Inspection on 04/10/08 for Kelso

This inspection was carried out on 4th October 2008.

CSCI found this care home to be providing an Good service.

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

Kelso 20/10/06

Kelso 24/01/06

Kelso 17/11/05

Kelso 14/03/05

Kelso 11/01/05

Kelso 30/01/04

Kelso 16/05/02

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Queensmount

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Didsbury Court Rest Home

Belma

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Kelso 10 Clifton Road Southbourne Bournemouth Dorset BH6 3PA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Juanita Glass     Date: 0 4 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Kelso 10 Clifton Road Southbourne Bournemouth Dorset BH6 3PA 01202432655 F/P01202432655 a.ackrill@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Angela Elizabeth Ackrill Type of registration: Number of places registered: Mrs Angela Elizabeth Ackrill,Mr Kenneth Alan Ackrill care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: NVQ4 in management and care to be successfully completed by 30/04/07 by Mrs Angela Elizabeth Ackrill. Date of last inspection Brief description of the care home Kelso is a private nursing home that is registered to accommodate 12 people in the category of old age. The home is owned by Mr and Mrs Ackrill and Mrs Ackrill is the Registered Manager. The staff team work closely with her in respect of the day to day management of the home and a registered nurse is on duty 24 hours each day. The home is located in the Southbourne area of Bournemouth close to the seafront, shops, pubs and post office. The home was opened in 1988 and consists of a two storey building with a large lounge dining room. Four of the homes bedrooms are single and four are double rooms. Residents bedrooms situated on the first floor are accessed by Care Homes for Older People Page 4 of 24 Over 65 12 0 Brief description of the care home the main stairs or a passenger lift. The communal assisted bathroom is situated on the first floor and separate toilets are available at both levels. The home provides residents with nursing and personal care and all services including meals, cleaning and laundry. The home has gardens to the front and rear of the building these are well maintained and easily accessible with the aid of a portable ramp. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Current fees range from 561 pound to 650 pound per week. This inspection took place over one day and a total of four hours were spent in the home. To gather enough evidence to support our judgements for this inspection, we The Commission asked the service provider to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self assessment that focuses on how well outcomes are being met for people living in the home. It also gives us some numerical information about the service, and how they intend to maintain or improve outcomes for people using their service. Care Homes for Older People Page 6 of 24 Once we had received this information we carried out a visit to the home and spoke to people living there and staff who work in the home. Whilst in the home we also looked at documents maintained for the day to day running of the service. These included care plans, staff recruitment and training. Also records relevant to the administration of medication, service records and health and safety. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents benefit from adequate written information, a chance to visit the home and a full assessment of their needs. This means they can make an informed decision before moving in and their needs are fully met. Evidence: We the Commission looked at a copy of the homes Statement of Purpose and Service User Guide. This was readily available in the home and provided immediately. We saw that it was well written and contained all the information a person would need to tell them about what care the home can and cannot provide. It also states clearly the fees and what they pay for with a list of extra charges clearly mentioned. The guide states that the home can accommodate the religious or cultural needs of people with different beliefs or cultural backgrounds. We spoke to the manager about how they would assess a person who wished to move Care Homes for Older People Page 10 of 24 Evidence: into the home. She said they would visit the person either at their home or in hospital. They would talk to them, a relative or advocate and staff at the hospital or a social worker. They would also look at existing care plans for the person. We then looked at the records held in the home for people who had not lived there very long. They all had completed assessments and community or hospital care plans. We spoke to the people living in the home, but they did not mention how the experience of moving into Kelso had been for them. People wanting to move into Kelso can visit and spend some time there to meet other residents and the staff who will be looking after them. This is often done by a relative or advocate on their behalf. If the manager and staff feel they can meet the needs of the person they will offer a trial period when both the person moving in and staff can decide whether the home is really the best placement for them. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from personal and specialist healthcare support that is provided in a person centred way respecting their privacy and dignity. They benefit from and are protected by the homes policies and procedures for the administration of medication. Evidence: We looked at the care plans for people living in Kelso a person centred approach to recording the care provided has been developed and shows that staff are aware of peoples personal likes and dislikes. We looked at the care plans for three people they all showed that the staff at Kelso understand the way to record the personal way a resident likes to be cared for. All the care plans seen reflected this approach with clear guidelines for staff about peoples likes and dislikes and the way in which they preferred to receive their care. Staff had written care plans that reflected the persons personal preferences and the way they wished to be cared for. Care Homes for Older People Page 12 of 24 Evidence: Staff spoken to said they knew each individual, their preferences and when they preferred to be helped or left alone. We observed staff chatting and laughing with residents in an easy and relaxed way. People we spoke to said they were well looked after and that staff cared for them very well. One person said that their health had improved a lot since moving into Kelso and it was all down to the excellent care they had received. Another person said they knew all the staff and the staff knew what was needed and when. All the care plans included appropriate risk assessments and showed signs of regular review. People living in the home have access to health care specialists and care plans showed that the specialist services could be consulted when the home felt they needed some expert advise. Residents were helped to attend out patient appointments, the dentist and the chiropodist. Regular reviews are carried out with the GP looking at specific health needs and medication. The home has very clear policies and procedures for the receipt storage and administration of medication and staff handling medication are appropriately qualified to do so. We looked at the records kept by the home for medication. We found that they were up to date and showed clearly when staff had given medication to people. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from an approriate range of social opportunities available in the home, which reflects their interests and preferences. There is a strong sense of homeliness and inclusion of family and friends in life at Kelso. People living in the home are helped to exercise choice and control in their daily lives within their capabilities and desire to do so. The dietary needs of residents are well catered for with a balanced and varied selection of food available that meets their tastes and choices. Evidence: People spoken to said that they were free to make decisions about how they spent their days and they were happy with the lifestyle they had at Kelso. Care records showed that each resident was helped to choose their daily routine. This included what time to get up in the morning and go to bed at night, whether the resident chose to stay in their room or go downstairs to the lounge. Whether they liked to read, watch television or listen to the radio. This was interspersed with a lot of cheerful interaction with staff, who spent time with each resident on a one to one basis as far as time would allow. We observed a relaxed and cheerful rapport between residents and staff. Care Homes for Older People Page 14 of 24 Evidence: Residents said that their visitors were always made welcome at the home and they could have visits in private. This was confirmed by visitors coming and going throughout the day. People spoken to said that they enjoyed the food provided. One lady said she always enjoyed the food at Kelso especially as she did not have to cook it. One member of staff stated that they all knew what peoples likes and dislikes were and cultural dishes could be provided if requested. Meals were planned much like a family home rather than stipulated by a set menu. The menu offered choice and changes were made in accordance to residents wishes. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from and are protected by the complaints and safeguarding procedures in the home. Staff are fully aware of the procedures to follow to protect people from abuse. Evidence: Kelso has a very clear complaints policy and procedure, which is easy to read. It shows a clear timeline and action to be taken if some one wishes to raise a concern or complaint. A copy is clearly displayed in the hall. People we spoke to said they knew who to approach and felt they could raise any issue with the manager if they so wished. The manager keeps a full record of all concerns, complaints and compliments they receive. The manager and staff were aware of the local policy and procedure for Safeguarding Adults under No Secrets. Staff records showed that they had all received appropriate training in Safeguarding Adults. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from a comfortable, well equipped and homely environment, which is well maintained and decorated with access to well maintained garden areas. People are protected by staff awareness of appropriate infection control guidelines. Evidence: We carried out a tour of the premises and saw that the home is well maintained both inside and out. The gardens were attractive and accessible for people living in the home. All areas of the home were clean and tidy and there were no unpleasant odours. Peoples rooms reflected their personal interests with ornaments, pictures and family photographs. People we spoke to said the home was always clean and tidy. Staff were observed to use personal protective clothing when approriate and had a clear understanding of infection control guidelines. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from and are protected by the staffing levels and skill mix of staff in the home. The homes recruitment procedures and staff training further protect them from the possibility of abuse. Evidence: We looked at the personnel files held by the home for some of their staff. We also looked at the staffing rota and the training records for people working in the home. The staffing rota showed that there is always enough staff in the home with the right skill mix to support the diverse needs of the people living there. They also showed that staffing is flexible so extra staff could be bought in to cover extra busy times such as activities or when care needs are higher. People spoken to said there were always enough staff in the home and they never had to wait long if they rang their bell for help. The manager confirmed that staff are encouraged to attend the NVQ In Health and Social Care training. This has resulted in the home having 75 of their staff qualified in an NVQ 2 or 3 and other staff working towards the qualification. Care Homes for Older People Page 18 of 24 Evidence: Staff personnel records showed that all mandatory training had been attended and dates for further updates were advertised in the office. Staff had also attended training that was considered relevant to their role in the home and the diverse needs of people living there. Qualified staff had attended training to maintain their qualification and knowledge. Staff said they felt well supported by the manager in attending any training they were interested in that would also benefit the home. Kelso has strict policies and procedures for the recruitment of new staff. Since the last inspection the manager has not needed to recruit new staff, however she confirmed that she would obtain all the required documentation before a person started work. She has also introduced the Skills for Care Induction for any new staff to complete. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a well run home with an appropriately qualified manager. They are protected from financial abuse through safe and stringent policies for managing residents money. Both people working and living in the home are protected by robust health and safety procedures. Evidence: Kelso is managed by Mrs Angela Ackrill an experienced manager who has completed the Registered Managers Award. People spoken to said that the manager and staff were very approachable and they could talk to them at any time. An annual survey of residents views is carried out. These contained comments from relatives such as, we are happy with the personal homely care that is provided, and we are happy that mother is well looked after by caring staff. Care Homes for Older People Page 20 of 24 Evidence: The Annual Quality Assurance Assessment (AQAA) returned to the CSCI was clear about the homes continued commitment to maintaining improvement and providing an environment that recognises the diverse needs of the people in their care. The manager confirmed that the home currently does not directly handle residents financial affairs. People either manage their own money or have a relative or power of attorney to act on their behalf. We looked at records relating to the servicing of equipment used in the home. All the records were up to date and available for inspection, these included the COSHH records, which are the guidelines for staff to follow if they spill, drink or are splashed by chemicals used in the home. The implementation of health and safety within the home was satisfactory. All residents have personal risk assessments. Generic risk assessments are in place and reviewed regularly including hot water checks. A review of the firelog showed all tests, training and drills were being carried out to the Dorset Fire Brigade guidelines. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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