Inspection on 13/02/06 for Keele House

This inspection was carried out on 13th February 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

Keele House 23/01/09

Keele House 06/02/07

Keele House 04/10/05

Keele House 02/02/05

Keele House 24/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Keele House Keele House 176 High Street Ramsgate Kent CT11 9TS Lead Inspector Christine Grafton Unannounced Inspection 13th February 2006 09:40 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 Keele House DS0000060970.V278795.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. Keele House DS0000060970.V278795.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Keele House Address Keele House 176 High Street Ramsgate Kent CT11 9TS 01843 591735 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) Soory & Co Ltd Dr Menaka Soory Ms Joan Elizibeth Smith Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Keele House DS0000060970.V278795.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To admit one (1) Service User whose date of birth is 02.05.1946. At any time no more than four (4) persons under the age of 65 years but over the age of 55 years to be accommodated for respite care. At no time can more than one (1) person be admitted for emergency respite care. 4th October 2005 Date of last inspection Brief Description of the Service: Keele House is a detached building comprising of two properties joined together, one side three-storey and the other side two-storey. There are two shaft lifts, one on each side, which provide access to all floors. There are 27 single bedrooms and 2 doubles. 22 bedrooms have ensuite toilet facilities. Bedrooms are provided with call bells and most have television points. There are 3 lounges; a separate dining room and 2 separate quiet sitting areas, one on the first floor and one in the basement - all easily accessible. There is also a separate small room for smokers use. There is an enclosed garden with patio and seating area for residents use, weather permitting. The home is located within easy reach of local shops and all public amenities. There is onstreet parking in the adjacent road. Keele House ownership changed on 7th June 2004. There has been continuity in management in that the Registered Manager stayed on and has worked at the home for over 25 years. The owner visits the home weekly. There is a staff team of full and part-time workers, including carers who work a rota that includes 2 staff on waking duty at night. There are designated staff members responsible for the cooking and cleaning. The home aims to ensure that the care provided to residents suits their individual needs. Keele House DS0000060970.V278795.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection covered a morning period. It consisted of speaking with the manager, two staff members, checking some records relating to issues raised at the last inspection and looking round some areas of the home. Several residents were spoken to. At the time of this inspection there were 26 residents. The last inspection was announced and took place on 4th October 2005. An additional inspection took place on 25th November 2005, following a complaint received by the Commission. This report includes details of that visit. As the majority of the national minimum standards were assessed at the last announced inspection, this inspection mainly focussed on following up issues from the additional visit and checking the requirements and recommendation from the announced inspection. As the report does not cover all the standards, the reader may wish to refer to the last inspection report, for a fuller overview of the home. What the service does well: What has improved since the last inspection? The kitchen has been completely upgraded since the last inspection. Arrangements have been made for a new call bell to be fitted in the laundry, so that staff can easily be contacted when working there away from the main resident areas. Staffing levels have been improved following the additional visit in November. Keele House DS0000060970.V278795.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. Keele House DS0000060970.V278795.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 Keele House DS0000060970.V278795.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): None of these standards were inspected on this occasion. Standards 1, 3 & 6 were inspected on 04/10/06 (See previous report). EVIDENCE: Keele House DS0000060970.V278795.R01.S.doc Version 5.1 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, 8 & 9 The home’s care planning system provides most of the information needed to meet residents’ needs. However, the recording of care plan reviews and risk assessments still needs some improvement to fully meet the minimum standards and regulations. The personal and health care needs of residents are, in the main, being met. Overall, medication procedures are satisfactory, but procedures for dealing with the medications of respite residents need reviewing to ensure those residents are not placed at risk. EVIDENCE: The care of an ex-respite care resident was case tracked at the additional visit of 25th November 2005. Information was gained prior to the visit from a letter of complaint and discussion with the person’s relative. At the visit, four staff members, plus the manager were interviewed and the care plan was checked. This indicated that most of the person’s health needs had been met, but there was one issue that it was not possible to assess if it had been properly addressed. The person had contracted a cold and ‘tickly cough’, but the care plan records did not show whether the doctor had been contacted, or if this had been followed up. The daily records and staff discussions indicated that the person had been well for most of their stay. It was clear that the staff had a good understanding of the person’s needs. Keele House DS0000060970.V278795.R01.S.doc Version 5.1 Page 10 A care plan checked for a current resident contained a wide range of relevant information to enable staff to provide the care needed. The manager had sought information from the Internet about a medical condition for staff to read and the care plan contained good action plans for staff to follow. There was evidence of regular reviews, but some important information had not been updated and there was no risk assessment for the resident’s anticoagulant treatment with Warfarin. There was also another risk regarding alcohol intake that had not been addressed. This was an important omission as the resident was prescribed psychotrophic drugs. Procedures for dealing with the medications for respite residents were checked. Staff had been re-dispensing drugs from their original