Inspection on 26/06/09 for Kinoo Lodge

This is the latest available inspection report for this service, carried out on 26th June 2009.

CQC 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

Kinoo Lodge 30/06/06

Kinoo Lodge 19/10/05

Kinoo Lodge 12/04/05

Kinoo Lodge 16/02/05

Kinoo Lodge 13/09/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Kinoo Lodge 86 Gladys Avenue North End Portsmouth Hampshire PO2 9BH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Nick Morrison     Date: 2 6 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Kinoo Lodge 86 Gladys Avenue North End Portsmouth Hampshire PO2 9BH 02392614219 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: shirine-keeno@yahoo.co.uk Mrs Bibi Saheyda Keeno,Mr Abdool Taleb Keeno care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Kinoo Lodge is a registered home providing care support and accommodation for up to 11 adults with a learning disability. At the time of the inspection there were 5 people accommodated, four within shared bedrooms. The registered manager Mrs Keenoo also owns the home jointly with her husband. They live in accommodation, which adjoins the care home. Members of their immediate and extended family including Mr and Mrs Keenoo, provide all staffing at the home, which covers 24 hours per day. The home has links with local health and social services teams for people with a learning disability, including local day care services run by Portsmouth City Council. The building consists of a conversion of two houses into one property. Communal facilities comprise a lounge, kitchen-dining area and a recreation room, communal toilets and bathroom and a small garden. The home is located in Gladys Avenue, Portsmouth about a half mile from the main shopping areas of Northend and Kingston. Care Homes for Adults (18-65 years) Page 4 of 24 Over 65 0 11 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 26th June 2009 and lasted five hours. During this time we toured the premises, looked at the files of four service users and met with three service users. We also observed the support they were receiving and observed interaction between them and members of staff working in the home. We met with the Manager and spoke with two other members of staff. We received written feedback from one member of staff, one GP and one relative. All records and relevant documentation referred to in the report was seen on the day of the inspection visit. We also referred to services own self-assessment of the home. Care Homes for Adults (18-65 years) Page 5 of 24 What the care home does well: What has improved since the last inspection? 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 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 Adults (18-65 years) Page 6 of 24 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 7 of 24 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Service users benefit from having their needs and aspirations assessed prior to moving into the home. Evidence: There had been no recent admissions to the service as all the people living there had been there for a number of years. Service users files showed that assessments had been completed prior to them moving into the home and had involved service users and other professionals. In discussion the Manager spoke about the process they would use in assessing new referrals that might be made and was able to demonstrate an understanding of the need to complete comprehensive assessments and to be clear that the home could meet a persons needs prior to accepting them into the home. She also told us it would be necessary to consider compatibility with the people already living in the home. Written feedback from a relative told us that they and the service user were fully involved in making a choice about whether or not to move into the home. Care Homes for Adults (18-65 years) Page 8 of 24 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Service users benefit from having clear care plans and risk assessments in place and from being supported to make their own decisions Evidence: We looked at the care plans of four people living in the home. The plans were written with service users and written from the service users point of view. The plans related to the wishes of the person and were focused on ensuring that people were supported to lead the lifestyle they chose and were supported in the way they preferred. Each plan was reviewed with the service user on a regular basis and progress notes were recorded. Care plans contained risk assessments which were also devised with the service user and written to support them achieving their aspirations. The risk assessments were also reviewed on a regular basis along with the care plans and there was evidence that that they were revised as necessary. Service users spoken with understood that risk assessments were in place to support them to achieve their aspirations within a Care Homes for Adults (18-65 years) Page 9 of 24 Evidence: safe and considered framework. Care plans contained information about the limits of decisions service users were able to make for themselves. Otherwise service users were supported to make decisions for themselves. Staff spoken with, and observed during the inspection visit, were clear about the importance of supporting people to make their own decisions. Service users spoken with were clear that they make their own decisions and said that staff supported them to do this when necessary. In observing interactions between service users and staff throughout the inspection we were able to see that staff presented choices to service users in a clear and understandable way and gave them time to consider and respond. Care Homes for Adults (18-65 years) Page 10 of 24 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. People living in the home are supported to take part in a range of activities, according to their choices and are supported to maintain contact with family members. They also have their nutrition needs met through planned meals based on their own preferences. Evidence: People who use the service also attend local day service provision in Portsmouth in order to address their social, recreational and educational needs. Service user files showed that the home liaises closely with the day services with, and on behalf of, each service user to ensure that the activities they take part in at the day service are relevant to the service users needs and wishes. There are regular review meetings which staff from the home attend and the care plans at the home People living in the home were supported to maintain contact with their friends and Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: families. Records were kept of visits from families and of people going to stay with families. People were also supported to maintain contact with their families over the telephone and staff assisted them to make telephone calls if necessary. Food in the home was of good quality and people spoken with during the inspection visit said they enjoyed their meals. There was a weekly menu in place that had taken account of the known individual preferences of service users. Service users were able to change their minds and deviate from the menu if they chose to. The home had recently begun to use pictures of food to support people in making choices about what they wanted to eat. On the day of the inspection we were able to observe these being used in practice. The Manager told us she is planning to develop this use of pictures to assist people in menu planning. Care Homes for Adults (18-65 years) Page 12 of 24 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. Service users are protected by the homes medication practices and benefit from having their other healthcare needs addressed. Evidence: Care plans contained information on how people preferred to be supported with their personal care. The files of people living in the home demonstrated that healthcare needs were monitored and that people were supported to use healthcare services as necessary. There were comprehensive records relating to each persons health. Each persons healthcare needs were monitored and recorded on a regular basis. Where people had used healthcare services there were records detailing the time and date, the reason why they attended and any outcomes as a result of the consultation. Staff in the home liaised closely with healthcare professionals in the interests of people living in the home. Service users spoken with