CARE HOME ADULTS 18-65
2 and 8 Kingsthorpe Grove 2 and 8 Kingsthorpe Grove Kingsthorpe Northampton NN2 6NT Lead Inspector
Irene Miller Unannounced Inspection 17 October 2007 10:30
th 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service 2 and 8 Kingsthorpe Grove Address 2 and 8 Kingsthorpe Grove Kingsthorpe Northampton NN2 6NT 01604 791266 01604 716177 Dawn.briggs@careresidential.co.uk 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) The Richardson Partnership for Care Mr Brian Richardson, Mrs Jacqueline Richardson, Miss Laura Richardson, Mr Gregory Paul Cheater Ms Jane Catherine Payne Care Home 18 Category(ies) of Learning disability (18) registration, with number of places 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2 and 8 Kingsthorpe Grove Care Home is registered to provide personal care to male and female service users who fall within the following categories: Learning Disability (LD) 18 The maximum number of persons to be accommodated at 2 Kingsthorpe Grove is 8 The maximum number of persons to be accommodated at 8 Kingsthorpe Grove is 10 22nd January 2007 2. 3. Date of last inspection Brief Description of the Service: 8 Kingsthorpe Grove was a six bedded home then became a ten bedded home, at the time of the inspection, though was due to increase to a eighteen bed home very shortly after the inspection, it is three stories high and is situated on a main road, in close proximity to the Kingsthorpe Shopping centre. Northampton town centre is approximately a mile and a half away and there is a convenient bus service to either Northampton or Market Harborough. The home has a pleasant garden area that is well used by service users. The home is registered for people with learning disabilities and provides long term placements. The current fees range from between £1000 to £1399 per week with additional costs for hairdresser, toiletries, newspapers, and magazines. The homes statement of purpose that sets out the range of services available at the home is available upon request to all residents and their representatives. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is based upon outcomes for Service Users and their views of the service provided. The visit was unannounced and focused on ‘key standards’ under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for younger adults aged between 18-65 years. The care needs of three people living at the home were looked at in depth this involved looking through written information available on their care, such as the care plans (a care plan sets out how the home aims to meet the individual service users personal, healthcare, social and spiritual needs). Time was spent with the people living in the home, during which time the views on the quality of care of the service users were sought and discussion took place with the staff and the registered manager. Some of the service users were unable to comment on their care therefore observations of staff and service users interactions were made with an aim to establish if service users were satisfied living at the home. Sample checks were carried out on the homes policies and procedures and records in relation to staff recruitment, complaints, and general maintenance and upkeep of the facility were viewed. The registered manager Mrs Jane Payne was available at the home throughout the visit. What the service does well:
Prospective service users have full needs assessments carried out prior to entering the home, in conjunction to care programme approach assessments (CPA) and trial visits prior to moving in are encouraged, and all service users fully consulted. Information is made available on what care and services the home can and cannot offer, (through the statement of purpose and service user guides) this ensures that service users and their representatives can make an informed choice as to whether the home is right for them, and able to fully meet their needs. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 6 The individual care plans had full details of the service users abilities and the level of support required to meet individual aims and objectives and maintain skills and independence. There is good specialist support available from health and social care professionals, which enables service users to lead their preferred lifestyles. The home is pro active in reviewing the service users care plans and responding to changes in mental and physical healthcare needs, calling upon specialist support when required. The management and administration of the home is open and transparent, the views of service users and their representatives are sought and action taken where required to continually improve on the services provided at the home. The physical and mental healthcare needs of service users are met through having a team approach, which ensures that service users rights are promoted and protected There are good risk management systems in place, which are reviewed regularly. The staff recruitment practice is robust and there is a commitment to staff training, which ensures that staff employed to work at the home have the necessary skills to care for the people living at the home. The management of the home is open and transparent; the views of the residents and their representatives underpin the service that is provided. What has improved since the last inspection? What they could do better:
No requirements or recommendations have been made. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 7 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. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good. People that use the service can be assured that their needs will be fully assessed prior to moving into the home and that their individual needs and aspirations will be taken into account This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within the care plans there was records of assessments of needs having been carried out prior to the admission of a service user that evidenced that the social, emotional and physical needs of service users are identified and form the basis of the plan of care. On speaking with the registered manager, staff and service users it was established that prospective service users are invited to visit that home on several occasions, short stays and overnight stays, prior to moving in, this allows for the opportunity to meet all of the service users and enables an informed choice to be made as to whether the home is right for them. In discussion with service users it was confirmed that full consultation takes place when a new service user may be considering moving into the home, and this was also confirmed in discussion with staff who demonstrated a good
