Inspection on 18/01/06 for Keb House

This inspection was carried out on 18th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Keb House 21/07/08

Keb House 23/07/07

Keb House 25/07/06

Keb House 19/07/05

Keb House 22/11/04

Keb House 15/06/04

Keb House 17/02/04

Keb House 14/11/03

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Keb House Haytons Lane Appleby Scunthorpe North Lincolnshire DN15 OAP Lead Inspector Malcolm Stannard Unannounced Inspection 18th January 2006 09:30 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 Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Keb House Address Haytons Lane Appleby Scunthorpe North Lincolnshire DN15 OAP 01724 733956 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) 01724 734800 kebhy@aol.com Mrs Helen Elizabeth Young Mrs Helen Elizabeth Young Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (18) of places Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2005 Brief Description of the Service: Keb House is a care home situated in the village of Appleby near to the town of Scunthorpe. It comprises of an older Victorian style house and an annexe of a single storey purpose built extension. There is a courtyard used for parking and domestic needs and a garden and sitting area to the front of the home. The newer part of the home has its own kitchenette, dining area and lounges. There are no retail providers in the village, but residents can access a nearby church and public transport is available. Since the last inspection the homes registration has been varied to enable care to be provided for people who may suffer from dementia and are over 65 years of age. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken on an unannounced basis. Some parts of the building were inspected and a few of the records were looked at. Six of the residents were able to be spoken with, as well as two relatives who were visiting. The manager was available during the inspection. What the service does well: What has improved since the last inspection? The statement of terms and conditions has been amended to ensure it contains details in relation to fees payable and the room, which is to be occupied. Residents individual plans of care now contains evidence that residents or their relatives have been consulted in relation to the plans contents. The protection of vulnerable adults information available in the home has been amended to ensure it contains all required guidance and is in a format, which makes it easier to follow. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 4. An assessment carried out prior to admission, ensures that residents needs can be met. A contract in the form of a statement of terms and conditions is available which sets out the rights of both parties fully. EVIDENCE: A statement of purpose is available which meets with the requirements of the standard and the associated schedule. This statement is made available to residents, relatives and social care professionals. Recent amendments have been made to some of the information included to ensure it provides up to date addresses etc. All residents are provided with a statement of terms and conditions; this has now been amended to include details of whom is responsible for the fees, the total cost payable, (including any extras) and the room, which is to be occupied. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 9 An assessment is carried out prior to any admission. This is completed by the manager or deputy at the prospective residents home or in hospital. The assessment is used in conjunction with any local authority information to ensure that the home can meet the resident’s needs, and contributes to the plan of care. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 & 9. Each resident has an individual plan of care, which records his or her needs. Evidence is available of consultation having taken place. The medication policies, procedures and storage system protect residents. EVIDENCE: An individual plan of care is available for all residents, the home uses the standex system of recording and the content of the plans is becoming much more comprehensive. Each care need identified is recorded on a separate sheet, which allows room for assessment and changes to be recorded. The plan of care is reviewed on a monthly basis by the manager or the deputy. Information contained in risk assessments in relation to falls is in the process of been moved to the appropriate place in the plan of care. This has been completed in some cases, but requires to be completed for all care plans. The risk of falls assessment now includes the availability of a section where the affects of medication or problems with eyesight, which may compound problems, can be identified. There is now, evidence available of resident or relative consultation in regard to the plan of care, a separate document now been available which is signed Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 11 by a resident or their advocate to confirm that explanation and clarification has taken place. The home use the “Nomad” system of medication storage and administration. All medications are ordered using a repeat prescription system on a four weekly basis. Actual medication is delivered on a weekly basis by a local pharmacy. The medication is receipted into the home by the member of staff on shift on a Sunday evening. All staff at the home have completed Safe handling of medication or administration training. Four residents medications were tracked and found to be correct. The secure storage, recording systems and actual medications were seen to be satisfactory. There are policies and procedures available for staff guidance in relation to medication including one in regard to self-medication. There are no residents who presently self medicate, however should this be requested, the homes management would carry out a risk assessment and include the residents GP in reaching a decision as to the safety of the request. A lockable provision would be provided for those who then required it. The pharmacy send a representative to visit the home regularly to assess the system and offer advice. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13. Residents are able to maintain contact with family and friends and encouraged to take part in local community activities. Standards 12, 14 and 15 were assessed at the last inspection and met fully. EVIDENCE: Visitors are encouraged into the home at all reasonable times, some are provided with transport by the home from Scunthorpe to enable them to maintain contact. Many of the residents spoken with said that they received visitors and family members. Two relatives were able to be spoken with during the visit. One of these lived some distance from the home and had visited to take her mother out to a local public house for a meal. She stated that “ the home was excellent” and provided “good care”. A private area for visitors can be made available or residents can use their own rooms if they wish. One resident receives visits from a solicitor who acts as an advocate for her. Residents are encouraged to take part in local community activities should they so wish. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. A vulnerable adults procedure and policy is available and staff are formally trained in order to protect residents from abuse. EVIDENCE: The protection of vulnerable adults policy has now been totally rewritten. It is now a much-simplified version and the guidance for staff includes a flow chart, which indicates the actions to be taken in a step-by-step manner. Advice has been taken form the adult protection coordinator. Staff members undergo vulnerable adults training and a whistle blowing policy is available for the protection of all. The proprietor/ manager lives on the site and this enables her to observe all staff whilst working, including those on nights. All staff are checked via the Criminal Records Bureau including a POVA 1st check. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 14 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): 22. Residents are assessed and provision is made for any specialist equipment they may require to maximise their independence. EVIDENCE: The home continues to provide a homely type environment, been comfortable and clean. General maintenance work is carried out regularly and as soon as possible after any areas for improvement have been identified. Residents are provided with specialist equipment where this is necessary; the homes management ensure that proper assessments are carried out where a need is identified. The home also provides general aids such as grab rails, handrails and ramps etc. A call system is available throughout the home should residents need to summon help. New windows have been fitted in the kitchen and a new dishwasher is to be provided soon. The manager stated that it is intended to provide upvc sheeting shortly to all walls in the kitchen to aid cleaning. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 15 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 & 30. Staff members complete a basic training programme covering all appropriate areas. The competency of staff members cannot be proven due to no staff member holding an NVQ qualification. EVIDENCE: All staff undergo an initial training programme, which covers the requirements of induction and foundation training. This programme includes areas such as basic care, health and safety, fire prevention, prevention of abuse and moving and handling. All staff spend a day away from the home for an initial days training. The acquisition of NVQ qualifications for staff members is proceeding extremely slowly; there is no staff member who holds an NVQ qualification at this time. Four staff members are currently undertaking NVQ’s, two at level 2 and two at level 3. Four further members of staff are soon to begin an NVQ 2. The manager of the home stated that the matter of staff qualifications is been taken seriously and encouragement and help to complete these is given to all staff. The manager commented that the home employs a large number of part time staff, some of whom only work for 8 hours a day. She said that these staff can be reluctant to dedicate the large amount of time needed to complete NVQ’s. The requirement is for 50 of staff members to hold an NVQ qualification. All staff members have undertaken accredited dementia and managing behaviour training following the variation to the homes registration. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 16 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 & 36. The management of the home is carried out in an appropriate and open leadership style. Completion of formal management qualifications will enhance this leadership. Formal supervision of staff is required to be carried out as required by the standard. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection and is currently undertaking the registered managers award. She explained that she hopes to have completed this by May 2006. She stated that she then intends to undertake an NVQ assessors award. The owner/manager is a qualified nurse. The deputy manager is also undertaking the registered managers award and intends to also undertake an NVQ level 4. Formal supervision of staff has fallen by the wayside somewhat recently due to other commitments having to take priority. The manager explained that she is Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 17 to introduce a new supervision system, which will allow senior staff members to carry out supervision of care staff, thereby easing the load on herself. Those supervision records, which are available, are now appropriately filed. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X 3 X X X X STAFFING Standard No Score 27 X 28 1 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X 2 X X Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard OP28 OP36 OP31 Regulation 15 17 18 Requirement 50 of care staff must be qualified to NVQ level 3 or equivalent. Staff must be formally supervised as per the requirements of the standard. The manager must hold a relevant care and management qualification. Timescale for action 19/04/06 28/02/06 19/04/06 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 OP7 Good Practice Recommendations The risk assessment on the management of falls should be transferred to the appropriate place within the plan of care. Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Keb House DS0000002886.V279507.R01.S.doc Version 5.1 Page 21 - 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!