Care Home: The New Close

What the care home does well Service user comment: `The staff are always ready to talk to me if I feel I need advice etc., they are friendly and helpful`. Relative comments: `In general it is a very well run home`. `I am very glad they had a place when my mother needed it`. `Everyone seems to be treated as an individual as far as possible.` `Nine out of ten times the staff are very kind and look after clients well, it is a happy well run home`. `Staff are patient and sensitive to my relative`s needs`. `Meals are excellent, plenty of variety, my relative always eats his meal`. `The home cares. It gives us the peace of mind to know that my relative is well cared for`. `The home seems to be fine thy way it is we are satisfied`. `We are very pleased with the care and attention that is provided and can find no fault with the care home staff or service they provide`. `They provide an excellent service`. `I am particularly impressed by the efforts of the activity staff and the way they encourage people to participate`. `The activities are very good`. `The staff give patient kindly attention and help at all times`. `The staff is excellent when promoting privacy and dignity to all residents`. Staff demonstrated their awareness of equality and diversity and this was also reflected by a relative comment: `The diverse staff team are equally, caring and friendly`. Staff comment: The home provides excellent care on all levels, the domestics keep the home clean, the cook is excellent, the activities are excellent they do a good job aimed to keep residents mentally and physically active`. Visitor comment: `As a visitor acting on behalf of the resident I know who to contact if the resident is not happy, should an occasion arise`. What has improved since the last inspection? Staff have been trained in person centred planning an overall care plans have improved. The hours to provide activities for residents have been increased resulting in the range of activities improving. The flooring in the dining room areas has been replaced. What the care home could do better: Relative comment: `I feel the standard of food has slipped. On the whole reasonable but lacks flavour. Too many egg and chips, some weeks it is the same on the menu for tea at least three times`. `I feel that sometimes my relative does not get enough support to ensure that he eats the meal before it gets cold`. There are shortfalls in the recording in care plans with regard to outcomes of action taken, clear guidelines for staff and communication. The home needs to ensure that protocols are in place to identify when residents may require pain relief medication and ensure records are countersigned when required. Residents would have their dignity enhanced by one to one attention when being assisted to eat their meals and staff interaction includes residents at all times The menus are in the process of being reviewed to provide variety especially at teatime and the home needs to ensure that meals are served at the appropriate temperature The residents would benefit from personalised visible indicators to assist them to identify their bedroom Staff preparing and serving food should receive basic food hygiene training. Recommendations have therefore been made in this report. CARE HOMES FOR OLDER PEOPLE The New Close Conyngham Lane Bridge Canterbury Kent CT4 5JX Lead Inspector Penny McMullan Key Unannounced Inspection 13th December 2007 09:30 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 The New Close DS0000023607.V352756.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. The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The New Close Address Conyngham Lane Bridge Canterbury Kent CT4 5JX 01227 780070 01227 830710 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.kcht.org Kent Community Housing Trust Mrs Susan Keiper Care Home 63 Category(ies) of Dementia - over 65 years of age (63) registration, with number of places The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The residents shall be 60 years of age and over Date of last inspection 8th August 2006 Brief Description of the Service: The New Close is a residential care home providing care for up to 63 people, aged 60 and over, with dementia. The home is situated in a cul-de-sac in the village of Bridge, near Canterbury. The village has a number of shops, including a post office, pharmacy and small supermarket. The New Close is owned by Kent Community Housing Trust, which manages 22 residential care homes for older people in Kent. The Trust also provides a range of home care services. All accommodation is on the ground floor. The home is surrounded by extensive gardens and there is a large parking area to the front of the property. The home has been divided into two by a coded door entry system, with separate staff teams for each wing. This enables staff to have free access to all areas of the home and limits the access for residents, to ensure their safety. Each wing has a dining room, a number of small lounges and a visitors room. Residents rooms are accessed from the lounge areas. There are 55 single rooms, of which 23 are en-suite and 4 double rooms. The home contains a large number of toilets and 7 bathrooms with disabled facilities. The email address is: sue.keiper@kcht.org.uk The current inspection report is on display in the entrance to the home. The fees for this home range between £397.99 and £491.20 per week The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out over a period of time and concluded with an unannounced visit to the home of 8 hours. The Registered Manager assisted throughout. Residents, relatives and staff were spoken to. Observations included interactions between residents and staff. Information in this report also includes feedback from postal surveys sent to Residents, Relatives, and staff. The Annual Quality Assurance Assessment information has also been included in this report. Overall feedback from relatives and staff is positive however there are mixed comments with regard to the standard of food at teatime and respect and dignity to residents which have been included fully in the relevant parts of the report. What the service does well: Service user comment: ‘The staff are always ready to talk to me if I feel I need advice etc., they are friendly and helpful’. Relative comments: ‘In general it is a very well run home’. ‘I am very glad they had a place when my mother needed it’. ‘Everyone seems to be treated as an individual as far as possible.’ ‘Nine out of ten times the staff are very kind and look after clients well, it is a happy well run home’. ‘Staff are patient and sensitive to my relative’s needs’. ‘Meals are excellent, plenty of variety, my relative always eats his meal’. ‘The home cares. It gives us the peace of mind to know that my relative is well cared for’. ‘The home seems to be fine thy way it is we are satisfied’. ‘We are very pleased with the care and attention that is provided and can find no fault with the care home staff or service they provide’. ‘They provide an excellent service’. ‘I am particularly impressed by the efforts of the activity staff and the way they encourage people to participate’. ‘The activities are very good’. ‘The staff give patient kindly attention and help at all times’. ‘The staff is excellent when promoting privacy and dignity to all residents’. Staff demonstrated their awareness of equality and diversity and this was also reflected by a relative comment: ‘The diverse staff team are equally, caring and friendly’. Staff comment: The home provides excellent care on all levels, the domestics keep the home clean, the cook is excellent, the activities are excellent they do a good job aimed to keep residents mentally and physically active’. The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 6 Visitor comment: ‘As a visitor acting on behalf of the resident I know who to contact if the resident is not happy, should an occasion arise’. 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 New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 7 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. The New Close DS0000023607.V352756.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 The New Close DS0000023607.V352756.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): 3 and 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Detailed assessments are carried out to ensure the home can meet prospective residents care needs. EVIDENCE: Arrangements are in place to ensure that prospective residents have a thorough care needs assessment prior to coming to live at the home. One relative comment: ‘We were shown around the home in a most helpful and efficient manner by the Assistant Manager who answered my questions most thoroughly’. Standard 6 does not apply to this home. The New Close DS0000023607.V352756.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 who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care, which a resident receives, is based on their individual need. Overall the principles of respect, dignity and privacy are put into practice. The effective management of the medication ensures that resident’s health care needs are promoted. EVIDENCE: A detailed care plan is in place for each resident and each person has a designated key worker. Relatives confirm they are involved in the planning and information recorded. The plans cover all aspects of health and social care including individual preferences for activities. When required behavioural charts and incidents forms are in place. Some of the information does not record the outcome of the action taken when incidents occur, which does not The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 11 make it clear for staff to provide ongoing monitoring. There are risk assessments in place, which also require clearer guidelines for staff. A recommendation has been made in this report. The carers have attended person centred planning training and overall care plans have improved. Staff spoken to demonstrated their awareness of meeting resident’s needs but this was not always fully detailed in the recording in the care plans. Communication guidelines need improvement; there is information to say that residents use facial expressions but the plan does not say what they are or what they mean. The health care needs of residents are monitored through the care plans. All appointments are recorded with outcomes and there is a visiting chiropodist, involvement with the Home Treatment Team, Community Psychiatric Nurses and District Nurses. Four relatives spoken to say how well the home contacts them with regard to health matters relating to their relatives. There is the necessary equipment provided for the prevention of pressure sores. Due to the high dependency of the residents and the number of residents who require two staff and a hoist for their moving and handling there is a high demand on the use of the equipment. The home needs to ensure that this equipment is sufficient to ensure that residents are not kept waiting when they require personal care or toileting. Overall the administration and storage of medication is good and trolleys are used for the safe transportation to each wing. All staff administering medication has received training. MAR sheets (Medical Administration Record) are in good order however hand written entries need to be consistently countersigned to reduce the risk of error. Medication needs are listed in the care plan however there are no protocols for PRN (as and required) medication to service users who lack capacity to say if they require pain relief. It is recommended that each resident have a protocol in place to ensure that staff can identify and if necessary administer the PRN medication. Overall staff were observed treating residents with dignity and respect. However, care must be taken when assisting residents with any tasks that staff talk to the resident and not continue their conversation with other members of staff. A relative comments: ‘We all know that people who suffer with dementia can be difficult but there are times when staff talk to them I have wanted to say they are not children and they are old enough to be your grand parents’. Another relative says: ‘ The staff respect his privacy and dignity’. The New Close DS0000023607.V352756.