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Inspection on 19/03/06 for Kara House Residential Care Home

Also see our care home review for Kara House Residential Care Home for more information

This inspection was carried out on 19th March 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides pleasant surroundings for the residents. They stated they had nice rooms and enjoyed living at the home. Residents` visitors are made to feel welcome and visiting can take place in private. Residents received support to maintain their hygiene, they wore clean, pressed and well maintained clothes.

What has improved since the last inspection?

There have been some significant management changes over the past 12 months, the registered manager is supported by a new operations director who is assisting in the development of all aspects of the home. Training programmes are being developed for all staff to ensure they receive mandatory and additional training as required. The registered manager has completed NVQ level 4 training and achieved the Registered Manager`s Award.

What the care home could do better:

Training for staff is in place, however some training, such as adult protection and fire drill training, has to be prioritised. Residents` safety is compromised by poor fire safety procedures. The home must cease wedging doors open and ensure all fire doors self close and fit into their rebates. Staffing levels, support and rotas require reviewing to ensure the home is appropriately staffed and that records demonstrate the staffing levels and duties of staff at all times. Quality assurance and Regulation 26 visits require completing, with reports submitted to the CSCI as required. Kitchen records need completing to meet environmental health standards.

CARE HOMES FOR OLDER PEOPLE Kara House Residential Care Home 29 Harboro Road Sale Manchester M33 5AN Lead Inspector Sylvia Brown Unannounced Inspection 19th March 2006 1:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kara House Residential Care Home Address 29 Harboro Road Sale Manchester M33 5AN 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) 0161 973 0754 0161 969 0223 Trinity Merchants Limited Mrs Carol Richards Care Home 21 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users will be over the age of 65 and may additionally have a physical disability. 14th October 2005 Date of last inspection Brief Description of the Service: Kara House provides accommodation and personal care for up to 21 service users within the category of old age (OP), but any of the service users could have dementia (DE/E). Kara House is a private residential care home that is owned by Trinity Merchants Limited and the home is managed by the registered manager, Mrs Carol Richards. The home is a large Victorian property set in pleasant and spacious grounds. There are car parking spaces at the front of the grounds. The two-storey building has a newer extension to the rear of the property. There is a stair lift to the first floor. The home has 15 single bedrooms and three double bedrooms. The home is situated in a residential area of Sale, within easy reach of the motorway network, public transport and the local shops. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Kara House was unannounced and took place on a Sunday afternoon, with a total of nine hours spent on the premises. During the inspection the inspector spoke with residents and staff, looked at a number of records and observed staff as they went about their day to day routines. The registered manager attended the home to assist in the inspection and provided information regarding the home’s progress in meeting requirements made at the last inspection. The inspector also inspected all private areas used by residents. At the conclusion of the inspection feedback was provided to the registered manager. What the service does well: What has improved since the last inspection? There have been some significant management changes over the past 12 months, the registered manager is supported by a new operations director who is assisting in the development of all aspects of the home. Training programmes are being developed for all staff to ensure they receive mandatory and additional training as required. The registered manager has completed NVQ level 4 training and achieved the Registered Manager’s Award. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 6 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. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Information is provided to residents and they are able to visit prior to making any decisions about their future. They have their needs assessed prior to being accommodated and receive terms and conditions of residency. EVIDENCE: The registered manager confirmed that the home’s statement of purpose and service user guide are in place and kept under review. They are provided to residents and relatives when required. The manager confirmed that residents and relatives are able to visit the home and spend time observing the day to day routines prior to making any decisions about the future. The inspector advises that such visits are recorded and incorporated into the assessment and admission process. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 9 The home completes an assessment of need with all residents prior to admission. The inspector looked at two such assessments and found they required further detail to ensure enough information was available to compile the initial care plan. Assessments should also detail the date completed, who by and who was consulted. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 10 Residents have care plans in place however would benefit from more detail. They have their health care needs met and are treated with dignity and respect. EVIDENCE: The inspector looked at two care files, they were appropriately personalised ensuring the individual preferences of residents were recorded in addition to their care needs. Daily records would benefit from more information to reflect the day-to-day routines and achievements of the residents. All residents spoken to stated they felt well cared for and had their health care needs met. They stated they have visits from medical professionals when required and felt that the home takes action appropriately to meet their needs. Though care plans were personalised, they did not fully identify nutritional and oral health care needs and how they should be met both on a daily basis. It was reported that a new form had been developed to meet all elements of standard 3. Residents appeared well cared for and wore clean clothes, which were well maintained. Staff had formed positive relationships and were observed to be communicating in an appropriate manner and addressing the residents by their Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 11 preferred names. The registered manager confirmed that staff are trained at induction how to treat residents in a dignified and respectful manner. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 & 15 The home had an activities programme and residents have the opportunity to socialise. Food served to residents appeared appetising. EVIDENCE: The registered manager stated that the home provides residents with the opportunity to socialise and join in activities. There were indicators that activities took place, it is recommended that information about activities is made available and that a fuller record is kept to record which activities residents prefer. The registered manager stated that the home does not manage residents’ finances, they receive support from family members or legal representatives. At the time of the inspection the home’s menu was under review. The registered manager stated residents had been consulted regarding their preferences and that a nutritionist was currently advising the home on the planned menu. Observation of the teatime meal served was that residents enjoyed the soup and sandwiches, all were served on white bread, without salad items and or accompaniments, which was the preferred choice of the residents. The home served drinks at teatime from a large communal pot of Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 13 tea with milk included does not ensure that residents receive their tea as they prefer. The inspector also noted that coffee was not routinely offered however the manager reported that staff are aware of which residents preferred lemon tea and coffee and these were provided. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Adult protection procedures are in place and there is an ongoing programme of staff training. EVIDENCE: The home has adult protection procedures in place. The registered manager stated that she recognises that all staff have not received up to date formal adult protection training and has included such training in the staff’s individual training programmes to be completed over the next 12 months. The manager reported that all staff are made aware of the basic principles of local Adult Protection procedures as part of the homes induction training. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 25 & 26 Residents live in a homely environment, which is clean and well decorated. . EVIDENCE: The home is set in nice grounds and offers residents outdoor seating in fine weather. Communal areas of the home were furnished in a homely and comfortable style, which residents appeared to enjoy. The fluorescent light in the Parker bathroom did not have a cover fitted, which is not compliant with health and safety regulations a cover needs to be fitted to reduce the risks to residents should the fluorescent tube break. The registered manager stated that since the last inspection some of the residents’ rooms had been repainted and were more inviting. One resident invited the inspector to view her room, it was personalised, clean and well maintained, with the layout as the resident required. It was noticed that a number of call points did not have cords in place, the manager reported that Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 16 some of the residents take the cord and put it in a drawer in their bedrooms however, the cords are always replaced by staff before the residents go to bed to ensure they have access to staff in an emergency. Kara House is a large home and it was recommended that the manager undertake a risk assessment of all residents with regard to handrails around the home to aid residents who have mobility difficulties. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 30 The staffing levels at the home appeared to meet the needs of the residents and appropriate training is available to all staff. EVIDENCE: On the day of the inspection the home appeared to be appropriately staffed. Care staff also undertake domestic duties and the home will need to monitor and review staffing levels to ensure that the changing needs of residents continue to be met. The rota identified that the home does not employ housekeeping staff and the cook also completes care duties, however her rota failed to identify the hours completed individually for both employment positions. There was no indication of who completed cooking duties when the cook was off or who completed housekeeping duties. Night duties failed to record starting and finishing times. The inspector was not able to gain access to the home’s staffing records. However, the CSCI have made separate arrangements to inspect the home’s recruitment and selection procedures. The registered manager was able to demonstrate the home’s induction and foundation training met the required standard. She confirmed that staff are paid to complete training and are given time off rota to ensure they are available. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 The home is managed by a competent and trained person. Residents benefit and are kept safe from improved management systems. EVIDENCE: Since the previous inspection the registered manager has completed NVQ level 4 training and has achieved the registered manager’s award. Throughout the inspection she recognised areas of development and had plans to improve areas which were below that required. Residents were known to the manager and it was evident that they felt safe and confident with her management style. The registered manager stated that she is included on the care rota from 8 am until 2 pm and from 2 pm until 4pm she carries out office based tasks. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 19 The home has yet to complete a quality assurance audit as detailed within Regulation 24 and Standard 33. As stated previously within the report, the home does not manage residents’ finances. Not all staff have received formal supervision. The registered manager confirmed that informal supervision is provided on a daily basis when she works alongside care staff. However, regular formal supervision needs to be programmed and it is recommended that this is at least 6 times a year. Health and safety records were inspected and found to meet the required standard. Servicing of gas appliances was undertaken in February 2006. Electrical equipment was serviced in August 2005 and the home’s testing of legionella certificate remains valid. The kitchen was well equipped and the manager stated that the home had been given a food safety award from Trafford Borough Council. All accidents are recorded and records are filed correctly within the residents’ individual files in accordance with data protection. The door of room 13 was wedged open with a chair. It was acknowledged that the occupant of the room prefers to have the door open and the manager must undertake a risk assessment and take advice from the local fire safety officer as to the fitting of automatic closure devices. Other fire safety doors failed to self close or fit into their rebates appropriately which, in the event of a fire, could increase the risk for residents it the manager arrange for all fire doors to be checked as part of the homes maintenance programme. Night staff must receive fire safety training. Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 2 Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP33 Regulation 24 Requirement The registered person must complete quality assurance procedures. The registered person must programme formal staff supervision. The registered person must ensure that all night staff receive up to date fire safety training. The registered person must take advice from the local fire safety officer with regard to an appropriate automatic closure system for bedroom doors and in the interim period complete a risk assessment for those residents who want to keep their bedroom door open. The registered person must arrange for fire doors to be checked to ensure they fit into their rebates correctly. Timescale for action 01/09/06 2 OP36 18 01/06/06 3 OP38 23 18/05/06 4 OP38 13 01/05/06 5 OP38 13 01/05/06 Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 22 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 3 5 Refer to Standard OP3 OP7 OP15 OP31 Good Practice Recommendations The registered person should develop a pre-admission assessment document to evidence admission procedures. The registered person should ensure that daily records include residents’ preferences and daily activities. The registered person should cease serving drinks of tea from a communal pots which include milk. The registered person should ensure that the registered manager has sufficient time of the rota to fulfil her role and responsibilities. The registered person should ensure care staff receive formal supervision. 6 OP36 Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 23 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Kara House Residential Care Home DS0000005617.V275592.R02.S.doc Version 5.1 Page 24 - 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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