Random inspection report
Care homes for older people
Name: Address: Kenilworth Care Home Duncan Place Loftus Saltburn TS13 4PR one star adequate service 21/07/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Andrea Goodall Date: 1 7 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Kenilworth Care Home Duncan Place Loftus Saltburn TS13 4PR 01287640203 F/P01287640203 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Maureen Middleton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Sunny Okukpolor Humphreys care home 20 Number of places (if applicable): Under 65 Over 65 20 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 20 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not faling within any other category - Code OP, maximum number of places: 20 Date of last inspection Brief description of the care home Kenilworth Care Home is a two storey Victorian House, with a purpose built, modern extension to the rear, which is situated in its own grounds, with a spacious garden, accessible to people who use the service. There is a paved entrance to the rear and car parking adjacent to the entrance. The home provides accommodation for 20 older
Care Homes for Older People Page 2 of 11 2 1 0 7 2 0 0 9 Brief description of the care home people, both male and female. Thirteen of the bedrooms are located on the ground floor, offering en-suite facilities of toilet and wash hand basin, and are well decorated. First floor bedrooms are accessed by the stairs and/or stair lift. First floor bedrooms do not offer en-suite facilities but they do have a sink. The home has two lounges and a spacious entrance hall with seating, and the dining room is bright and spacious. The laundry is located in the basement. There is a telephone available for people who use the service, and the home has a no smoking policy. Care Homes for Older People Page 3 of 11 What we found:
Before the visit we looked at information we have received since the last key inspection visit on 2009. We looked at any changes to how the home is run. We asked the Provider for their view of how well they care for people in their AQAA (an annual quality assurance assessment). We made an unannounced visit to the home on 17th June 2010. During the visit we talked with people who use the service, the manager and staff. We joined residents for a tea-time meal. We looked at how staff support the people who live here. We looked at information about the people who use the service, and how well their needs are met. At the time of this visit the home was typically full with 20 people living here. The home has been open for about 20 years and it is a valued resource in the local community. Many of the residents and staff are from the local village so have a shared interest and knowledge of local history and culture. Several of the current staff have worked at the home for many years. They have a very good knowledge of peoples needs, but this is not fully set out in care records so new or agency staff would not have this information. Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. The care records at Kenilworth include detailed assessments about each persons daily needs, such as mobility, dementia needs and risk of falls. However each persons assessed needs are not set down in a plan of care. In this way staff do not have written guidance about how to support people with their specific care needs in a consistent way. Some people have been assessed by the home as needing extra support or encouragement with their meals. However there are no nutritional assessments in place, and weight records are only sporadically recorded. In this way the home does not have a clear baseline point to check whether people are losing or gaining weight. Other people have had a history of falls, but the falls assessment is not completed. Some peoples moving and assisting assessments are not fully complete. Some care records are still written in pencil instead of pen. The home has made improvements to its medication system following recommendations at the last inspection. Medication is well managed and records are up to date. The medication room is a suitable and secure place to store medication at the right temperature. Staff were courteous and friendly in their support of residents. Staff support residents in an unhurried manner, and tasks such as mobilising, eating and washing are carried out at the residents own pace. All the residents and visitors who took part in this inspection commented very positively about the supportive attitude of staff. One person said, Ive been to other homes, but Im pleased to be here. Its like being in your own home. A visitor said, Its like one big happy family. All the staff are very caring and its all about making the residents feel cared for. Another resident said, The staff are lovely. They
Care Homes for Older People Page 4 of 11 are all local and are very friendly. You can say anything to them and have a laugh with them. There have been more opportunities for social activities since the last inspection. People have enjoyed themed events such as Ascot Ladies Day and the World Cup, as well as regular activities such as Motivation Classes and coffee mornings at the local community centre. Residents also talked about local walks out with staff to the shops, and about entertainment sessions that have involved relatives. It was clear that staff understand that meals and mealtimes are very important part of peoples daily lives. The cook asks people what they fancy, and residents suggestions are used in the menus. The manager stated We like to give people whatever they want. We like them to have snacks, crisps, cakes and drinks at anytime - just like they would at home. Residents described the meals as very good. One person said, You can have what you want. Its never the same thing twice, and we often have three choices for tea. The home is a large Victorian mansion that has been extended to the rear. It is set in its own very well-kept gardens and there is access to the garden and a paved patio area so that residents can sit out in better weather. Overall the accommodation is very comfortable, inviting and homely. One person said, I have