Inspection on 05/12/05 for Keate House

This inspection was carried out on 5th December 2005.

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

Keate House 24/10/06

Keate House 21/06/05

Keate House 01/02/05

Keate House 27/05/04

Keate House 02/03/04

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 Keate House Brookfield Road Lymm Warrington Cheshire WA13 0QL Lead Inspector Maureen Brown Unannounced Inspection 09:05 5 December 2005 th 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 Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Keate House Address Brookfield Road Lymm Warrington Cheshire WA13 0QL 01925 752091 01925 754022 keatehouse@tiscali.co.uk 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) Mrs Avis Clarkson Mr Malcolm Clarkson Mrs Avis Clarkson Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 48 service users to include: * Up to 48 service users in the category of OP (old age, not falling within any other category. Bedroom numbers 1 & 94 only may be used to accommodate two service users. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 21st June 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Keate House is a care home providing personal care and accommodation for up to 48 older people. The home is located in Lymm, close to the village centre shops, pubs, restaurants and banks. The home was opened in 1989 and consists of a four-storey building with service user accommodation on the ground and first floors. In December 2004 a three-storey extension was completed providing additional single bedroom en-suite accommodation. The home has forty-four single and two double bedrooms, all of which are en-suite. There are two passenger lifts. Car parking is provided at the front of the building and there is a garden to the side. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 5th December 2005. The total time in the home was five and a half hours. The inspector spent half an hour planning the inspection by reviewing previous inspection reports and the service history. The inspection included a tour of the communal areas and a selection of bedrooms, inspection of records and discussions with twenty residents, the coowners, the manager, senior care assistant and other staff on duty. Twelve out of thirty-eight standards were assessed and most were met. Surveys were given to residents and sent to relatives and GP’s. Seven relative surveys were received. Comments included “we have been very happy with the care Mum is receiving”, “very satisfied with the care given” and all agreed that they were satisfied with the overall care given. Feedback from this inspection was given to the co-owners and the administrator at the end of the inspection. What the service does well: What has improved since the last inspection? The statement of purpose and service users guide had been updated to include new staff information and details of the new extension. Details of wishes at the time of death with regard to the residents were now being kept and controlled drugs register is being checked on a weekly basis. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 6 The number of staff who had obtained NVQ level II in care had increased 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. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 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 Keate House DS0000027005.V267335.R01.S.doc Version 5.0 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&6 Sufficient information is provided for residents to make a decision about moving into the home. Intermediate care is not provided. EVIDENCE: The statement of purpose and service users guide are produced in a bound file and include information about the facilities, services provided, fees, terms and conditions of residence. A copy of the most recent inspection report was available separately. Residents and relatives confirmed that they were aware of the service users guide and the inspection reports. Since the previous inspection the home’s statement of purpose and service users guide has been updated to include new staff information and details of the new extension. The manager stated that intermediate care was not provided at Keate House and the co-owners confirmed this. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 9 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 & 10 The residents’ health, personal and social care needs are met by the staff team who also respect their right to privacy. EVIDENCE: Samples of seven residents’ care records were seen during this inspection. These were comprehensive and well presented in individual binders. Each contained basic information, all areas of personal care information, social activities, a record of visiting professionals and a copy of the daily report sheets. The care plans seen were drawn up in consultation with the residents and family and were based on their assessed needs. The residents signed their care plans to show that they agreed with the contents. The care plan format has changed since the previous inspection. The care plans were not being reviewed on a monthly basis, social services reviews were not up to date and risk assessments were not completed. Including residents’ life history, a photograph and the date of arrival would improve the care plans. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 10 During discussions with relatives and residents they stated that they were aware of the care plans. Since the previous inspection details of wishes at the time of death are now kept on file. Daily record sheets seen showed day-to-day activities of each resident. They were written clearly, easy to follow and were signed by carers. One friend commented that “there were not enough activities” for the residents. During discussions with the residents they said, “the care was very good” and “I like my room” also “the staff are lovely”. Other comments included “the food is good” and one resident said, “it is very comfortable”. Relatives spoken to said they were “very happy with the care Mum is receiving”, “staff are very friendly and there are no visiting restrictions” and also “Mum is happy here”. See requirement Nos. 1, 2 & 3 and recommendation No. 1. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 11 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): 14 Residents’ were able to take part exercise control and choice over their life. EVIDENCE: Residents’ privacy and dignity is discussed during the inspection process. It is also documented in the statement of purpose, which the inspector saw. During the inspection a sample of bedrooms were seen and these were decorated to residents’ personal tastes. They also had their own belongings, photographs and personal mementos in the bedroom. One resident said, “my room is very nice” and “I can have my own phone and television here”. Visits from family and friends were recorded in the case notes. Residents shared with the inspector the contact they had with family members and said they could choose to see visitors within their own room or in the shared lounge/dining area. Relatives said that they were always made very welcome by the staff and were offered refreshments. They said that they could visit their family in the privacy of their own bedroom, in one of the lounges or sit in the courtyard during the better weather. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 12 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 Residents and relatives were satisfied with the support they received from the manager and staff. No complaints had been made since the last inspection. EVIDENCE: The policy on complaints was seen and relevant paperwork was available in the event of a complaint being received. The Commission or the home had not received any complaints since the last inspection. Discussions with residents and relatives they indicated that they were aware of the complaints procedure and if they had a problem then they would contact the manager. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 13 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 & 26 The home provided a clean and comfortable environment for the people to live in. EVIDENCE: The home was furnished in a domestic style with additional equipment such as grab rails, raised toilet seats and hoists provided as necessary to meet the residents’ needs. There was a good standard of décor throughout. Heating and lighting was sufficient throughout the home. The garden area is enclosed and residents are encouraged to sit outside during the better weather. The home was clean, tidy and free from any unpleasant smells. The new extension was now complete and this has significantly improved the facilities for the residents. The home now has 44 single and 2 double bedrooms all of which are en-suite. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 14 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): 28 Appropriate staff training provided enables staff to meet residents’ needs. EVIDENCE: At the time of this inspection the agreed staffing levels were met. The staff team included the co-owners, managers, deputy manager, senior care assistants, care assistants, domestic staff, laundry staff, cook, kitchen assistants, maintenance staff and administration staff. The manager said that nine of twenty-four staff had completed NVQ level II in care, which is slightly below the recommended 50 . The deputy manager has the NVQ level IV Registered Managers Award. See recommendation No. 2. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 15 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): 36, 37 & 38 Staff received support to enable them to meet residents’ needs. Records are stored appropriately. Arrangements are in place to minimise the risk so that the safety and welfare of residents are promoted. EVIDENCE: The deputy manager said that one to one staff supervision was given on a regular basis. Supervision notes were seen and records were up to date. Observed day-to-day supervision of staff was good and the staff team confirmed they were supported by the manager and the senior staff in their delivery of care to residents. The staff said that formal supervision was conducted on a regular basis. Supervision records were kept in a locked cupboard with staff files, in the office. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 16 All policies and procedures seen were up to date and accurate. These were kept secure within the home. All records seen were kept secure in the office within the home. Residents and relatives said, “the home is lovely” and “it is very comfortable”. They said that the manager and staff were very welcoming and friendly. This was confirmed during the inspection. Relatives said the staff worked in a very friendly manner. Safe working practices included fire safety in which all weekly checks are carried out and recorded, up to date certificates for electrical safety, portable appliance testing and tests and servicing for all equipment for moving and handling. These checks ensure that the residents are being protected by the procedures in place. The gas safety certificate was out of date. The co-owner said that this check would be completed as soon as possible. See requirement No. 4. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 17 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 X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 3 2 Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 18 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 OP7 Regulation 15 Requirement The registered person must ensure that risk assessments are completed for all residents for moving and handling and any other perceived risk. The registered person must ensure that the social services reviews of residents are kept up to date. The registered person must ensure that the care plans are reviewed on a monthly basis. The registered person must ensure that the gas safety certificate is kept up to date. Timescale for action 30/01/06 2 OP7 15 31/03/06 3 4 OP7 OP38 15 16 30/01/06 30/12/05 Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP28 Good Practice Recommendations The registered person should include residents’ life history, a photograph and the date of arrival in the care plans. The registered person should produce a plan to show how 50 of care staff will be qualified to NVQ level II. Keate House DS0000027005.V267335.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. 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