Inspection on 20/07/09 for Kathryn`s House

This is the latest available inspection report for this service, carried out on 20th July 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kathryn`s House 04/05/06

Kathryn`s House 06/10/05

Kathryn`s House 09/06/05

Kathryn`s House 13/12/04

Kathryn`s House 17/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Kathryn`s House Kathryn`s House 43-47 Farnham Road Guildford Surrey GU2 5JN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kenneth Dunn     Date: 2 0 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Kathryn`s House Kathryn`s House 43-47 Farnham Road Guildford Surrey GU2 5JN 01483560070 01483301490 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Z Z Merali care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 29 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Kathryns House is a large terraced house in the town centre of Guildford. The service provides care and accommodation for up to 29 older people, ten of whom have dementia. The accommodation is on four floors with a lift to access the upper floors of the home. The lower ground floor is accessible only by a staircase and therefore accommodates residents who are fully mobile. Care Homes for Older People Page 4 of 27 29 0 Over 65 0 29 Brief description of the care home The home has an outdoor area at the rear, which has benefited from investment to enable residents to sit outside in safety and comfort. There is also a small area set aside for parking. Fees range from 400 pounds sterling per week for a shared double bedroom to 520 pounds sterling per week for a single bedroom. Hairdressing is charged at various rates and chiropody is a set charge of 8 pounds per person. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This visit was part of a key inspection, which took place over four and a half hours commencing at 09:30 am and finishing at 13:00pm. The last key inspection was carried out by the commission was on the 24th September 2007. Information was provided to us before this visit in the annual quality assurance assessment. (AQAA). This is an assessment that focuses on how well outcomes are being met for people living in the service, reference is made to the AQAA throughout this report. During this visit we had the opportunity to speak with four people who live in the service. Feedback was also received from members of staff and a social care professional. During this visit we looked around the home and some people invited us to see their Care Homes for Older People Page 6 of 27 bedrooms. We looked at a random sample of some care plans, risk assessments, medication administration practises,staff recruitment and training records, health and safety and policies and procedures. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 27 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving into the home can be confident their needs will be assessed through admission and assessment processes and their physical needs will be met Evidence: People have their needs assessed before they move into the home to ensure their needs can be met. The home has a policy and procedure on admission to and discharge from the home. The registered manager is trained in the principles of assessment of peoples needs. We reviewed a random sample of four peoples individual files which showed that pre admission assessments are being carried out. The registered manager advised that all documents should be signed and dated and original assessment documentation should remain on peoples files. The files reviewed however were not fully signed and dated by the manager or the indavidual who is to recive care. Assessments seen included Care Homes for Older People Page 11 of 27 Evidence: sufficient information about peoples background and social histories, interests and lifestyle preferences. Staff therefore have the information they need to engage people in meaningful interaction and activities in line with their individual backgrounds, wishes, expectations and lifestyle choices. There is a percentage of people who live in the home that are experiencing significant levels of dementia or mental health difficulties. It was clear during the visit that the home has the capacity to meet these specialist needs in a way that promotes the wellbeing and enhances the quality of life for people who live there. The home does not provide intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home have their physical and personal care needs met, staff are respectful and demonstrate an understanding of the individuals living at Kathryns House. People can be confident staff will care for them with respect and maintain their privacy and dignity. People should be protected through the safe handling of medication. Evidence: The people who live in the home have individual and well designed plan of care. The plans are reviewed regularly to ensure that they accurately reflect the needs of the individuals concerned. Daily records are kept the information about how the care plan has been followed or the welfare of people promoted is minimal but contained relevant details. The information gathered in the assessment process means the residents have their social, emotional and spiritual needs met. The four care plans sampled provided information regarding the health and personal care needs of the individual and provided further information to enable staff to meet their emotional and social needs or preferences. Care Homes for Older People Page 13 of 27 Evidence: The home has a risk management systems in place to minimise potential risks to the people who live at the home. The service is able to demonstrate up to date knowledge of social care issues relevant to peoples individual needs. Care plans contain information about peoples background