Inspection on 17/10/05 for Kingsmead Lodge

This inspection was carried out on 17th October 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

Kingsmead Lodge 22/03/07

Kingsmead Lodge 20/06/05

Kingsmead Lodge 08/12/04

Kingsmead Lodge 29/07/04

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

CARE HOME ADULTS 18-65 Kingsmead Lodge Crawley Road Roffey Horsham, West Sussex RH12 4RX Lead Inspector Ms A Campbell-Currie Announced Monday, 17 October 2005 @ 10:00 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. Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Kingsmead Lodge Address Crawley Road, Roffey, Horsham, West Sussex, RH12 4RX 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) 01403 211790 Dr Shafik Hussein Sachedina and Mr Shiraz Boghani Miss Eunice Mundopa CRH(N)-Care home with nursing 20 Category(ies) of PD- Physical disability registration, with number of places Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Only service users with a physical disability with a physical disability may be admitted, some of whom may also have a learning disability. Date of last inspection 20 June 2005 Brief Description of the Service: Kingsmead Lodge is a care home with nursing that is registered to provide a service to twenty people who are between the ages of eighteen and sixty-five years and who have a physical disability (PD). A condition of registration is that only service users with a physical disability may be admitted, some of whom may have a learning disability. Kingsmead Lodge is a purpose built, single storey building located on the outskirts of Horsham in West Sussex. There are twenty single rooms with ensuite facilities that include a toilet and wash hand basin. There is a large activities room, a small quiet lounge, two dining rooms, a sun lounge and a spa pool. There is an enclosed sensory garden and an indoor sensory room. Sussex Health Care own Kingsmead Lodge. The owners and responsible individuals are Dr S Sachedina and Mr S Boghani. The registered manager is Miss Eunice Mundopa who is responsible for the day-to-day running of the home. Kingsmead Lodge is on the same site as another care home that is owned by the Sussex Health Care Group. Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place during a morning and afternoon. Prior to the inspection information and comments were gathered and used in the planning of the inspection. Two relatives returned comment cards and eight service users were assisted by staff to complete comment cards. At the time of the inspection three people were visiting their families, one person was at college and two were at a day centre. All the service users who were at home were seen. A tour of the building took place; time was spent with four service users and two members of staff in a communication group. One service user was spoken with, two relatives and seven members of staff including the manager. The comments received were positive about the care provided at Kingsmead Lodge. The relatives spoken with particularly praised the vigilance of staff regarding a health matter. What the service does well: What has improved since the last inspection? Service users have been supported to attend the college courses of their choice. One person who had been reluctant to attend has been encouraged by staff and is now attending courses four days each week and is enjoying this experience. A summer fete was held and the money raised was sufficient to Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 6 purchase a new computer for the use of service users. One service user has been supported to move to a different room following a review discussion when she raised this issue. Several service users have been providing with a new sleep system that helps them to rest in more comfortable and supported positions. 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. Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.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 Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.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) 1, 2, 3 and 5 Service users and their relatives are provided with the information they need to help them make a decision about moving to Kingsmead Lodge. Assessments are carried out before people move to Kingsmead Lodge to ensure that their aspirations and needs could be met. Staff are provided with the knowledge and skills they need to help them meet the needs of the people who live at Kingsmead Lodge. Sussex Health Care provides a copy of the terms and conditions of accommodation at the home. EVIDENCE: Sussex Health Care has provided a Statement of Purpose and Service User Guide. Key information has been provided in symbol format to assist people who use this form of communication. There is also information on the organisations web site. There is a comprehensive format for assessing the needs and aspirations of service users who express an interest in moving to Kingsmead Lodge. A completed form was seen on the case records of someone who has recently moved to the home. The key information had been included and assessments from other health and social care professionals had been taken into account. It is clear from training records and discussion with staff that they have been provided with the knowledge and skills they need to assist them to meet the needs of service users. People are provided with a detailed statement of the terms and conditions of their stay in the home. Key information is also provided in symbol format in the Service User Guide. The Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 9 manager has said that this information would be explained to each person in using a form of communication most easily understood by the individual. Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 10 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, 8 and 10 The assessed needs and personal goals of each person are detailed in a person centred care plan. Service users are encouraged and supported to take part in all aspects of their life at Kingsmead Lodge. People can be confident that their privacy and confidentiality is protected. EVIDENCE: A sample of care plans were read and included detailed information about the needs and personal goals of service users. A person centred approach is being used and it was clear that the person’s views and wishes about the way care should be provided had been taken into account. Health and social care needs were noted and clear guidance provided for staff. Risks had been identified and assessed to ensure the protection of service users. It was evident that people have access to specialist care where necessary including assessment and consultation with the physiotherapist and speech therapist. Reviews had been held and changes of need identified and acted upon. There are meetings held for service users so that they can be kept up to date with information and also contribute to the day-to-day running of the home. Decisions are made in this forum about menus and activity programmes. The manager said that changes in policy would also be discussed at these meetings. Service users who need one-to-one communication are also given this opportunity. There is Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 11 a confidentiality policy and staff are clear about the need to protect the privacy and confidentiality of service users. There are lockable facilities for confidential information that is not in use. Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 12 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) 14, 15 and 16 Service users are supported to take part in a variety of leisure activities to meet their needs and wishes. People are encouraged and supported to maintain and develop their relationships with relatives and friends. Service users’ rights are respected and responsibilities recognised in their daily lives. EVIDENCE: There is a lively programme of activities and entertainment at Kingsmead Lodge. Service users are consulted about the activities they wish to pursue and it is clear that staff work hard to ensure that they are provided with a full and interesting life both at home and in the community. A photographic record is kept of many of the activities and outings and a number of photographs are displayed on walls and in the hallways. People were very proud to have won second place in a local garden competition with the sensory garden; there was a photograph in the local paper. Every opportunity is taken to involve the local community in activities and a local fun day due to be held soon should attract visitors. Musical entertainers come to the home and an organisation that brings a number of small animals is a great favourite. There is a coordinator and two assistants who plan the activities and outings and keep daily records of activities service users have been involved in. All service users were given a Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 13 choice of five holiday destinations on the south coast this summer. Some new destinations were tried and proved to be very successful with suitable facilities for people who have physical disabilities. There are already plans for holidays for next year so that people can begin saving. There is a flexible approach to supporting people in their relationships with family and friends. Relatives are given advice and support in taking their son or daughter home for visits. People are encouraged to make contact with others of their own age who live in other homes run by Sussex Health Care. People are also supported to maintain contact with school friends. Two people stay at Kingsmead Lodge for respite. Both people use the same room at different times of the week. The manager was advised to ensure that the room is personalised for each individual during their stay. Individual choices and freedom of movement within the home is encouraged within people’s capabilities. Staff respect people’s privacy and choice about spending time alone or in company. Everyone has a communication book outlining their needs, wishes and preferred method of communication. There are also notices on some service users’ doors providing staff with information about how to enter the room where communication is a problem. Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 14 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) 19 and 21 The physical and emotional needs of service users are documented and met. The ageing, illness and death of service users would be handled with respect. EVIDENCE: The health and emotional needs of service users were clearly documented in the case records that were seen. There are two GPs who visit the home each week for monitoring, advice and individual check ups. There was evidence to show that people have access to specialist medical services and that they are supported to attend hospital appointments where relatives are unable to do this. There was evidence to show that the vigilance of staff had ensured that one service user had received prompt hospital treatment for a condition that might otherwise have been missed. The parents of the service user said that the staff had responded extremely well and quickly. There was evidence to show that nursing staff review the health and welfare of service users monthly. There are policies in place regarding supporting people who are ill or may be dying. The home has the facilities to support people at home for as long as possible. There are training opportunities for staff to attend courses in coping with loss and bereavement. Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.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) 22 The views and concerns of service users and their supporters are sought and acted on. EVIDENCE: There is a complaints policy and procedure that is provided in symbol format to assist people who use this form of communication. It is clear that the views of service users are actively sought through one-to-one sessions with key workers and through resident’s meetings. Three complaints have been recorded and investigated in the past twelve months. The system for recording complaints was discussed with the manager who was advised to ensure that confidentiality is protected. The record of complaints should show the actions, timescales and outcomes of the investigation of complaints. Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.