Care Home: Kirkhill

What the care home does well Copies of the Service user guidance and the Statement of purpose are available to visitors. The information is in plain English with pictures to make it user friendly. The health and personal care that people receive is based on their individual needs. The care staff, practice the principles of respect, dignity and privacy whilst at work. They receive training, support and supervision by the management at Kirkhill so that they continue the good practice. People using the service are involved in decisions about their lives. They play an active role in planning the care and support they receive. People who use the service are able to express their concerns and have access to a complaints procedure. The people using the service and the staff working at the home are protected from abuse, and have their rights protected due to the training and supervision of staff. The physical design and layout of the home enables people who use the service to live in a safe and comfortable environment, which encourages independence. The staff are trained and skilled to support the people who use the service. The management and administration of the home is based on openness and respect. It has an effective quality assurance system, which is used by all levels of staff to help monitor and make improvement. What has improved since the last inspection? The interior painting and decoration of the building is in progress and the rooms look clean, bright and welcoming. What the care home could do better: The staff and the management at Kirkhill should continue their commitment to the good standard of care and support they deliver to the people using the service. When administering medication the staff should be aware of the reason why the medication is given and the common side effects, so that they are able to monitor the people. Those service users living at Kirkhill may wish to end their lives at the home rather than being transferred to another organisation. This is often due to personal choice and familiar staff and surrounding. Therefore it is advisable for care staff to receive formal end of life care training so that they are able to support people.The home has team leaders and key workers allocated to service users. Key worker role should be explored and time should be allocated for carers (key workers) and their clients so that they are able to spend quality time together. The management should make sure additional staff are on duty to take on the duties on the units whilst carers escort service users to appointments. CARE HOMES FOR OLDER PEOPLE Kirkhill 127 Low Edges Road Sheffield S8 7LE Lead Inspector Marina Warwicker Key Unannounced Inspection 11th February 2009 10:00 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 Kirkhill DS0000067347.V374185.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. Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kirkhill Address 127 Low Edges Road Sheffield S8 7LE 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) 0114 2373211 0114 2377146 vin.lewin@sct.nhs.uk None Sheffield Care Trust Manager post vacant Care Home 29 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (29) of places Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Where additional services are provided eg day care, outreach, escort duty, staffing for this must be over and above that required for the registered service. 2nd March 2007 Date of last inspection Brief Description of the Service: Kirkhill is a two-storey purpose built care home. It provides personal care for service users with mental health problems. Kirkhill is situated in the Low Edges area that is approximately five miles from Sheffield City centre. It is well served by the public transport. The home is registered for 29 places and divided into 2 units. Each unit has it’s own bathrooms, toilets, dining room and lounge area. A shared communal area is provided on the ground floor giving opportunities for service users from both units to meet and socialise. First floor accommodation is accessed by means of a passenger lift and staircase. The home has a safe useable garden areas and car parking facilities. The current fees: Respite charges £127.75 per week For residential care (dependant on assessed charges) range from £102.90 to £402.00 per week. Additional charges are made for hairdressing and chiropody. Furthermore, Kirkhill provides both a 10 place day-care unit and the Brooklees Day Hospital (an NHS Sheffield Community Trust) facilities for service users with mental health problems. These areas are accessed via the main entrance but do not impact upon the lives of service users who reside at Kirkhill. These services are neither registered nor inspected by the Commission for Social Care Inspection (CSCI). Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. An inspection of this care home was carried out on Wednesday 11th February 2009 between 10 am and 5 pm. The staff, the management and the people using the service were not informed of our visit and therefore it was unexpected. Seven people who use the service were consulted and six staff were spoken with. A further ten people using the service, ten staff and three professionals who came into contact with the people were contacted by post and telephone to obtain feedback about the service. Comments received from the surveys have been included in the body of the report. Any comments received after the publication of this report will be shared with the management of the home. Time was spent observing and chatting with staff, the visitors and the people using the service. The manager was present during the inspection and received the feedback on our findings The premise was inspected, which included bedrooms of people using the service, the communal areas and the kitchen. Twenty five people were using the service on the day of the site visit. Samples of records such as the care plans, staff recruitment and training files were checked. We would like to thank the people who live at Kirkhill, their relatives, the staff who took part and the manager for their contribution towards this process. What the service does well: Copies of the Service user guidance and the Statement of purpose are available to visitors. The information is in plain English with pictures to make it user friendly. Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 6 The health and personal care that people receive is based on their individual needs. The care staff, practice the principles of respect, dignity and privacy whilst at work. They receive training, support and supervision by the management at Kirkhill so that they continue the good practice. People using the service are involved in decisions about their lives. They play an active role in planning the care and support they receive. People who use the service are able to express their concerns and have access to a complaints procedure. The people using the service and the staff working at the home are protected from abuse, and have their rights protected due to the training and supervision of staff. The physical design and layout of the home enables people who use the service to live in a safe and comfortable environment, which encourages independence. The staff are trained and skilled to support the people who use the service. The management and administration of the home is based on openness and respect. It has an effective quality assurance system, which is used by all levels of staff to help monitor and make improvement. What has improved since the last inspection? What they could do better: The staff and the management at Kirkhill should continue their commitment to the good standard of care and support they deliver to the people using the service. When administering medication the staff should be aware of the reason why the medication is given and the common side effects, so that they are able to monitor the people. Those service users living at Kirkhill may wish to end their lives at the home rather than being transferred to another organisation. This is often due to personal choice and familiar staff and surrounding. Therefore it is advisable for care staff to receive formal end of life care training so that they are able to support people. Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 7 The home has team leaders and key workers allocated to service users. Key worker role should be explored and time should be allocated for carers (key workers) and their clients so that they are able to spend quality time together. The management should make sure additional staff are on duty to take on the duties on the units whilst carers escort service users to appointments. 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. Kirkhill DS0000067347.V374185.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 Kirkhill DS0000067347.V374185.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&5 (6- not applicable) People who use this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People who may wish to use the service and their representatives have the information needed to make an informed decision abut choosing the home. They are able to speak with people using the service and find out how well the home is able to meet their needs. EVIDENCE: Three peoples’ care files were checked; four residents, two care staff and the management were consulted when assessing this outcome area. Copies of the Service user guidance and the Statement of purpose were available to the visitors. The information was in plain English with pictures to make it user friendly. Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 10 The staff whom we spoke with said that, every service user was referred by care managers, who can be social workers or nurses and that their managers decided whether they had the resource to look after the service user before accepting the admissions. One of the staff said, “ The assessments by the social service help us get an idea of the resident’s needs. Including any special needs we need to be aware of.” The three care files had copies of the original needs assessments of the people. Two residents said that they did not visit the home before they came in. Another two people made the following comments. “I know I like living here. I can’t manage at home.” “I am glad I came here. The staff are wonderful. If I come out of here I know I will only end up in hospital.” The staff said that the regular reviews by the multi agency helped them to confirm whether the people were happy living at Kirkhill. Kirkhill DS0000067347.V374185.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): 7,8,9,10&11 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The health and personal care that people receive is based on their individual needs. The care staff practice the principles of respect, dignity and privacy whilst at work. They receive training, support and supervision by the management at Kirkhill so that they continue the good practice. EVIDENCE: Four residents, three care staff and one relative were consulted. Three care plans were also checked to assess the outcome of this section. The care plans reflected the needs of the people and the actions to be taken by the staff to fulfil the aspects of personal, social and health care needs. The contact details of the health care professionals with the comments made at their visits to each individual were recorded in their individual care records. We deduced that such records help with the multi-agency care programme approach to care. Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 12 The residents said that the care plans were drawn up with their help or their relatives. One person said, “The team leaders call it reviews and I am asked whether I would like anything changing. Sometimes care staff tell me that I should try and help myself more. I get fed-up and just don’t like doing much.” Two care staff made the following comments. “The care plans are completed by the senior staff. We read it and if we want we can speak to the seniors/ team leaders about it.” “We include all service users in their daily care management. They let me know what they want and when. I read the care plans if I want to check after the handover when I come on. My main role is to support the people in their own home. I see Kirkhill as the service users’ own home.” The management informed us that all service users were registered with the local general practitioner. One of the staff said that the GP visited if they made a request but the Psychiatrist and the Community Psychiatric Nurse checked peoples’ medication regularly whilst they carried out reviews of the residents. The care staff were informed of any changes by the