Inspection on 07/04/08 for Kingsfield

This is the latest available inspection report for this service, carried out on 7th April 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Kingsfield 252 Abbey Road Barrow in Furness Cumbria LA13 9JJ Lead Inspector Marian Whittam Unannounced Inspection 7th April 2008 09.00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsfield Address 252 Abbey Road Barrow in Furness Cumbria LA13 9JJ Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01229 836000 kingsfield@applehealthcare.org Apple Healthcare Limited Vacant Care Home 27 Category(ies) of Dementia - over 65 years of age (5), Mental registration, with number disorder, excluding learning disability or of places dementia (2), Old age, not falling within any other category (27), Physical disability (1), Physical disability over 65 years of age (5) Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of of 27 service users to include: *Up to 5 service users in the category of DE (E) (dementia over 65 years of age). * Up to 2 service users in the category of MD (Mental disorder excluding learning disability or dementia under 65 years of age).*Up to 1 service user in the category of PD (physical disability under 65 years of age). *Up to 5 service users in the category of PD(E) (physical disability over 65 years of age). * Up to 27 service users in the category of OP (old age not falling within any other category). 25th April 2007 Date of last inspection Brief Description of the Service: Kingsfield is a Care Home registered to provide care for up to 27 people with a variety of needs. The home is an extended semi-detached Edwardian style house with residents bedrooms on three floors. The two upper floors of the home are reached by a chairlift and the access to one area is by two steps. The home is in a residential area on the outskirts of Barrow in Furness, and is set back from the main road into the town. The home is on a bus route into Barrow and out of town and the bus stops are close by. The home is close to local public houses, churches and a shop. Outside the home has a car park at the front and side of the house and at the back and side of the home there are two enclosed patio areas with flower borders and seating areas for service users and those who want to smoke. The rear patios have ramps for wheelchair users. Information is available to prospective residents from the recently updated and improved Statement of purpose, the service users guide and the home’s information pack; this is provided for prospective residents and supplied to all residents when they come to live there. These are also available in large print on request. A copy of the last inspection report is also available for people to look at. The fees charged by the home range from £337.00 to £449.00 per week as at the date of the inspection and an additional charge is made for personal toiletries, newspapers, magazines, also hairdressing and chiropody, personal transport and some outside activities. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This site visit to Kingsfield forms part of a key inspection. It took place on 07.03.08 and we (The Commission for Social Care Inspection, CSCI) were in the home for seven hours. Information about the service was gathered in different ways: • Annual Quality Assurance Assessment document completed by the manager identifying what the service does well and what could be improved. This was returned to CSCI before the visit. • The service history. • Interviews with residents, visiting healthcare professionals and staff on the day of the visit. • Observations made by us in the home during the visit. • Completed questionnaire survey forms from people living in the home, staff working there and from healthcare professionals coming into contact with the service. During the visit we spent time with people living in the home and talking to them about their experiences. We looked at care planning documentation and assessments to ensure the level of care provided met the needs of those living in the home and made a tour of the building to inspect the environmental standards. Staff personnel and training files were examined and a selection of the service’s records required by regulation. We assessed the handling of medicines through inspection of relevant documents, storage and meeting with the manager, other staff and residents. What the service does well: People living in the home we talked with spoke well of the staff and the help and support they get from them. The home provides a homely and informal atmosphere for residents and we saw that staff have a good rapport with them and know them well. The home is kept clean and tidy and many residents have chosen to personalise their bedrooms, to make them more homely, some with the involvement of their families. The home works with other healthcare agencies and gets specialist help for residents when this is needed. This includes the local GPs and District nursing teams as well as specialist services such as the intermediate support team. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 6 Survey responses from GPs visiting the service indicate that staff work well with them and take advice and direction to meet resident’s health care needs promptly. Care plans and activities are developed with residents to make sure their personal preferences are included. There are good systems for handling medication to make sure that people’s medicines are managed safely and that residents receive the correct treatment. Training and staff development is being given a high priority in the home. The service has robust recruitment systems to ensure they get the right staff and promote the safety and wellbeing of people living there. What has improved since the last inspection? Since the last inspection many of the planned changes, refurbishments and service developments have taken place or been completed. This is especially evident with the improvements to the environment and to care planning. The owners have embarked on a major programme of work to improve the environment and facilities in all areas of the home. Bedrooms have been redecorated and halls and corridors, bathrooms have been significantly upgraded and decorated with new baths and hoists, the kitchen and food store has been improved and new equipment and hot water boiler and laundry equipment. Extensive work has been done on the roof and work is being done on the grounds. This work is continuing to make the environment better and more accessible for people living there and the