containers into weekly nomad cassette boxes. The risks associated with this practice were discussed and the manager agreed to review this practice and seek advice from the pharmacist. Keele House DS0000060970.V278795.R01.S.doc Version 5.1 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): 15 The meals in the home are good, offering both choice and variety. EVIDENCE: The complaint received prior to the additional visit of 25th November 2005 highlighted that the records of food provided were not detailed enough to show individual choices, or what and how well each resident has eaten. At this visit, the record of food was seen to show the main dinnertime meal and alternative, plus a separate teatime record showing a variety of choices. The kitchen refurbishment has been completed since the last inspection. Keele House DS0000060970.V278795.R01.S.doc Version 5.1 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 Complaints are taken seriously, investigated and appropriate action taken. EVIDENCE: The complaint received by the commission referred to previously had four main components, covering the quality and choice of food provided, the quality of care, the manager’s attitude and staffing levels. The food complaint was not upheld, the care complaint was inconclusive, the issue regarding the manager’s attitude was accepted, but the staffing issue identified a shortfall in the number of staff on duty at that particular time. Following an ‘additional visit report’ being sent to the registered provider, prompt action was taken to address the issues raised and a response sent to the complainant. Since the announced inspection of 4th October 2006, one complaint had been received by the home. This had been appropriately recorded and a full investigation carried out. The record showed that the manager had given feedback to the complainant and the manager confirmed that practices had been changed as a result of the complaint to improve procedures. Keele House DS0000060970.V278795.R01.S.doc Version 5.1 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 The standard of the environment within the home is good, providing residents with an attractive and homely place to live. EVIDENCE: Areas of the home seen on this occasion were again well decorated, well maintained and comfortably furnished. The kitchen has been completely refurbished since the last inspection. The manager stated that a new call bell is to be fitted in the laundry at the next service engineer’s quarterly visit. Keele House DS0000060970.V278795.R01.S.doc Version 5.1 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): 27, 29 & 30 The number and skill mix of staff on duty have been improved to appropriately meet the needs of current residents. Recruitment procedures need to be tightened to ensure that residents are fully protected. EVIDENCE: The additional visit of 25th November 2005 identified that the home had been short staffed on two days in October 2005 when four staff were off sick. At this inspection, it was seen that the registered provider and manager have taken action to address staffing numbers. This has involved alterations to the staff rota, so that a carer now does split shifts to cover the morning and evening periods. The new deputy manager also covers the mornings, plus the early afternoon period. Staff on duty at the time of this visit consisted of: four carers, the deputy manager, the manager, a cook and a cleaner. The manager confirmed that the home has registered with a staff agency who can be called upon to provide additional cover if needed. Only one new staff member had been recruited since the last inspection. The file was seen to contain most of the relevant information required by the regulations, including an application form, identity checks, two references and the appropriate criminal records bureau (CRB) check. However, one reference and the protection of vulnerable adults register (POVA) first check were both dated after the person started work at the home. There was no interview record and no induction record. The application form indicated appropriate Keele House DS0000060970.V278795.R01.S.doc Version 5.1 Page 15 previous experience and qualifications. The staff member demonstrated competence when spoken to. Keele House DS0000060970.V278795.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): 35 Procedures for the handling of residents’ monies ensure their best interests are protected. EVIDENCE: The manager stated that residents are encouraged to manage their own personal monies wherever possible. The home keeps records of residents’ monies and any financial transactions, for those residents who may not wish to keep their own money, or lack capacity. Residents’ financial records were being appropriately kept. Keele House DS0000060970.V278795.R01.S.doc Version 5.1 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 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x x Keele House DS0000060970.V278795.R01.S.doc Version 5.1 Page 18 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 Standard OP7 Regulation 15 Requirement Care plans must be kept under review and all relevant information (including risk assessments) must be recorded. (Previous requirement 04/10/2005 partially met and carried forward). The registered persons must promote and make proper provision for residents’ health and safety. (Previous requirement from 04/10/2005 partially met and carried forward). The registered persons must make appropriate arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. (Previous requirement from 04/10/05 carried forward). Practice for re-dispensing medications for respite residents to be reviewed to ensure safety. Keele House DS0000060970.V278795.R01.S.doc Version 5.1 Page 19 Timescale for action 30/04/06 2 OP8 12 30/04/06 3 OP9 13(2) 13/02/06 4 OP29 19 5 OP30 18 New staff must not be employed 13/02/06 unless they are fit to work at the care home and information is obtained as specified in Schedule 2. Recruitment procedures must ensure that gaps in employment are checked out, appropriate references obtained and CRB/POVA checks are carried out for all employees prior to their start date. Where an employee starts work after a POVA first check, before return of the CRB, they must be properly supervised as specified in the Miscellaneous Amendments Regulations 2004 and records kept. New staff must be provided with 30/04/06 structured induction training and records kept. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Keele House DS0000060970.V278795.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Keele House DS0000060970.V278795.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. 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