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): 12,13,14,15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have access to a variety of social and recreational activities and visitors are welcome. Overall residents enjoy a healthy and varied diet with an emphasis on home cooking. EVIDENCE: There is a flexible programme of activities tailored to individual interests and choices. Information on previous hobbies and activities is recorded in the care plan in consultation with relatives/representatives. This enables the coordinators to plan and provide stimulating individual and small group activities. At the time of the inspection the local school children arrived to sing carols and there was planned entertainment in the afternoon. There are two planned activities weekly and outings are arranged to go to the garden centre/coffee shop. The garden is well used in the summer and residents have the The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 13 opportunity to grow vegetables. Hand and foot massages are provided for the less able residents Service user comment: ‘I am offered a programme of activities organised by the staff and if possible I usually attend. A great deal of time and effort is put in to these activities whish is appreciated by the residents judging by their enjoyment’. Visitors are welcome in the home. There is a relative support group who meet on a regular basis. They feel supported by the staff and can visit their relative in private or in the communal lounges. Family visiting at the time of the inspection confirm that the home always keeps them informed of any issues with regard to care of their relative. The home involves relatives in all aspects of the residents care to promote choice and personal preferences. Residents are encouraged to bring in personal possessions for their rooms. Residents were observed choosing where to be in the home and are supported to go to their bedrooms if they wish. A small number of residents do have a key to their room. Advocacy services have been used in the past however there is no current resident who requires an advocate at this time. There is a four weekly menu in place and residents likes and dislikes are recorded in their care plan. Residents are asked what they wish to eat and if they change their mind there is always an alternative available. The cook checks the meals every day to ensure that residents receive choice and preferences. She demonstrated how she ensures that each resident no matter what diet is able to access the same menu as all of the other residents by providing sugar free jelly, custard and cakes. Special diets are catered for and monitored. Feed back from relatives visiting indicates food is good and from observation food looked nutritious and appetising. There are several residents who require assisting when eating and each resident would benefit from one to one assistance to enhance their dignity. Staff also need to inform residents when they deliver the meal to the table to prompt and assist residents to enjoy their meal and include residents in the conversation at the table. Feedback from a relative indicates that the standard of food has slipped and lacks flavour. ‘At teatime the variety is limited the eggs are like rubber balls and the food is often cold, there is not enough variety at teatime and the food is usually cold and unappetising’. Another relative comment: ‘I feel sometimes my relative needs more help when eating as cannot cut food and over the last few months food ends up on the floor because unable to pick it up. The odd one gives the impression it is too much effort and they might have to get up and stop the conversation they are having with another member of staff. Team leaders need to ensure the help is given before the person’s food is cold’. The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 14 There is therefore mixed feedback with regard to the food served in the home. The Registered Manager is aware that the menus need to be reviewed and will be addressing and monitoring the issues raised from relatives’ comments. The New Close DS0000023607.V352756.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 the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. A satisfactory complaints procedure is in place and residents can be sure the home will listen and act on any issues. Staff have received adult protection training and arrangements are in place to protect the residents from harm. EVIDENCE: There are policies and procedures for dealing with concerns, complaints and protection of vulnerable adults. Staff are aware of safeguarding adult protocols and know how to report any concerns. The majority of staff have received adult protection training. The organisation is in the process of reviewing the restraint policy with regard to the use of cot sides and chairs, which may restrict the movement of residents. There have been no complaints since the last inspection. The complaints procedure is on display and relatives spoken to have no complaints. The Registered Manager has an ‘open door’ policy and is very proactive to include relatives/representatives in all issues in the home. The New Close DS0000023607.V352756.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 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident benefit from an environment, which is well maintained, clean, comfortable and homely. EVIDENCE: There is an ongoing plan for the building to change the use of the double bedrooms to become small lounges with direct access to the gardens. There are no specific dates for this to begin but this will commence sometime next year. Skylights are being fitted to provide additional light to the communal rooms. Areas of the home have been divided to provide a more homely atmosphere. There is an ongoing maintenance plan and the home and gardens The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 17 are well kept. Since the last inspection some bedrooms have been redecorated. The corridors and walls in some areas are painted the same colour and residents would benefit from more visible indicators to identify their own room. Laundry facilities are satisfactory with infection control procedures in place. All staff have received infection control training and the home smells pleasant and employs sufficient domestic staff ensure the home is always clean. The home ensures there is always domestic staff on duty and employ agency staff to cover for sickness or vacancies. One service users comments: ‘The home is always clean’. The New Close DS0000023607.V352756.