Inspection on 12/07/07 for Kensington

This inspection was carried out on 12th July 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

Kensington 12/07/06

Kensington 19/07/05

Kensington 26/04/05

Kensington 05/11/04

Kensington 05/05/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Kensington Ayton Street Byker Newcastle Upon Tyne Tyne & Wear NE6 2DB Lead Inspector Suzanne McKean Key Unannounced Inspection 12th July 2007 09:30 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 Kensington DS0000000409.V344238.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. Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kensington Address Ayton Street Byker Newcastle Upon Tyne Tyne & Wear NE6 2DB 0191 265 2888 0191 276 2888 kensington@ladhar.co.uk 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) Mr Baldev Singh Ladhar Mrs Lilian Lancaster Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (47), Physical disability (2) of places Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The five basement rooms are only to be used for service users requiring personal care 12th July 2006 Date of last inspection Brief Description of the Service: Kensington is a home providing nursing and residential care. It is situated in a residential area of Byker, on the outskirts of Newcastle upon Tyne. The home is purpose built and was first registered in August 2000. Accommodation is provided over three floors. The lower ground floor has five beds registered for personal care only. A passenger lift is available, if required. The bedrooms are all en-suite and of a good size. Double bedrooms are available if required. There are lounges available on each floor and a designated smoking area. There are two homes on this site and they share kitchen and laundry facilities. They are otherwise independently staffed and function separately. The home charges fees of between £355 and £365 per week depending upon the needs and requirements of the individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide. A copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Summary: This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 12th July 2007. During the visit we: • Talked with people who use the service, relatives, staff, the manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe & comfortable, We told the manager what we found. Seven requirements were identified at the last inspection, all of which have been met. The recommendation has also been met. No requirements were made as a result of the inspection and only one recommendation. What the service does well: The home has a pleasant atmosphere and the relatives and residents were positive about the experience of living and visiting the home. The care plans are detailed and completed to a good standard allowing the staff to give the care in line with the information contained within them. Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 6 The care for those people who have reached the end of their lives is good and the staff have worked hard to ensure that they give effective sympathetic support for the residents at this time of their lives. The manager has a good understanding of the needs of the residents and staff and works hard to ensure that professional relationships are maintained in the home in a friendly and respectful way. 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. The summary of this inspection report can be made available in other formats on request. Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kensington DS0000000409.V344238.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good detailed assessment carried out by the staff prior to admission, which forms the basis for the development of the care plan and ensure that the good care can be given. The home does not offer intermediate care. EVIDENCE: The care plans contain comprehensive pre-admission assessments, which are completed by the Manager or the senior staff. The pre-admission assessment is then used to develop the care plan. The care plans also have a care management assessment, which is completed by their social worker as part of the assessment process. This is given to the Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 9 home on or before admission and from these documents an individual care plan is produced. All of the care plans looked at had these in place. The home is not registered for, and therefore does not provide, intermediate care. Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 10 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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is good individual care planning and the care is being given in line with these. The residents have their healthcare needs met effectively. The staff treat residents with respect and maintain their privacy so far as possible both when delivering care and throughout their daily life. The residents receive their prescribed medication in line with safe working practices. The medicines in the home are well managed and safely disposed of as necessary. EVIDENCE: Each resident has an individual plan of care, which is based on the admission assessment and is then added to during the placement. The care plans contain an assessment for nutrition, wound care, moving and assisting, and continence promotion as well as a dependency score. These are up to date and detailed. Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 11 The home has recently changed the documentation and this has had a positive effect. It has however been a significant piece of work and the staff will need to take some time to familiarise themselves with the new way of working. Resident or relatives are consulted when writing the care plans and this is confirmed by the completion of a form, which is signed by them. Residents have access to NHS services and facilities. There is a good range of pressure relieving mattresses for the prevention of pressure sores. Nursing action taken for wound care was well recorded although the home only currently has one resident with a pressure wound. And the home seeks expert advice from external professionals if necessary. The staff could describe the way they maintain residents privacy and were seen doing so when delivering care. The residents were complimentary about the care they received and said that the staff treat them in a “kind and caring” way. An example of the comments made was that the staff were “lovely” and “we couldn’t get better care”. Staff address the residents by their preferred name and there was a good relationship seen between the residents and the staff. The systems for managing medicines in the home are in line with safe working practice guidelines. Staff record the medicines being ordered, the prescriptions are then checked on receipt from the General Practitioners and are then sent to the Chemist for dispensing. The medicines are then again checked against the records when received into the home so that any errors can be picked up. No residents are currently managing their own medication. The home has recently introduced a strategy for caring for those residents who have reached the end of their lives. This is a system, which is being introduced in a number of areas of care in both NHS, and community based care. Its use in care homes is relatively uncommon at this time. The manager was positive about a recent experience in which it was used. The documentation for this was very detailed and was a good example of good end of life care. A number of the staff have completed additional training in the care of the dying. Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 12 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are satisfied with the flexibility of their routines and social activities, which meet their cultural, social, religious and recreational interests and needs. More individualised social assessment would further improve this. There are effective arrangements in place for residents to maintain contact with their family and friends and the local community, which are suited to each individual’s needs and vary accordingly. Residents have a well-balanced nutritious diet, which offers choice and is good quality and well presented. EVIDENCE: Residents said that they are encouraged to take control of their daily routines in simple but important ways including “the time they get up”, and what and when they eat. They also said they make choices about how they spend their day and that they were “satisfied” with the activities available. Some Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 13 organised activities are available and staff confirmed that residents choose to take part or not. The home has until recently had an activities co-ordinator. This person is now working only in the sister home on the same site and the manager has recruited a replacement who will commence her employment once the recruitment procedure has been completed. There are some home-based social opportunities for residents to participate in. The individual recording of the resident participation is good and describes their participation or if they “declined” to participate. Also one to one time is given for those who do not wish to, or are unable to take part in, group activities due to their physical limitations. This could be improved further to describe the level of enjoyment and have more detailed planning in the documentation as to the way it is organised for individuals. A relative said that the home was a “a nice place for me to visit and that her relative was happy and settled.” The residents’ bedrooms are personalised reflecting individual choices and preferences and residents asked said they were happy with the decoration. Residents receive visitors when they wish and use their own rooms, the small lounges or the larger, busier lounges to receive them. Relatives confirmed that they are made welcome. Information about visiting is given in the residents’ guide. The food being served at lunchtime on the day of the visit offered choice and appeared to be well presented and well received by the residents. There have been some issues around the quality of the food however on speaking to the manager action has been taken to address this. Residents spoken to said that the food was “okay” but that it had been “really nice recently”. Staff spoken to were aware of the need for some residents to have their food intake monitored and knew about which foods were important for these residents. Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 14 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good system for managing and dealing with complaints, which makes it possible for them to be investigated and action taken to address any issues identified. The residents are protected from abuse through the effective process for recruitment and selection of staff and through staff induction and training programmes. EVIDENCE: The complaints procedure is available in the service users guide and a copy is available at the front entrance as well as being displayed in other places in the home. The Manager records complaints made and there has been six new complaints recorded since the last inspection. The manager records all expressions of concern so that she can address them both as part of the complaints procedure and for quality assurance purposes. All but one of the complaints were about the food and the home has taken action to address the problem. Residents understood how to make a complaint, and could identify the way this would be dealt with. Relatives who were visiting the home were aware of the Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 15 complaints procedure but felt that their concerns were being dealt with before the need for formal complaint. All of the staff have received protection of vulnerable adults training. Staff could describe the principles of protection of vulnerable adults and were knowledgeable about how to alert senior staff of any concerns they have. There has been no protection of vulnerable adults issues raised since the last inspection. Kensington DS0000000409.V344238.