2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 10 understanding of the importance of the existing service users having the opportunity to discuss whether they wanted a new resident to come and live with them at the home. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 & 9 Quality in this outcome area is good. People who use the service can be assured that they will be supported in accessing the personal and healthcare support that they require. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users spoken with were aware of their individual care programmes and in the care plans and risk assessments viewed it had been identified what control measures were in place to allow residents to take risks and have a good level of independence in line with their level of understanding and capabilities, the assessments were regularly reviewed by the healthcare team and updated as needs change and progress achieved in the individual goals. There was written procedures for staff to follow on specific therapeutic behavioural approaches when responding to challenging behaviour, and there was records of assessments and reviews made by the mental healthcare professionals involved in the care of the service users, in addition there was
2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 12 records on the contact that service users had with their GP and on speaking with one of the service users they said that they visited their GP independently and this was again supported by documentation within their plan of care. The service users were observed taking part within a small group activity, making witches hats for an up and coming Halloween Party, whilst other service users were spending time in the kitchen preparing food and others chatting with staff. All of the service users spoken with confirmed that they were happy living at the home and pleased with the care and support they received. Saying that they thought they had good opportunities to be independent and that the staff respected them and they felt they were well looked after. The care records and observations made during the visit demonstrated that service users were encouraged and supported in making decisions about their lives and have the opportunity to exercise as independent a life style as possible. One of the service users spoken with said that they regularly go shopping by bus to Northampton Shopping Centre and that they had taken another service user with them in an effort to help them to be more confident and independent when out in the community. The staff spoken with demonstrated an awareness of the importance of enabling service users to make decisions about their lives and in discussion it was confirmed that service users are asked their views on important issues, and that meetings were held to discuss life within the home and minutes were available of the meetings. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People that live at the home are offered a range of individualised activities to promote independence and maintain daily living skills. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In discussion with staff and service users and from the written records available within the care plans there was evidence to demonstrate that service users have full access to community facilities. The individual care plans had records of service users accessing the local community independently and with staff support, such as outings to the local shops, pubs, parks and clubs and going to the local post office to collect their money. Many of the service users enjoy going out to the local pub and on the afternoon of the visit a small number of service users went to the local pub with staff support. One of the service users said that that they regularly go out for a meal on a Friday night with a friend from the home.
2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 14 In discussion with the staff and the registered manager it was established that community relationships were good and that the service users were very much integrated within the local community. One service users said that they like going swimming and trampolining and had started a course in massage. The day to day activities included group activities and one to one time with service users, on the day of the visit a small group of service users were taking part in a craft session facilitated by a trained art therapist, the therapist visits the home for two hours each week. There was evidence around the home of arts and crafts that the service users had made and each service user had their own portfolio of work. Service users were observed to move around the home freely and to spend time within the communal lounges and also within their individual bedrooms. Some of the service user have potential challenging behaviour and therefore are unable to attend formal day centres or colleges, although some service users did go out to work. Within the care plans there was records of individual activity programmes that take place in house. Within the rear garden of the home there was recreational equipment available for service users to access such as a large trampoline, table tennis, and a large garden version of connect four. In discussion with service users they said that they felt supported by the home to have regular contact with their families and in discussion with staff it was demonstrated that they had an understanding of the importance of service users having the opportunity to experience personal relationships. Arrangements were in place to meet the religious, spiritual and cultural needs of all service users, opportunities were available for service users to attend the local churches to worship. One of the service users from an Asian ethnicity had a named member of staff as their keyworker who was also from Asian ethnicity. Arrangements were in place for the service user to visit their family and have opportunities to socialise with other people from the Asian community and attend their temple of worship to take part in Hindu festivals. The weekly menu was varied and offered a choice of meals on a daily basis, which demonstrated that service users individual cultural and dietary needs were catered for, during the visit one of the service users was busy preparing their own lunch, this was a regular routine for the service user and aided in promoting more independence. Observations of care practices during the inspection visit demonstrated that there was a strong commitment to following each resident’s individual daily routines, and in promoting skills and independence. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People living at the home can be assured that their health and personal care needs will be fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Through observations of care practice, records available and discussion with staff it was demonstrated that the service users complex needs are met with full account of their physical and emotional capabilities, this is achieved through the teamwork and specialist support available from the healthcare professionals based on site. There was evidence of service users physical and mental health needs being regular reviewed and records were available of service users having received treatment from their general practitioner, physiologist and regular health checks having being provided. The medication held within the home was sample checked and was well managed, and there was a policy and procedure for the safe administration of medications in place.