and social histories, former interests and preferences to enable staff to provide person centred care to each resident or interact with them in a meaningful way. Staff were observed providing care in a respectful way and with gentleness and patience during the site visit they were seen to take action and to promote dignity and privacy. People who live in the home can be confident there are sufficient qualified staff in the home to meet their health care needs and people are supported to access a variety of health care services such as dentists, opticians, chiropody and the local GP. People are protected through the safe handling of medication. Medication is stored securely and administered by trained staff in line with current good practise guidance. On the day of the site visit the records for recording the administration of medication had not been signed this was discussed with the manager and an explanation was given a review of previous records demonstrated this was a one off isolated event. One resident said that it is a nice place to be as there is flexibility I like the diversity of people, the staff are extremely nice and obliging. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lifestyle experience of people who live in the home ensures their social and recreational needs are met in line with their individual abilities, expectations and preferences. People have opportunity to exercise choice and control over their own lives. Residents partake of good home cooked food and are offered choices. Evidence: The home has a weekly schedule of activities, which has been designed on a very wide base in an attempt to encourage all residents to participate in these events. There is no clear records of who attends the activities and if they have gained any benefit from the process. The home does not employ a dedicated activates coordinator instead the staff group take on this role in turn, which can result in repetitive, poorly planned and inappropriate activities at times. The lifestyle experience of people who live in the home are reviewed in an attempt to satisfy their social and recreational interests, needs or lifestyle choices. There is information available about previous lifestyles, interests and preferences to guide staff to provide meaningful activities. Staff were seen to be very gentle and patient with the residents and were able to spend time just chatting. Care Homes for Older People Page 15 of 27 Evidence: There are weekly and monthly religious church services organised by the home. In the Annual Quality Assurance Audit (AQAA) the registered provider Residents are provided with any information about activities in the local area if they wish to attend. Some residents attend day centres and holy communion is held on a weekly basis and other services regularly. All activities are paid for, for example dance and exercise, from the residents fund. One resident takes daily trips into town on his scooter. Another resident helps with very simple house keeping chores. There are no restrictions on visitors to the home and people are encouraged to maintain contact with family and friends. People who live in the service have home cooked food. There is one dining room in the home. During the site visit staff were observed supporting residents to the dining room. The AQAA stated that residents are given choice of what they wish to eat, as menus are put up on the board outside the kitchen. During the visit residents were seen to look a the menu and ask what as for lunch. One resident stated I am very happy here, I came here from the hospital I feel like I am on holiday staff are very nice and the food is jolly good Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are protected from abuse and should be confident that their complaints will be acted upon. Evidence: The completed AQAA stated that The Home has a clear and accessible complaints procedure detailing timescales and how complaints are dealt with. The complaints procedures are displayed at the front of the Home and that All service users and staff are informed of the complaints procedure and would be fully supported by all staff in making a complaint. During the site visit it was observed that the home has an open and responsive complaints procedure. The manager stated that any issue that does arise will be dealt with almost immediately to ensure that issues can be handled speedily and effectively. The AQAA stated that Residents feel comfortable raising issues informally and are confident in expressing and problems they may have to both staff and Registered Manager, who has an open-door policy. It was discussed that there is a need for the registered manager to keep clear and accurate records of all complaints and that a log should be used as apposed to loose Care Homes for Older People Page 17 of 27 Evidence: leafs of paper as was the current practise. The home had a current copy of the local Surrey County Councils Safeguarding Adults procedure on display and staff and management stated that they were fully aware of the procedures and would if they had to be able to take appropriate actions if required. The completed AQAA stated that in the last 12 month there has been no complaints recorded at the home. A review of the records supported that no complaints have bee made and no complaints have been received directly by the commission. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The overall needs of the residents are being met by the current environment, however the current home has limitations, that will be greatly improved with the redevelopment and enlargement of the home. Evidence: The home was created with the redevelopment of a row of terraced house in the city centre of Guildford and as a result Kathryns House is not perfect as a care home for older people. The service has had long term plans in place for further redevelopment and enlargement by the inclusion of the remaining house in the terrace. The registered provider stated that this will allow the home to fully develop and create an environment which will effectively met the needs of the residents. The final planning approval of the redevelopment plans received planning permission in February 2009, the registered provider stated that everything is now almost in place and when the outstanding section of the redevelopment is in place the building works can start. The shared bedrooms sampled during the partial tour of the home remain an issue although curtains are provided around beds the layout of the rooms does not provide the occupants with clearly designated private areas. Care Homes for Older People Page 19 of 27 Evidence: The communal areas of the home were clean and well kept a stain on the carpet in on of the sitting room was highlighted during the partial tour, this was immediately cleaned and sanitised by the registered provider. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from the support of the committed and caring staff team. They can be confident there are sufficient numbers of care staff on duty to meet their needs. Recruitment practise needs tightening up to ensure people are fully protected Evidence: People who live in the home benefit from the support of the committed and caring staff team. They can be confident there are sufficient numbers of staff on duty to meet their needs. Staff observed during our visit demonstrated respect, were gentle, kind and patient with people who live in the home. The staff rota was examined, this showed there are sufficient numbers of staff on duty at the home, throughout the day and night. In the AQAA provided by the manager it stated that at least 70 of care staff have a National Vocational Qualification. People who live in the home are largely protected through the recruitment policies and procedures in operation in the home. A random sample of four staff files was undertaken as part of the site visit. In all four files there was some shortfalls in recruitment processes designed to protect the people Care Homes for Older People Page 21 of 27 Evidence: who live in the home in that there were still some gaps in employment histories. The manager stated that a full audit of the staff files had been undertaken in line with a requirement made by the previous inspection report (24/09/2007) in order to ensure that all highlighted gaps were completed. The registered manager stated that a further review would be undertaken to ensure that the all required information would be in place to ensure the residents ongoing safety. Checks are carried out through the Criminal Records Bureau and references are obtained. The registered manager stated that all staff are trained in house in infection control. basic food hygiene, first aid, fire safety, health and safety and moving and handling. A resident stated that I think of Kathryns House as my home and the staff my family, they are so friendly. An other resident stated that the staff are very helpful and that I have my independence and I have caring people looking after me. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for the day to day management of the home are good ensuring that the home is well managed. Policies and procedures are in place. The health, safety and welfare of the residents and the staff are promoted and protected Evidence: The home is well managed by the registered manager who is fully qualified to undertake this role. The registered manager has several years experience in the provision of care for older people. The home successfully gained an award in Investor in People on the 20th of March 2009. The registered manager is supported on a daily basis by the registered provider who has a sound knowledge of administration and home management. The manager stated that they operate on open and inclusive style of management and make themselves available to see residents and relatives as much as possible. One resident stated that Care Homes for Older People Page 23 of 27 Evidence: the manager isfantastic. The home has a comprehensive set of policies and procedures to ensure that the residents and staff are safeguarded. Care plans are reviewed monthly, and audits of medication are also undertaken monthly. Health and safety audits are undertaken and maintenance checks weekly. The health, safety and welfare of the residents and the staff are observed and promoted. All staff are familiar with the health and safety policy in place and undertake training in this policy during their induction period. Risk assessments are in place for all identified risks and to promote safe working practise. However it is recommended that the registered manger undertakes risk assessments on self medicating residents. The inspector observed that COSHH (Control of Substances Hazardous to Health) procedures are adhered to. Fire safety is observed and there is a contract in place for the maintenance of fire fighting equipment. All staff have regular training in fire safety awareness. The AQAA indicated that all the required safety certificates are in place and renewed as required. Gas certificate 12/05/09, Electrical PAT testing 28/07/08, Lift service 09/06/09 and Water analysis 22/01/09. The inspector noted the home kept records of all accidents and incidents and these are reported accordingly. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered manger must 10/08/2009 ensure that medication is recorded when given and not retrospectively. To safeguard the residents from potential medication errors. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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