Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Kilpeacon House Grey Road Altrincham Cheshire WA14 4BU The quality rating for this care home is:
two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sylvia Brown
Date: 0 3 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 30 Information about the care home
Name of care home: Address: Kilpeacon House Grey Road Altrincham Cheshire WA14 4BU 01619282784 01619296400 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Lina Margaret Skeath,Mr James Skeath care home 24 Number of places (if applicable): Under 65 Over 65 0 24 dementia old age, not falling within any other category Additional conditions: 24 0 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 categories: Old age, not falling within any other category - Code OP, Dementia - Code DE. The maximum number of service users who can be accommodated is: 24. Date of last inspection Brief description of the care home Kilpeacon is a care home providing personal care and accommodation for 24 older people. It is owned by Mr. and Mrs. Skeath. The home is located in an established residential area of Altrincham, close to shops, bus and train routes and other amenities. The home is a detached two-storey building and has 14 single and 5 shared bedrooms, most of which have en-suite facilities. There is a dining room, a lounge with dining area, and a conservatory. A passenger lift is available. The home has parking spaces and well maintained gardens within the Care Homes for Older People
Page 4 of 30 Brief description of the care home grounds. The current fees for the home range from #450 to # 475 per week, with additional charges for hairdressing, personal toiletries, newspapers and magazines. Further information about the service can be found in the homes Statement of Purpose and Service Users Guide. These are provided to people who are considering a move to Kilpeacon House or who are already accommodated. Copies of the documents are available to read at the home on request. Care Homes for Older People Page 5 of 30 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: The inspection report is based on information and evidence gathered by the Care Quality Commission(CQC)since the last key inspection,which was completed in April 2008. This was a key inspection which included a site visit to the service. The site visit was unannounced, which means the registered manager and staff were not told that we would be visiting. The registered manager and the registered provider were both on the premises during the site visit and supported the inspection process. For reporting purposes the preferred term to be used for people living and receiving a service at Kilpeacon House is residents. As part of the inspection process we gathered information from a number of people Care Homes for Older People
Page 6 of 30 which included, where possible, talking with and seeking the views of residents during the site visit. Prior to the site visit we also sent out surveys to residents and members of staff. This gave them an opportunity to tell us about their opinions on the services provided at the home.Comments received are included within the report. We case tracked residents living at the home, this means we looked in depth at their care support which included looking at their records in detail. We observed them as they went about their daily routines and received support from staff members. This helped us get a better view about how people living at Kilpeacon House are looked after and supported. In March 2009 the registered provider completed a self assessment form, which is called an Annual Quality Assessment Audit(AQAA).This document should tell us in detail what they and the registered manager has done since the last key inspection to meet and maintain the National Minimum Standards. It should also tell us what they felt they were doing well, how they had improved within the past 12 months and their plans to develop in the next 12 months.The AQAA contained enough information to tell us what we wanted to know, however we have advised the registered provider to contribute more actively to the completion of any future assessments to provide the registered manager with the opportunity to complete the document in order to obtain a wider perspective can be obtained about how the service is being developed and managed by them. We also gathered information through general contact with the home through their reporting procedures which are called Notifications and through information we may have received from other people, such as the general public and professional visitors. We have not received any complaints or allegations of abuse about this service within the last six months. Following the last key inspection the registered provider sent us an improvement plan which detailed what action they were going to take to improve and develop the services at the home and make sure that the home was operating to the required standard. This report is a public document and should be on display within the home and can be made available for reading. What the care home does well: The registered manager continues to maintain a relatively stable staff team who have worked there for some considerable time. Whilst there has been four staff leaving within the past twelve months, three left to have babies. Vacancies are covered by contracted staff and bank staff who are known to the service. The registered manager does not use agency staff. This means that residents receive care from people they know and trust and who know their needs and personnel preferences for support. Residents told us that they always and usually get the support they need. We were told by one resident that we are all well looked after whilst another said that the staff members were good. The pre admission process is also done well. From the records we looked at we could tell that the registered manager had been out to visit two residents before they moved into the home, one of whom was in hospital and one who lived in their own home. Because one person was not able to always understand what was being said or have the ability to understand written information provided by the registered manager, she took along a photograph album which contained photographic information about the home and the people who lived there. When we asked residents if they received enough information before they moved in, they stated they had, though one person did not fully remember the information given to them, they did remember the visit by the registered manager. Another said that after looking around the home they were pleased with the way people seemed happy and comfortable. When asked if there were enough members of staff to support them one resident told us there were too many and that they did not need them, but they were always there, another said they are most helpful at all times. We looked at a two week rota and assessed that there were enough staff on duty to meet the needs of residents and the demands of the home. The rota clearly indicated when staff were on care support duties and when they completed ancillary work. Residents are kept safe by good recruitment and selection procedures being in place. The registered manager ensures she has all the required information about prospective staff before she interviews them, she makes sure references received are valid and she makes completes all statutory checks before verbal and written offers of appointment are sent. All staff members complete a homes induction as well as the required Skills for Care Common induction programme. 