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 who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from care being provided by qualified staff that are caring and kind. Staffing levels are adequate and a review of the deployment of staff could improve quality of time spent with residents. EVIDENCE: Staffing levels appear adequate and the Registered Manager says the staff are able to meet service users needs. There are less staffing on during afternoon shifts and due to lack of interest in a shift from 4pm to 8pm additional staffing hours have been provided during the day. The home must continue to review the deployment of staff to ensure busiest times have additional staff on duty to meet resident’s needs. One staff comments that ‘we do the best we can to with the staff on duty to look after the residents well’. There are several staff vacancies at this time, a part time Team Leader, night carers, and domestic staff. The home’s part time staff together with agency staff is covering these shifts. There will be a recruitment drive early next year meanwhile the home endeavours to cover with the same agency staff and there is never all agency staff on duty. Two night staff is completing their The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 19 induction training. When asked what the home could do better one relative comment: ‘More staff maybe’. One service user comment: ‘The staff are always available when I need them’. Over fifty percent of staff have obtained a National Vocational Qualification (NVQ) level 2 or above with further courses planned in the New Year. Staff files indicate that a robust recruitment process is followed with all checks in place. The current application form only asks for ten years previous employment and the home is in the process of amending the application form to read full employment Staff undertake an induction which is to Skill for Care specification. Staff say they are receiving training in mandatory subjects and dementia care. There is an on going training programme and further training is planned for dementia, infection control and medication. The home needs to ensure that all staff handling food are trained to do so. The home is also providing care to residents who are suffering from Parkinson’s disease, Diabetes and Epilepsy and it is recommended that staff receive additional specialist training to meet their individual needs. The New Close DS0000023607.V352756.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): 31,33,35 and 38 People who use the 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 well managed and arrangements are in place to ensure that resident’s financial interests are safeguarded. The home is run in the best interests of the residents and health and safety is promoted. EVIDENCE: Relatives and staff spoke highly of the manager and assistant manager and have confidence in their ability to run the home efficiently. The Registered Manager demonstrates a clear understanding of good dementia care and holds The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 21 an NVQ 4 in Management and is currently completing the care modules to complete the Registered Manager Award. Quality assurance systems are in place. Relatives say they have regular meetings and when issues are raised action is taken. They feel their views are listened to and acted upon in the best interests of the home. Staff feedback indicates they also feel very supported by the management team. There are regular staff meetings and one-to-one staff supervision take place. Auditing of records takes place together with monthly visits from the provider. One relative comment: ‘Yes I have received a questionnaire from the home re the care and there are relatives meetings’. Arrangements are in place to ensure that resident’s money is protected. There are sound accounting systems in place. There are secure facilities in the home and the financial records are in good order, with receipts for all transactions. There is an ongoing training programme for staff to complete their mandatory training. Accidents are recorded and appropriately actioned. Fire safety arrangements are in place together with environmental risk assessments. There is a full time maintenance technician to repair and maintain the home on a daily basis. All of the necessary safety checks have been completed. The New Close DS0000023607.V352756.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 x x 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 x x x 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 x 3 x 3 x x 3 The New Close DS0000023607.V352756.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. 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 Refer to Standard OP7 Good Practice Recommendations Care plans should record the outcome of the action taken when incidents occur and risk assessments need to provide staff with clearer guidelines for a safe practice of work. Communication guidelines need to indicate what facial expressions mean to individual residents. 2 OP9 The home needs to implement a protocol for PRN (as and required) medication to residents who lack capacity to say if they require pain relief. To ensure that hand written entries need to be consistently countersigned by staff to reduce the risk of error. The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 24 3. OP10 To ensure that staff are include residents in their conversations especially when assisting them to eat To review the practice of one carer assisting two service users to eat their meals. To ensure that resident’s are provided with a varied tea time menu and the food is served at the right temperature Where necessary to provide residents with personalised visible indicators to assist them to identify their individual bedrooms. The home to provide basic food hygiene and any specialist training to meet individual residents needs. 4. OP15 5. 6. OP19 OP30 The New Close DS0000023607.V352756.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local 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 The New Close DS0000023607.V352756.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. 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