team leaders following reviews. This was confirmed during the interviews of staff. One care staff said, “I get to know if there have been any changes to the care plans from the team leader. They are good at keeping us up to date. The service users are also able to tell us.” None of the people living at the home on the day of the site visit had pressure sores. The staff and the management confirmed this, however there was one resident who had an ulcer, which had been seen to by the district nurse. Two service users had been assessed as being able to manage their medication. They kept their medication in a safe place in their individual rooms and the staff each day checked to ensure that they had taken their medication and also the medicine was securely stored. The evening medication administration by the staff was observed. This was carried out satisfactorily. The staff said that the supplying pharmacist checked the medication and unused medicine was disposed of regularly by the pharmacy contract. The staff who handled medication have had training and there was ‘buddying system’ to self monitoring the administration of medication. It would be useful for staff for know why the medication was given and the side effects of the medicine so that they are able to monitor the service users. Some care staff felt that having such information would be very useful. Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 13 During the site visit the staff knocked on the bedroom doors before entering peoples’ rooms, spoke to people in a caring and respectable manner and when speaking among themselves about the service users they addressed the individuals in an appropriate way. It was obvious that there was mutual respect between the staff and the service users. None of the care staff spoken to have had formal training on end of life care. Two staff said that they have had experience in caring for people who were dying. During the discussions with the management it was highlighted that often when people become ill and in need of nursing care they were transferred to an appropriate service. Hence the staff at Kirkhill have not had the need for supporting and caring for people dying. Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 14 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&15 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Individuals are involved in decisions about their lives. They play an active role in planning the care and support they receive. EVIDENCE: Three service users, two staff and a relative were spoken with. Care plans of three service users were checked. Peoples’ interests were recorded in the care plans. The manager and the staff said that they kept a record of those who participated in the activities and outings that were organised by them. One service user said that s/he had been on trips and liked them very much and wanted to know whether there could be more trips if possible. Another person said, “I go out when I want and do what I want. I am happy as I am.” Some feedback indicated that the key workers did not have any time allocated for them to support or take their clients out. One person suggested moving to Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 15 ‘person centred care’ and the key workers being more involved in peoples’ lives than just making sure the service users’ rooms were tidy and their toiletries were purchased. The manager was informed of this. People using the service were able to receive visitors and go out visiting people as long as it was identified in their care plans. On the day of this site visit it was very wintry and the service users were happy to stay indoors where it was comfortable and warm. Some people when they moved into Kirkhill had brought in personal possessions and made their room homely. The others had a minimum of furniture since that was their choice. Those people who needed help with handling their money received assistance from an independent agency. However, a small amount of pocket money was handled by the home to help people with their daily expenditure. Records were kept and checks were carried out of the small amount of money the home kept for the people using the service ‘as a float’. On the day of the site visit we witnessed the checks carried out by staff. Lunch and evening meals were observed. Some of the comments from the people were, “Food is lovely here.” “I get what I ask for and I always enjoy the food.” “I am always ready to eat. I like the food they give us. We can have snacks if we want.” The care staff said that they like eating with the residents since it gives people the feeling of a family atmosphere. The staff also said when they tasted the food they were able to make comments about the quality and presentation of food served at the home. The residents were given a choice of meals; if they were not keen on what was served on the day they were able to get something of their choice. People and the care staff said that the cook was obliging and was ‘happy to make extras’. Those service users who needed support/encouragement during mealtimes were given help by the care staff in a discreet manner. The service users and the staff enjoyed the mealtime. The cook had a five-week menu rota and there were plenty of snacks for people. The cook had a list of special diets for those who needed it. Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 16 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&18 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People who use the service are able to express their concerns and have access to a complaints procedure. The people using the service and the staff working at the home are protected from abuse, and have their rights protected due to the training and supervision of staff. EVIDENCE: The complaints procedure was available for service users, their relatives and staff. Three staff and a team leader were spoken with. They were familiar with the home’s policy for handling formal complaints. All staff interviewed said that if there was a complaint they would listen to the complainant and if possible take immediate action to rectify it and then inform the person in charge. The manager maintained records of formal complaints. The staff had attended training in adult protection procedures to ensure that the service users were safe and they knew what to do if an allegation was made. When they were interviewed the staff demonstrated that they were confident and able to respond to concerns or complaints competently. The staff training files checked had evidence that care staff had received training on safeguarding adults. Kirkhill DS0000067347.V374185.