98 of staff have completed National Vocational Training (NVQ) at Level 2 and 3 have completed or are in the process of completing NVQ at level 3 which exceeds the National Minimum Standards. Voluntary and work experience support workers are also checked by the registered manager to see if they are suitable and safe people to work with vulnerable adults. They complete mini induction procedures, are allocated an experienced member of staff as their mentor and on each duty a care worker is assigned to support them and monitor their practice with reocords of their observations and support being kept. This means that service users receive a consisstant quality of service and are supported by staff who know what to do and are competent. When we asked residents if there was anything they would like to tell us we were told Care Homes for Older People Page 8 of 30 I am very happy with the care and I have never had reason to complain I am very happy with my care. What has improved since the last inspection? Since the last inspection the registered provider, manager and staff team have worked hard to improve aspects of the home and their own practices. New monitoring systems have been put into place by the registered manager to spot check medication stocks,records and staff members practice. We looked at staff members training records which identified that all staff with responsibility to administer medication have completed an in depth training course in the management of medication. Because of this we feel that residents are now receiving their medication safely by competent and trained staff who are fully aware of their role and responsibilities to make sure they administer medication as prescribed and in a safe manner. Systems have also been introduced to make sure that when residents leave the home for social leave they are provided with their required medication which is recorded and can be accounted for at all times. The manner in which the registered manager records fire safety practices and the monitoring of fire safety equipment has improved. From looking at records we could see systems in place for regular practical fire drill training at the frequency agreed with the fire safety service. Safety checks for the testing of firse safety equipment was recorded correctly and there was an up-to-date fire risk assessment which has been viewed by the fire safety service. Action had also been taken by the registered provider to safeguard residents by making sure all bedroom and fire safety doors close correctly in order to reduce the risk of the spread of fire and smoke in the event of a fire emergency. External exit doors have been fitted with alarms which prevents residents leaving the building undetected and new extention cords have been fitted to call points to support residents to summon assistance when they need. When we consulted with residents about if they felt safe and who could they talk to if they were not happy, they all stated they had someone they could trust to talk to. They told us I talk to those in blue ( which are staff) they would tell the first member of staff they saw and I would tell the manager. Since the last inspection the registered manager has consulted with relatives and resident and had completed an annual quality assurance and held a residents meeting which relatives were invited to. We have been told that plans are in place to hold regular meetings to enable the views of residents and relatives to be heard as a group and to promote their involvement in future development of the services provided. Parts of the home have been redecorated and residents have received new bedding and curtaining. New side table have been purchased as have footstools and new lighting which makes the home appear a much brighter and cheerier place to live. We were able to look at records and observe the day to day routines and talk with residents about social activities. We found that the home is providing an improved Care Homes for Older People Page 9 of 30 activities programme and that residents had been consulted individually about their own personal preferences regarding activities. Whilst one person told us I would like to go out more another said they joined in quizzes and made things. During the course of the site visit we spent time looking at the residents preparations for Easter which included card and Easter bonnet making. We have been provided with the planned activities for residents over the summer which includes trips to local places of interest such as garden centers, the theater and restaurants. Residents at Kilpeacon House are also supported to attend family events such as birthday parties and weddings. What they could do better: 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 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 10 of 30 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 11 of 30 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. Prospective residents are provided with information about the services at the home and are able to visit to look and look around the home, observe the daily life and routines and speak with people who live there. This means that they can can make an informed decisions about their future and about moving into to Kilpeacon House. Evidence: The AQAA stated that all prospective service users are invited to visit the home without making an appointment. At this time they and their family are able to meet with others who live at Kilpeacon and look around the home. This makes sure that all residents are able to make informed choices about if Kilpeacon House would be a suitable place for them to live. We looked at the care files of two residents who had moved into the home since we last inspected. We could see from the records that the registered manager had visited