2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 16 There was information available within the care records of medical appointments and input from nurses, GPs, dentist, optician, chiropodist etc. Accident/Incident Records were checked and demonstrated that appropriately action had been taken to all situations presented. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People living at the home and their representatives can be assured that any concerns or complaints they may have will be listened to and acted upon, and that they will be protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was a complaints policy in place and records were available of concerns raised with the manager although since the last inspection no formal complaints had been received and the Commission for Social Care Inspection had not received any complaints regarding the home since the last inspection had taken place. Staff training had taken place on safeguarding adults and in discussion with staff it was confirmed that they had a sound knowledge of the importance of protecting service users from potentially abusive situations, this was also demonstrated within the service users individual risk assessments such as the support systems in place to ensure the safety of service users when out in the community unsupervised. Service users said that if they were worried about anything they would speak to staff or the Manager and they thought it would be followed up. Regular meetings where held with service users and all service users are invited to attend and share their views about the home. Records of these meetings were available for service users and staff to refer to.
2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. Service users live in a modern homely and comfortable environment, and standards of hygiene are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A limited tour of the building was conducted and all communal areas were clean, pleasantly furnished and decorated to a good standard. The kitchen was clean and well organised and there were records available to demonstrate that food safety systems were in place. The laundry was clean and well organised and procedures were in place to reduce the risks of cross infection. Some of the service users were pleased to show their rooms bedrooms and the personal items contained within them evidenced that individuality was important to as to the colour schemes and décor. Personal items contained
2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 19 within the bedrooms reflected the hobbies and interests and individuals lifestyles. Some bedrooms having double beds and ground floor rooms having patio doors leading out into the garden. Standards of cleanliness and odour control in all areas of the home were good. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People living in the home benefit from having a staff team that are well trained and supported to meet the needs of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels on the day of inspection were appropriate to meet the needs of the residents living at the home. There were two members of staff on during the day/evening, with a member of staff on duty during the night with another member of staff sleeping on the premises. Records were available to demonstrate that the staff receive all mandatory training such as health and safety, moving and handling, fire awareness, food hygiene, safeguarding adults and medication training. Induction training is provided in meeting the specific health and emotional needs of residents such as understanding and managing challenging behaviour, non-violent physical crisis prevention, diabetes, epilepsy, makaton, health and safety, moving and handling, first aid, infection control, learning disability and acquired brain injury. In discussion with staff it was confirmed that the training was specific to the needs of the service users living at the home.
2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 21 The recruitment files of two staff were viewed and contained all of the necessary recruitment and selection documentation. Clearances had been obtained from the Protection of Vulnerable Adults Register (POVA 1st), the Criminal Records Bureau (CRB) and references had been obtained prior to the members of staff taking up employment. Records of interviews were available that demonstrated that equal opportunities were practiced. Staff spoken with said they had one to one supervision with the registered manager on at least a six weekly basis, saying that they felt well supported, liked working at the home and found it very rewarding and had a pride in providing a good service to residents. Observations during the visit of staff and service user interactions showed that Residents were relaxed with the staff. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People live in a home that is run in their best interests and promotes their health, safety and welfare. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has worked at the home for a number of years and has the necessary qualifications, skills and experience to ensure that the home is managed efficiently and staff and service users all spoke highly of the registered manager. The systems for assessing and reviewing the resident’s ongoing needs were well managed, the care records viewed were up to date and evidenced that service users were supported through having a multi disciplinary team approach.
2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 23 The management systems were open and transparent; quality assurance systems were in place to gain the views or residents and their representatives to ensure that the resident’s rights are promoted and protected. Risk assessments were detailed and informed the staff on the control measures in place to ensure residents safety. There is a high commitment to ongoing staff training and that staff are provided with training that is specific to the service users needs. 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 3 X 3 X X 3 X 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 2 and 8 Kingsthorpe Grove DS0000031599.V349543.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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