Inspection on 14/10/05 for 27-29 Kingsley Road

This inspection was carried out on 14th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

27-29 Kingsley Road 12/02/09

27-29 Kingsley Road 06/02/07

27-29 Kingsley Road 20/06/05

27-29 Kingsley Road 17/11/04

27-29 Kingsley Road 10/05/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Kingsley Road, 27/29 Roseneath 27/29 Kingsley Road Northampton Northants NN2 7BN Lead Inspector Mrs Kathy Jones Unannounced Inspection 14th October 2005 08:00 Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 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 Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 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 Adults 18-65. 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 Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kingsley Road, 27/29 Address Roseneath 27/29 Kingsley Road Northampton Northants NN2 7BN 01604 459432 01604 792382 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) Royal Mencap (Housing & Support Services) Vacant Care Home 10 Category(ies) of Learning disability (10), Physical disability (3) registration, with number of places Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include 3 people with an assoicated Physical Disability (PD). Date of last inspection 20th June 2005 Brief Description of the Service: 27/29 Kingsley Road is a Residential Care Home providing long-term care for 10 Adults with a learning disability. The home is run by the Royal Mencap Society and is situated on a busy main road within easy reach of local shops and amenities and has good access to public transport. Northampton town centre is only a short distance away. Residents rooms are located on all three floors of the home with a stair lift which can be used to assist with access to the first floor. There are eight single bedrooms and one double. Three of the bedrooms have en-suites and there are two shared bathrooms in the home. There is one shared lounge and a separate dining room and a large garden to the rear of the home. Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over approximately four hours on the morning of a weekday. Although the inspection visit was scheduled early to enable the inspector to talk to residents before they left for day centres it happened to coincide with a day the day centre was closed for staff training. Prior to the inspection the Inspector spent one hour reading the last inspection report, the homes service history and planning the areas to be inspected. The inspection involved talking to residents about the care that they receive, the activities that are provided including a recent holiday and the general routines of the home. Interactions between residents and staff were observed throughout the inspection. Discussion took place with staff and the acting manager during the inspection about the training and support staff receive to meet residents needs, their views on the care and support provided to residents and progress since the last inspection. Communal areas and with their permission a room shared by two residents were seen. A sample of residents records were reviewed which included medication records, financial records, activities records and daily notes. Following the inspection some information was clarified with the acting manager who advised of some actions taken immediately after the inspection. What the service does well: Staff have developed good relationships with residents and appear to know individual Residents very well. Residents spoken to confirmed that they were happy with the staff and had no concerns about the care provided. There is a relaxed atmosphere in the home and a lot of conversation between staff and residents. Routines in the home are flexible and were very relaxed on the morning of the inspection, as the majority of residents had chosen to have a lie in due to the day centre being closed. The activity record shows a variety of outings and activities and staff appear keen to organise outings of interest to individual residents. Residents have all had a holiday, which they appear to have enjoyed. Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Care planning and risk assessment processes need to improve to support the care of residents. As identified during the last inspection care plans do not include all aspects of health and care needs or identification and planning to achieve personal goals. Care plans and risk assessments are not used as a working tool to support and guide the care provided putting residents and staff at risk in some instances. General improvements in the organisation and management of records are needed to support and monitor the care provided. For example keeping health care records up to date to ensure that Staff are fully aware of Residents health care needs and the actions required to meet the needs. Work needs to continue on updating staff training including adult protection and National Vocational Qualification training in learning disability in order that residents needs can be properly met and that staff understand ways in which the risks of abuse can be minimised. Systems for the management of resident’s monies need to be improved to provide better protection for residents and staff. The support required for residents and the management of their finances should form part of the care planning process. Please contact the provider for advice of actions taken in response to this Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 9 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 the following standard(s): This section of the standards was not reviewed during this inspection This section of the standards was not reviewed during this inspection EVIDENCE: This section of the standards was not reviewed during this inspection. Standard 2 the key standard to be inspected during a twelve month period has not been reviewed as it relates to the assessment of prospective residents, which is not applicable, as the home has had no new admissions. Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 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 the following standard(s): 6, 7, 9 Care planning processes do not fully support individual choices and aspirations. EVIDENCE: Little progress has been made since the last inspection in developing the care planning and risk assessment processes to support the care of residents. It continues to be the case that care plans do not include all aspects of health and care needs or identification and planning to achieve personal goals. Discussion with staff and the acting manager highlighted that care plans and risk assessments are not used as a working tool to support and guide the care provided. For example records for one resident included some incidents of challenging behaviour, which put other residents, and staff at risk however there was no plan in place to instruct staff in managing the behaviours in an appropriate and consistent manner. The acting manager advised that a worker from another home was visiting occasionally to assist with the development of risk assessments and that training for staff had been organised however acknowledges that some Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 11 additional assistance for a short concentrated period of time would be more beneficial to the outcomes for residents. Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 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 the following standard(s): 13, 14, 16, 17 Routines in the home are flexible and relaxed and residents enjoy various leisure and community activities. EVIDENCE: The day centres that the majority of residents attend were closed for training on the day of inspection therefore residents were at home. Routines in the home were relaxed and residents were able to get up and have breakfast as and when they chose. Individual preferences were taken into account with residents having the choice of eating in the dining room or their rooms and where able encouraged to prepare their own toast and cereals. Hot drinks were made as and when required. Discussion with residents, staff and a sample check of the activities record confirmed that residents have the opportunity to use local facilities. One resident showed the inspector the activity record, which included visits to the local balloon festival, shopping trips and meals out which she particularly enjoyed. Staff are aware of individual interests and a resident told of a recent trip she had enjoyed with a member of staff to Buckingham Palace however Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 13 the planning of activities needs to form part of the care planning process to ensure that all residents are able to take part in activities which are linked to their personal goals and interests. Residents confirmed that they had all been away on holiday since the last inspection, which they had enjoyed. The two residents spoken to about the holiday had been to Blackpool however another group had been to a different location. There is a six week menu plan in place and residents confirmed that they are happy with the meals and if they do not like what is on the menu they can have an alternative. Fresh fruit was available in a bowl in the dining room. Residents are not currently involved in the preparation of main meals however some do make their own snacks. Residents spoken to were happy with the routines in the home and also that their privacy and independence is respected. Staff were observed to respect residents and to include them in conversations. Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 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 the following standard(s): 19, 20 The overall standard of care and management of medication appears to be good however more advice from health professionals particularly in assisting with a consistent approach to the management of behaviours needs to be accessed. EVIDENCE: It was identified at the previous inspection that resident’s records relating to health care needs were not up to date and relevant information had not been included in care plans and risk assessments. The acting manager confirmed that this is still the case. The need for staff support and guidance in managing residents behavioural needs appropriately and consistently has been identified and the acting manager has arranged staff training and has made referrals for professional assessments to be carried out where necessary. A sample check of the medication system identified that residents prescribed medication is available and that there is a system for recording medication received into the home and medication administered. Advice was given to ensure that any medication carried forward from the previous cycle is included in the records to ensure a complete audit trail. The date of opening was not noted on eye/ear drops, which have a limited shelf life when opened. More Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 15 secure storage is being provided for medication and the location is due to be altered to enable easier administration. Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 23 Lack of staff training in protection of vulnerable adults and the lack of planning in relation to supporting residents with the management of finances puts both residents and staff at risk. EVIDENCE: Complaints were not reviewed during this inspection however The Commission for Social Care Inspection have received no complaints about Kingsley Road since the last inspection. The organisation has a core training programme for new staff, which includes some adult protection training. Some of the staff that have worked at the home for several years have not had this training however the acting manager confirmed that she is intending to organise this. A sample check of the management of resident’s finances identified that the systems in place are such that it is not easy to track the benefits; allowances and expenditure received for individual residents monies. The lack of evidence to demonstrate how individual residents are supported to make appropriate choices and how decisions are made as to how to spend their money leaves both residents and staff vulnerable. The inspector has been informed since the inspection that money taken out in part payment for a vet’s bill for the homes cat is to be reimbursed. The acting manager has been asked to investigate another transaction and is advised to seek an independent audit of resident’s finances. Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 17 A sample check of residents personal monies held by the home confirmed that records are kept of transactions and a sample check of money held was found to correspond with the record. Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 18 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 the following standard(s): 25, 28, 30 The home was clean, warm and comfortable but would benefit from additional shared seating space. EVIDENCE: A full tour of the premises was not carried out however the communal areas of the home and a shared room were seen during the inspection. Communal space in the home consists of a lounge and a dining room. The lounge is comfortably furnished however is very small given the number of the residents living in the house. This was discussed at the previous inspection and the acting manager has advised that quotes for increasing useable lounge space have been obtained and submitted to the owners of the premises. The shared room seen was clean and comfortable and residents showed the inspector new furniture which had recently been purchased. Residents spoken to during the inspection said that they are responsible for the cleaning of their own rooms with help from staff if needed. The home has an industrial washing machine with a sluicing facility and a tumble drier. Infection control procedures include the provision of disposable Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 19 gloves and aprons for staff and the provision of antibacterial liquid soap and hand towels in all bathrooms and toilets. Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 20 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 The training programme needs to continue in order that all staff are appropriately qualified and trained to meet Residents needs. EVIDENCE: Since the last inspection staff training records have been updated and discussion with staff confirmed that the acting manager is arranging training to address any identified shortfalls. Some training has already taken place, which includes managing challenging behaviour arranged to assist staff in meeting resident’s needs. Particular areas of training need identified during the inspection are protection of vulnerable adults, care planning and risk assessment training. Qualification training and are still waiting for places to be booked. The previous inspection identified that only a small proportion of staff have completed a National Vocational Qualification in care. The National Minimum Standards recommend that at least 50 of Staff complete this qualification at level 2 or an equivalent course by 2005. Discussion with staff identified that there continues to be staff who are keen to do National Vocational Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 21 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 41, 42 While some progress has been made particularly in relation to staff training there is no clear development plan to improve and maintain standards and the care provided to residents. EVIDENCE: Standard 37 has not been assessed during this inspection as although there is a manager in post the application for registration submitted to The Commission for Social Care Inspection has not yet been fully processed. Following the last inspection the acting manager has arranged movement and handling training for staff, which was confirmed by a member of staff. A member of staff confirmed that staff had also received other relevant health and safety training including first aid. A representative of the organisation carries out monthly visits to the home to check the quality of care provided. Records of the visits confirm that resident’s views are sought as part of this process. A review of the most recent report Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 22 identifies that shortfalls have been identified relating to care planning and risk assessment however there was no clear plan as to how the shortfalls were going to be addressed. Following discussion during the inspection the acting manager has confirmed that she is making alterations to resident’s records to ensure that they are all individual and protect confidentiality. Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 23 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 X X X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score X 3 X X 2 X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X X 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kingsley Road, 27/29 Score X 2 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 X 2 3 X DS0000012833.V259402.R01.S.doc Version 5.0 Page 24 Yes 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 6, 19 Regulation 12 (1) (a ), 13 (4) (c ) Requirement Care plans and risk assessments must be must be in place which include health care needs and risks and have details of the required actions of the carer. ( A previous timescale of 30.08.05 has not been met) Care plans must include personal goals and demonstrate opportunities for personal development. (A previous timescale of 30.09.05 has not been met) Staff must receive Adult protection training. A review of residents finances must be carried out and if appropriate monies re-imbursed. Confirmation of the actions taken must be forwarded to The Commission for Social Care Inspection. Clear and transparent systems must be put in place for the management of residents finances which protect residents and staff. Clear development plans must be put in place to adress shortfalls identified through DS0000012833.V259402.R01.S.doc Timescale for action 30/12/05 2 7, 9 12 (1) (a), 12 (2), 12 (3) 13 (6) 13 (6) 30/12/05 3 4 23 23 30/12/05 15/11/05 5 23 13 (6) 15/11/05 6 39 24 (1) (b) 30/11/05 Kingsley Road, 27/29 Version 5.0 Page 25 monitoring visits. 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 28 35 Good Practice Recommendations Consideration should be given to implementing plans to provide more shared lounge/sitting space. Plans should be implemented to support at least 50 of staff in achieving a National Vocational Qualification level 2 or equivalent in Learning Disabilities Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Kingsley Road, 27/29 DS0000012833.V259402.R01.S.doc Version 5.0 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!