Care Homes for Older People Page 12 of 30 Evidence: both residents in their current placement and assessed their needs and talked with them about the services available at Kilpeacon House. The meetings helped both the prospective residents to talk with the registered manager about any matters of concern they had about moving into a residential care home. Both residents were offered the opportunity to look around the home and meet others who live at the home before they made any decisions about their future. We could tell from the records that residents had been provided with information on the home and had been told about what kind of support they would receive should they decide to move into the home. Care Homes for Older People Page 13 of 30 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. The health and personal care needs of residents are recorded, known and met by staff members. This means residents receive the individual support they want and need to enable them to maintain good health as far as possible. Evidence: Each resident had a care plan in place which was personalised and reflective of their individual needs and preferences. From the sample of records we looked at, we could see that residents had been consulted about their needs and how they would like to be supported. Health care checks and visits from medical professionals were recorded, which meant we could tell that service users were supported to maintain good health. Residents had full health care assessments in place and where required risk assessments had been completed. Risk assessments also included what action was to be taken to keep the resident safe whilst at the same time continuing to promote their independence and take every day risks. Care Homes for Older People Page 14 of 30 Evidence: Residents files also recorded their weights. Where residents were identified as being at risk of losing weight, the registered manager had consulted with medical professionals and made sure nutritional assessments were completed and that the resident received a well balanced diet which they liked. From the records we looked at we could see where some residents had started to gain weight because of the systems in place to support them. Residents personal possessions were recorded in detail which included their own fixture and fittings brought from home. This means that in the event of them leaving the home, all their belongings should be accounted for. At the previous inspection we identified that daily records failed to identify the required information and did not enable the reader to know what the residents daily life and routine were like. At that time the registered manager gave assurances that this would be reviewed and that records would be developed. At this inspection we found the registered manager had done what she said and the records had improved. All information on a resident is now kept together so that the reader can easily see the care and support provided over a 24-hour period. We have advised the registered manager to continue with developing these records to make sure that all care staff record the care support they have provided and make sure that they in some way discribe the daily life and routines of the residents. When we spoke with residents about the services provided at the home, one person told us its lovely here,nothing to grumble about with others nodding in agreement. The homes 2008 annual quality assurance states that of residents consulted 98 considered the care they received was excellent with a further 2 stating the care was good. Since the last inspection all staff with responsibility for administering medication hade completed or were in the process of completing an extensive training programme relating to the management and administration of medication. The training is completed over four months and assessed by an external examiner. The training requires that staff learn about medications and their effects, correct procedures for administering and recording of medication and its management. The registered manager has also encouraged additional staff to complete the same training so that they are familiar with the process for the safe management of medication which may be required should they gain promotion to a senior position in the future. The records of medication administered were maintained to a good standard and completed correctly. Sample signatures of staff were available for reference purposes
Care Homes for Older People Page 15 of 30 Evidence: and records and receipt books were in place for medication arriving at the home and being returned to the pharmacist. The registered manager has also developed a recording system which makes sure that all medication given to residents when are on social leave from the home are recorded and accounted for. This means that residents at Kilpeacon House received their medication as prescribed and in a safe manner. We saw residents as they spoke with staff members and observed how they received their support. From what we saw residents appeared relaxed with staff and were spoken to in a polite and respectful manner. All residents wore clean and well cared for clothes which identified that staff were respectfull of the residents personall things. Residents preferred name was used by members of staff and when support was being provided it was discreet. From conversations we had with residents we know that they were generally contented with the support they received and had no concerns about how they were looked after. Care Homes for Older People Page 16 of 30 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. Residents have the opportunity of joining in activities and are able to receive guest in private. This means they have they are supported to follow their chosen interests and activities and are able to keep in touch with friends and family as they wish. Evidence: During the inspection we were able to meet with residents some of whom took pleasure in showing us their achievements in making Easter cards. We also observed that they had made Easter bonnets for the homes Easter competition. The home has developed an activities programme which attempts to meet the individual social needs of all residents. The registered manager stated that she makes sure a personal approach to providing social support is in place and that residents individual preferences for activities are known by staff. In addition to group activities residents who prefer spending time alone receive one-to-one time with staff members. Records of residents involvement in activities are recorded. The AQAA stated that all residents received visits from relatives a number of whom take the residents out to local venues and places of interest. Since the last inspection the homes activities programme has improved and an