a large room upstairs which I chose myself. It has wonderful views across the countryside. All the bedrooms viewed during this visit were well decorated, and highly personalised. People can choose to spend time in the privacy of their own rooms whenever they wish. At this time the locks fitted to bedroom doors are not a suitable type, as the rooms may not be accessible in an emergency (although no-one currently has a key to their room). The home has four bathrooms which is a good ratio for the 20 places it provides. However two bathrooms are generally unused as they contain standard baths without lifting equipment, so these rooms are being used for storage. The two remaining bathrooms do have hoists but one is currently broken and the home has been waiting for new parts for this for some time. This means that the 20 people who live here have only one bath to use, which is not sufficient. Lighting is quite dim in one ground floor corridor, the medication room and a staff office, mainly due to energy-efficient light bulbs. The provider is currently looking into additional wall lights for the corridor. Since the last inspection all staff have completed new training in safeguarding adults which was provided by Redcar and Cleveland authority. It is good practice that the manager is also arranging training for staff in the Mental Capacity Act and in deprivation of liberty. It is also good practice that most of the 14 care staff have achieved a national qualification in care (called NVQ 2 or 3). At this time only a few staff have had training in dementia care, but there are more people coming into care homes now with dementiacare needs. However, at the time of the visit, the staff training records were not up-to-date because training certificates had not been received by the home. In this way the training records did not demonstrate that all staff had current training in mandatory health & safety
Care Homes for Older People Page 5 of 11 matters. Following the inspection visit, the manager sent an updated training record to the CQC. The updated training records shows that domestic staff have not had mandatory training in COSHH (Control of Substances Hazardous to Health), and domestic and catering staff have not had training in manual handling. This means that they may not be up-to-date with the current health & safety legislation and practices when carrying out their daily duties. The manager and deputy manager have worked here for 20 years. In discussions it was clear that they try very hard to ensure that Kenilworth does not become institutional or rigid in its service. The manager described how they try to make the service as flexible as possible, and that the individual and diverse needs of each person are respected. The home has recently had an independent audit to check the quality and safety of service for the people who live here. The audit was carried out on behalf of the Redcar and Cleveland authority which funds many placements to this home. The home scored 4* (out of a possible 5*). It was clear from discussions with residents and staff that this home continues to be well managed and is run in the best interests of the people who live here. What the care home does well: What they could do better:
Care plans must be completed to show how the home will support each person with their assessed needs. The bath hoist must be repaired or replaced so there are enough bathing facilities. Arrangements must be made for the remaining staff without training in Manual Handling and COSHH to receive this so that they work in a safe way. Other things that would make the service better include
Care Homes for Older People Page 6 of 11 - care records should only be written in ink - all parts of the assessments should be completed including nutrition, moving and assisting, and falls - the provider should look for suitable locks for bedrooms doors - lighting to the ground floor bedroom corridor should be improved - and staff should receive training in Dementia Awareness to support them in their care of people who have dementia-type needs. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 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, 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 7 15 Care plans must be 07/09/2010 completed to show how the home will support each person with their assessed needs. This is to ensure that staff have the guidance to support people with their care needs in a consistent way. The bath hoist must be repaired or replaced. This is to ensure that there are sufficient bathing facilities with suitable adaptations to meet the mobility needs of the people who live here. 07/09/2010 2 21 23 3 30 18 Arrangements must be made 07/09/2010 for the remaining staff without training in Manual Handling and COSHH to receive this. This is to ensure that all staff are fully aware of the latest health & safety legislation and practices. Care Homes for Older People Page 9 of 11 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 1 2 7 8 Care records should only be written in ink, not in pencil, and staff should be instructed about this. Nutritional assessments should be carried out for all residents on admission, and regular weight records should be taken to check their on-going nutritional health. All parts of the moving & assisting assessments should be fully completed to show what specific equipment each person uses to support their mobility. Falls risk assessments should be completed for people who have been identified as at risk of falls. The Provider should consider how suitable locks can be fitted to bedrooms doors. Residents should be provided with a key to their room on admission unless a risk assessment shows otherwise. Lighting to the ground floor bedroom corridor should be improved to prevent a tripping hazard. Also the lighting in the staff office and medication room should be increased. Remaining staff should receive training in Dementia Awareness to support them in their care of people who have dementia-type needs. 3 8 4 5 8 24 6 25 7 30 Care Homes for Older People Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 11 of 11 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
