’ and miss opportunities to interact with people. One area that our SOFI observation highlighted was that some people got more time and interaction with staff than others. These tended to be individuals who were more vocal and / or mobile. Staff need to make sure that they are spending time with everybody sitting in the lounges – a ‘butterfly’ approach may be needed with staff moving from person to person more often. It is strongly recommended that staff teams continue to try to move away from task based care to more person led approaches. This is clearly starting to happen but still needs strong positive leadership from those in charge on each floor to keep moving forward. We looked at the records kept for three members of staff. Recruitment checks are completed and these included a Criminal Records Bureau (CRB) check. Staff have had training in a number of areas such as moving & handling, accident reporting, Fire Safety, dementia care and Safeguarding Adults. Some staff have the NVQ Level Two or Three qualification and training for other staff members is ongoing. In order to support the development of the service, we have recommended that care staff have continued training around dementia, person centred care and care planning. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 20 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, 32, 33, 35, 36 and 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well run. There are good arrangements to make sure that the health and welfare of people using the service is protected. EVIDENCE: People who live there said “I speak to the manager – she’s lovely to everybody”. Comments from relatives or friends of individuals included “we are very impressed with the manager and the way she runs the home”, “very good Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 21 matron” and “most of all I feel that the manager is responsible for an exceptional environment of care and compassion - we have a great deal to thank her for”. One Person who lives at the home said “I speak to the manager – she’s lovely to everybody”. A relative or friend of an individual told us about the regular meetings held for the people who live there and for relatives or friends. We saw minutes of these meetings as well as for a nutritional committee that meets to look at any issues around people’s diets. The ‘Friends of Kingston Care Home’ still takes a very active part in raising funds and arranging events. A newsletter is also produced for the home. We saw that a system for regular individual staff supervision is in place but this still needs development to make sure that all full time staff receive this at least six times per year. The manager told us of plans to make sure that other senior staff are trained to be ‘supervisors’ – this is important to make sure that all staff receive a regular 1-1 with their line manager. Health and Safety checks take place to make sure people are kept safe and good records are kept of these. Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X 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 4 17 X 18 3 3 X 3 3 X X 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 3 3 X 3 2 X 3 Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP30 Regulation 18 (1) (c) Requirement The activities organiser must have suitable training in providing activities for the people who live there. This is particularly important to benefit the people who have dementia who are living in the home. 2. OP36 18 (2) All full time care staff must receive supervision with their line manager at least six times per year (pro-rata for part time staff). This will help to make sure that good quality care is being delivered to people living at the home. 01/09/08 Timescale for action 01/12/08 Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 24 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 OP1 OP3 Good Practice Recommendations The user guide to the home should be made available in different formats. The assessment format should be looked at to make sure that good quality person centred information is being captured. This can then be used to inform the care plan from when the individual moves in. A self-assessment form could be used and/or questionnaires given to relatives or friends. A life storybook could be started at this stage. Equality and Diversity issues should be looked at by the home to make sure that these are being properly addressed at the assessment stage. 3. OP7 The home should continue to look at ways to make the care plans more person centred and better reflect the individual’s life and preferences. Care plans need to give specific information about how the person likes the care and support to be delivered. 4. OP7 Life storybooks should be developed with people living there. These books should be used to help communication and engagement. Staff should also think about developing their own life storybooks to share. Daily notes and evaluations need to be reviewed to make sure that good quality useful information is being recorded. Care staff should see the provision of social and emotional care as important parts of their work. Opportunities for occupation and engagement need to be ongoing throughout the day particularly on the two upper floors. Care staff need to make sure that they are spending time with everybody. DS0000068285.V365566.R01.S.doc Version 5.2 Page 25 5. OP7 6. OP12 Kingston Care Home The organisation should seriously consider employing an additional activities co-ordinator for the home. Care staff should discuss the use of the television in lounges and how appropriate it is to have these on all day. 7. OP15 Menus should be available in a picture format. Staff eating with people who live there should be considered seriously by the home. Cloth napkins should be used instead of paper ones. The practice of staff wearing plastic aprons should be looked at as this appears clinical and not at all homely. 8. 9. OP16 OP19 The complaints procedure should include pictures of key people in the home. Care staff should look at how the environment could be made more homely for the people who live there. Lounges and hallways should be filled with items to provide stimulation and interest. Occupational items such as dressing tables, hats stands, rummage boxes, work benches, typewriters and boxes of soft toys /dolls should be provided. 10. 11. OP19 OP21 Memory boxes should be used to help people who have dementia find their bedrooms. The staff team should discuss the need to have toilets for visitors and whether this is consistent with it being people’s home. It is strongly recommended that further training be provided to staff around person centred care, dementia care and care planning. Care staff need to keep moving away from task based care approaches. Senior staff need to continue to model person centred approaches for care staff. 12. OP30 Kingston Care Home DS0000068285.V365566.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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. 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