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Inspection on 15/08/05 for Kenilworth Nursing Home

Also see our care home review for Kenilworth Nursing Home for more information

This inspection was carried out on 15th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a clear service user focus that is helped by the Registered Manager and staff having a detailed knowledge about all the service users. There is good communication between staff, service users and relatives, which contribute to the smooth running of the home. Staff and service users appeared to have positive relationships with each other. The atmosphere in the home on the day of the inspection was relaxed and friendly.

What has improved since the last inspection?

All the requirements from the previous inspection have been met.

What the care home could do better:

The home should keep the subject of adult protection as an ongoing item at team meetings.

CARE HOMES FOR OLDER PEOPLE Kenilworth Nursing Home 26/28 Kenilworth Road Ealing London W5 3UH Lead Inspector Ged Durkin Unannounced 15 August 2005 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. Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Kenilworth Nursing Home Address 26/28 Kenilworth Road, Ealing, London, W5 3UH 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) 020 8567 1414 020 8567 1052 Mr and Mrs Gopaul Mr Coossialsing Gopaul Care Home 40 Category(ies) of Dementia (0), Dementia - over 65 years of age registration, with number (0), Mental disorder, excluding learning of places disability or dementia (0), Old age, not falling within any other category (0) Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 31/1/05 Brief Description of the Service: Kenilworth Nursing Home is a 40 bedded Care Home giving care to service users within the category of Mental Health. The home, which is situated in a quiet residential area close to Ealing, is sited in two detached, two storey houses, which have been joined into one building. Rooms are sited on three levels with a lift connecting the floors. The home has 15 double rooms and 10 single rooms. There are several communal areas, which vary in size and are all utilised by service users. There is also a garden area that, when the weather allows, service users can use. The home is 10 minutes walk from Ealing Broadway, where there is a shopping centre and access to bus, tube and rail transport facilities. Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 10:40 am and 3:45 pm. The Inspector met with the Registered Manager and senior staff, spoke to a number of service users and two relatives, who were in the home during the inspection. The majority of service users spoken with by the Inspector had some degree of dementia or mental health needs and, as such, were unable to directly respond to the Inspector’s questions. The Inspector also had a tour of the premises, examined various policies and procedures and interviewed two members of the staff team. What the service does well: What has improved since the last inspection? What they could do better: Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 Page 6 The home should keep the subject of adult protection as an ongoing item at team meetings. 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. Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 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 Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 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) 3, 4, 5 and 6 The home ensures that any prospective service users have a full assessment. The home also tries to ensure the full participation, if they choose, of the service user’s family. EVIDENCE: The Registered Manager informed the Inspector that prospective service users must have a needs led assessment prior to being referred to the home. The Inspector viewed the assessment process that prospective service users undergo. It was detailed and thorough. Once admitted to the home there is a trail period and during this time the home compiles a care plan based on its assessment and after 4-6 weeks a meeting is held to confirm whether the placement is to be permanent. The Registered Manager tries to ensure full family involvement and always recommends that the service user and family visit the home prior to any decision to commence a trial stay. The home does not offer intermediate care. Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 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, 9 and 10 The home ensures that all the service user’s health, personal and social care needs are met through individual detailed care plans that are reviewed on a regular basis to ensure appropriate care and treatment is sought. The home has satisfactory medication policies and procedures and a safe system of administration for medication. In addition, service users are treated with respect and are able to maintain their privacy, when they wish. EVIDENCE: The Inspector discussed in detail the health care needs of specific service users with the Registered Manager and staff. Appropriate timely care was being given and this was supported by examination of these care plans, which were up to date and contained the appropriate assessments and documentation. Care plans are constructed to identify individual needs and are then assessed on a monthly basis to review how these needs are met. In addition, the home has the necessary equipment such as pressure relieving mattresses, height adjustable beds, hoists, and specialist nursing chairs. All the service users need varying degrees of support in having their personal care needs met ranging from verbal prompting to full care having to be given by staff. On the day of the inspection all the service users appeared appropriately dressed and Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 Page 10 groomed. The care plans viewed also have a specific area for social care needs of individual service users that the home does its best to meet. The Inspector viewed the medication system used in the home. Only qualified staff administer medication and the home uses a local pharmacist for its supplies. The Inspector viewed the medication administration sheets and all were in order. Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 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, 14 and 15 The home ensures that service users have the opportunity to have their non health and personal care needs met, whilst maintaining contact with family and friends, having choice and control over their daily lives and receiving satisfactory meals at a time convenient to them. EVIDENCE: The home has a full-time activities co-ordinator who is responsible for organising activities for the service users. In addition, the home has a calendar of events through-out the year. Seven service users had been on a day trip to Brighton the previous week. On the day of the inspection cards and bingo were being played. The home has wide ranging contacts with different religious denominations in the community and is able to ensure that service users who wish to, are able to follow their individual faiths. The home has a flexible visiting policy and encourages service users to receive visitors. Service users are able to exercise choice over many aspects of their daily lives that include choice of food, activities, clothes and when to go bed and when to get up. The Inspector viewed lunch being taken. The home is able to ensure that any service user with dietary requirements is able to have them met. Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 The home has a clear complaints procedure and the Registered Manager understands the importance of ensuring that service users are protected from abuse. EVIDENCE: The Registered Manager places great importance on communication and interviews with relatives confirmed that if they had any concerns they would bring them to the manager. The home has a clear adult protection and complaints policy. All staff receive training in adult protection. One of the staff members interviewed was not familiar with the term “Whistle-blower” but was able to tell the Inspector the steps she would take if she came across any abuse. This was discussed with the Registered Manager and the Inspector suggested that adult protection be a standing item at staff meetings. The Inspector examined one service user’s accounts for whom the Registered Manager is appointee for and all was in order. Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26. The home’s environment is clean, safe and well maintained. EVIDENCE: The home was clean with no noticeable odours. The home has its own maintenance man who ensures the upkeep of the home. The roof and lift are maintained by external companies. In addition, there are dedicated cleaning staff who are also responsible for the laundering of service user’s clothes. The home also has two carpet cleaners and two air purifiers, which ensure there are no unpleasant smells in the home. The Inspector viewed a number of service user bedrooms and all were furnished according to individual taste. The home has an enclosed rear garden that is utilised by service users in fine weather. Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 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 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 The home has sufficient trained staff, who are able to meet the needs of the service users. The home also has a robust recruitment process. EVIDENCE: The Registered Manager informed the Inspector that there are always nine staff on duty in the morning, (three qualified and six care assistants), seven staff in the afternoon, (two qualified and five carers) and four waking staff at night (one qualified and three carers). There are separate domestic, maintenance and kitchen staff. Examination of the staff rota confirmed these staffing levels. Care staff are allocated at the beginning of each shift and are responsible for the care of those service users during that shift. As well as having qualified staff a high proportion of care assistants are undergoing or have completed NVQ level 2 training. Training for staff includes infection control, emergency aid, dementia care, food hygiene and moving and handling. The Inspector looked at three staff records and found them to include all the necessary details as required in the Care Home regulations. One original CRB certificate was not available because it was held at the other home owned by the Registered Manager where this person also works. Evidence was seen, however, that the CRB was satisfactory from the umbrella organisation used by the Registered Manager. Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 Page 15 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) 32, 33, 35 and 38. The home is managed and administered so as to ensure that service user’s needs are met and their welfare protected. EVIDENCE: The home has produced a quality audit in June 2005 based on service users, relatives and staff completing a questionnaire. The results have been published and distributed. The exercise is due to be repeated in January 2006. The home has a number of quality assurance systems as part of an overall strategy. These include monthly checks undertaken by senior staff that include environment check, risk assessment check, policies and procedure check, fire point check and emergency lighting check. The last fire drill was on 10/6/05 and the home’s fire prevention equipment, along with the nurse call system is maintained on a regular basis by an external company. The last time the home was inspected by the LFEPA was in October 2002. It was discussed with the Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 Page 16 Registered Manager and the Inspector suggested that he might invite them back to check the current fire prevention measures. The home has recently completed a legionella check for which they are waiting for the result. The front door is kept locked but all staff have a key with which to open it when necessary. Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 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 x x 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 3 x 3 x x 3 Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 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. 2. Refer to Standard 17 38 Good Practice Recommendations Adult protection should be a standing item on staff meetings The Registered Manager should invite the LFEPA to inspect current fire prevention measures in the home. Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing, London W5 2ST 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 Kenilworth Nursing Home G61-G10 s10949 Kenilworth NH v214267 150805 Stage 4.doc Version 1.40 Page 20 - 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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