said staff always supported them to use healthcare services whenever necessary. The system for administering medication in the home was clear and was stated in the homes policies. Staff who were involved in administering medication said they had received training and demonstrated that they had a good understanding of medication Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: issues. Medication records were clear and up-to-date and all medication was stored appropriately and safely. There was a comprehensive system in place for monitoring medication with regular checks and crosschecking to minimise the possibility of any errors occurring. Care Homes for Adults (18-65 years) Page 14 of 24 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Service users benefit from being able to make complaints where necessary and are protected by the homes safeguarding policies, procedures and practices. Evidence: The home has a complaints policy in place and service users spoken with said they were clear about how to complain if they wanted to, but had not felt the need to make formal complaints, as issues were resolved in house meetings or in conversation with the manager or their keyworker. No complaints had been received at the home. The complaints procedure was written in an easy read format and service users had their own copy. There were behavioural supports plans in place for people whose behaviour occasionally caused problems for other people in the home. The way the plans were written demonstrated a positive approach to such behaviour and that individual service users were involved in the plans put in place for them. Any incidents were recorded. The home has good policies and procedures in place for dealing with allegations or suspicions of abuse. The service user spoken with had some knowledge of their rights and of abuse issues. Examination of policies and records showed that clear records were kept of all transactions where the service supported people with their finances. Money was kept safely and securely and service users had access to their money for their daily needs. The Manager informed us that she was supporting some service users to make large purchases from their savings for items that would make their lives more comfortable, such as individual chairs. In discussion it was apparent that some people living in the home had no family to support them in Care Homes for Adults (18-65 years) Page 15 of 24 Evidence: making such decisions about expenditure. Also, as they had lived in the home for many years, they did not have active Care Managers. In some of these cases the Manager was making the decisions about expenditure and told us she was concerned about how this may appear. The Manager was clear that the decisions she made were in the best interests of service users. Through the discussion the Manager identified that more effort to involve Care Managers or family in such decisions should be made and that, where this was not possible, independent advocacy services should be sought to represent the views of service users in such decisions. The manager was able to show us evidence of how she had attempted in the past to involve Care Managers in decisions about service users expenditure, but had found it difficult to engage them in this on an ongoing basis. She also gave us documented evidence of how she had tried to engage Advocacy services in this process without success. The Advocacy service informed us that believed the Manager acted in the best interests of service users. Written feedback from the GP informed us that he thought staff in the home were good at acting in the best interests of the people who live there. Care Homes for Adults (18-65 years) Page 16 of 24 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Service users benefit from living in a clean, safe and homely environment. Evidence: Four of the five people who use the service share rooms. The Manager confirmed that those people had made a positive choice to share rooms, and they had done so for many years. The Manager said people had been offered the opportunity to have single rooms but had declined. The home has a good-sized lounge which is homely with adequate comfortable seating and a large flat screen television. There is a kitchen and open plan diner and a separate leisure room with pool table and various games for use by people living in the home. The home is comfortable throughout. Peoples bedrooms are individualised and they had been involved in choosing decoration for the their own rooms as well as for communal parts of the home. The home has sufficient bathing and toilet facilities to meet the needs of people who live there. During the site visit all areas were noted to be clean, tidy and free from unpleasant odours. Written feedback from a relative told us that the home was always when they had visited. There is a utility room where the homes laundry is carried out. the time of the Care Homes for Adults (18-65 years) Page 17 of 24 Evidence: inspection visit this room was clean and tidy. The home has Infection control policies in place and no issues relating to this were identified during the course of the inspection. Care Homes for Adults (18-65 years) Page 18 of 24 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Service users benefit from being supported by adequate numbers of well trained staff and are protected by the homes recruitment policies and practices Evidence: There were two members of staff on duty throughout each part of the day and night. In addition the manager was available during the daytime. Service users spoken with said there were sufficient staff available in the home to meet the needs of the people living there and to ensure that they could go out and use local facilities at specific times during the week. Staff also said they felt the staffing was sufficient to meet peoples needs. Staff training was well managed and good records were kept of the training that each member of staff had received, what training they still needed to do and when updates were required. Staff spoken with said the training was useful and relevant to their role and that access to training was good. Discussion with a member of staff on the day of the inspection visit, as well as reference to staff files, demonstrated that all staff received regular support and supervision sessions with the manager and that records were kept of these sessions. We were also told that the manager was always available for advice and support and that staff found her to be very supportive throughout their work. The Manager supplied us with information regarding National Vocational Qualifications (NVQ) for Care Homes for Adults (18-65 years) Page 19 of 24 Evidence: staff showing that staff have undertaken NVQ 2 and NVQ 3 training. Staff recruitment files demonstrated that all necessary pre-employment checks were undertaken prior to people beginning work in the home. These included Criminal Records Bureau checks and written references. Care Homes for Adults (18-65 years) Page 20 of 24 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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. Service users benefit from living in a well managed home that is safe and responsive to their needs. Evidence: The Manager is registered and has demonstrated that she has the skills, knowledge, experience and qualifications to manage the service effectively. The home is a family run business and promotes an inclusive and friendly atmosphere. Service suers were very comfortable in the presence of the Manager and were able to ask her for anything they wanted. There is a system for quality assurance in the home and service users views are sought as part of this process. Those views are then used as part of planning the development of the service. The Manager demonstrates a good understanding of Health and Safety issues and ensures that potential risks are identified and managed. Staff working in the home all have training in Health and Safety and the member of staff spoken with demonstrated a good understanding. All Health and Safety records maintained and up-to-date. No Health and Safety issues were identified through the course of this inspection. Care Homes for Adults (18-65 years) Page 21 of 24 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 Adults (18-65 years) Page 22 of 24 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 Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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