Inspection on 27/09/06 for Katherine Lowe House

This inspection was carried out on 27th September 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.

Other inspections for this house

Katherine Lowe House 04/08/09

Katherine Lowe House 13/08/08

Katherine Lowe House 02/02/06

Katherine Lowe House 17/05/05

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 M41 7NL Lead Inspector Joe Kenny Key Unannounced Inspection 27th September 2006 11:30 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 Katherine Lowe House DS0000032577.V309910.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. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Katherine Lowe House Address Barton Road Urmston Manchester M41 7NL 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 748 2844 0161 747 5377 Trafford Metropolitan Borough Council Mrs Rosemarie Hargreaves Care Home 45 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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. 2nd February 2006 2. 3. 4. 5. 6. Date of last inspection 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. The home is accessed off the Davyhulme Circle, Barton road exit and is close to a residential area and local shops. The home is close to public transport routes into Urmston , Flixton and junction 3 and 4 of the M63. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 5 Accommodation is set on three levels, with a number of small lounge dining areas located throughout the building near bedroom areas. Sufficient communal space, bathrooms and toilets are available to meet residents needs. The weekly fees are £380:29. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out unannounced on the 27 September 2006. Time was spent discussing welfare matters relating to the residents the home supported and examining documentation in relation to the running of the home, staffing, care planning and residents’ satisfaction, with the service. The inspection findings are based on information received from the home since the last inspection in the form of pre inspection questionnaires, copies of monthly visits by a manager for the service and any notification of significant events since the last inspection. Informal discussions were held with staff and residents and observations on the day were also used to support the findings of the inspection. Comment cards were sent out prior to the inspection and none were returned. Additional comment cards were sent to the home for distribution following the inspection. None were received by the Commission. A tour of the building was undertaken and records relation to care plans, staff and residents’ files, training programmes, staff rotas and medication were examined. No intermediate care is provided at the home. What the service does well: The staffing arrangements and deployment of staff continue to be well maintained by the home. The number of staff on throughout the day was appropriate to meeting the needs of residents. Programmes of development, supervision and training support staff in the delivery of care. Residents are encouraged and supported in matters relating to daily living. Residents choices, preferences, privacy and dignity are respected by staff. The home continues to hold meetings with residents and their family/representatives to ascertain their views about the care and the services offered at the home. The monthly visit reports are comprehensive audits of the conduct of the home. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 7 The manager stated that the Commission’s reports are available to staff, residents and relatives. 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. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 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 the following standard(s): 1, 3, 4 and 6 is not applicable to the home. Quality of this outcome area is good. This judgement has been made using available evidence and a visit to the service. The information about the home and services offered was clear and reflected the services offered at the home. The assessment and admission process provides residents and the relatives with clear and detailed information to allow them to make a choice about where to live. EVIDENCE: There had been no changes to the homes statement of purpose since the last inspection. The manager stated that all residents referred to the home are referred through the local authority and will receive a visit from the manager and a member of staff prior to their admission. The visit to their home or hospital setting is used to introduce the resident to the services at the home and to enable the manager and staff to gather additional information to support future programmes of care. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 10 The visit included completion of a profile of the residents needs, likes and dislikes, a dietary plan and an opportunity to meet with relatives if possible and allow the resident to plan a trial visit to the home. A key part of the assessment related to the residents’ ability to mobilise and to assess which room would be offered if the resident had mobility needs as some rooms are larger and the home is set on three levels. It was positive to note that this process is also conducted for residents receiving respite care . Following an admission, daily reviews are conducted in the first six weeks to assess if the individuals needs are being met by the home. The home is advised to clearly set out information in the statement of terms and conditions in relation to fees and who is responsible for payment. The files sampled during the inspection all contained a multidisciplinary assessment of individual residents’ needs. Copies of the service users guide are available in each bedroom. The home does not provide intermediate care. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 11 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 of this outcome area is good. This judgement has been made using available evidence and a visit to the service. The records relating to health and personal care indicated that staff are meeting the residents’ assessed needs. Medication procedures protected residents. EVIDENCE: The home offers 31 permanent places and four rooms are reserved for respite care, offering short terms breaks for people from the local community. There were 36 permanent residents and three respite placements in the home at the time of the inspection. Information indicated that only one of the permanent residents had been assessed as high dependency, the remaining residents being assessed as medium to low dependency. A selection of residents’ files were examined with specific reference to daily recordings on support and care plans. The documents examined indicated that Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 12 the home had taken action to address comments in the last inspection report in relation to language used when reporting. To monitor report writing the home had adopted the practice of senior staff recording information from verbal information provided by staff. Care staff only contribute to the monthly review process. The manager indicated that a review is currently underway and staff are to be provided with training in report writing. Medication procedures ensured medication was held securely and regularly monitored and audited by a designated member of the management and senior staff team. Nine designated staff are responsible for the administration of medication. The system and records were examined and were found to be held in order. Records were consistently completed when administering and medication trolleys were clean tidy and well organised. During discussion with staff and from examination of residents’ records there was a clear commitment to ensure residents had access to health services. Each resident is registered with a general practitioner. District nurses visit to administer insulin and to monitor pressure preventative care plans, The one service the home was having difficulty accessing into was dental care. Each resident is assigned a nominated key worker to support them and ensure care needs are being met. Each key worker is supported by a nominated Senior carer. The plan of support for one resident indicated to be ‘checked hourly’ during the night. On examination of records there was no evidence that this was being complied with. The home is required to retain evidence the such hourly checks are being conducted. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 13 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 of this outcome area is good. This judgement has been made using available evidence and a visit to the service. Daily living arrangements enabled residents to plan how they spend their day, maintain contact with family and local community and respected their social, religious, dietary and personal preferences. EVIDENCE: The living arrangements in the home are based on residents’ choices and preferences. Residents were encouraged and supported to make choices about aspects of daily life. This related to choosing the time to get up and how they spent their day. There was clear evidence of choice and discussions with residents in relation to meal and menu arrangements. The home holds regular focus meetings with residents and relatives to involve them in daily living and social arrangements in the home. The deployment of staff ensure a member of the staff team is available to residents in the lounges located throughout the home. There are eight lounges and the numbers of residents in each lounge range for 4 to 7 residents. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 14 Residents are free to access and use their own bedrooms during the day and this was evident when a tour of the building was undertaken. Informal discussions were held with residents and all confirmed or indicated they were happy with the arrangements relating to personal and social care. Activities are run by students form Trafford College, by staff working in each of the lounges and weekly events such as social gatherings at week ends. Meals are planned using a seasonal, three weekly rotating menu plan. The menu plan had been review three weeks prior to this inspection. The weekly menu offers residents choice, with two alternatives listed for each meal. Meal times are flexible and appropriately spaced throughout the day Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 15 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 of this outcome area is good. This judgement has been made using available evidence and a visit to the service. Residents and relatives had access to a clear complaints procedure. Programmes of training in adult abuse awareness for staff and compliance to Local Authority procedures protected residents. EVIDENCE: The homes complaints procedure informs relatives and residents of the procedure relating to concerns or complaints they may have about the service. The records indicated that the home had dealt with two complaints since the last inspection. No complaints had been received by the Commission in the same period. The home had also started a programme of training in adult abuse awareness for all staff. Training had been provided to all staff and staff received a certificate to confirm their attendance on the course. Staff have also signed a tracking sheet confirming they have read Trafford Local Authority’s guidelines on adult protection and whistle blowing procedures. Evidence was seen on the day that this was in place. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 16 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, 23, 24, 26 Quality of this outcome area is good. This judgement has been made using available evidence and a visit to the service. Overall, the home was clean, tidy and comfortable, with a good standard of furnishings and fittings. EVIDENCE: The home offers residents accessible secure out door facilities. The location of the home enables residents to access local shops, however the home’s proximity to the Davyhulme Circle/round about, would require residents to be supported when they went out. The interior is spacious and set out on three levels. A lift allows access to each level. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 17 Work had been completed on rewiring, fitting of a new boiler and new PVC windows to the front of the home. A programme of redecorating is required to address some damage to walls and wallpaper where old wiring had been removed. There was a good standard of cleanliness maintained by staff. The lounges offer small group settings and residents indicated they were happy with their accommodation. Bedrooms were clean bright and personalised to reflect the interests of individuals. Bedrooms provide 37 single occupancy and four double bedrooms. The doors to bedrooms on the extension side are fitted with self-closing devices. There are no self-closers on the older part of the home. This arrangement will require addressing through the homes internal fire risk assessment. The call system was tested and the response time was poor. This needs to be monitored by the home. Bedroom door 11 did not shut effectively into its frame. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 18 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, 29, 30 Quality of this outcome area is good. This judgement has been made using available evidence and a visit to the service. Recruitment, training and supervision procedures used by the home, protected residents from risk of harm or poor practice. EVIDENCE: Information in the pre inspection questionnaire indicated that 53 of the staff team had achieved NVQ Level II of above. Information relating to training was very clear and clearly set out training achieved by individual members of staff and detailed training planned for their future. This information was available in their files and on a training chart in the main office. The staffing levels maintained by the home were appropriate to meeting residents needs. The home works to an assignment of 478 care hours and 128 night care hours. In the period since the last inspection, the home had received direction to start recruitment programmes, following a temporary freeze on recruitment. The procedure for recruiting staff were clearly set out and involved the manager of the home at all stages. This included the selection and interviewing of applicants and involvement in carrying out Criminal Record and POVA first checks. Evidence of such checks were on staff files. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 19 A total of 26 care staff are employed, 9 domestic staff and designated catering staff. The use of agency staff is now down to a minimum. Programmes of supervision are conducted by the manager, who will supervise management and senior staff and senior staff supervising care staff. Programmes of supervision appeared to be well maintained. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 20 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, 34, 36, 38 Quality of this outcome area is good. This judgement has been made using available evidence and a visit to the service. The management and administration arrangements for the home evidence that the home is being run in the best interest of residents their relatives and staff. EVIDENCE: The management arrangements for the effective running of the home are conducted in the best interest of residents. A representative, appointed on behalf of the service, carries out regular monthly, unannounced visits to the home and completes a report, in writing, concerning the conduct of the home. A copy of the report is forwarded to the Commission on a monthly basis. This addressed a requirement made at the last inspection. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 21 Appropriate procedures are in place to support residents in the management of their finances and included systems internally to allow residents to access their finances and ensure their money is held securely. Information in the pre inspection questionnaire confirmed that regular maintenance and servicing of equipment is carried out in line with health and safety requirements. This included specific weekly and monthly tests and checks on the fire systems and conducting of fire practice drills. Information also confirmed that the home holds regular meetings with relatives to ensure they are involved in daily living arrangements and can contribute to development of the service. Staff are supported in the development of skills to enable them to care for residents. Staff indicated that training and supervision programmes are sustained by the management team as part of their individual support plan. Information on the pre inspection questionnaire detailed the policies and procedures in use at the home. The information indicated policies and procedures review dates pre date May 2005 and earlier with the last review date for the first aid procedure dating to 1996. The home is advised to ensure all policies and procedure are more regularly reviewed to ensure information is monitored and updated. The home is advised to develop their quality assurance system which gathers and audits the views of residents in relation to the service they receive. Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 22 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 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 3 X X 3 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X 3 X 3 X 3 Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 23 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 OP8 Regulation 12 Requirement Specific plans of support and intervention must be evidenced through the homes records. A programme of redecorating is required to address some damage to walls and wallpaper where old wiring had been removed. The home is required to take action in relation to self closers on doors and ensure all doors shut effectively into their frame. Timescale for action 22/11/06 2 OP19 23 22/11/06 3 OP19 23 22/11/06 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 OP2 Good Practice Recommendations The home is advised to set out information in the statement of terms and conditions in relation to fees and who is responsible for payment. DS0000032577.V309910.R01.S.doc Version 5.2 Page 24 Katherine Lowe House 2 3 OP22 OP31 The home is advised to monitor responses to the emergency call system. The home is advised to ensure all policies and procedure are regularly reviewed to ensure information is monitored and updated. The home is advised to develop their quality assurance system which gathers and audits the views of residents in relation to the service they receive. 4 OP33 Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 25 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 Katherine Lowe House DS0000032577.V309910.R01.S.doc Version 5.2 Page 26 - 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!