Inspection on 09/09/05 for 11 Kilford Court

This inspection was carried out on 9th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

11 Kilford Court 30/06/09

11 Kilford Court 05/07/07

11 Kilford Court 11/10/06

11 Kilford Court 14/10/04

11 Kilford Court 05/04/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 11 Kilford Court Mortimer Road Botley Southampton SO30 2EN Lead Inspector Wendy Thomas Unannounced 09.09.05 10:00am 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 11 Kilford Court Address Mortimer Road, Botley, Southampton, SO30 2TN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01489 790949 Choice Support CRH 6 Category(ies) of LD- 6; LD(E) - 2 registration, with number of places 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the LD category are only to be admitted between 45 and 65 years of age. 2. Two named serive users may be accommodated in the LD(E) category. Date of last inspection 07.04.05 Brief Description of the Service: 11 Kilford Court is purpose built as a residential care home for people who have learning disabilities and associated physical disabilities. There are four bedrooms on the ground floor, which are fully wheelchair accessible, and two bedrooms upstairs for service users who are more physically able. The home is situated on a small housing estate in Botley, approximately a quarter of a mile from local shops and pubs and access to public transport services. The home has a minibus that is equipped to provide transport for physically disabled service users.The management of the home transferred from MacIntre Care to Choice Support in February 2004. As well as residential care, the home provides day service activities for the service users. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited the home between 10:45 and 18:00 on Friday 9th September. During the course of the inspection four of the six service users went out at some point. The inspector spent time with three of the service users and joined those that were in at the time for lunch. The inspector met with a service user’s relative who was visiting the home. The inspector also had discussions with two of the staff and the manager. Time was also spent examining service users’ files and the medication cabinet and recording. Due to the communication needs of the service users the inspector was only able to have a conversation with one of the service users. A pre-inspection questionnaire had been completed by the manager and submitted to the Commission for Social Care Inspection. What the service does well: What has improved since the last inspection? Work is underway to improve service user plans. Those that are being updated contain a good level of detail, enabling staff to support service users 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 6 effectively, especially where they have special physical requirements. The manager is looking at the risk issues and risk management strategies for the service users and developing clear, straightforward and detailed plans for these. Service users are no longer sharing prescribed medication. The manager reported that the fire alarm system is now being tested weekly in accordance with fire regulations. The carpets have been cleaned. Unfortunately they continue to look stained and further action will be needed. Three full-time and two bank staff have started work in the home since the last inspection. Two further full-time staff plus more bank staff have been recruited. They are awaiting pre-employment checks to be completed satisfactorily before starting work in the home. This will help to relieve the long-term difficulty of recruiting staff and ease staff shortages. 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. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The admission procedure ensures that the needs of service users moving into the home can be met. EVIDENCE: 11 Kilford Court provides a long-term home for the service users. There have been no new admissions for several years. If a vacancy does arise, however, there is an “admissions and discharges” procedure, which applies to the three Choice Support homes in the area. It includes checklists and ensures there are opportunities for service users to visit the home on several occasions before deciding on, and going ahead with the move. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9. Improved service user plans facilitate the meeting of service user needs. Thorough risk assessment and risk management strategies minimise the risk of harm to service users, whilst supporting appropriate continuing development EVIDENCE: Progress has been made in reviewing and improving service user plans for several of the service users. Very detailed support plans were seen for a service user who has had a period of ill health leading to very specific requirements for supporting their physical well-being. The manager was working on reassessing service users in relation to risk issues and was drawing up a comprehensive portfolio of risk management strategies for each service user. This had not yet been completed but significant progress had been made. The format was clear, could be easily followed, and was relevant for the service users and their needs. There is a folder available with pen-pictures of the service users outlining their care needs, personality traits, and general information about them and how to support them. This is a valuable introduction for new and agency staff. It was acknowledged that some of the information needed updating. This was apparently in hand. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 10 Although there is still work to be done on the service user plans (service delivery plans) for most of the service users, the requirement that these be reviewed and updated regularly, made in the previous two reports, is judged to have been met because of the work being done 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 17 Service users benefit from opportunities to take part in various activities out of the home, in the local community and further afield. The dietary needs of service users are met and food available meets service users’ tastes and choices. EVIDENCE: The household diary had details of a number of activities happening locally, however service users had attended few of these. There continue to be a number of staff vacancies and this impacts negatively on the opportunities available to service users, as agency staff may not have sufficient knowledge and experience of the service user to support activities. Service users do get out to participate in activities, however not as often as their timetables suggest they would like. Two service users were planning to have a day out at Longleat. Examination of service users’ diaries demonstrated that they individually take part in a range of activities including organised day services, arts and crafts sessions, local walks, visits to garden centres, shopping trips, going to the pub or out for meals, hydrotherapy, visiting a near by nature 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 12 reserve, going for drives, visits to the RSPCA and Blue Cross and special trips to Marwell Zoo, a bus and car rally and Monkey World. Notes refer to a service user’s “in-house” activities but do not specify what these are. It is suggested that more detail is given, so that opportunities in the house can be more readily monitored and a wider range of activities developed, especially for those service users unable or unwilling to take up opportunities outside of the home. The home has a communication book for staff. Issues relating to service users’ well-being were included in this with requests to monitor a service user’s health issues and a request to widen the sorts of activities one of the service users is offered out of the home. The inspector joined the service users whilst they had their lunch of fish fingers, potato waffles and mushy peas. The home’s menus were seen and appeared to offer varied and nourishing meals. There was no record of any desserts being offered. The records of any alterations to the menus and what service users have eaten do, however need to be improved. Staff are aware of service users’ likes and dislikes. Where communication difficulties make it hard to involve them in menu planning these are incorporated into the menu. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20. Improvements in service users’ plans are ensuring that support for personal care and healthcare support is being fully documented promoting service users’ well-being. Recording errors and overwritten medication administration sheets could put service users at risk of the mal-administration of medication. EVIDENCE: As noted above the manager is working on developing new care plans. These give a good level of detail as to how service users’ personal care and health care needs are to be met. Further work is still needed as not all service users have new care plans. The person with the most pressing health care needs had been prioritised. The home takes appropriate action in supporting service users’ health care needs. A visiting relative commented that any health concerns regarding their relative are quickly followed up by the home by contacting the person’s GP. The manager informed the inspector that there was ongoing contact with occupational therapy regarding one service user, with the district nursing team for another service user, and a hospital referral had been sought for another service user. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 14 It was reported that the practice of service users sharing prescribed food thickener had ceased following a requirement in the previous inspection report. The alterations to the medication report required in the previous inspection report had not been made. The manager gave a verbal undertaking that these would be completed imminently. The medication administration process was examined. There were a number of recording errors in that medication was not always being signed for. If a service user’s medication was dropped it wasn’t given, as it was difficult to get the pharmacy to replace it. If medication is prescribed it must be given. The medication administration sheets had a number of crossings outs and hand written notes. The manager reported that there was a problem with the pharmacy keeping the instructions on the medication administration sheets up to date. The home must ensure that they, the GP and pharmacist liaise to make sure that the medication administration sheets used in the home are up to date. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These two standards were not assessed on this occasion having been inspected during the previous inspection. The Commission for Social Care Inspection had not received any complaints about the home and there had been no recorded incidents involving the protection of vulnerable adults. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 Service users benefit from a comfortable and homely environment. One service user’s dignity and safety could be compromised due to the delay in making necessary alterations to the shower room. EVIDENCE: The situation by which one service user has to access the shower room has long been unacceptable with some tricky wheelchair manoeuvring and the potential for their dignity to be compromised should this not be successful. Alterations to the shower room have been discussed throughout this time but as yet have not been implemented. The manager explained that the plans had now been agreed and the contract had gone out to tender. The manager reported that the carpets identified in the previous inspection report had been cleaned twice since then. However the hall carpet and that in one of the service user’s rooms was still stained. The carpet in the lounge is also becoming worn and marked. The home needs to plan for replacing the carpets in the medium term. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 17 It was reported that the housing association had agreed to replace the bathroom flooring during the current financial year due to staff identifying a risk of slipping. The planned improvements in the lounge had not been carried out (replacement of chair covers, separating off the sensory area with a curtain), however she was hopeful they would be completed during the financial year. The home had bought a vibrating chair for the sensory area and it was reported that five of the six service users had used and enjoyed it. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 and 35. Staff are able to identify training opportunities and attend courses that will enable them to improve their knowledge and support the service users more effectively. Staff records held in the home did not demonstrate that appropriate recruitment practices were in place to ensure that service users were properly supported and protected. EVIDENCE: The home continues to have staff vacancies, however this has improved since the last inspection. One of the home’s bank staff is currently covering one of the vacant posts. The remainder of the shortfall is made up of agency staff. It was reported that there were sometimes communication difficulties if the agency staff were not proficient in English. Three full-time and three bank staff have been appointed in the past six months. There were no staff files available for them. The manager reported that she had been involved in interviewing the staff but had not seen their references. The records are reported to be held by the organisation’s personnel department. The records need to be held in the home and available for inspection. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 19 The manager reported that she was developing a new induction checklist, as the ones available did not meet the needs of the home. The staff had had a team day on 2 August 2005. Those spoken with reported that they had discussed developing activities and skills, goal setting, the specific needs of individual service users, and how to improve the service. New staff have all completed first aid, health and safety and basic food hygiene training. They had not yet had moving and handling training, other than as part of the in-house induction, despite a number of service users needing support with moving. The staff spoken with said that there was a booklet with a list of courses they could request to go on. As well as mandatory training (first aid, moving and handling, fire safety, health and safety and basic food hygiene) individual staff had attended a range of training including bereavement, communication, risk around the individual, and a hi-house “values” training. New staff had attended five-day foundation training at the Choice Support local office. The manager reported that two care staff are trained to NVQ level 2 or above, with a further 2 currently undergoing training. However at just 15 this falls short of the expectation that 50 will be trained by the end of 2005. Some of the staff spoken with thought that the sleep-in shift was long and tiring. With its 11am start going through to 11 am the next morning. 10.30pm to 7.30am is the on call period when the staff are otherwise off duty. This was discussed with the manager who said that this had been raised with the staff team, but although they were tired, and this affected their work by the end of the shift, they preferred this pattern of working to others being considered. However the manager said she would raise it with the staff team again and consider other proposals. One member of staff spoken with said that they found the other staff helpful and described their induction, which seemed well thought out. Another member of staff was very enthusiastic about the home and the service users, saying that it was a friendly place to work and that they liked working there. An agency member of staff had made an entry in the communication book saying how much they had enjoyed working in the home. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 By having staff who know the service users and their methods of communication well, their views are taken into account when plans are made for the service. There are appropriate controls and procedures in place to promote the health and safety of service users and staff. EVIDENCE: The manager reported that Choice Support had a number of service users on the Choice Support board. These service users have drawn up a survey for service users living in Choice Support homes. This has been sent to all service users to complete. It is commendable that the organisation seeks the views of service users, however the manager did not think that the questionnaires were appropriate for the needs of the service users at 11 Kilford Court. Because of the communication needs of most of the people living at 11 Kilford court, gauging their views involves knowing the service users and observing their 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 21 responses to different situations. Listening to the staff discussing service users it is apparent that they are responding to this communication. For example a service user attends regular hydrotherapy sessions because they are relaxed and smile when in the pool. Information submitted by the manager in the pre-inspection questionnaire indicates that health and safety is being promoted in the home and following a requirement in the previous inspection report, the fire fighting and detection equipment is now being tested weekly. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x x x 2 Standard No 31 32 33 34 35 36 Score x 3 x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 11 Kilford Court Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 23 Are there any outstanding requirements from the last inspection? 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. 1. Standard 20 Regulation 13(2) Requirement A system must be developed to ensure that if meication is dropped or wasted the service user still gets the prescribed dose. Medication recording must be tightened up and a system developed for constant monitoring of this. Staff records as stipulated in Schedule 2 of the Care Homes Regulations 2001 must be kept in the home. Timescale for action 2/12/05 2. 20 13(2) Reg 17(1) Schedule 3 19 Schedule 2 2/12/05 3. 34 2/12/05 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. 2. Refer to Standard 17 24 Good Practice Recommendations Food records should be kept. A timescale is needed for the replacement of the worn and stained carpets. 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 24 Commission for Social Care Inspection 4th Floor, Overline House Belcyhnden Terrace Southampton SO30 2FD National Enquiry Line: 0845 015 0120 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 11 Kilford Court H54 S59147 11 Kilford Court V248703 090905.doc Version 1.40 Page 25 - 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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