Inspection on 25/06/10 for Kent House

This is the latest available inspection report for this service, carried out on 25th June 2010.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/06/2011.

Random inspection report Care homes for older people Name: Address: Kent House Augustine Road Harrow Middx HA3 5NS one star adequate service 04/08/2009 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: Ram Sooriah Date: 2 5 0 6 2 0 1 0 Information about the care home Name of care home: Address: Kent House Augustine Road Harrow Middx HA3 5NS 02084214550 02084215568 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Elizabeth Corbett Type of registration: Number of places registered: Conditions of registration: Category(ies) : Home Group Limited care home 40 Number of places (if applicable): Under 65 Over 65 40 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 40 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 need on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Kent House is located in a quiet residential cul-de-sac in Harrow Weald off Long Elmes, not far from the Uxbridge Road. It is close to some local shops. Other public amenities are available in Harrow Weald or Harrow on the Hill, which are accessible by buses or by car. The home is about five-ten minutes walk from the bus stop and is located next Care Homes for Older People Page 2 of 11 0 4 0 8 2 0 0 9 Brief description of the care home to Headstone Lane train station. There is parking for about 8-10 cars in the grounds of the home. kent House is currently registered to provide personal care for forty people with frail elderly care needs. The home was first registered in 1989 under Warden Housing. It was re-registered in April 2009 under Home Group Ltd. Home Group is the main housing association and is made up of smaller housing associations including, Warden Housing. It has two care homes. The building is a two-storey purpose built care home. Accommodation for residents is provided in thirty-two single and four double bedrooms all with en-suite facilities. There are thirteen bedrooms, two lounges, a large dining room and a conservatory on the ground floor. The rest of the bedrooms are found on the first floor. There is also a small kitchenette and a small lounge and library on that floor. The home has gardens to the rear and side that are well maintained and accessible to people who use the service. The home charges 560 pounds for privately funded residents and accept residents from local authorities. Residents from Local authorities do not pay a top up. Care Homes for Older People Page 3 of 11 What we found: The random unannounced inspection took place on Friday 25th June 2010. It started at 10:20 and finished at 15:10. It was arranged to check on compliance with previous requirements that were imposed on the home. The last key inspection took place on the 4th August 2009 when the home was rated as providing adequate outcomes for residents. During this inspection we looked at the management of medicines and inspected the care plans of two residents. We also made a brief tour of the premises, observed what was happening in the home and spoke to one visitor, four residents and eight members of staff. The registered manager had a day off on the day of the inspection and a team leader was in charge of the home. She supported the inspection as best as she could and we were able to give her feedback about the inspection. Residents in the home were on the whole clean and appropriately dressed. They sat in various areas of the home, including outside in the garden, according to their wishes. All appeared to be comfortable and relaxed. Some were watching TV, others were listening to music, some sat in their rooms and a few were enjoying the nice weather. All residents who spoke to us told us that they were very satisfied with the care and support that they receive. They spoke about the manager and staff very highly. One resident said that the staff would do anything for you. A visitor said that staff always have time for the residents. Residents reported that their choices are respected by staff. They say that they are able to choose the activities that they want to take part in, the meals that they want to eat and how and where they spend their day. A few residents stayed in their rooms as they did not want to go to the lounges and we noted when we toured the premises that they all had their call bells to summon help if that was needed. The activities programme showed that there were visits by a representative from the local Church of England Church every two weeks. There was also input from the Baptist Church and the Pentecostal Church. A member of staff informed us that a representative from the Roman Catholic Church visits the home regularly to see residents who practice this religion. There was therefore evidence that the home supports residents with practicing their religion as required. We observed lunch being served. The majority of residents had their meals in the dining room that was appropriately prepared. There was fish in batter, poached fish, chips and peas. There was chicken for those who did not want fish. Some residents wanted a salad on the side and this was also provided. All residents said that the kitchen always provides an alternative if they do not want a particular meal and if enough notice is given. The chef also told us that all food is cooked in-house and from fresh produce including, the fish in batter. We were informed that the home has a new menu that has been drawn up with contributions from residents.We did not look at the menu and are unable to comment on Care Homes for Older People Page 4 of 11 its content. However, the overwhelming majority of residents were satisfied with their meals. Residents told us that they have enough to do during the day as the home arranges a number of activities including, outings. One person said that they are pleased that staff take them out despite the upheavals of arranging the outings. A plan for activities was available for inspection and we noted that entertainment features regularly on the plan. We were informed that the home has recruited another part-time activities coordinator to assist the one part-time activities coordinator that was in post previously. During the inspection a resident told us that the activities coordinator was on annual leave and that a trip that had been planned was canceled because it was too hot on the day. We also noted little on the day in terms of social and recreational activities. We observed that staff were busy caring and supporting residents and few had time to carry out social activities