Inspection on 18/06/07 for Kenilworth Nursing Home

This inspection was carried out on 18th June 2007.

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.

Other inspections for this house

Kenilworth Nursing Home 02/09/08

Kenilworth Nursing Home 23/08/06

Kenilworth Nursing Home 19/12/05

Kenilworth Nursing Home 15/08/05

Kenilworth Nursing Home 31/01/05

Kenilworth Nursing Home 14/09/04

Kenilworth Nursing Home 23/09/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Kenilworth Nursing Home 26/28 Kenilworth Road Ealing London W5 3UH Lead Inspector Robert Bond Key Unannounced Inspection 10:00 18th June 2007 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 Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 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. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 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 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) 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 DS0000010949.V336634.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 40 elderly mentally infirm 40 adults over the age of 40 with dementia Date of last inspection 23rd August 2006 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 in Ealing, is sited in two formerly 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. The current range of charges is from £517 to £1,200 per week. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was a ‘key inspection’ that considered the home’s performance in achieving the key National Minimum Standards (NMS) for older people living in care homes, as published by The Department of Health. The home’s success in achieving anticipated outcomes was measured for 22 Standards, and the home was deemed to have exceeded the outcome for 4 standards, and met the outcome for the remaining 18 standards. The inspector made 3 recommendations. This is a clear improvement upon the previous CSCI inspection report, which had given the home 13 requirements to comply with, and 3 recommendations. All the requirements made in that previous report have been met. The Inspector sent out and received back a pre-inspection questionnaire from the home, and 4 questionnaires completed by residents or their relatives. These responses were all positive. One respondent wrote, “The home provides a safe environment for the vulnerable. I have had no concerns to raise about the care of my mother”. The Inspector spent four hours at the home during which time he toured the premises, spoke in depth to two residents, chatted to several members of staff, and interviewed the proprietors, nurse in charge, and the administrator. A variety of records were examined and two resident’s care files were casetracked (examined in detail). On the day of the inspection, electricians were busy installing a new call-bell system throughout the home. Additional staff had been rostered for the day in case any problems arose as a result. A practice that is commended. Diversity and equality issues are given prominence within the home as evidenced by the range of cultural and religious observance opportunities the home provides for the residents. The home had 2 vacancies on the day of the inspection. What the service does well: The operation of the home is focussed around the care needs of the residents, and staff have a detailed knowledge of those needs. Excellent assessments of residents’ needs are undertaken. Record keeping throughout the home is mostly excellent. Staff and residents appear to have positive relationships with each other. The atmosphere in the home on the day of the inspection was relaxed and friendly. The home is fully staffed, and sufficient staff are rostered Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 6 on duty. Thorough recruitment checks are undertaken and good training records are kept. The home was seen to be clean, tidy and mostly well decorated, well furnished and equipped. The home’s complaints procedure is well advertised, appropriate safety checks are undertaken, and internal quality assurance systems are in place. What has improved since the last inspection? What they could do better: The ongoing programme of redecoration should be continued as there are still a few areas of the home where the standard of decoration falls short. The ongoing programme of replacing damaged furniture should be continued as the Inspector noted in one double room that neither bedside cabinet was lockable, and their appearance was poor. The records of resident’s weights that are taken monthly should indicate the extent to which the weight has increased or decreased. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 7 The questionnaires that are used for the annual internal quality monitoring exercise should be dated to avoid any possible confusion over which year they refer to. 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. The summary of this inspection report can be made available in other formats on request. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 8 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 Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each resident has a clear written contract concerning their stay in the care home. The needs of residents are fully assessed prior to the resident moving into the care home. Assessed needs of every kind are kept under regular review. Intermediate care is not provided at the care home. EVIDENCE: The Inspector enquired about the contracts or terms and conditions for residents that are produced by the care home. The Registered Manager replied that a standard contract was used when a local authority purchased a place at the home. He added that at present two residents are self-funding. The Inspector therefore examined one of the contracts issued to a self-funding resident and found it to be sufficiently transparent and informative. The Inspector case-tracked two care files chosen at random. He found that both files contained detailed assessments undertaken by a member of staff from the home prior to the resident moving in. The home was also able to Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 10 produce examples of referrals and hospital assessments submitted by referring local authorities. Additional specialist assessments were on file that covered manual handling needs, the likelihood of falling, skin care, continence, nutrition, and risk generally. All were seen to be regularly reviewed and updated. The assessment information was seen to be used in the writing of the resident’s care plans. The standard and range of assessments completed at Kenilworth House is commended. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal and social care needs are well documented in individual plans of care. Residents’ health care needs are well met. Residents are well protected by the home’s medication policies and practices. Residents are well treated in terms of respect and privacy. EVIDENCE: The Inspector case-tracked the care files of two residents selected at random. Both files contained detailed care plans that had been written around the residents’ assessed needs. Personal care, health care, and social care needs were all well identified, together with how to meet those needs. Cultural and religious needs were also considered in detail. In terms of health and nutrition, the Inspector identified from the monthly weight record that one of the residents being case-tracked had suddenly lost weight. Other records showed that as a result his/her food and fluid intake had been closely monitored and recorded for a month, and that appropriate medical intervention had been sought and obtained. After a change of Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 12 medication the resident started eating again. However the weight charts for both residents case-tracked did not show how much weight was being gained or lost each month, despite the form in use having a space for this information to be recorded. A recommendation is therefore made. The Inspector examined a sample of the home’s medication storage arrangements, and the records kept of medication administration. This included records for controlled medication, and the collection for destruction of unused medication. All were found to be in order. The Inspector observed residents being treated with dignity and respect by staff members. Residents’ privacy was seen to be maintained by staff knocking on bedroom doors, and by the provision of screens within the double bedrooms. The Registered Manager explained that not all bedrooms are lockable, and not all rooms have a lockable cabinet, as the needs of some residents preclude this. The Inspector however was shown examples where privacy had been enhanced by the use of locks that the resident could control. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ social, cultural, religious and recreational interests and needs are being satisfactorily met. Residents are sufficiently encouraged to maintain links with relatives and the local community. Residents are facilitated in exercising choice and control over their lives. Residents are offered a wholesome and balanced diet that takes account of religious and cultural needs. EVIDENCE: The Inspector noted that individual care plans consider social care needs. The home’s advertised activity programme now covers the whole week with additional activities scheduled for weekends. These activities include reminiscence for residents with dementia. The Inspector examined the visitors signing in book and found that on the previous Saturday and Sunday only two residents received a visit from relatives. The Registered Manager provided the Inspector with details of the religious services and contacts that were available for residents. A new development is Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 14 that the home provides transport, staff escort, and money for refreshments for residents to attend a local Roman Catholic church. The Registered Manager described visits to the park and the town centre by residents. Other activities discussed with the Inspector were a planned Bar-beque in the back garden, and a day out to Brighton for approximately 12 residents who were thought to be interested. The Inspector observed that residents were able to bring items of their own furniture into the home, but not pets. The Inspector read minutes of two Residents Meetings were outings and food choices were both discussed. The Inspector was provided with a sample food menu. The lunch served on the day of the inspection was savoury mince, mashed potatoes and mixed vegetables, followed by pears and custard. The alternatives on offer were vegetable curry and rice, and fresh fruit. Halal meat is available and is stored separately in the kitchen. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives can be confident that complaints will be properly dealt with. Residents are appropriately protected from abuse by the home’s procedures. EVIDENCE: The Registered Manager reported that the home had received no complaints in the period since the previous CSCI inspection. No complaints were made to the Inspector during his inspection of the home, or by questionnaire response prior to the inspection. The home’s complaints procedure is appropriate, and is well advertised throughout the home. The home’s Protection of Vulnerable Adults procedure has been updated to meet the required standard. The Inspector noted evidence that staff are being trained in Safeguarding Adults. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in an environment that is sufficiently safe and well-maintained. Residents live in a home that is satisfactorily clean, pleasant and hygienic. EVIDENCE: The Inspector toured the home, including seeing a sample of the bedrooms. He found the home to be clean and tidy throughout, and did not note any malodours. The home was seen to be satisfactorily decorated in general, with the exception of a few small areas where redecoration was awaited. The Home was seen to be well furnished and equipped throughout, with the exception of two bedside cabinets in one double room. Much communal furniture and carpeting has however recently been replaced. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 17 The programme of redecoration and replacement of furniture however should be continued. On the day of the inspection, the call bell system was being replaced. The Inspector tested the existing system and found it was still operational. The Registered Manager reported that a new piano had been purchased, and additional room coolers provided. The kitchen has been refurbished, and the hot water supply improved. Hoists are provided where residents need to be assisted in this way. The back garden was seen to be attractive and well maintained. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ needs are well met by the number of staff provided, and by their good skills base. The extent of qualification of the care staff is satisfactory. The residents are well protected by the home’s recruitment policies and procedures. The staff are well trained and apparently competent. EVIDENCE: The Registered Manager reported that as the call bell system was being replaced that day, he had rostered additional staff to be on duty. This is commended. The Inspector checked the home’s staff rota for the week and found that it did show that three additional staff were rostered that day. The roster showed that sufficient staff are rostered at all times. The Registered Manager reported that one resident requires one to one care. The turnover of staff is very low with only one person leaving during the last year. Eleven of the staff group of 52 are first level qualified nurses. The PreInspection Questionnaire states that 54.8 of care staff hold an NVQ level 2 or above. The Inspector examined the recruitment files of two recently appointed staff members. In both cases, all appropriate recruitment procedures and checks Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 19 had been undertaken. The files were also set up and maintained in a way that clearly demonstrated the above, which is commended. The files seen contained evidence that thorough induction training had been undertaken, and signed for. Records of other training events were also seen by the Inspector, and the Registered Manager described the contents of the training programme provided. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is very well managed. The home is run in the best interests of the residents. Residents’ financial interests are well safeguarded. The health, safety and welfare of residents and staff are well promoted and protected. EVIDENCE: One of the joint proprietors is also the Registered Manager. The absence of requirements at this inspection, and the home’s success in meeting all the requirements of the previous CSCI inspection is evidence of good management, which is commended. Residents are consulted at regular monthly meetings. In addition residents and relatives are formally consulted annually by questionnaire. The Inspector read Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 21 a sample of their responses, which were generally positive. Unfortunately the questionnaires were not dated. A recommendation is made accordingly. The Inspector checked the home’s records of money held on behalf of residents. The Inspector found that residents’ money was being spent appropriately, and that good records were being maintained. The Inspector checked hot water temperatures, fridge/freezer temperatures, legionella certificate, lift and hoist maintenance records, and first aid box contents. All were in order. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 22 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 3 4 x x N/A 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 Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 4 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 x 3 x x 3 Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no 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. 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 3 Refer to Standard OP8 OP19 OP33 Good Practice Recommendations When the weight of residents is recorded each month, the record should show how much weight is gained or lost. The ongoing programmes of redecoration and replacement of damaged furniture should be completed as soon as possible. When questionnaires are sent out by the care home as part of their internal quality assurance system, they should be dated so that one year’s results can easily be distinguished from another year’s. Kenilworth Nursing Home DS0000010949.V336634.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: 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 © 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 DS0000010949.V336634.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!