Inspection on 29/08/08 for Kingsley Rest Home

This is the latest available inspection report for this service, carried out on 29th August 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

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Maple Lodge

Heathlands

Aston Court Nursing Home

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Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/12/2008.

CARE HOMES FOR OLDER PEOPLE Kingsley Rest Home 7 Southlands Avenue Wolstanton Newcastle under Lyme Staffordshire ST5 8BZ Lead Inspector Yvonne Allen Key Unannounced Inspection 29th August 2008 09:30 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 Kingsley Rest Home DS0000069469.V370752.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. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsley Rest Home Address 7 Southlands Avenue Wolstanton Newcastle under Lyme Staffordshire ST5 8BZ 01782 628 154 01782 626 740 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) Robert David White Lesley Karen White Robert David White Care Home 12 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (12), of places Physical disability over 65 years of age (3) Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person shall provide personal care and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Old Age not falling within any other category OP 12 Dementia over 65 years of age DE(E) 3 Physical Disability over 65 years of age PD(E) 3 The maximum number of service users to be accommodated is 12. 2. Date of last inspection 30th August 2007 Brief Description of the Service: Kingsley is a largely Victorian house of character located facing the green in the township of Wolstanton. There are a range of local shops and facilities within half a mile of the home, with a much wider range of choices in the adjacent town of Newcastle under Lyme, including a major hospital complex. There are good road connections, and frequent bus services along the main road that crosses the green (Wolstanton Marsh) in front of the home. Car parking is available on the service road immediately in front of the home. The previously high standard of physical environment was improved in 2002 with the addition of an extension providing single bedrooms with en-suite facilities and an assisted bathroom, or on the ground floor. The main part of the building provides large pleasant reception areas with seating, a lounge area and separate dining area. The kitchen adjoins the dining area, and is in itself adjoined by the storage areas, and there is a laundry located in the basement. On the ground floor there are bedrooms and an assisted bathroom. The first floor is reached by a staircase that also has a stair lift on it, and there, eight further single bedrooms (six with en-suite facilities), and two shared bedrooms (one of which has en-suite facilities) are located. All furniture, fittings, and equipment are to a high standard. The proprietors state that the aim for a quality environment, and are committed to maintaining high standards of care. Kingsley caters for up to 12 older people in a homely, relaxed, family typesetting, with good standards of environment and care. Three people may have a physical disability, and these would be accommodated on the ground floor, which gives good access to all necessary facilities. Three of the people in the home may also be diagnosed as having the dementia care needs. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 5 The fees charged by the home range from £373.00 to £423.00. The home accepts people who are funded by Social Services as well as people who are self-funding. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. The inspection process commenced several weeks prior to the visit. The visit to the home 4 hours to complete. Prior to the inspection visit the Providers had completed a self-assessment tool, which is known as the Annual Quality Assurance Assessment (AQAA). Completion of the AQAA is a legal requirement and it enables the service to under-take a self-assessment, which focuses on how well outcomes are met for people using the service. This AQAA was very detailed and gave us good information about the services offered. All of the Key minimum standards were assessed and for each outcome a judgement has been made, based on the evidence gathered. These judgements tell us what it is like for the people who live in this home. The ways in which in we gathered evidence to make our judgements were as follows – We looked at any information we had received about the home since the last Key Inspection. We had not received any complaints about the home nor had there been any safeguarding referrals. We spoke with the people who live in the home We spoke with the staff who work at the home Discussions were held with the Registered Manager/Provider. We examined relevant paperwork and documentation at the home. We walked around the home. At the end of the inspection visit we discussed our findings with the manager/providers. All the outcome areas have been assessed as “good”. We have not made any requirements and have made 6 recommendations. Since the inspection visit, the Providers have sent us a letter stating that these recommendations have since been addressed. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? The Providers have made improvements to all areas since they purchased the home and are continually striving to improve outcomes for the people who live there. We were told by staff that “things have improved greatly in all areas” since these Providers took over the running of the home. There has been continual improvement to the décor and fabric of the home and this has helped to improve the appearance and comfort of the environment for the people who live there. The outside area has been improved and developed. There have been improvements to the care plans and the delivery of care. The Statement Of Purpose has been revised and developed further. The staff training and development programme has improved and staff are supported to meet their training needs. The recommendation to replace the communal towel in the staff toilet with a single use/disposable paper and towels dispenser has been addressed by the Providers. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 8 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. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 9 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 Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 10 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): Standards 1,3 and 4 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken. Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the person. People wishing to move into the Home are provided with a statement of terms and conditions or a contract. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 11 EVIDENCE: In their AQAA the Providers say – “If a relative rings for a bed vacancy then we encourage the relative to come for a visit – no appointment is necessary. If the relative likes the home we then go out and assess the resident’s needs to ensure that Kingsley is the appropriate place to be. All residents have a contract. We use an admission sheet that is used in conjunction with Statutory Care Management Multi Agency Assessment. All contract are kept in the patient’s records in the office.” During the inspection process we found the above to be an accurate and true reflection of what the home does. Discussions with the manager identified that he goes out to assess people prior to offering a placement at the home. He said that he only offers a place at the home to people whom he feels able to meet their needs. At the time of the inspection visit the home was full with 12 people all with personal care needs. There were 11 accommodated in the home and 1 in hospital. The senior care assistant informed us that three of the people had dementia care needs and that the staff at the home managed these needs well. When we looked at the care plans we saw that these needs were assessed and care planned to meet these needs in a person centred way. We looked at a random selection of care plans and saw the pre-admission assessment tool, which is used to assess the needs of people prior to being offered a place at the home. This tool is comprehensive and assesses all the activities of daily living. It was noted that one person did not have a date of admission documented. This was an oversight as the other plans did have this date in place. All of the people in the home are given a contract outlining the terms and conditions of their stay. Those people who have their care funded (or part funded) have a contract with their funding body such as Social Services. People who are paying for themselves also have a contract with the home and we saw a sample of a self-funding contract. We spoke to most of the people in the home and two of them told us that they came for a look round the home before they came in and 1 said her relative had come to look around and choose for her. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 12 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): Standards 7,8,9 and 10 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. EVIDENCE: In their AQAA the Provider tells us -“We ensure that all the clients’ healthcare needs are met at all times. We check the MARS sheets weekly to ensure that medication is used correctly and we regularly check inhaler techniques of the clients using inhalers. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 13 All staff are aware that before entering a client’s room they must knock first and that in the shared room the privacy screen must be in place at all times when the clients are in the room. All staff ensure that nurse call bells are in reach. We have developed a good working relationship with the local PCT. We have comprehensive care plans that remind staff that it is a confidential document and must not share information with anyone else without the consent of the client. We have sheets showing the audit of the MARS sheets.” During the inspection process we found the above to be an accurate and true reflection of what the home does. We looked at some care plans of the people who live in the home. We found these to contain individual risk assessments and plans of care based on allowing and encouraging people to remain as independent as possible. In practice, people are treated as individuals with their preferences and choices promoted and upheld. However individual plans do not reflect this as well as they should do and it is a recommendation to include this in the care plans. Regular reviews of care plans take place at least monthly but there is little evidence of inclusion of people and/or their representatives into these reviews. It is recommended that people are made more aware of the opportunity to join in their care plan reviews and if they are unable to do so then their representative be given this opportunity. There were several examples of where external healthcare professionals have been sought to give advice and/or treatment for people. This includes GPs, District Nurses, Practice Nurses, Opticians, Chiropodists and Dentist. Staff receive training and support to enable them to meet personal and healthcare needs of people. We were told that the Community Matron comes in to carry out staff training such as – wound healing, bowel care, dehydration training. Other training staff have received includes, accountability, documentation and diabetes. We saw documentation to confirm this. Each person is registered with a GP who will come out to see him or her at the home. Some people are able to retain their own GP if they live in the area but others may have to change. Whichever way – the GP support is good at the home. As the Providers are both Registered Nurses the health care needs of people who live in the home are assessed and monitored well. We looked at the medication process. Only care staff that have received accredited medication training administer the medication. The manager, who is a nurse, oversees the medication process. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 14 We looked at the receipt, storage, administration, documentation and disposal of medication and this was found to be in keeping with requirements. Staff told us that they were only allowed to give out medication once they had received the “proper training”. There was one person self-medicating an inhaler at the time of the visit. It is recommended that a policy is developed in respect of self-medication and that a risk assessment is undertaken on people who wish to self-medicate. Also it is recommended that a sample of staff signatures is obtained in respect of staff who administer medication so that it can easily be identified who the administering carer is for that particular medication round. People in the home are offered plenty of drinks. We saw bottled water in all of the bedrooms, which is provided fresh every day. We observed hot drinks being served throughout the visit – with lunch and mid afternoon. Discussions with two staff members identified – “All residents are treated with privacy and dignity - its like one big family here”, “Residents get up when they wake up – we have a natural waking policy”. Staff were observed to be polite and courteous with people using the service during the visit –knocking on doors and addressing them politely yet in a friendly manner. Attention to small but important details is evident. One example of this is a box of wet wipes put out onto the table for the convenience of people once they have finished their meals. People told us – “I am very well cared for here –nothing is too much trouble” and “I see the doctor whenever I want to”. Also –“Staff are very kind and considerate”, and “They see to my every need.” Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 15 Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 16 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): All the standards in this area were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are involved in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. People who live at this home have the opportunity to maintain important personal and family relationships. The meals served are balanced and nutritious and cater for the varying cultural and dietary needs of individuals. EVIDENCE: In their AQAA the Provider told us –“We have no set time for relatives to visit, if they wish they can stay for lunch. We have diabetic residents so food is Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 17 catered around their needs. One lady is vegetarian so vegetarian meals are prepared for her. We have an exercise lady who comes in every Monday and alternative Thursdays. We have a hairdresser who visits every Tuesday. We have a menus board in the dining room so that residents can see what is on the menus for the day so that they can ask for an alternative if they want to. We have a reminiscence corner in the hallway, which gets residents and families talking. One lady prefers to stay in her room all day – that is her choice.” During the inspection process we found the above to be an accurate and true reflection of what the home does. People who live in the home told us that their personal choices and preferences are upheld throughout all the aspects of daily life. They said: “Oh yes I like to read books and have plenty of these.” Oh the meals are very good and they will always make you something else if you don’t like what’s on the menu.” “Good home cooking.” “Can’t fault the meals.” “I like an early morning cuppa and I always get one – you can always have a drink made for you day or night” “I can have a bath or a shower whenever I want.” The staff told us – “Residents get up when they wake up – we have a natural waking policy”. They explained in detail the people’s likes and dislikes – as mentioned these need documenting in care plans. The cook knows the people using the service well and is aware of each person’s individual needs and preferences in respect of meals. Discussions with the manager, staff and people in the home identified that there is an activities programme in place – including a lady who comes in to do gentle exercises. People are encouraged to continue with their previous hobbies and interests. We observed an activity session taking place in the lounge. Newspapers are delivered daily for people. People go out to the local shops and other amenities. Parties are held for birthdays – one lady told us about her recent 100th birthday party, which had been arranged by the home. One lady is an avid reader and there are lots of books in her room. Another lady has religious pictures around her room and attends church services. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 18 Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 19 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): All the standards in this outcome were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is clearly written and easy to understand. This is supplied to everyone living at the home and is displayed in a number of areas throughout the home. People who live in the home understand how to make a complaint and are clear about what will happen if a complaint is made. The systems adopted by the home help to safeguarding the people living there. EVIDENCE: In their AQAA the Provider tells us -“We have had no complaints in the 18 months since we have been here. We have had no complaints of abuse. There are notices in every room telling clients and their relatives how to make a complaint and who to complain to. All staff will have training in how to recognise abuse and vulnerable adults.” During the inspection process we found the above to be an accurate and true reflection of what the home does. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 20 We, the commission, have not received any complaints, concerns or safeguarding referrals in respect of this home since the last Key inspection. We saw that the Complaints Procedure was clearly displayed in the home. It was also included in the Service User Guide – a copy of which is given to every body in the home. Discussions with four of the people who live in the home identified that they did not have any concerns but if they did they would know who to go to. They told us – “I don’t have any concerns but if I did I would go to one of the girls or Robert or Lesley – they are all very good.” “I have never had any cause for concern –the home is very good.” “If anything is bothering me I see one of the girls and they sort it out straight away.” We spoke to two staff members at length – one new starter and a care assistant who has worked at the home for many years. Both confirmed that they had received instructions in Safeguarding and were able to explain what they would do if they suspected abuse. Examination of the staff files identified that staff are very carefully selected to work at the home and undergo stringent checks including Protection Of Vulnerable Adults (POVA) check. This is to ensure that they are suitable to work with vulnerable adults. Examination of staff training files identified that training is given to all staff in the recognition and reporting of abuse. The home has a Whistle blowing Policy in place which staff are aware of. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 21 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): Standards 19 and 26 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is domestic in character and provides a very pleasant, safe place to live. The environment promotes the privacy, dignity and autonomy of the people who live there. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 22 EVIDENCE: In their AQAA the Provider told us -– “We maintain a clean and pleasant environment for clients to live in safely. All areas are well maintained and a rolling maintenance scheme is in place. There are no unpleasant odours. We have revamped the kitchen to make it more user friendly. We have had the dining room and lounge decorated as well as the hall, stairs and landing. We have had new carpets in the lounge, hall, stairs, landing and back corridor. Most of the rooms have been decorated and more new carpets in the rooms. Some bedroom furniture has been replaced. Most clients have their own furniture and belongings in their rooms.” During the inspection process we found the above to be an accurate and true reflection of what the home does. We walked around the home and found it to be clean and well presented. There were no mal odours and everywhere looked clean and fresh. People are encouraged to personalise their bedrooms and we saw examples of these. We saw in one person’s bedroom how she doesn’t like her curtains drawn and there was a notice on the side in her bedroom for staff to tell them this. Another bedroom contains an abundance of books, as this person is an avid reader. Each bedroom is different according to the preferences and needs of the person living there. The home’s fixtures and fittings are domestic in character and help to create a homely atmosphere. We noted aids and adaptations in place as we walked around the home. These help people with mobility problems to stay independent for longer. The Providers have an ongoing programme of redecoration and refurbishment and keep the home environment well maintained. They are in the process of converting two bedrooms so that each room will be ensuite. One of the senior care assistants is in charge of the housekeeping and it is her responsibility to keep the home clean and tidy. She was in the process of hovering at the time of the visit. We were given a copy of the cleaning schedule for the home. There is a main lounge leading off from the dining area, which is cosy and inviting. Most of the people sit here after lunch and socialise. There are other small sitting areas for people if they wish to be private or quiet. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 23 The kitchen was clean and tidy. Attention is given to maintaining standards of hygiene and infection control both in the kitchen and the laundry area. The Providers have developed the front garden into a pleasant area for people to admire. This contains attractive flowerbeds and potted plants. The rear of the home also provides an attractive and accessible outdoor sitting area, which the Providers plan to develop further. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 24 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home are looked after by a carefully chosen skilled and competent staff team. Staff are caring and attentive to the needs of people. EVIDENCE: In their AQAA the Providers tell us – “We ensure that there are sufficient staff on duty to care for the residents who are competent in their jobs. We have a new staff induction training. We have clinical supervision documents. We have a staff rota and all staff have a CRB check when offered a position of carer.” During the inspection process we found the above to be an accurate and true reflection of what the home does. At the time of the visit there were 12 people accommodated in the home all with personal (residential) care needs. One person was in hospital at the time. There were 3 carers working on the floor and 1 doing the cooking. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 25 The duty rota was seen and this confirmed that these are the usual staffing ratios. At night there is 1 carer awake and 1 on ‘sleep in’ duty. Both Providers oversee the care and running of the home and are usually supernumery but said that they occasionally work on the floor. Both are first level nurses. There is a staff training and development programme in place at the home and there has been a great deal of progress in this area since the last Key inspection. We were shown copies of the staff training that has taken place and which is arranged for the near future. Staff spoken to confirmed that training has improved and that they feel supported with their training needs. Three carers are doing NVQ level 3 and four are doing NVQ level 2 plus one doing an apprenticeship in care. The monthly training plan was seen – this included training updates in Moving and Handling and Infection Control. The Community Matron also comes in to give staff training – areas of training have been wound healing, bowel care, dehydration training, accountability, documentation and diabetes. At the time of this inspection, there were 3 people in the home with differing degrees of dementia care needs (for which the home is registered). In light of this, it is recommended that care staff receive dementia care training so that they are able to recognise and meet the needs of people with dementia. We spoke with a staff member who had recently started to work at the home. She confirmed that she was receiving induction training and that she found this to be very thorough and comprehensive. We looked at a random sample of staff recruitment files. The staff recruitment procedure is robust with staff being carefully selected to work at the home. Prospective staff are interviewed, require 2 written references and undergo Criminal Records Bureau (CRB) and Protection Of Vulnerable Adult (POVA) checks before being offered employment at the home. We observed staff as being attentive to the needs of individuals during our visit to the home. Staff spoken to confirmed that they had undergone these checks. People told us – “The staff are very helpful – nothing is too much trouble for them”, and, “They are all friendly and help me when I need help”. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 26 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home is well run and managed in the best interests of the people who live there. EVIDENCE: We met with both Providers, one of whom is also the Registered Manager of the home. They both have a wide experience in the care of older people and are both first level nurses. They continue to keep themselves updated with their training needs as part of their PREP requirements for the Nursing and Midwifery Council (NMC). Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 27 People who live in the home spoke very highly of both Providers –“Its very good here and Robert and Lesley are always coming round to see us,” and, “If anything is bothering me I can always talk to them.” Staff were also complimentary about the Providers – “Since the new owners have taken over, the home has come on leaps and bounds,” and, “they are very supportive and I can ask them or go to them at any time.” The Providers monitor the quality of the services at the home and regular audits are carried out. Regular meetings are held with the people using the service – and we saw the minutes of the last one. People who live in the home are asked how they feel and can put forward suggestions for improvement. We saw samples of surveys, which are sent round regularly, and the manager explained some of the changes, which have taken place as a result of the surveys. In their Statement Of Purpose the Providers ask that the person in the home or their relative/representative deal with finances. They told us that people usually take care of their own personal allowances or their representative does this. The Home has a Health and Safety policy statement in place. Records and documentation relating to the maintenance of equipment were seen. These had been kept up to date. Also fire safety records were examined – a service of fire safety equipment had taken place on 18/04/08. We were given a copy of the amended Fire Evacuation Procedure, which is clearly displayed, around the home. Staff told us that they had received training in mandatory Health and Safety areas such as Manual Handling and Fire Safety training. Staff also undergo regular fire drills to assess competency in this are. We looked at records of these. The carer who had started to work at the home in May of this year told us that she had not yet had a fire drill. It is recommended that new starters undergo a fire safety drill during their induction training to ensure that they have an understanding of their role in the situation and are competent. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 28 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 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x 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 x 18 3 3 x x x x x x 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 3 3 3 x 3 x x 3 Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 29 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 OP38 Good Practice Recommendations It is recommended that new starters undergo a fire safety drill during their induction training to ensure that they have an understanding of their role in the situation and are competent. It is recommended that care plan documentation reflect the good practices, which are taking, place such as documentation of personal preferences and choices throughout the activities of daily life in the home. In practice, this is happening and staff are very aware of the individual needs and preferences, but care plans should document these so that any new staff can refer to them. It is recommended that care staff receive dementia care training so that they are able to recognise and meet the needs of people with dementia. It is recommended that a policy is developed in respect of self-medication and that a risk assessment is undertaken on people who wish to self-medicate. DS0000069469.V370752.R01.S.doc Version 5.2 Page 30 2 OP7 3 4 OP30 OP9 Kingsley Rest Home 5 OP9 6 OP7 It is recommended that a sample of staff signatures is obtained in respect of staff who administer medication so that it can easily be identified who the administering carer is for that particular medication round. It is recommended that people are made more aware of the opportunity to join in their care plan reviews and if they are unable to do so then their representative is also is given this opportunity. Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Kingsley Rest Home DS0000069469.V370752.R01.S.doc Version 5.2 Page 32 - 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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