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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The general standard of cleanliness is good and the building is well maintained. The necessary specialist equipment for the control of infection is provided in the home and the staff were aware of their responsibilities in this respect. The environment is generally good and there is a programme in place to ensure it remains in good repair and pleasant. It is safe and is appropriate for the residents who live there. EVIDENCE: The home was purpose built for the client group and as a result has good-sized corridors and is designed to allow service users to use the entire home with ease and in safety. The decoration is in keeping with the style of the home and the furnishings are suitable for the residents living in the home. The Manager Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 17 has an ongoing redecoration plan and has identified equipment and furnishings she feels are needed to maintain the standards. The residents spoken to were happy with the decoration and maintenance standards. The home is clean and was odour free. The residents’ bedrooms were personalised reflecting individual choices and preferences and three residents asked about their bedrooms said they were happy with the decoration and that they were kept clean by the staff. The laundry was clean, organised and well equipped. The sluices were tidy, clean and odour free and the disinfectors operational. Staff followed infection control policies throughout the day. The light and emergency call cords were all clean and all emergency cords reached skirting level. Kensington DS0000000409.V344238.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff are recruited and selected using a robust system, which ensures that they do not present a risk to the residents and have the necessary skills and qualifications to care for them. All staff are given comprehensive induction. There is a good training programme in line with the companies policies and including moving and handling, fire, protection of vulnerable adults and health and safety. EVIDENCE: Staff records are completed in line with the company policies and procedures, including two references and a completed application form. The requirement to have a CRB and POVA check in place is applied to all of the staff in the home. The is a system in place for doing an analysis will to identify skills gaps for the staff so that additional training can be given as necessary. The training records allow the Manager to plan training; it was very clearly maintained and offered an efficient and easily examined system. Statutory and clinical training is given in line with the company policy and includes moving Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 19 and handling, fire, and health and safety. All staff have had the training at necessary intervals. The training display board in the managers office is particularly effective in allowing the manager to identify easily if individual staff are up to date with their training programme. More than 50 of the care staff have achieved the National Vocational Qualification to level 2. Kensington DS0000000409.V344238.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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager, ensures that she has systems in place to make sure that the home is managed effectively taking into account the needs and wishes of the residents. Clear safe working practices are used in the home in line with the company policies and procedures. Formal supervision for the care staff up to date and ensures that they are working to the expected standard and are supported. Personal allowance management is good and the systems and records are in place to allow audit to be effective. Kensington DS0000000409.V344238.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager maintains her Professional Portfolio according to the NMC (UKCC) requirement for updating to maintain her nursing registration. The records to support the Managers confirmation that she ensures safe working practices in relation to first aid, food hygiene and moving and handling are in place and are satisfactory. Formal supervision for care staff is up to date. Senior staff also work with carers to carry out informal supervision of their practice when delivering care and the qualified nurses are knowledgeable about the skills of the care staff. The manager takes the necessary action to ensure the health and safety of the service users. This is supported by the policies and procedures and by discussion with the Manager. The Manager facilitates relative and resident meeting, which although they are not well attended, give the opportunity for the home to communicate formally with them. During the visits the relatives visiting were chatting in a very positive way with the staff and all of them were spoken to by the Manager. This gives them the opportunity to approach her informally if necessary. The home uses a number of internal mechanisms as part of the quality assurance process. Recent questionnaires have been used to find out the views of the resident and relatives and she is using these to make improvements as necessary. The personnel records kept in the home of residents who are receiving assistance to manage their finances are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the service user were in place. The personal allowance records examined allowed the audit of individual residents moneys to ensure that it is being managed effectively. The home have taken steps to limit the amount of money held by them in the home and have sought alternative ways of achieving this depending upon the individual residents financial situations. A number of the residents have personal back accounts. Kensington DS0000000409.V344238.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Kensington DS0000000409.V344238.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. Refer to Standard OP12 Good Practice Recommendations The recording of social activities should be improved further to allow them to demonstrate more effectively the resident’s enjoyment and future planning. 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