CARE HOMES FOR OLDER PEOPLE
Kendal Bank Quarr Gillingham Dorset SP8 5PB Lead Inspector
Trevor Julian Unannounced 26 August 2005 11:00
th 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. Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Kendal Bank Care Address Kendal Bank Quarr Gillingham Dorset SP8 5PB 01747 825666 01747 825002 care@kbc.gb.com Mrs P M Halstead 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) CRH PC - Care Home Only 3 Category(ies) of OP Old age (3) registration, with number of places Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 0ne place for a named service user - category MDE(Mental Disorder [Elderly]) Date of last inspection 9th March 2005 Brief Description of the Service: Kendal Bank is located in an attractive rural area of North Dorset, five minutes away from the A303 trunk road and ten minutes away from Gillingham town, which is on the main Waterloo train line. The home is registered to provide care and accommodation to three older people with low care needs. The home overlooks a pretty garden, paddocks and fields. The service user accommodation is comprised of three single bedrooms, bathroom, lounge and a dining area in the kitchen all located at ground floor level. Kendal Bank is also the home of the proprietors and their family and a very homely, comfortable environment is provided Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 26th August 2005 between 11:0014:00. The whole inspection process including preparation, travelling, inspection, and report writing took 10 hours. The visit was the first of two inspections due in the inspection year and the inspector’s first visit to the home. Mrs Halstead was on the premises throughout the visit. Information was gathered through discussion with the three residents, the owners, a tour of the premises and a check of some records and policies. For the purpose of this report the terms resident and service user are interchangeable. What the service does well:
As a home offering just three places Kendal Bank in the family home the residents feel part of an extended family, this fact was greatly appreciated by the current residents. The home had a friendly and relaxed atmosphere. Residents felt they were treated with dignity and respect. Information was available for prospective residents to assist their decision about suitability of the home. Residents were each provided with a copy of the previous inspection report. Care plans were in place to identify care needs and how those needs were to be met. The records were signed by the residents to confirm their involvement in the process. The residents said they had good support from their GP and other community health services. The residents were encouraged to maintain their links with family and friends and this included help with transport arrangement. Residents said their friends were made welcome and that they often had the opportunity to go out with the owners. The residents all felt the food was very good with their individual preferences respected. They added that there was a steady supply of drinks throughout the day. The premises were maintained to a reasonable standard. Any redecoration was carried out as needed but with consideration was given to the impact of any work on the residents.
Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 Page 6 The home was clean and well presented. Each of the residents had a cordless alarm system used to alert the staff of any difficulties. Staffing levels were appropriate for the current needs of the residents. As the owners live on the premises they provide sleep-in cover overnight. The home was well run. As the owners are on hand at all times the residents felt they were consulted about their wishes and given good levels of choice. Records showed the fire warning system and fire fighting equipment were regularly checked and any faults rectified. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kendal Bank D55 S26828 Kendal Bank V246593 260805 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 Kendal Bank D55 S26828 Kendal Bank V246593 260805 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) 1 and 3. Standard 6 - Intermediate Care was not offered at Kendal Bank. Information was available to prospective residents and their carers to assist them in their decision about the suitability of the home. Systems were in place to assess any prospective resident to ensure that the home is able to cater for their needs. EVIDENCE: The home had a residents’ guide which gave information to prospective residents. The residents in the home said they had been given copies and they also had copies of the previous inspection report. One person said she had read the report and that she felt it reflected life at the home. The residents had all been at the home for some time. There was a process for carrying out pre – admission assessments when needed. The residents in the home said that they had visited before taking the placement. Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 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 standard(s) 7, 8 and 10. Each resident had their own care plan in place to inform staff how care needs were to be met. Residents’ health needs were met with support from community health services. Residents were treated with dignity to respect their basic rights. EVIDENCE: The care records were checked for one person; they contained information about how assessed needs were to be met. There was an Occupation Therapist’s report, which was used as a basis for a manual handling assessment. The plans showed appropriate levels of detail for the assessed needs. The care plans were signed to show resident agreement. Documents confirmed that the resident was able to manage her own medication with some support. One resident said she had recently visited an optician for some new glasses. The residents were patients of the same general practice and they said the owner made arrangements for home or surgery visits. A visiting chiropodist provided foot care every six weeks.
Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 Page 10 Since the last inspection the owners and staff had completed a medication course and were awaiting the certification. Residents were seen to be treated as part of the family, there was a homely atmosphere and the residents felt they were included in decisions about the daily running of the home. Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 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 standard(s) 12, 13 and 15 Residents’ social needs were considered during the assessment process to make sure the needs can be met. The home encourages family and friends to maintain contact to reduce the feeling of isolation. The home provides good food in appropriate surroundings thus promoting good nutritional intake. EVIDENCE: The residents enjoy lots of trips out with the owners. Within the home there was a variety of reading materials available for the residents. There were televisions in the bedrooms and there was a large screen TV in the lounge which was enjoyed by the residents. The home is in a rural area with an attractive garden. Outside the patio door in the lounge there were bird tables and feeders; residents said there were always plenty of birds taking advantage of the food on offer. On from the bird tables were views of a paddock and a field which were home to several horses. All the residents said they enjoyed the views from the window. The hairdresser was in the home and she confirmed that she visited every fortnight. Activities were very informal and reflected the homely approach
Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 Page 12 made to daily living in the home. One resident said she enjoyed trips to local show jumping events and often saw friends and acquaintances at the shows. The residents said they kept in contact with their families and friends who were always welcomed into the home. Two people said they paid weekly visits to their relatives with Mrs Halstead helping with transport. The residents were unanimous in their praise for the food provided. Mrs Halstead explained that two of the residents had requested a particular item which didn’t suit the other resident so that item was held over for when she was away visiting her family. Individual preferences were respected. Residents said that they were woken in the morning at their preferred time with a cup of tea and that drinks were served at regular intervals throughout the day. Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 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 standard(s) Not assessed during this visit. EVIDENCE: Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 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 standard(s) 19. The home was clean and well maintained providing a safe and hygienic environment. EVIDENCE: The home was clean and well presented there were aids and adaptations in place to aid mobility these included ramps, grab and handrails and a battery operated lifting bath seat. Each resident had a cordless call button which alerted staff if the resident required assistance. There were no plans for major alterations; redecoration took place as needed. Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 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 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) 27,29 and 30. The home was appropriately staffed to meet the needs of the residents. The homes recruitment and training procedures and practise assisted in protecting the residents. EVIDENCE: Mrs Halstead provides most of the care hours with support from her staff. Mr & Mrs Halstead had developed training plans for staff to include manual handling, health and safety, medication, etc. as well as working towards NVQ2. Recruitment records were checked for two members of staff. Both files showed that the home had followed a clear procedure to ensure that all checks and references were in place. The records were securely held. Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 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 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) 33, 36 & 38 The home takes account of residents’ views to ensure that the home is run in their best interest. Safety systems and training were in place to safeguard the residents and staff. EVIDENCE: The home had carried out one formal Quality Assurance Survey with the results confirming high levels of satisfaction. The home is run with the needs of the residents as the main priority. One person said that if she wants to go somewhere or wants something the owners arrange to sort it out. It was clear that the residents are consulted on a daily basis to ensure their needs are met. Staff supervision records were up to date. Fire records showed weekly and monthly tests of the warning system and equipment was up to date. Safety procedure training was give to all staff. Staff had been trained in safe moving and handling techniques.
Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x x 3 x 3 Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 Page 18 No 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Kendal Bank D55 S26828 Kendal Bank V246593 260805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole Dorset, BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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