work done so far indicates a commitment to development and improvement. The Statement of purpose has been updated and improved and includes details of the accommodation provided. There is an informative service user guide given to prospective residents and an information pack is provided in all bedrooms. This will improve access to information about the home for current and prospective users of the service and is available in large print. Since the last inspection work has been done to improve the care planning systems and approaches. Care plans are clearer and give relevant information, are easier for staff to follow and update and include individual risk assessments. The service is moving towards a more individualised or person centred approach to care practice and developing care plans with people living there. The risk of falls is being assessed and motion alarms used to alert staff with those most at risk. The key worker system continues to develop and people’s psychological health needs are being more systematically monitored now so action can be taken quicker. Procedures for providing palliative care have been reviewed and updates and some staff have training in this and supporting people through bereavement and loss. Profiles or ‘pen pictures’ of people living in the home have been developed with residents and their families. This has helped to increase people’s involvement in their own care and in defining their own goals. This improvement in personal involvement is alongside increased activities provision and planning to help in Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 7 providing more meaningful recreation for people. Activities and recreational preferences are now included in the individual care plans and are recorded. Since the last inspection people have told us that the catering has improved and that they now have greater choice and variety in the food offered. Complaint recording and investigation has been improved and the recording of actions taken and monitoring to stop reoccurrence. The procedures for safeguarding adults have been reviewed, made clear and reflect current multi agency guidance. All care staff now receive formal supervision at least 6 times a year and an annual appraisal. Staff training programmes and records are now in place and staff are being encouraged and supported to undertake a range of training and development to improve their skills and develop service provision for people living there. Staff are now being paid to attend all training sessions, which they say, makes them feel more valued. Health and safety procedures and policies and fire risk assessments in use in the home have been reviewed to make sure they are up to date and in line with current legislation and good practice. A thorough review of all policies and procedures has been done to bring those up to date as well and these are available to staff and residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 1, 2, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home and facilities is available before and following admission so people have information to help them make an informed choice. Assessments of people’s needs are done before coming to live there to make sure they can be met. EVIDENCE: General information is available about the service for prospective residents and their families in the statement of purpose and this is supported by an informative service users guide to help them make an informed choice about the service. This includes information on the size of bedrooms in the home and where they do not meet current minimum space requirements. This information can be made available in other formats if required by people and is also provided in a welcome information pack in people’s bedrooms for reference. This pack also contains useful information leaflets and contacts for Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 10 further information about care, the role of CSCI, paying for care and what to look for in a care home. The statement of purpose/service user guide we looked at was clear and gave a general over view of what the service provides. The notice board in the foyer of the home gives information of what is going on in the home and the daily menu. The manager generally does the pre admission assessments with another member of staff. There was evidence that the service will take time to help people settle into the home following admission and that it tries to involve families in finding the best means to do this. Prospective residents are given the opportunity to spend time in the home before they make a decision about living there. This may be through a visit or through a trial stay if a room is available. This was evident for one person who came for a short stay which they extended until they felt able to make a decision. We looked at four people’s care plans and the pre admission assessments that had been done to make sure the home was able to meet an individual’s needs before they came to live there. The pre admission assessments we looked at contained the relevant information from which to develop a basic individual care plan. The manager discussed how the service intends to continue to develop its pre admission assessments to make them more individualised. Where the assessment has been done by social services a copy is included in the care plan. Where appropriate other care agencies and professionals have been involved in providing information before admission and advice after admission. Residents are given a statement of terms and conditions of residency or a contract if they fund themselves, setting out the rights and obligations of the individual. These are regularly reviewed and the provider is reviewing them at the moment. The service does not provide intermediate care. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care which people using this service receive is based on their individual needs. Privacy, dignity and personal choice are promoted at all times. EVIDENCE: All residents have an individual plan of care that is clearly set out and easy to follow. The care planning system has been improved significantly since the last inspection and information is now better organised and easier for staff to follow and update. It is based on initial assessments and the plans set out individual’s health, personal and social care needs incorporating personal preferences and include appropriate clinical risk assessments. The risk of falls is being assessed and motion alarms used for those most at risk. Care plans and assessments are being reviewed regularly and were being updated so staff had the information to care for and support people. Monitoring of care and health needs is being done and there is now a thorough monthly review of the plan Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 12 that highlights any issues of concern to follow up and where changes have been made to the care provided. Approaches to care planning are now much more focused on the individual, their preferences and goals and the service is continuing to develop this within its information gathering and planning and through key workers. The acting manager checks care plans to monitor if procedures are being followed and necessary information recorded. We looked at medication handling, records and practices and found there were systems in place for storage ordering and checking medication to make sure that medicines and the quantities received were correct before administration to residents. Training records show that staff have been given training in handling medication and that clear procedures are in place. There are protocols for the use of homely remedies and also for ‘as required’ medicines. Controlled drugs are not kept for people in any quantity and are recorded accurately and kept separately. However the cupboard used for storage does not comply with the requirements of the Misuse of Drugs (Safe Custody) Regulations. We discussed this with the provider and acting manager and recommended that they replaced the existing cupboard with one that met the regulations. From speaking with people living in the home and examining their current care plans it was evident that they are being much more routinely involved in planning their care as it affects their lifestyles and quality of life. One person told us “I am asked more about what I want and am happy living here now, I know I can look at my plans now and they don’t tell me what I must do all the time”. Residents spoken with said their privacy was respected and felt their dignity upheld. Observation during the inspection, including moving and handling practices suggests that resident’s dignity is being promoted and independence promoted in accordance with their plans. One person told us that, “I like to be independent but can’t walk far now but if I ring the bell the staff come quickly”. We observed that all the staff addressed the residents in a respectful manner and that the staff at the home showed a good understanding of the residents and their needs and communicated well with them. One resident told us that, “everyone is very nice and kind to me”. There are policies and procedures in place for the care of the people at the end of their lives and these have been reviewed to ensure they reflect current good practice in palliative care. Information was being gathered expressing people’s wishes and preferences on this. Training records show that some staff, with a particular interest, have undertaken training in palliative care approaches, bereavement and loss. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are able to make choices about their lifestyle and are supported to maintain their independence. EVIDENCE: The home has two activity coordinators who provide group and some individual activities for people living there. Activities and recreational preferences are included in the individual care plans and individual records are kept of what people have taken part in. Care plans include personal profiles that have been developed with residents and /or their families where possible. This provides useful information for those supporting residents with activities that are meaningful to them and suit their capabilities. This was evident for one person who was able to follow a personal interest by attending a railway exhibition where they met some old friends and went for a trip in a vintage bus, which they had enjoyed. For another person it was taking a trip into town to have tea out. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 14 People told us they saw their visitors when they wanted and some went out for the day with family and friends. Forthcoming social events are advertised in the home on the notice board including times for the exercise sessions and Tai Chi. People we spoke to enjoyed the activities they took part in including bingo, singing, going for a walk, to the shops, playing dominoes or out with friends and several enjoyed the musical entertainments and commented positively on the Christmas festivities. The owners have purchased new flat screen televisions for the lounges that receive digital channels to improve choice for residents. Some residents told us they enjoyed the weekend film sessions “especially the musicals”. Some people told us they chose not to attend some activities and were not made to feel they had to. Some people said they liked to stay in their rooms and watch their television or listen to their music and one person liked to draw, although they said they came to the lounge for bingo. People living there have access to religious services and weekly pastoral support from clergy of their choice. As part of developing and improve recreational opportunities the provider has plans to extend the availability of computer and Internet access to residents who want this. This includes using a web cam to help them keep in touch with family and friends who live away. A choice of meals is offered each day from the menu on display and people we spoke to said that staff asked them what they wanted each day and could have an alternative if they didn’t like the daily choices offered. One relative commented, “There is a good varied menu and my mother’s appetite has returned over the last 6 months”. People we spoke with all made positive comments about the food offered and one said “The food is a lot better now, it has really improved, there is a good choice and I can have salmon and scampi, which I really like and its good meat like lamb. On a Sunday I get a good cooked breakfast and I enjoy that”. We visited the kitchen, which has been refurbished along with the food storage areas. We spoke with the cook about the menus and how they included resident’s choices in it and examined their records for food served, food temperatures and cleaning. The kitchen was generally clean and tidy and the service has a 3 star rating from the Environmental Health officer. Meals are served either in the lounge/dining areas or in the resident’s rooms depending on the their preference. