Inspection on 19/07/05 for Kensington

This inspection was carried out on 19th July 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.

Other inspections for this house

Kensington 12/07/07

Kensington 12/07/06

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 NE6 2DB Lead Inspector Aileen Beatty Announced 19 July 2005 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 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 B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kensington Address Ayton Street Byker Newcastle upon Tyne NE6 2DB 0191 265 2888 0191 276 2888 N/A Mr Baldev Singh Ladhar 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) Mrs Lilian Lancaster CRH 49 Category(ies) of OP Old Age - 47 registration, with number PD Physical Disability - 2 of places Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The five bedrooms registered in the basement of the home are to be occupied by service users who require personal care only. Date of last inspection 26/04/05 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. Accomodation 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 ensuite 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. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and started at 09.30 a.m. It took place over 5 hours and included a tour of the premises, inspection of records and discussion with staff and service users and visitors. What the service does well: What has improved since the last inspection? What they could do better: The standard of meals provided by the home must improve. The home must continue working towards having 50 of staff qualified to NVQ level 2 or above. The manager must continue working towards NVQ level 4. Staff must remember to date all entries in care records. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 Page 6 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. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 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 Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 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, 2 and 5. Information is provided to service users to enable them to help decided where to live. A contract and statement of terms and conditions are provided. Prospective service users and their representatives have an opportunity to visit the home and assess the quality of the service offered. EVIDENCE: The statement of purpose and service user guide has been updated for all Ladhar homes. They are attractively laid out in a user- friendly format. They were examined and are found to contain all of the required information. Trial visits are offered and it the first six weeks are regarded as a trial period whereby the resident may terminate their residence agreement with reasonable notice. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 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 overall standard of care provided is good. The standard of care planning and record keeping continues to improve. Service users are treated with respect. Procedures for the administration of medicines are satisfactory. EVIDENCE: The manager is continuing to audit care plans on a regular basis. The care plans of most recently admitted residents were examined and found to be of a good standard. They contain admission assessment information, nutritional assessments, pressure area assessments, moving and handling assessments, dependency rating scales and associated care plans. Care plans cover physical psychological, spiritual and social needs. The care plans have been signed by residents. Other care records randomly selected were found to be up to date and accurate. Staff must be reminded to remember to date all entries made. Accountability sheets continue to be used to ensure that staff check that all aspects of personal are carried out effectively. Residents appeared clean and well cared for during the inspection. One relative questioned (via the pre Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 Page 10 inspection questionnaire) whether these sheets are always accurately completed. They felt that these were sometimes signed but the resident did not appear to have received the care described. The manager was informed of areas of concern and will monitor this. It was noted that times are not always recorded on these forms. Medication records were checked and found to be up to date at this inspection. Eye drops are now dated when opened, and controlled drugs were checked and found to be safely stored. Residents are treated with respect. Staff were polite and courteous, and try to preserve the dignity of people in their care. At the last inspection, a recommendation was made that staff training certificates relating to personal care such as continence promotion be removed from communal areas. This has been carried out. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 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. Social and recreational needs of residents are being met. Service users are encouraged to maintain contact with the local community and family and friends. Meals are not always provided to a satisfactory standard. EVIDENCE: A new activities coordinator is in post. He is a magician and entertainer who is very experienced. A number of interesting activities are organised. Children have visited the home and performed Scottish dancing. There have been father’s day celebrations, beetle drives, balloon modelling, and plate juggling. Personal profiles are used to provide information about past interests and experiences so that these may be used in activity planning. Relatives and friends are encouraged to visit and there are sometimes trips outside the home. There were a number of complaints about the standard of meals provided. These have been passed to the manager who is meeting with the Operations Director and kitchen staff to attempt to resolve these. The kitchen was inspected and was found to be clean and hygienic. Kitchen staff are doing basic and intermediate food hygiene. A variety of drinks are reportedly offered to residents. Jugs of juice were seen in lounges. It was noticed, however, that the afternoon drinks trolley was only Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 Page 12 set with tea and coffee. A selection of drinks must be offered to people who are not in the communal areas. Additional storage shelves are required for spices, currently piled on top of the microwave, and knives should be more easily accessible. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 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) 16 and 18. Satisfactory procedures are in place and are followed when dealing with complaints. Satisfactory procedures are in place relating to the protection of vulnerable adults. EVIDENCE: A complaints procedure is available to residents and visitors to the home and is publicly displayed. The complaint book was examined and has been filled in correctly by the manager. A protection of vulnerable adults policy is available. There is also a whistle blowing policy. Staff questioned were aware of both of these policies. It was recommended at the last inspection that external training such as Local Authority adult protection training be provided. This is being arranged. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 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 and 26. The home is safe and well maintained. It is clean and hygienic. EVIDENCE: A tour of the premises was carried out and all communal areas and most bedrooms were inspected. The home was found to be clean and tidy and well maintained. Some furniture has been replaced, cleaned and re-upholstered since the last inspection. There is an ongoing programme of redecoration and maintenance. Room audits are carried out. Very detailed cleaning schedules are in use and checklists are monitored by managers. Plastic toggles have been fitted to light pull cords. Fire doors are no longer chocked open. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 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. Service user needs are met by sufficient staff. The recruitment policy protects service users. Staff are trained and competent to do their jobs. EVIDENCE: Staff rotas demonstrate that minimum staffing levels are being met. Training has been provided relating to the protection of vulnerable adults, report writing, risk awareness, wound and skin care, moving and handling, first aid, deaf awareness, communication, activities in care, fire safety, safe working, food hygiene and swallowing difficulties. A list of future training planned is available. 25 of staff have NVQ level 2 or above in care. The manager is completing level 4. 21 staff have a current first aid certificate. Staff files checked found that recruitment procedures were followed and appropriate criminal records checks have been carried out. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 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, 35, 36 and 38. The home is run in the best interests of service users. Financial interests are safegaurded. health safety and welfare of service users is maintained. EVIDENCE: The manager and staff at the home have worked hard to meet the requirements set at the last inspection. The manager has been supporting the adjacent home, Balmoral Court, in the absence of a permanent manager. There is no evidence that this has had an adverse affect on the management of Kensington. Records examined are mostly up to date and an improvement was noticed. Resident’s money is kept separately and they have individual accounts. Staff supervision is now up to date. A requirement set at the last inspection has been met. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 Page 17 Risk assessments are in place. Residents who require bed rails have risk assessments in place. It is recommended that all staff receive training in relation to bed rails and the associated risks. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 Page 18 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 3 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 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 x 3 x 3 3 x 3 Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 Page 19 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. 2. Standard OP7 OP15 Regulation 15,17 16 (2) (i) Requirement Dates and times must be added to all entries on care records. A variety of drinks must be offered to all service users. Timescale for action Immediate. Immediate. 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 OP28 OP31 OP15 Good Practice Recommendations The home should continue towards working towards the standard of having 50 of care staff qualified to NVQ level 2 by 31/12/05 The manager should continue working towards NVQ level 4 Additional storage should be provided in the kitchen for spices and knives. Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Northumbria House Manor Walks Cramlington, Northumberland NE23 6UR 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 Kensington B53-B03 S409 Kensington V229102 190705 Stage 4.doc Version 1.30 Page 21 - 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!