Care Homes for Older People Page 17 of 30 Evidence: external entertainer visits more frequently. To make sure that the individuality of residents is not lost and to help staff understand residents life prior to living in a care home, the registered manager has developed recording systems to include information about residents life from child hood through to admission into the home this includes information about their hobbies, interests, employment , places they have lived , friends and family. The manager told us that this information is used by staff when spending time with residents to promote and stimulate conversation and memory as well as enabling the home to provide activities the residents liked. Within the dining room we saw that the days menu was displayed, furthermore there was also a picture menu on display of the foods to be served. We were told by the registered manager that the cook meets with residents each morning to discuss the food options for the day and to find out what each resident would like to eat. Better records are now kept of the meals taken by residents which identified that whilst alternative options are not displayed on the menu, residents know of them and are able to make alternative choices. We would advise that alternative food options are recorded on the menu for residents to see. When we met with residents they told us that the lunchtime meal they had received was lovely and that they enjoyed it very much. Care Homes for Older People Page 18 of 30 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. Residents and visitors are confident that there complaints will be dealt with appropriately and that systems are in place for the protection of residents living at the home. This means that residents feel safe to make complaints and that staff are trained in the protection of vulnerable adults and know how to protect and report any suspicions of abuse. Evidence: During the course of the inspection we looked at a number of records including staff training files. They identified that in 2008 all members of staff members received training in the protection of vulnerable adults. At the time of the inspection three new staff were waiting to complete the training. The registered manager told us that as part of the homes own induction programme, new staff are given an overview of the homes and Local Authority adult protection procedure and receive relevant information to inform them of the action to be taken should they suspect abuse. With the exception of the three new staff all staff have completed NVQ 2 training which includes an element of protecting vulnerable adults. When we spoke with staff members during the course of the inspection they confirmed that they had attended training and had confidence in the systems in place to protect the residents. All staff receive copies of the general Social Care Council Code of Conduct.
Care Homes for Older People Page 19 of 30 Evidence: Training records identified that the registered manager and deputy have completed additional training in adult protection which identifies the role and responsibilities expected of staff in a management position when an allegation of abuse is made. We have not received any information regarding any suspicions of abuse at the service. The AQAA recorded that one complaint had been received at the home within the last 12 months and that it had been investigated within the appropriate timescale and was upheld. When we looked at records we could see that recording of complaints had improved and the action taken by the registered manager to investigate were recorded better. The registered manager told us that residents and relatives are provided with information about the homes complaint procedure at the time of admission. From the records we looked out we could see that the registered manager had held a residents and relatives meeting within which she sought their views on the standard of services provided at Kilpeacon House. We have not received any complaints about this service. Care Homes for Older People Page 20 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home which is suitable to meet their needs and comfort. This means that residents live is a home which offers enough private and communal space and is clean and well maintained. Evidence: Since the last inspection some redecoration has been completed and new lighting installed which has improved the general appearance of the areas used by residents. During the inspection we met with a number of residents some of whom informed us of their satisfaction with the services provided and stated that they had newly decorated bedrooms which they appreciated. All parts of the home we clean, well lit and warm, residents have been provided with additional side tables to support them to receive drinks safely when seated in the lounge areas. They had also been provided with new footstools where required to support their health care needs and comfort. The bedrooms we looked at were personalised according to the residents own taste. The registered provider explained that when residents move into the home he encourages and supports them to bring as much of their own belongings as will fit safely into their rooms which includes furniture. One room we looked at contained a lot
Care Homes for Older People Page 21 of 30 Evidence: of the residents own items from home, it was clear that the resident was supported well to make the room their own and had been able to arrange their furniture as they wished and have their own curtains and bedding. Some bedroom doors do not have appropriate locking devices, the registered provider stated that he has plans to improve this by fitting bedrooms doors with a suited locking system which will enable residents to lock their doors if they wish and ensure privacy for themselves and security for their personal belongings. The suited system will enable staff to gain access to their rooms in times of emergency and need. Action has been taken to make sure all bedroom doors close properly which in the event of a fire emergency will prevent the spread of smoke and fire. Systems were in place and carried out by the registered provider to make sure the home meets safety requirements and ensures it is a nice safe place to live. A handy person completes small repairs where required and additional professional services are employed when needed. We were told by the registered provider that plans are in place for the re tiling of the kitchen area. Since we last inspected new work surfaces have been fitted. We observed that the main internal kitchen door remained open which is not best practice. To ensure that fire safety is maintained at all times and reduce the risk of cross infection,the kitchen door should remain closed. Care Homes for Older People Page 22 of 30 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. The residents of Kilpeacon House have safe and appropaite support as there are enough trained and competant staff on duty at all times. They have confidence in the staff because they have recruited correctley and assessed as fit people to support them. Evidence: The residents of Kilpeacon House continue to be supported by a staff team who are recruited correctly and who have appropriate training and supervision. We observe staff as they went about their duties to support residents and found them to be polite and courteous when speaking with residents and completed moving and handling support correctly. Training records confirmed that most members of staff continued with their training and had, since the last inspection undertaken training in the management of medication, mental capacity act, food handling, palliative care and protection of vulnerable adults. 98 as staff have completed NVQ training at level 2 with 3 completing training at level 3 . This exceeds the current required standard. Recruitment and selection procedures are in place and after looking at three staff files we could tell that the registered manager takes the correct action to make sure that all