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 16, 17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are able to express their concerns knowing they will be listened to and acted upon. EVIDENCE: There are clear procedures in place for dealing with complaints and concerns. The complaints policy and procedure is part of the guide for the people using this service and there was also a copy on display in the foyer. There is also a suggestion box for people to use. The complaints procedure can be provided in different formats if people need or want this. There has been one complaint passed to the provider by CSCI since the last inspection and we saw that these were fully recorded in the home’s records and had been investigated and action taken to prevent any reoccurrence. A report was also passed to CSCI following the investigation. Any concerns that had been raised by other agencies had also been fully investigated and recorded. The resident’s we spoke with during the visit were all aware of the procedure and what they would do to should they need to use it. They had confidence that the manager would act on their concerns. One person told us, “Jackie, the manageress is the one I talk to if anything puzzles me, she’s very nice”. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 16 Staff we talked to told us that if they had any problems they would speak to their line manager or the home manager if they had any concerns about the care of the residents or any other issues. Information on advocacy services and contacting them is available in the welcome pack. Residents who want to are supported to stay on the local voting register. The service has internal policies and procedures for the Protection of Vulnerable Adults (POVA). We looked at these and they are in line with multi agency guidance. The acting manager has requested new copies of the local multi agency guidance from social services and is waiting for that. Staff records show that all staff have enhanced Criminal Records Bureau (CRB) checks before they start work to protect residents. The home has made one referral to social services using safeguarding adults procedures to protect the interests of residents and this was investigated by the appropriate agencies and actions were taken. Care staff have had training on recognising abuse and the adult protection procedures. This subject is also covered in National Vocational Qualification (NVQ) training, which over 50 of staff have done. The service has procedures in place to help staff deal with aggression by people living there, any missing persons and a policy on restraint. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 19, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment within the home is of a consistent standard providing resident’s with a well- maintained, well equipped, clean, safe and homely place to live. EVIDENCE: The home is being well maintained with an overall good standard of decoration and provides a clean, tidy and homely environment for residents. Significant improvements have been made across all areas of the home’s environment, including the roof, in order to update and improve the home for the people living there. The bathrooms and top floor shower room have had major refurbishment and attractive new tiling and non -slip flooring and one bathroom has been fitted with a hydrotherapy bath. People we spoke with said Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 18 that they liked this new spa bath facility. New lighting in bathrooms make the atmosphere more relaxing for people using the spa bath. There are ample dining and lounge areas for people in the home and these were clean and homely with domestic style lighting and good natural ventilation. One lounge now has tea and coffee making facilities so visitors can help themselves to drinks. There has been redecoration of the hallway and some bedrooms and the lounges are due to be redecorated under the planned refurbishments. The home smelt fresh and was clean at this visit with maintenance staff acting quickly to deal with any cleaning problems as they occurred. The cleaning staff have an industrial carpet cleaner to deal appropriately with the range of stains they encounter as well as rota for carpet shampooing. Resident’s bedrooms that were seen had a satisfactory standard of decoration, furnishings and soft furnishings and had locks on the doors, which some residents used when they went out. Many residents have brought into the home their own possessions, personal items and electrical equipment and this helped to make their bedrooms more personal and homely. Some bedrooms had been decorated according to the personal tastes of the occupants. The redecorated and refurbished bedrooms had attractive soft furnishings with lockable drawers for medications or personal items. There are some shared bedrooms and these have screens available to promote privacy where people choose to share. One bedroom has en suite facilities. There is a suitable range of moving and handling equipment adaptations in the home to help residents get about, including a stair lift. The laundry is small but tidy and organised and has a new tumble drier to improve the laundry service. The home has policies and procedures in place for infection control and records show staff have been given training on this. From observation staff are following the procedures and using appropriate protective clothing. There is a sluice facility that promotes good hygiene and infection control. The kitchen has also been improved to give better catering facilities with new stainless steel worktops, new kitchen units and refrigerator as well as a new hot water boiler. There is a patio area that a lot of people use and new furniture has been provided for those who want to sit out. The owners have identified that there is scope for improving the gardens and improving people’s access and use of them. We discussed this with the owner and this will be done as part of their development planning. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment processes, staff training and sufficient staffing promote a consistent level of individual care for the people living there. EVIDENCE: Staff rotas and observation during the visit indicate the home has sufficient staff on duty with a range of skills and experience to provide a consistent level of individual care for the number of people currently living in the home. There was evidence on record and on staff surveys of the service encouraging and supporting staff to undertake a range of training beyond the mandatory. Staff have individual training files showing all training they had attended. There was evidence of training plans discussed at the last inspection having been implemented. Training is being more systematically planned and is being given a high priority, with staff paid to attend training and rotas adjusted to allow them to attend. On the day of the visit staff were having fire safety training from an outside co agency. Over 50 of staff have the NVQ level 2 qualification in care and some have expressed an interest in taking the Level 3 qualification. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 20 The home has 2 part time maintenance people who deal with general maintenance and carpet cleaning and 2 part time cleaning staff covering 6 days a week to keep the home clean and safe. People living in the home we spoke to were positive about the staff and their care. One told us that “The staff are very good, I can’t walk far and when I ring my bell they come quickly”. Staff surveys were also positive on training, induction and their recruitment process. All staff are provided with a useful and informative staff handbook including the home’s equal opportunities policy, grievance procedure and disciplinary rules and procedures to promote greater clarity and openness with staff. Staff meeting take place regularly and records and staff comments confirm that regular formal supervision takes place and annual appraisals are being done. One carer said” We have supervision every 8 weeks which is done in private and any problems I have are dealt with sensitively by the manager”. We examined recruitment records and found the system in use to be robust and thorough. Records of recent staff recruitment show that all necessary checks to safeguard residents are being done prior to staff starting work there and staff have probationary periods. Staff comments confirmed that they did not work with residents until all checks had been done. The home has a stable core of staff that work well together as a team. One carer said, “ We are a very close team with a lot of years of experience”. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 31, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed with the people living there being involved in all aspects of home life and staff respecting their rights and best interests. EVIDENCE: After a period without a permanent manager there is now a new manager in post. Formerly the deputy manager, Mrs Jacqueline Bryden, has over 26 years experience in care and has now been appointed as manager. She has applied for registration as manager with Commission for Social Care Inspection and holds the Registered Managers Award. The manager and providers have Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 22 successfully implemented the changes and improvements they outlined in their development plans at the last inspection and maintained those already made. We discussed management priorities with the new manager and provider and they displayed a clear vision for the home of developing existing services and improving the service for the people living there. Staff comments indicate that the management approach is open and inclusive. For example, “If I have a problem or concern about anything I can go to my manager who will take time to listen to me. I do not feel intimidated by her and she is easy to talk to.” One resident told us “The boss comes round and asks me if everything is OK”. The manager has reviewed procedures, systems and practices in the home and is working with staff and residents to identify areas to focus on. The management team has implemented several changes that have had positive outcomes for the people living there. Regular staff meetings are being held with staff contributing to the agenda. This allows staff feedback as well as internal reviews of policies and procedures and information sharing. The manager and provider have already reviewed all the service’s policies, procedures, and practices in the home to reflect good practice and current legislation. These have been well organised and available to staff and any one who wishes to see them. There are also residents meeting to get feedback from those using the service and their ideas. The service also does its own quality monitoring using satisfaction surveys and these are due to go out to residents, relatives and other people who come into contact with the home. The manager does quality checks on medication and care planning. This is done informally and is being effective but the manager should consider making a record of any audit she does so that any areas identified are attended to quickly within set timescales. As part of quality monitoring the manager should also consider doing a full quality audit across the service at least annually to measure success in meeting its aims and objectives. The home has a policy for the safe handling of residents money and all financial dealings are now witnessed and recorded by 2 people and checked monthly by the manager and provider. We observed the system in practice with relatives putting money into a person’s spending money. On the whole the records required for the operation of the home that were examined on this occasion were up to date and accurate to help ensure the home is a safe and comfortable place to live. Records of equipment checks and servicing contracts indicate that the home has systems and practices to promote resident health and safety. Fire training for staff is being given and recorded and moving and handling training is being done. Fire risk assessments in use in the home have been reviewed to make sure they are up to date and in line with current legislation and good practice. Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 3 3 3 Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations The Provider should consider replacing the current controlled drugs storage cupboard with one that complies with the Misuse of Drugs (Safe Custody) Regulations 1973 for greater security. The manager should consider making a record of any audit that is done so that any areas identified are attended to quickly within set timescales. The manager should consider doing a full quality audit at least annually across the service as part of the service’s quality assurance system to measure success in meeting its aims and objectives. 2. OP33 3. OP33 Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingsfield DS0000068447.V361531.R01.S.doc Version 5.2 Page 26 - 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. 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