Inspection on 24/05/07 for Kensington House (North East) Limited

This inspection was carried out on 24th May 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 House (North East)... 05/10/05

Kensington House (North East)... 21/04/05

Kensington House (North East)... 02/11/04

Kensington House (North East)... 26/05/04

Kensington House (North East)... 20/11/03

Kensington House (North East)... 31/07/02

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

CARE HOME ADULTS 18-65 Kensington House (North East) Limited 32 Denmark Street Gateshead Tyne & Wear NE8 INQ Lead Inspector Mr Lee Bennett Key Unannounced Inspection 24 May and 18th June 2007 1:00 th Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 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 Kensington House (North East) Limited DS0000007395.V336553.R02.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 Adults 18-65. 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 House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kensington House (North East) Limited Address 32 Denmark Street Gateshead Tyne & Wear NE8 INQ 0191 477 5843 NO FAX donnamcd@blueyonder.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) Kensington House (North East) Limited Mrs Donna McDowell Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (1) of places Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2005 Brief Description of the Service: Kensington House is care home, providing personal care for up to 5 people with a learning disability. Nursing care is not provided, but District Nursing services can be arranged where necessary. It is an adapted, terraced care home with accommodation provided over three floors. The first and second floors are accessed by flights of stairs, so the home would not be suitable for a person with a physical disability. There is a small paved garden to the front, and an enclosed yard to the rear of the home. The home is situated within walking distance of central Gateshead, and is near to local public transport links and a wide range of local facilities, including a health centre, a library, shops, pubs and places of worship. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the visit: We looked at: • Information we have received since the last visit on 5th October 2005 • 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 24th May 2007. A further announced visit was made on 18th June 2007. During the visits we: • talked with people who use the service, relatives, 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 the people that work here had the knowledge, skills & training to meet the needs of the people they care for • looked around the building to make sure it was clean, safe & comfortable We told the manager and owners what we found. What the service does well: Kensington House has a pleasant, homely atmosphere. There is a family feel here, which is due to the approach, and hard work of the owners, who both staff the home. Service users are involved in the day-to-day running of the home and appear to be comfortable and relaxed. It is well maintained and decorated to a high standard. The people who live here told the inspector how they keep active, go to college, have voluntary jobs and enjoy a good range of leisure activities. They access a broad range of community facilities, and their skill and independence is encouraged. They take regular holidays at home and abroad. A relative commented: “Mr and Mrs McDowell are very caring and discerning in the way they care for my son. He is very happy and contented at Kensington House and live a full and varied lifestyle. I am extremely satisfied with the overall care provided.” Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 6 The home is well managed. 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 House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2 and 3. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each service user’s care needs are assessed prior to their move to the home, and periodically thereafter to a good standard. This will help ensure that each service user’s needs are met at the home and inappropriate admissions avoided. Service users’ personal and social needs are met at the home to an excellent degree. EVIDENCE: Each service user has a care managers’ (social workers’) assessment undertaken before they move here. The home’s owner / manager also looks at each person’s needs and how they can be met. This is written up and details each service users’ abilities and needs. From time to time these are looked at to make sure each person’s needs can still be met here. From these assessments, plans of care are then developed to guide care practice. This is then translated into the way in which care is delivered. The information outlined within service users’ care plans and their progress notes, along with observed practice, demonstrates how the service is able to Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 9 meet their needs. The home’s owners, who staff the home, have undertaken training relevant to learning disabilities and general care topics. If necessary, additional advice and guidance can also be sought from visiting professionals, such as the District Nurse, for health care needs, as well as other health care professionals from the Community Learning Disability team. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users’ care plans are in place, and reflect their observed needs (including their cultural needs and personal preference) to a good level. Effective care planning can offer guidance to care staff regarding care practice and ensure consistency where necessary. Service users are, as far as is practicable, consulted on and participate in the life of the home to an excellent level. This can help in the development of an inclusive service for those living there. Service users are supported to take risks within a risk management framework. This helps to ensure they remain safe and that their independence is promoted to an excellent degree. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 11 EVIDENCE: Each service user has a care plan in place, which is updated each year after a care review. This involves the service user, their relatives, the manager and a social worker. Care plans are written in a clear style. The aim of the owner / manager is to ensure that these plans are written in such a way that in an emergency, someone who did not know the service user would, by reading these, have a clear guide to each persons needs, preferences and goals for the coming year. Care plans focus on each persons’ skills and strengths, as well as their needs. Care plans are signed by the service user to provide evidence that they have been involved in these. The owner / manager was given advice to include picture or symbol prompts to aid further discussion and understanding. Those service users asked were able to give examples of how they make decisions affecting day to day choices and decisions, about their lives, and the way the home is run. This was observed during discussions about activities and plans for the day, mealtime choices and so on. Service users and the owners will discuss routines in the home, and service users have been able to make choices about décor schemes, trips out and personal purchases. There are regular house meetings where service users can voice their opinions on future plans, menus and activities. Areas of risk (such as road safety and cycling skills) are documented within each service users’ care file. A model that focuses on the benefits gained by the activity is used, and each risk area is identified, who or what may be harmed is noted, current and additional control measures are documented, and this is dated and then reviewed. One of the home’s owners was able to explain how areas of risk are assessed, and how service users are supported to gain independence as part of a risk management approach. One example included independent travel on the local bus network. The home’s owner explained how they would initially accompany the service user concerned, and then observe the activity more discreetly, before the service user undertook the activity independently (once assessed as being able to manage this safely). Additional safety measures would also be put in place involving the other people involved in his care. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are assisted, to an excellent degree, to lead active and fulfilling lifestyles by having a regular community presence, and by accessing a range of community facilities. This will assist in them leading a full and enjoyable life. Service users are supported to maintain their personal relationships and friendships, to a good level, which helps them to keep in touch, and be involved in their family life. Service users rights are respected, and routines in the home are flexible to a good level. This can help to promote a flexible service that encourages and promotes service users’ choices and preferences. Service users are offered and receive a varied, wholesome, nutritious and wellpresented menu. This can contribute to their general health and wellbeing. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 13 EVIDENCE: Relatives indicated that they are made welcome in the home, and are able to visit their relative in private. Although contact with relatives varies, due to individual circumstances, service users are assisted to ‘keep in touch’ by sending cards, making phone calls and being supported to visit their relatives and friends. Service users explained to the inspector some of the activities they take part in and that are planned for the future, which include attending formal day services, voluntary work, college courses, going shopping and having various trips out. This allows them to interact with people outside of their immediate home environment. All of the service users are registered to vote, and there are no restrictions imposed to their personal rights or freedoms. All service users are able to freely express their views and opinions, which they did so to the inspector. The service user’s living at Kensington House do not have any specific health related dietary needs. The main meal of the day is during the evening, and service users are able to help themselves to drinks and light snacks as they please. Service users are involved in the preparation and clearing away of meals, which is normally a communal activity. Service users are offered a choice of what they would like to eat and the home’s owners are aware of their personal preferences. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users receive personal support appropriate to their needs and preferences, to an excellent standard, which can help to ensure their privacy and dignity is respected. Service users health care needs are identified and arrangements are made to help ensure they are promoted and met to a good level. This can contribute to their overall wellbeing. Medication arrangements are appropriate for the needs of service users, and are managed in a good and safe manner. EVIDENCE: The service users living at Kensington House have their personal care needs outlined within their case files. Their needs are supported and met, where appropriate, in private, and they are encouraged to be independent where Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 15 possible. The owners are able to demonstrate, through discussion and observed practice, a good understanding of service users’ needs. Service users are supported in receiving regular access to primary and secondary health care services, such as those from the GP and dentist. Where the home’s owners have had concerns regarding the health and wellbeing of service users, appropriate interventions have been sought, and these are documented within each service users care file. Regular screening takes place, including weight checks in the home, and those undertaken by regular GP, dental, optician and out patient appointments. A record of medical appointments and their outcome is retained on each service users personal care file. Locked storage has been installed for service users’ medications, with internal and external medicines stored separately from one another. Printed administration records are kept, and identify who was responsible for each medication administration. Due to their levels of need, service users are not able to administer their own medicines, and the owners therefore assist in this area. Training has been received in relation to medication administration. A stock check was undertaken for a sample of medications held in the home. This was concluded successfully, with stocks held corresponding to those recorded. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ views are listened to and acted upon to a good level. This can help contribute to a service user centred service. Service users are protected from abuse, neglect and self-harm. EVIDENCE: A clear complaints procedure exists within the home. There have been no complaints reported within the past twelve months. As noted above, service users are able to directly express their views and opinions on the service they receive. Those relatives, from whom comments were received, all stated that they were satisfied with the overall care provided, are aware of the home’s complaints procedure, but to date felt they have not needed to complain. Service users are clear about who they would speak to if they had any concerns or complaint. The home’s owners have received training from the local Adult Protection Coordinator, which will help to explain the role of adult protection, and to offer guidance to staff. The registered owner / manager has also developed policy and guidance material for use within the home. Both the home’s own and the local authorities adult protection procedures are available in the home, should guidance be needed in this area. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 27 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from excellent, well maintained, homely, safe and clean accommodation. This can help promote a positive image for service users, and ensure they remain comfortable and safe. Service users bedrooms are furnished to a good standard. This can contribute to their comfort during their stay at the home. EVIDENCE: Communal space is provided on the ground floor and includes a lounge, a dining room and conservatory. Service users’ bedrooms are situated on the first and second floors, and contain modern furniture and are decorated to suite service users’ personal preferences. Service users have access to all areas of the home and are well informed about future plans for refurbishment and minor alterations. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 18 Tiled and laminated floors in communal areas contribute to the ease of cleaning and maintenance, and the home’s owners continue to invest in the property to maintain a high standard of accommodation, such as alterations for improving the first floor bathroom. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by the home’s two owners, who are competent and who have received training relevant to their roles and the purpose of the home. This can ensure that service users are supported in a safe manner, by people who have an excellent understanding of their needs. Service users are protected by the home’s recruitment policy and practices, which can help ensure unsuitable candidates do not gain employment in the home. These are implemented to a good standard. EVIDENCE: The home’s owners have received a range of training, relevant to the needs of service users, health and safety, and to care in general. The manager keeps clear records of the training received, which can assist in planning. Training has included safe medication management, dementia awareness, positive care and emergency first aid. Future training planned includes NVQ level 4, safer handling of food hygiene, diabetes awareness and infection control. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 20 Two people have been recruited to the home to work for short periods. They were only employed after sufficient recruitment checks were undertaken. These included the receipt of a CRB ‘disclosure’, two written references and confirmation of physical fitness. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ views are incorporated into the home’s quality assurance arrangements that provide a systematic basis for self-improvement. The home is safe and free from hazards to service users. EVIDENCE: The registered owner / manager has developed a quality assurance system as part of her NVQ work, which has been implemented within the home and includes a training analysis, premises audit, swot analysis and plans for service users’ holidays. Regular (4 to 6 weekly) meetings with service users are held, at which their views are sought. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 22 There were no observed practices or hazards to the health, safety or welfare of service users. Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 4 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 3 X X 3 X Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 24 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. 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. Refer to Standard Good Practice Recommendations Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Kensington House (North East) Limited DS0000007395.V336553.R02.S.doc Version 5.2 Page 26 - 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!