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) 25, 26, 27, 28, 29, and 30 Service users’ bedrooms meet their needs and promote their independence. There are sufficient bathroom facilities. There are sufficient communal areas to meet the needs of service users. People are provided with the specialist equipment that they need. There are laundry facilities and a programme for keeping the home clean however a number of carpets were in need of cleaning. EVIDENCE: Service users’ bedrooms were designed to meet their needs. The en-suite facilities include a toilet and wash hand basin. The rooms are of sufficient size for people who use wheelchairs and every room has a tracking hoist. The shared spaces are homely and provide areas for lively activities, quiet reflection or group work. There is a sensory room and a spa pool. There are two dining rooms. There are sufficient bathing and shower facilities. The inhouse physiotherapist provides assessment and treatment plans to ensure people have the equipment and care that they need. People are under frequent review to ensure that the equipment they have meets their needs. The wheelchair clinic comes to the home to provide a service so that people do not have to travel to London. Several people have special sleep supports Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 17 tailored to their physical needs to ensure their comfort at night and to support their posture. There are suitable sluicing and laundry facilities. There is a dedicated member of staff who carries out laundry duties. The home was being cleaned on the Monday of the inspection. There is a maintenance and redecoration programme at Kingsmead Lodge. It was noted that several carpets were in need of cleaning. Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.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) 31, 32, 34, 35 and 36 Staff at Kingsmead Lodge are clear about their role and responsibilities. Service users are supported by competent and qualified staff. The recruitment policy and procedure protects service users. Staff are provided with opportunities for training and are well supported and supervised. EVIDENCE: Sussex Health Care has provided staff at all levels with job descriptions. The staff spoken with were all clear about their roles and responsibilities. The staff who work at Kingsmead Lodge are provided with the information, training and guidance they need to provide care to people who have physical and learning disabilities. Three staff have achieved the NVQ level three award and two have achieved the NVQ level two award. One member of staff is being supported to study for the NVQ level four award. There is a recruitment policy and procedure that is followed to ensure a robust recruitment process for the protection of service users. The samples of records seen showed that the necessary checks had been carried out prior to members of staff beginning in post. There is a comprehensive induction and training programme in place. Annual appraisals are carried out and records are kept of staff attendance on courses. The staff spoken with said that they are actively encouraged and supported to attend training courses and to share their knowledge in day-today practice. There was evidence to show that the manager carries out Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 19 regular supervision meetings with staff. Written records are kept with required actions identified. The staff spoken with said that they feel well supported by the management team and that this helps them to do their job well. Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.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) 37, 38, 39, 40, 41, 42 and 43 Service users benefit from a well run home. The leadership and management approach contributes to the positive experience of staff and service users. Sussex Health Care has developed a system to seek the views of service users and their relatives. There is a comprehensive set of policies to protect the rights and best interests of service users. There are good systems for record keeping. The health and welfare of service users is promoted and protected. Service users benefit from competent and accountable management of the service. EVIDENCE: Miss Mundopa is a registered mental health nurse and has achieved the NVQ level four award in management. Miss Mundopa is committed to her own further training and personal development and is currently registered on a BSc degree in epilepsy, supported by Sussex Health Care. The strong leadership of the management team has resulted in an open, inclusive atmosphere where the views of service users and staff are actively sought and taken into account Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 21 in planning the service. Sussex Health Care has a quality assurance system in place whereby feedback is sought from service users, their supporters and staff. An external company carries out an audit of all Sussex Health Care services every three years. An audit carried out earlier this year was positive about most standards that were assessed. There is a comprehensive set of policies produced by Sussex Health Care and reviewed annually. There are also local policies for Kingsmead Lodge regarding issues that have occurred in the home. The records seen were in good order and up to date. There are policies, guidance and training for staff regarding health and safety issues. All the equipment is well maintained and serviced annually. All the necessary environmental checks are carried out by the relevant agencies. The home keeps a record of accidents and incidents. The Commissioned is kept informed of these events through the Regulation 37 reports. Sussex Health Care has their accounts audited annually and ensures that there is adequate insurance cover in place. There is an annual business plan for the organisation and an individual one for Kingsmead Lodge. Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.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 3 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x x x 4 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kingsmead Lodge Score x 3 x 3 Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 3 3 3 H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.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 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 Good Practice Recommendations Kingsmead Lodge H60 H11 S24164 Kingsmead Lodge V246791 171005 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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. 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