Inspection on 17/05/05 for Katherine Lowe House

This inspection was carried out on 17th May 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

Katherine Lowe House 04/08/09

Katherine Lowe House 13/08/08

Katherine Lowe House 27/09/06

Katherine Lowe House 02/02/06

Katherine Lowe House 24/02/05

Katherine Lowe House 20/07/04

Katherine Lowe House 28/10/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Katherine Lowe House Barton Road Urmston Manchester M32 0YT Lead Inspector Helen Dempster Unannounced 17 May 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 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. Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Katherine Lowe House Address Barton Road Urmston Manchester M41 7NL 0161 748 2844 0161 747 5377 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) Trafford Metropolitan Borough Council Responsible Individual Ms Anne Elizabeth Higgins Mrs Rosemarie Hargreaves CRH Care home PC Care home only 45 Old age Dementia - over 65 Category(ies) of OP registration, with number DE(E) of places Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home provides accommodation for a maximum of 45 service users, 24 of whom require care by reason of old age (OP) and 21 of whom are older people who require care by reason of dementia (DE(E)). Separate lounge and dining space must be provided to meet the needs of the service users who require care by reason of dementia (DE(E)). There are currently 3 named older service users who require care primarily by reason of mental ill health (MD(E)) and 1 named service user who requires care primarily by reason of physical disability (PD(E)). Should any of these service users no longer require accommodation at the home, these places will revert to the service user category (DE(E)). The Statement of Purpose must be maintained in line with the requirements of Schedule 1, of Regulation 4(1) of the Care Homes Regulations. The Statement must be kept under review and updated. Any changes to the home`s purpose must be agreed with the Commission for Social Care Inspection prior to implementation. The staffing arrangements at the home must be maintained in line with the minimum levels set out in the guidance published by the Residential Forum, `Care Staffing in Care Homes for Older People`. This must be reflected in the Statement of Purpose. The home must be managed at all times in accordance with the guidance and regulations issued in respect of older peoples` homes by the Secretary of State for Health under Sections 22 and 23(1) of the Care Standards Act 2000. The authority must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 24 February 2005 Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Katherine Lowe House is a purpose built local authority residential home, which provides accommodation and personal care to 45 older people. Of these places, 42-offer long-term care and the remaining 4, short term care. The home is located in a residential area of Davyhulme, Manchester, close to public transport routes into the City Centre and surrounding areas. The home has three floors and nine lounges are located throughout the building near bedroom areas. Sufficient communal space, bathrooms and toilets are available to meet residents’ needs. Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was conducted by 2 inspectors. It started at 10am and finished at 5pm on 17 May 2005. Only 2 of the 8 requirements made at the previous inspection in February 2005 had been fully addressed and this is worrying. There were also issues about fire safety and medication which the organisation needed to address immediately to make residents safe. Immediate requirements were made about these issues during the inspection. The inspectors spoke to residents and a range of staff during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Some of the residents did not have a statement of terms and conditions which told them about their rights. Overall, care plans were informing staff how residents wanted to be cared for but the staff needed to update care plans and risk assessments when Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 7 residents’ needs change. At the last inspection, the home was required to add details about the administration of “when required” (PRN) medication and any issues about prescribed medication. This hadn’t been fully done and the requirement was repeated. There were some problems with the way medication was administered and recorded and an immediate requirement was made. Overall, the home was working towards meeting residents’ social needs and residents said that they were able to receive visitors at any time. However, one resident said that she is not allowed to go out unless her daughter takes her out. The need for the manager to discuss this with the resident and do risk assessments to justify when residents’ choices are restricted due to risk was discussed. Staff were not familiar or confident in dealing with complaints which could restrict residents’ views being heard. A requirement made at the last inspection about staff having training in dealing with complaints was repeated. The Registered Manager said that she did not know about the Residential Forum Guidance for Staffing Levels in Homes for Older People. She was advised that she must monitor the staffing hours to make sure that they meet the dependency levels of residents. Fire safety tests of the fire alarm were not being recorded each week in the fire logbook. An immediate requirement was made about this. 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. Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 9 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 standard(s) 1, 2 and 3 Residents’ needs were being assessed before they were admitted to the home but the admissions policy was out of date and did not provide accurate information for potential residents. Residents’ rights were not consistently documented in a statement of terms and conditions. EVIDENCE: The admissions policy had not been reviewed to provide accurate information for people coming to live at the home. Some residents’ files were viewed and they did not all have a copy of the resident’s terms and conditions. A requirement was made to the effect that all residents must have a statement of terms and conditions. The files sampled during the inspection all contained a multidisciplinary assessment of individual residents’ needs. Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 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 standard(s) 7 and 9 Overall, care plans had information about how residents wanted to be cared for, but not consistently updating care plans and risk assessments when residents’ needs change could put them at risk. Medication administration and recording was potentially putting residents at risk. EVIDENCE: A number of care plans and daily report sheets were sampled. Care plans did have information on residents’ needs but they were not always dated and did not record that residents or their advocates had contributed to the care plan. Changes in needs and risk assessments were not always written in the care plans. Daily report sheets did not always reflect assessed needs. This included medication care plans. One example was that of a resident who had been seen by her GP concerning low blood pressure and what was described as “funny turns” where she became light headed. It was of concern that this crucial information had not been documented in the risk assessment concerning falls for this individual and had not therefore informed a review of this risk assessment. Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 11 At the previous inspection, a requirement was made to the effect that care plans must be extended to include details of the administration of “when required” (PRN) medication and any issues around compliance with prescribed medication. Where these documents were in place, they lacked detail, including why PRN medication was prescribed and the maximum daily dose. Some stated “on occasions will refuse medication” but the circumstances around this and what approach is helpful was not clarified. The requirement was therefore reiterated. Medication practice was discussed and sampled. There were gaps in the medication record where it was not clear where medication was administered or not. In some cases, symbols were used but the reason why medication was not administered was not consistently noted on the MAR sheet. The doses of Promazine administered to one resident were not consistently noted on the MAR sheet and the records were not being used to note the administration of creams prescribed by the GP. An immediate requirement was made accordingly. Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 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 standard(s) 13,14 and 15 Overall, the home was working towards meeting residents’ social needs. However, restrictions on residents choice and control over their lives was not consistently agreed and justified through the risk assessment process. Residents were provided with a wholesome, appealing and balanced diet and menu choices are offered. EVIDENCE: The manager was able to discuss the way in which residents’ social, religious and cultural needs were met. Since the previous inspection, a newsletter had been introduced which informs residents of the dates of meetings, any planned events and general information about staff training. This is good practice. Residents said that they were able to receive visitors at any time. However, one resident said that she “feels trapped” at the home as she is not allowed to go out unless her daughter takes her out. Other residents who she shares a lounge area with confirmed that this was the case. This resident’s file was viewed and there was no record of her having any outings since Novermber 2003. When this was discussed with the manager, she stated that the resident does go out but acknowledged that this was not recorded. The need for any restrictions on residents’ choice and control over their lives to be clearly agreed and justified through the risk assessment process was discussed and a requirement was made accordingly. Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 13 Menus were in place which demonstated that a wholesome, appealing and balanced diet was offered to residents. Menu choices were offered and residents said that the food is good. Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 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 standard(s) 16 and 18 Staff were not familiar or confident in dealing with complaints. This could restrict residents’ views being heard and could, potentially, put residents at risk. EVIDENCE: The complaints record was viewed and it was noted that the most recent complaint did not have a full record of the complaint being made and its investigation. The manager stated that the complainant, a lady in receipt of respite care, “complained about everything while she was here”. The only reference to this complaint was a letter about its investigation, written by a person who had conducted the investigation (which included interviews with staff at the home and access to confidential files) whom the manager was unable to confirm the identity/role of. The manager telephoned this individual at the request of the inspector and he confirmed that he was an independent investigator, employed by Trafford Council to investigate the complaint. Concern was expressed that the manager had been unaware of this fact and the need for staff to be clear about the role and identity of people seeking confidential information in the context of Data Protection Legislation. A requirement made at the previous inspection concerning the need for staff to have training in dealing with complaints was reiterated accordingly. The home did have a copy of Trafford Metropolitan Borough’ s “Protection of Adults from Abuse Policy” and staff had signed a monitoring sheet to confirm that they had read it. At the time of inspection, the manager stated that training in the implementation of this policy was planned but had not yet taken place. A requirement made at the previous inspection for which the timescale had lapsed was reiterated. Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 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 standard(s) 19 and 26 The premises were homely and comfortable and was meeting residents needs with the exception of necessary work to improve fire safety standards. EVIDENCE: The building was homely, comfortable, well maintained and clean. Residents said that they were happy with the accommodation. The building did not meet fire safety standards as outlined in Greater Manchester County Fire Service’s report, dated 14 June 2004. However, this work had commenced at the time of inspection. (See Management and Administration for details). Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Staff deployment needed consistent review to meet residents’ needs. EVIDENCE: The home has 8 lounge areas over 3 floors. The manager said that when she had redecorated a staff room to convert it to a lounge area, the third floor of the home would not be in use during the day and this would improve staffing arrangements. Residents with a diagnosis of Dementia were accomodated with other older people, rather than in specific areas in accordance with the conditions of registration. This had implications for deployment of staff in the context of residents’ dependancy levels. The home needs to ensure that staff are deployed to meet the assessed needs of residents, in line with the Residential Care Forum guidance for staffing levels in homes for older people. A requirement was made accordingly. Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38 Staff supervision and personal reviews were consistently provided to support them in their work. Fire safety work on the premises had commenced but fire safety checks needed to be consistently undertaken to safeguard residents and staff. EVIDENCE: At the time of inspection, the staff team were receiving individual supervision at 2 monthly intervals. Staff also received a personal review and development plan, which is good practice. At the time of inspection, there was a workman at the home completing fire safety work on fire doors. Fire safety tests of the fire alarm were not being consistently recorded in the fire logbook on a weekly basis. An immediate requirement was made accordingly. The requirement previously made for monthly unannounced monitoring visits to the home by someone on behalf of the organisation was re-iterated. Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 2 14 2 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x x x 3 x 2 Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 19 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 OP5 Regulation 12 Requirement The admissions policy must be reviewed to provide accurate information and all residents must have a Statement of Terms and Conditions. Daily report sheets must reflect residents documented assessed needs, care plans and all other residents records must be dated, care plans and risk assessments must be consistently updated to reflect changes in residents needs. Medication administration and recording practice be reviewed so that there is a clear auditing trail for all medication prescribed and administered. The reasons for administering when required (PRN) medication must be clarified in the care plan. Staff must receive training in dealing with complaints. Staff must be provided with training in implementing the protection of adults from abuse policy. Timescale for action 07/08/05 2. OP7 15 07/08/05 3. OP9 13 Immediate and on going from 17 May 2005. 4. 5. OP16 OP18 22(1) 13(6) 07/08/05 07/08/05 Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 20 6. OP34 26 7. OP38 23(4) 8. OP38 23 The Responsible Individual for the organisation must appoint a representative to conduct monthly unannounced visits to the home and must produce a report, in writing, concerning the conduct of the home. A copy of these reports must be forwarded to CSCI each month. All fire safety issues which require addressing outlined in Greater Manchester County Fire Service’s report, dated 30 May 2002 and 14 June 2004, must be actioned without delay. The outcomes of the tests of the fire alarm must be consistently recorded on a weekly basis. 07/08/05 07/08/05 9. OP14 12(3) 10. OP27 18 Any restrictions on residents choice and control over their lives must be clearly agreed and justified through the risk assessment process. The manager must monitor the 20/08/05 hours deployed during the day to ensure they meet the dependency levels of service users and that the home’s staffing levels are in line with the residential forum guidelines for staffing levels for older people. Immediate and on going from 17 May 2005. 20/08/05 11. 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 Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 9th Floor Oakland House Talbot House 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 Katherine Lowe House F55 F05 s32577 katherine lowe v227718 170505 stage 4.doc Version 1.30 Page 22 - 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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