Care Homes for Older People Page 23 of 30 Evidence: members of staff are recruited properly. Application forms were correctly detailed and had all the required information, furthermore references were received, CRB checks completed and interview procedures recorded prior to any decisions being made regarding the applicants suitability for employment. Records demonstrated that the registered manager checked the validity of references when received. Applicants were told about the outcome of their interview prior to offering them a position of employment in writing. Staff files contained contracts of employment, job descriptions, confirmation that they had received the general Social Care Councils code of conduct and induction programme. From looking at other records we saw that voluntary workers and work experience workers were assessed as suitable people to work with residents prior to their services being used. They completed a mini induction, were assigned an experienced member of staff as a mentor and were allocated a member of staff on each duty to oversee their practice and support them. The staffing rota has been developed since the last inspection and it contains more information about which members of staff are on duty and their allocated responsibilities. From the information we have been given we believe that the staffing levels at Kilpeacon House were at the time of the inspection appropriate to meet the needs of the residents and the demands of the service. Since last inspection four members of staff have left, three of whom were due to having babies. This means there continues to be a relatively low turnover of staff. Vacancies have been covered by additional hours worked by contacted members of staff or by the homes own bank staff who are known to the residents. Because of this residents receive continuity of care and are supported by people they know and trust. Throughout the inspection we saw staff and residents talking with each other and completing activities. From what we saw we feel that residents have been able to form positive relationships with staff members and feel relaxed when speaking with them. Care Homes for Older People Page 24 of 30 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. Kilpeacon House is a well run home which is managed by a registered manager who is trained and competent. This means that residents at the home get the right support because the manager makes sure that all aspects of the home are run correctly and in their best interest. Evidence: The registered manager continues to have a positive and encouraging management style, she has been at the home for over 14 years and works alongside members of staff and provides direct care support to residents. This means that she continues to have a good perspective on the day-to-day services provided and can directly observed the support residents receive from staff members. From training records we could see that the registered manager continues with her own training and has completed NVQ at level four and has the appropriate management qualifications.
Care Homes for Older People Page 25 of 30 Evidence: Since the last inspection we think the registered manager has worked hard to develop her own practice and put systems into place which enables her to assess the practice of others. Because of this we think there is a more formal support procedure in place for staff members and that the registered manager now has a recording system which enables her to have a formal overview of each aspect of the service. The AQAA stated that within the next 12 months a number of areas are to be developed relating to the continued development of care planning and risk assessing. The AQAA also identified that the way current systems involve residents, relatives and staff members is to be developed particularly how they are consulted and involved with the development of the service. The registered provider has stated that more residents and relatives meetings are to be planned in order to obtain collective views on the service. As the registered provider and manager has demonstrated that they have taken seriously the outcome of the last inspection and taken positive action to improve systems and service at the home, we have confidence that they will continue to develop the service as they state they will. The registered manager does not take responsibility for managing any service users finances. Any money spent by residents is provided by the home, who later invoice the resident or their next of kin. When we looked at staff records we could see that staff members including the senior and deputy management team receive formal supervision, we spent time with the registered manager looking at ways formal supervision sessions could be further used to evaluate staffs performance and promote their learning and development. Records of all formal supervision and team meetings are maintained and used for reference purposes when annual staff appraisals are completed. We looked at health and safety records and found that the registered provider takes the correct action to make sure that fire safety standards are maintained as required and that all equipment and utilities are serviced by professional contractors. Routine fire safety checks are completed by the registered provider as required. Fire safety records recorded that regular unannounced practical fire drills are carried out. The registered manager confirmed that such practices are completed for all staff members including night staff. The home has an up-to-date fire risk assessment which identifies the action to be taken in the event of a fire emergency. All accidents are recorded and the registered manager keeps us informed of any significant events concerning residents through the formal Notification process.
Care Homes for Older People Page 26 of 30 Care Homes for Older People Page 27 of 30 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 28 of 30 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 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 24 All bedroom doors should be fitted with locks which are suited to the residents capabilities and are accessible to staff in times of emergency. Residents should be provided with a key to their room unless their risk management suggests otherwise. Action should be taken to make sure that the internal kitchen remains closed when meals are not being served. 2 26 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - 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!