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): 19,22,24&26 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The physical design and layout of the home enables people who use the service to live in a safe and comfortable environment, which encourages independence. EVIDENCE: Grounds were kept safe and the paths were gritted during the winter weather to make sure service users, staff and the visitors were able to access the home safely. There had been a rolling programme of decoration of the premise and we observed the good results of this. The staff said that they had the appropriate equipment to use to help the people. Some service users had their own aids to help them with. Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 18 Individual bedrooms were decorated and furnished to suit the service users. Some people have chosen their decorations with the help of their key workers. The rooms had locks and the people had keys to their rooms. The premise was kept clean and free of offensive odours. Two staff were able to verbalise what they did to prevent the spread of infection. Kirkhill DS0000067347.V374185.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&30 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The staff are trained, skilled and in sufficient numbers most of the time to support the people who use the service. EVIDENCE: Three staff recruitment, training and supervision files were checked and three care staff were interviewed. Comments from the surveys were also included in this outcome area. The management had carried out a rigorous recruitment procedure and the staff were able to explain the process. Two care staff said that they had completed NVQ Level 2 in care and one other said that s/he was looking forward to working towards the award. The management structure helps the staff receive appropriate supervision so that they are competent to carry out their duties. On the day of the site visit there were two care staff on each floor with a team leader, an operations manager and a manager. Some of the feedback highlighted that when service users had to be escorted to appointments they did not have additional staff on the shift and it depended on if the managers were around whether they received help. Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 20 The three staff files checked contained evidence of regular training and development of staff. Three staff made the following comments. “ I receive training and I am confident and feel competent in the tasks I have to complete.” “The training here is good and the manager makes sure we attend the training sessions. I enjoy learning.” “It is only right we need to be regularly trained, so many changes and legislation if I don’t attend training how will I know what is right and what is wrong?” Kirkhill DS0000067347.V374185.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): 31,33,35,36 &38 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The management and administration of the home is based on openness and respect. It has an effective quality assurance system, which is used by all levels of staff to help monitor and make improvement. EVIDENCE: The management structure of the home meets the aims and objectives of the home. The manager is in the process of registering with the Commission for Social Care Inspection. The senior staff said that they continue to attend training to keep up to date with the changes and be competent in their jobs. Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 22 The management had carried out several quality monitoring activities and there was evidence to support this. Meetings with service users and staff had taken place and the minutes were displayed for people to read. One of the care staff said, “The staff meetings are useful even if we were to find out that we can not change some things. Its useful to keep us informed of the management plans.” Another said, “Staff meetings help me find out how well we are doing and get comments from such as this inspection.” Four staff spoken with said that they received regular supervision from their team leader and it was approximately every 6 weeks. Two service users raised their worries about the decision to close Kirkhill and they were having to move out into community housing. One of them was very worried about what would happen when the weather got worse and no one could get to support him/her. However we were informed that there was consultation between the providers and the people using the service about this. The staff interviewed said that all accidents, incidents and injuries were reported to the management and they followed them up. One of the care staff explained the induction programme where s/he had attended training and shadowing of experienced staff before being left on his/her own. Kirkhill DS0000067347.V374185.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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 2 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 X X 3 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 3 X 3 Kirkhill DS0000067347.V374185.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. 1. 2. Refer to Standard OP9 OP11 Good Practice Recommendations When administering medication the staff should be aware of the reason for the medication and the common side effects, so that they are able to monitor the people. It is advisable for the care staff to receive formal end of life care training. This is due to the changing needs of the people using the service and their wish to remain in their homes during their latter years. Key worker role should be explored and time should be allocated for carers and their clients. Additional staff should be on duty and take on the duties on the units whilst carers escort service users to appointments. 3. 4. OP27 OP27 Kirkhill DS0000067347.V374185.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Kirkhill DS0000067347.V374185.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. 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