with residents. We would recommend that the home makes alternative arrangements to cover for the activities coordinator when the latter is not working so that there is someone to address the provision of recreational activities in the home on a daily basis. We looked at two care plans during the inspection. We were informed by a member of staff that the home was revamping the care plans to make these more reflective of the individual needs of residents and to involve them more in the care planning process. The overall conclusion is that this is a step in the right direction. We noted that the care records appropriately addressed the needs of residents and that action plans were in place to address the needs of residents that have been identified. We also observed that these were reviewed monthly and that residents were involved in drawing up the care plans. We shall do a more thorough evaluation of the care records when the home has fully updated all the care records as it intends to do. Our inspection of the management of medicines showed that there has been many improvements. For example records were much more comprehensive and there were much fewer gaps in the medicines administration records (MAR) charts than what was observed during the last inspection. The amount of medicines remaining from a previous medicines cycle was also carried forward and the amount of all medicines received in the home was recorded when received in the home. We noted that the time for the administration of medicines was recorded as 0800, 1200, 1700 and 2030. This shows that the interval between the evening time and night time might be too short (three and half hours) for the administration of some medicines as it is necessary to allow an appropriate interval of time between doses. For example paracetamol tablets should always be administered 4-6 hours after the previous dose. It is also necessary to consider that for the optimal effect of certain medicines, the level of the medicines have to be, as far as possible, constant in the blood stream. This requires that the medicines be administered, as far as possible, at regular intervals of time. Staff informed us that they are aware of this and do not administer the medicines that require 4-6 hour intervals in between doses, at the time indicated on the MAR sheet. If that is the case then the MAR sheets must reflect this. A requirement was imposed on the home to address this aspect of medicines management during the last inspection. This requirement is left in this report. We observed that on a few occasions there were corrections in the MAR sheets Care Homes for Older People Page 5 of 11 particularly where staff have recorded the amount of the medicines received or brought forward. The corrections were made on top of previous entries and were therefore not very legible. It would have been preferable to cross the original entries and to write next to the crossed entries to make any changes more legible. During the inspection we randomly checked the amount of medicines in stock. We found that the amount of six medicines for five residents did not reconcile with the amount of medicines that should have been in place. There were more medicines than what should be in place for three of the medicines and there were less for the other three medicines. We therefore concluded that medicines were not always administered as prescribed. An immediate requirement was imposed on the home at the time of the inspection to address this shortfall. The home was on the whole clean and there were no odours. The areas that we visited appeared to be in good decorative order. The immediate requirements that were imposed on the home during the last key inspection in August 2009 regarding the use of window restrictors to reduce the risk of falling from a height, and devices to maintain a safe temperature for the hot water, have been actioned. We checked a sample of bedrooms and bathrooms, and noted that new window restrictors were in place and that these were of a type that could not be easily disabled. There were also thermostatic valves to control the water temperature to reduce the risk of scalding, in the bedrooms that we checked. What the care home does well: What they could do better: Our findings show that there has been improvement in many areas of the service, where requirements were previously imposed. One area that still require improvement is the management of medicines. The fact that the amount of medicines in stock did not reconcile with the amount of medicines that should be in stock suggests that medicines were not always administered as prescribed. The registered provider must address this area to ensure the safety of residents. Care Homes for Older People Page 6 of 11 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 R No £ 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 1 9 13 Medicines must as far as possible be given at regular intervals to ensure that residents receive the maximum benefit from the medicines. To ensure that the management of medicines is carried out safely. 17/11/2009 2 9 13 All medicines must be 17/11/2009 administered as prescribed and in cases of a variable dose, the actual amount that is administered must be recorded. To ensure that the management of medicines is carried out safely. 3 33 13 The home must keep a record of the valuables and property that is brought into the home by residents or their representatives. To provide an audit trail and to safeguard residents valuables and property as far as possible. 11/11/2009 4 38 13 The home must have 11/11/2009 systems in place to monitor the water temperature at hot water outlets to which Page 8 of 11 Care Homes for Older People 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 residents have acess to at intervals as determined by its risk assessment. To ensure that any problem with hot water is promptly identified and addressed to reduce the risk of scalding. Care Homes for Older People Page 9 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 1 9 13 The management of medicines must be carried out in a safe manner. All medicines must be administered as prescribed To ensure the safety of people that use the service. 31/07/2010 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 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 9 Any changes to entries in the medicines administration charts must be made clearly. It is preferable to cross out the original entries and to write next to the crossed entries to make any changes more legible rather than write on top of the original entries. 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!