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Inspection on 24/07/06 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 24th July 2006.

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.

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

What has improved since the last inspection?

The home had meetings planned with a catering specialist with a view to agreeing a contract to develop new menus specifically formulated for older people and to arrange a food delivery service.

What the care home could do better:

The home must ensure an enhanced CRB check or a POVA check is obtained before new staff start work.

CARE HOMES FOR OLDER PEOPLE Kara House Residential Care Home 29 Harboro Road Sale Manchester M33 5AN Lead Inspector Sue Jennings Unannounced Inspection 24th July 2006 10:00 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.V298128.R01.S.doc Version 5.2 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.V298128.R01.S.doc Version 5.2 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 (21), Old age, registration, with number not falling within any other category (21) of places Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users will be over the age of 65 and may additionally have a physical disability. 19th March 2006 Date of last inspection Brief Description of the Service: Kara House provides accommodation and personal care for up to twenty-one (21) service users within the category of old age (OP), but any of the service users could have a physical disability (PD/E) or 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 that is set in pleasant and spacious grounds. There are car parking spaces at the front of the grounds. The twostorey building has a newer extension to the rear of the property. There is a stair lift to the first floor. The home has fifteen 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. The current fees for accommodation at the home are £380.00 to £450.00 per week the fees include all meals, laundry, domiciliary chiropody and entertainment. Additional costs include hairdressing, dry cleaning and telephone calls. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was undertaken as part of a key inspection, which includes an analysis of any information received by the Commission for Social Care Inspection in relation to this home prior to the site visit. The visit was unannounced and took place over the course of 5 hours on Monday 24th July 2006. During the course of the site visit time was spent talking to the manager and the Responsible individual, 4 of the residents and 2 visitors to find out their views of the home. A number of the Commission for Social Care Inspection’s survey forms were sent to relatives by the home. The survey forms received from residents gave positive feedback about the home, meals and level of care provided. Time was spent examining records, documents, the residents and staff files. A tour of the building was also conducted. All but one of the requirements from the previous inspection had been addressed and there was evidence that the home was continuing to work hard to develop the service. Neither the home nor the Commission for Social Care Inspection had received any complaints in relation to this home. What the service does well: The homes décor, furniture and the facilities are of a high standard. The atmosphere in the home was warm and welcoming. The standard of cleanliness throughout the home was high. Each resident is registered with a local General Practitioner (GP) and where possible residents are able to retain their own GP. Residents are able to attend religious services in the community or a minister of their chosen faith can visit them in the home if preferred. A private room can be made available for these meetings. Family and friends are encouraged to visit regularly, where this is not possible staff at the home will assist residents to maintain contact via telephone or letter. The home has a complaint procedure and information about how to make a complaint is included in the home’s statement of purpose and function. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 6 Medication was stored appropriately and a policy on the use of homely remedies was available. The home carried out a pre-admission assessment to ensure residents were placed appropriately. The document was detailed and included resident’s preferences. What has improved since the last inspection? 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.V298128.R01.S.doc Version 5.2 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.V298128.R01.S.doc Version 5.2 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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs were identified and met and the home provided sufficient information to people in order for them to make an informed choice about admission. EVIDENCE: The home used a pre-admission assessment format. The written information contained in the assessment gave basic information about the persons care needs and was used to develop a care plan. The manager usually visited the prospective resident in their own home or in hospital. A more detailed needs assessment was then completed on the admission of the new resident. Copies of the social worker’s statement of needs were kept on each individual file that was seen. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 9 Discussions with residents confirmed that they or their relatives were able to come and look around the home before making any decisions about moving in. One relative spoken to said, “We were able to come and look around the staff were all very nice. The home did not provide intermediate care. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 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, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was meeting the health and personal care needs of residents. Care plans were detailed and identified residents needs. EVIDENCE: A sample of care plans was examined and contained details about the individuals needs and gave clear direction/instructions about how to meet needs. There was evidence that care plans were being reviewed and evaluated by a senior member of staff on a regular basis. Relatives had signed care plans to indicate that they agreed to the plan. One relative spoken to said that they had not seen the care plan but another member of the family may have done. The manager said that none of the residents had the capacity to sign their agreement to the care plans. All residents were registered with a local GP. Care plans recorded GP visits. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 11 A private chiropodist visited the home every 6 weeks. Care plans highlight risks this was good practice. Overall, medication practice was appropriate. Controlled drug balances were accurate and some good practice was evident including obtaining the GP’s approval in writing for the use of homely remedies and recording some details of personal preferences in taking medication. Sample signatures of staff administering medication were held. Medication is dispensed in a monitored dosage system (NOMAD) none of the residents administer their own medication. The manager and staff at the home had a good understanding of the care needs of older people. One resident spoken to said, “The staff are very helpful.” A relative spoken to said, “The staff are marvellous. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 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, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided a balanced and nutritionally balanced diet for residents and there were some social activities provided. EVIDENCE: The home demonstrated a good understanding of equality and diversity by addressing religious and cultural needs and care plans were reviewed on a monthly basis. Nutritional assessments ensured the health and safety of residents with poor dietary intake and records were kept to monitor diets. The menus were examined and it was noted that a range of foods were on offer that provided a well-balanced and nutritious diet. There was no one from a minority group accommodated at the home however the Responsible Individual said that if a referral was made this would be welcomed and they would research how best to meet cultural/dietary needs. Residents spoken to said that the meals are usually very good. One said, The meals are lovely. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 13 The menus were based on a four week rota and the Responsible Individual stated that they were in consultation with a catering company who provide not only a food delivery service but also a menu planning service. The residents are offered three meals a day, which are taken within normal times across the day. Hot and cold drinks and biscuits are offered throughout the day and supper is provided during the evening. It was noted that residents likes and dislikes are recorded in the care plan. A tour of the home was carried out and it was noted that the kitchen was clean and tidy. The store cupboards were well stocked and food was stored appropriately within the fridges and freezers. A relative spoken to said, There are activities and staff sometimes take people out. Ten survey forms were sent out and four were returned before the site visit. They gave comments such as ‘It would be difficult to find a better home. In my opinion it is the best in the area’. Another form completed by a relative stated ‘We know there are activities available but we are not told when they are or if we can join in’. It is recommended that the home inform relatives of activities available to residents to allow them to join in if they want to. A visitor spoken to said that they could visit at any time and could see their relative in the privacy of their own rooms or in the communal areas. Visitors spoken to said that the home asked for visitors to avoid meal times where possible. There were no restrictions on visiting unless previously requested by the resident. Visitors spoken to said that they were made to feel welcome by staff. It was noted that residents had brought in personal possessions and some furniture of their own. The home does not manage residents’ finances and families assisted residents with managing their personal finances. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has policies and procedures in place to safeguard residents from abuse and there is an ongoing programme of staff training. EVIDENCE: The home had a policy on protection of vulnerable adults from abuse in line with the Trafford Metropolitan Borough Councils policy. The home made staff aware of the various types of abuse. This included harassment, physical restraint, bullying and whistle blowing, sexual and physical abuse and the procedure to be used for suspected or actual abuse incidents that may occur. The home had a complaint policy that was known to relatives. One visitor spoken to said, We have no complaints. One resident spoken to said, “I have no complaints but if I did I would speak to the staff.” All staff are made aware of the basic principles of local Adult Protection procedures as part of the homes induction training. Evidence of this was seen on staff files and in discussion with staff. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are safe and the homes environment including the standard of hygiene was well maintained both internally and externally EVIDENCE: A tour of the building was carried out. The bedrooms were clean and tidy and there were no unpleasant odours detected. Residents spoken to said the home was always kept clean. One resident said, “The girls work hard to keep it clean.” There were sufficient toilets situated around the home. They were clearly marked and close to the communal areas and bedrooms. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 16 There was a small patio area in the centre of the grounds which provided a secluded and safe area for residents to walk or sit out. The furniture was of a good quality and clean. The communal areas are light and spacious with a good view of the garden. The carpet on the landing area was puckered and posed a tripping hazard. The Responsible Individual said that they were in the process of deciding the most suitable floor covering to replace the carpet. The Responsible Individual said that there were plans to provide fitted furniture in all bedrooms. An emergency call system was fitted to all bedrooms and communal areas so that residents could summon help if needed. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 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, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff were deployed in sufficient numbers to meet the needs of the residents and appropriate training is available to all staff. EVIDENCE: Staff said that supervision was ongoing and if they had a problem they would contact the manager to discuss it with her. Staff have attended training in respect of fire safety and there was evidence that monthly fire tests are undertaken. Staffing rotas were checked and showed that there were adequate staffing numbers on duty to meet the needs of the residents. The rota identified any shifts that needed to be covered and whether they had been able to be filled. The home was clean and tidy with no unpleasant smells indicating that sufficient ancillary staff were deployed. Lunch time was observed and there were two staff assisting residents with their meal - one member of staff giving out medication and kitchen staff giving out the meals and clearing dishes away. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 18 The Responsible Individual said that new staff received induction training . This includes adult protection, First Aid, Health and Safety, Food Hygiene, Moving and Handling and Control of Substances Hazardous to Health (COSHH). Dementia training has been provided to staff. The home’s induction and foundation training met the required standard. Staff are paid to complete training and are given time off rota to ensure they are available. The staff files examined showed that all of the documentation necessary for the protection of the residents was present. However, the Responsible Individual siad that some staff had started work before a POVA fiorst check had been completed. A minimum of a POVA first check must be obtained before staff start work. Following the site visit the home has provided information to say that all staff have now got CRB clearance. A number of staff had NVQ level II and level III. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 19 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s quality monitoring systems protected residents and the home had systems and procedures in place which safeguards and protects resident’s financial interests. EVIDENCE: First aid training had been provided and first aid boxes were seen in the kitchen and office. All staff are instructed in food hygiene awareness during the induction and most staff have received certificated training. The home had a policy on infection control. There was a policy on the Controls of Substances Hazardous to Health and the Responsible Individual said that the new supplier will provide data sheets on all products used. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 20 Notices are displayed in the laundry regarding COSSH regulations. A Health and Safety policy was seen. Fire safety equipment is inspected at the frequency required by the Fire Authority. Practical fire drills are carried out as required. The home’s certificate of registration was publicly displayed. The home is currently registered to accommodate up to 21 older people who may also have dementia. Transactions made on behalf of a resident were logged and receipts were held on file. Money was held in a safe. The registered manager has achieved the registered manager’s award. All accidents are recorded and records are filed correctly within the residents’ individual files in accordance with data protection. Fixed Gas and Electrical appliences had been maintained at regular intervals. The home had a quality assurance monitoring system in place in the form of questionnaires. This includes obtaining views of residents and their relatives. Anonymous questionnaires had been sent out to resident’s relatives/representatives in an attempt to gain their views. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 21 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP19 Regulation 23 Requirement The carpet on the landing area must be refitted or replaced as it is ill fitting and may pose a tripping hazard. The home must obtain a CRB/POVA check on all staff prior to commencing employment. Timescale for action 30/09/06 2. OP29 13 30/09/06 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 OP14 Good Practice Recommendations It is recommended that the home inform relatives of activities available to residents to allow them to join in if they want to. Kara House Residential Care Home DS0000005617.V298128.R01.S.doc Version 5.2 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.V298128.R01.S.doc Version 5.2 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. 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. 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