Inspection on 19/07/05 for Keb House

This inspection was carried out on 19th July 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 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 18/01/06

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 DN15 0AP Lead Inspector Malcolm Stannard Unannounced 19th July 2005 09:30 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. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Keb House Address Haytons Lane Appleby Scunthorpe DN15 0AP 01724 733956 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) Mrs Helen Elizabeth Young Mrs Helen Elizabeth Young Care home 18 Category(ies) of OP Old age 18 registration, with number of places Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22nd November 2004 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 a older victorian style house and an anexxe 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. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over five and a half hours. Some parts of the building were inspected and a number of records were looked at. Many of the fourteen residents were able to be spoken with, as well as chats with staff members as they worked. The manager and deputy manager were available during the inspection. What the service does well: What has improved since the last inspection? The management of the home has made a lot of effort since the last inspection to address the requirements which were made at that time, many of which were to do with the record keeping and staff recruitment/supervision. Staff members now complete a Criminal Records Bureau check prior to starting work in the home and an internal quality assurance system is in place. Staff also receive supervision every two months, to make sure they are able to carry out the job and don’t have any problems. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 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 J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 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 standard(s) 2, 3,5, and 6. The homes assessment ensures that residents needs can be met prior to admission. The contract or statement of terms and conditions requires information to be added to afford protection of fees and tenancy for all parties. EVIDENCE: The homes residents are split approximately 50/50 as to private and local authority placements. All residents have a contract or statement of terms and conditions. Further information is required to be contained in the statement of terms and conditions in relation to who pays the fees, the total cost payable (including any extras) and the room which is to be occupied. The manager said that she has obtained a template which she intends to introduce shortly, however this needs some work prior to been used. 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 J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 9 Residents and/or their relatives are free to make visits to the home prior to any commitment to reside there. The manager stated that the home trys to avoid making any kind of emergency admissions. The home does not offer intermediate care. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 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, 8, and 10. Each resident has a plan of care, which records his or her needs; evidence is needed that consultation has been undertaken. Resident’s health care needs are met in a proactive manner. Residents are treat with respect and dignity. EVIDENCE: An individual plan of care is available for all residents, the home has recently started to use the standex system of recording and the content of the plans is much improved. Each care need identified is now 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. Whilst there is a key worker nominated for each resident, the system has for various reasons been temporarily put into abeyance. It is intended to restart this system fully in the near future. Information contained in risk assessments in relation to falls should be moved to the appropriate place in the plan of care. There is no evidence available of resident or relative consultation, although a space is available for a signature to be obtained to confirm consultation, these are not completed. Practice would be enhanced if these were obtained. Evidence is available on individual residents files of a proactive approach to health care needs and a robust system of recording appointments was seen. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 11 Residents spoken to said that they were able to access health care when required, one stated” I just ask if I think I need a doctor”. Residents spoken to felt that they were treated with respect and their privacy was respected, during the visit staff members were observed to tap on resident’s bedroom doors prior to entering. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 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) 12, 13, 14 &15 The provision of recreational activities and local contacts allow for residents to continue carrying out the lifestyle they wish. Residents are able to maintain contact with visitors as they wish and exercise choice in their daily life. Food provision allows all residents requirements to be met. EVIDENCE: The home employs a part time activities coordinator who arranges stimulating activities on selected afternoons. The activities on the day of visit were held in the home and consisted of movement games including skittles. Residents are free to choose if they wish to join in or not and one lady discussed possible alternatives with staff. A hairdresser visits the home once per week. Many of the residents are able to entertain visitors and one lady spoken to said that the home arrange transport for her to travel from Scunthorpe. There are ample areas where visits can take place in private if required. One lady has a solicitor who acts as an advocate for her. Residents are encouraged to take part in local community activities should they so wish. Residents are able to exercise choice in their daily lives, including when to get up or retire to bed and how they choose to spend their day. One resident Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 13 spoken with said she was able to make suggestions to the staff and management. The food provision remains at a good standard with residents been able to ask for alternatives should they wish. The cook speaks on an individual basis with residents to find out their views and likes and dislikes and dieticians are consulted if felt necessary. Residents made no negative comments in relation to the food provided, one said “The food is alright”. There are two dining areas available, which allow for meals to be taken in a homely atmosphere. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 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 & 18. A complaints procedure and system is available which allows residents or relatives to make representation in relation to any concern. A vulnerable adults procedure and policy is available and staff are formally trained in order to protect residents from abuse. EVIDENCE: A complaints procedure is available and a complaints information booklet, which includes details of the local authority complaints procedure, is available in each resident’s room. There have been no formal complaints made since the last inspection. Residents spoken to said they knew how to make a complaint should they need to, one lady spoken with said, “I would know how to complain”. The protection of vulnerable adults information held in the home is much improved, along with the procedure available for staff to follow, this would benefit from been simplified. Both have been updated and written information is given to staff who also undergo vulnerable adults training. A whistle blowing policy is available to ensure protection for all. All staff are checked via the Criminal Records Bureau including a POVA 1st check. The home staff and management do not hold any appointeeships, a small amount of personal allowances are kept, these are recorded and stored securely. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 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, 20, 21, 23, 24, 25 and 26. The home provides a safe, comfortable and clean environment for residents, which is pleasant and homely. Rooms available meet the needs of individual residents. EVIDENCE: The home provides a homely environment, which despite showing inevitable wear and tear is comfortable and clean. General maintenance work is carried out as required and major work has been completed to the exterior of the building, which has been redecorated, and the fire system, which has now been linked to all parts of the home. There were no problems identified with the heating or lighting. A recent fire officer visit identified work, which was required to be carried out to some doors and signage. This work has been commenced and the fire officer intends to revisit in September 2005 to re-inspect these areas. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 16 Outside new garden furniture has been provided as well as tubs and a greenhouse. An employee of the home maintains the garden. Appropriate bathing and toilet facilities are available within the home. A contract is held for the disposal of any clinical waste products. A call system is available throughout the home should residents need to summon help. All residents bedrooms are comfortable and are able to be personalised with personal effects, including pictures and ornaments. One resident had a large collection of music tapes. Rooms seen during the inspection were suitable for residents needs. The home was observed to be clean and tidy throughout. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, 28, 29 and 30. Staffing numbers are appropriate for the number of residents present. Resident’s protection is ensured by staff completing a basic training programme and undergoing appropriate recruitment checks. Competency of staff members is not proven due to no care staff member holding an NVQ qualification. EVIDENCE: There were 14 residents living at the home at the time of the inspection. Care is provided by 17 care staff with the assistance of some ancillary staff. Three staff member’s files were looked at, these contained all information required by legislation, including evidence of a CRB and POVA first check having been carried out, written references sought and copies of relevant qualifications. Four care staff are presently undertaking National Vocational Qualifications, two at level two and two at level three. The manager and deputy are currently undertaking the registered managers award. The manager explained that they have recently changed their training provider and this resulted in a delay in the continuation of training. Presently no care staff hold an NVQ qualification or it’s equivalent, the requirement is for the home to have at least 50 of its care staff qualified to NVQ level two. The management of the home must ensure that this situation is addressed. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 18 The management have engaged a training agency to ensure that induction and foundation training is carried out. All staff therefore now \have an appropriate training programme covering areas such as Basic care, Health and Safety, Fire prevention, First aid, Prevention of Abuse and Moving and handling. All staff spend an initial days training at the centre in Lincoln. Recruitment procedures are satisfactory, with full work history and any gaps in employment been fully explored. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31, 32, 33, 35, 36, 37 & 38. The management of the home is carried out with leadership and appropriate guidance; ensuring residents receive a quality of care, which is consistent. A resident centred ethos is promoted within the home. Resident’s financial affairs are safeguarded by the homes policy. Health and safety provision within the home is addressed positively. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection and is undertaking the registered managers award. The owner/manager is a trained nurse and both she and her deputy are able to demonstrate a good awareness of the needs of the residents. The management of the home is very much user led and resident’s needs are foremost in the mind of the management, sometimes to\the detriment of the administration needs. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 20 An internal quality assurance system has now been started, this comprises of a survey, which is then evaluated to enable an action plan to be developed. Areas addressed so far are, the laundry, staffing and food. It is intended to survey relatives next. A financial/business plan is available for the home, which ensures the interests of residents are protected. Work has been carried out on the staff supervision programme and staff members now receive formal supervision on six occasions a year. An appraisal is carried out every six months with individual staff members. Some supervision records are held together and should be filed individually. Health and safety of residents is protected by the management ensuring safety certificates are up to date and appropriate risk assessments are carried out. Accident records were completed appropriately. Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 3 3 x 3 2 3 3 Keb House J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 22 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 2 Regulation 5 Requirement The statement of terms and conditions requires to be amended to ensure that it contains all required information The residents plan of care requires evidence to be contained that residents or their relatives have been consulted. The manager must hold a relevant care and management qualification. Timescale for action 19/10/05 2. 7 15 19/10/05 3. 31 18 November 2005 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. 3. 4. Refer to Standard 7 18 29 36 Good Practice Recommendations The risk assesment on the management of falls should be transferred to the appropriate place within the plan of care. The protection of vulnerable adults information for staff should be simplified in terms of steps to be taken in the event of any disclosure. 50 of care staff are required to hold an NVQ level 2 qualification or equivilent . Supervision records should be filed individually. J54_s2886_Keb House_v232811_300605_stage 4.doc Version 1.40 Page 23 Keb House Commission for Social Care Inspection Unit 3 First Floor Hesslewood Country Office Park Ferriby Road Hessle East Yorkshire 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. 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