Inspection on 02/04/07 for Kensington Lodge

This inspection was carried out on 2nd April 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 Lodge 02/04/09

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

CARE HOMES FOR OLDER PEOPLE Kensington Lodge 53 Broadmark Lane Rustington West Sussex BN16 2HJ Lead Inspector Mr E McLeod Unannounced Inspection 2nd April 2007 09:30 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 Kensington Lodge DS0000068624.V331920.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 Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kensington Lodge Address 53 Broadmark Lane Rustington West Sussex BN16 2HJ 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) 01903 786003 Gurkirit Kalkat Mr G S Nijjar Ms Deborah Helen Chant Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (18) Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New service Brief Description of the Service: The home is a detached property close to the town centre in East Preston, which has bus and rail links. Accommodation is provided on two floors, with passenger lift access. The home provides residential accommodation for up to 18 residents who are over the age of 65 who have suffered or suffer from mental illness or dementia. The registered manager is Ms Deborah Chant, and the registered provider is Mr Gurkirit Kalkat. Fees are £429 to £600 p.w. Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was arranged to undertake an assessment of all key standards from the national minimum standards for care homes for older people, aged 65 and over. Prior to the inspection visit CSCI had requested and received current information on the operation of the service from the provider, and written comments from people using the service and their friends and relatives on the service. This information was used in planning the inspection visit and in the writing of this report. The visit was undertaken by one inspector for five and a half hours on the 2nd April 2007, and the visit was not announced. The inspector spoke with people using the service, staff, and the registered manager. Four sets of care records, including pre-admission records were sampled. Three sets of staff records, including recruitment records, were sampled. The inspector observed a lunch sitting, and at different times during the day observed interactions between staff and people using the service. A partial tour of the premises was made, and policies and procedures for the home and other records were sampled which were relevant to the standards being assessed. What the service does well: The home provides a pleasant and comfortable environment for people to live in. Residents are happy with the meals they are receiving, and the activities being provided in the home. Staff are kind and considerate, and respond to the needs of residents. The home is well managed, and a training programme is in place for staff. Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 6 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 Lodge DS0000068624.V331920.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 Lodge DS0000068624.V331920.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No resident moves into the home without having had his/her needs assessed and been assured that these will be met. EVIDENCE: Fees are £429-600 p.w. Four sets of admission records were sampled, which indicated that full assessments of needs are being carried out on prospective residents before they are admitted to the home. Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Not all of the resident’s health, personal and social care needs are set out in the individual plan of care. The registered person promotes and maintains residents’ health and ensures access to health care services to meet assessed needs. Residents are protected by the home’s procedures for dealing with medicines. Residents feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Four sets of care plans were sampled, which indicated that each resident has a plan of care which is being regularly reviewed. Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 10 However, care plans sampled did not always provide specific guidance for staff on identified individual needs such as how the resident should be assisted at mealtimes, how the resident’s social care needs are to be met, or dealing with challenging behaviour. Residents interviewed said the care in the home was good, and it was said that staff were kind, pleasant and cooperative. Care records sampled indicated that residents are accessing the health services they are in need of, and relatives advised the Commission that they are kept informed of any health problems the resident may have. Two staff interviewed felt that an important part of their work was to provide reassurance for residents when they were becoming upset and confused, and take the time to talk to them. One member of staff said she had been able to make time for one resident who was isolated due to her infection being contained, which helped the resident fee less lonely. Staff said that infection control measures (such as use of alcohol gel and wearing protective clothing) had been commenced and that advice on this had been sought from the district nurse. Written questionnaires were returned to the Commission from 6 relatives, 1 resident, and 1 member of staff. The responses indicated that the needs of residents are being met, and that relatives are kept up to date with issues affecting their relative. The manager advised that there has been a change of pharmacist, and the medication administration system is consequently being updated. This includes a new photograph of the resident being placed on the medication administration record to assist with medication safety. Suitable arrangements are in place for the safe storage of medicines. Ms Chant advised that none of the residents have been assessed as being able to control their medicines. Medication administration records were sampled. A new system for recording medicines returned has been commenced following a recommendation at the previous pharmacy inspection. Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 11 To ensure privacy, residents are given assistance in their own bedrooms and in the one double room, screens are provided for privacy. There were no indications that residents are being discriminated against in the home from the sampling of records and the observation of interactions between staff and residents. Kensington Lodge DS0000068624.V331920.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines of daily living and activities available are flexible and varied. Residents maintain contact with family, friends and the local community as they wish. Residents are helped to exercise choice and control over their lives. Residents receive a wholesome, appealing, balanced diet in pleasing surrounds at times convenient to them. EVIDENCE: Activities arranged in the home include music and health, music, exercise, bingo, skittles, board games, reminiscence, hand and nail therapy, arts and crafts. There are also walks to the village or the beach. A record of what activities a resident has been offered or taken part in is kept. Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 13 People interviewed said they enjoyed doing jigsaws, playing bingo, and the musical entertainments. On the afternoon of the inspection, people were making up Easter baskets, and said they were enjoying doing that. One member of staff said she had began taking one person out once a day, and now does the same with another resident. One person helps staff with the bird table in the garden. Two staff said that by ensuring relatives felt welcomed, for example by providing tea and biscuits or making sure all their questions were answered when they came for an initial visit, made a difference to families and residents alike. Responses from relatives and friends indicated that they felt welcomed when they visited. Staff interviewed gave examples of how they help residents maintain contact with their family and friends. Four meals a day are provided. Alternatives to the main menu include baked potatoes and salads. Kitchen staff advised the inspector how diabetic diets are catered for, and that fresh fruit and vegetables were purchased from a local farm shop once or twice a week. The Safer Food system is being followed by kitchen staff. Good hygiene certificates are renewed every three years. Residents interviewed said they enjoyed the meals, and were provided with the types of food they liked. The inspector observed that people were given the choice of having lunch in the sitting room or conservatory. One person chose the sitting room as it was more out of the sun. The lunch sitting observed by the inspector was relaxed and unrushed, with residents receiving help if and when they needed it. Kensington Lodge DS0000068624.V331920.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): 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 and friends are confident that their complaints will be listened to, taken seriously, and acted upon. Residents are protected from abuse. EVIDENCE: Ms Chant advised that there had been one complaint since the change of provider, and records indicated that the complaint had been dealt with in a fair and satisfactory manner. Responses received from relatives and friends indicated that they have been made aware of the home’s complaints procedure, and that they feel they can approach staff with any concerns or complaints which they have. One relative wrote that the manager was “always helpful” and “very easy to approach”. Staff in the home continue to receive training in the protection of vulnerable adults, and information on the changes to local adult protection procedures Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 15 have been passed on to staff. Ms Chant said she had attended a local briefing on the changes to local adult protection procedures. The home’s procedures for when a resident goes missing were sampled. The Commission has been advised that the home does not act as financial appointee for any resident, and does not hold money for any resident. Kensington Lodge DS0000068624.V331920.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe, well maintained environment. People have access to safe and comfortable indoor and outdoor communal facilities. People live in safe, comfortable bedrooms with their own possessions around them. The home is clean, pleasant and hygienic. EVIDENCE: Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 17 Ms Chant said that improvements to the premises since the previous inspection have included new bedding, new chairs, new beds, and some new roofing; also that a new washing machine and new carpets have been provided and decoration in two bedrooms has been completed. Ms Chant said that there are advanced plans for a sensory garden for residents. There is a system in place to ensure maintenance of the premises, and records are kept for when the need for maintenance work is identified and when this has been carried out. A partial tour of the premises was made. The accommodation was found to be decorated and furnished to a good standard, and to be suitably homely and comfortable for the residents accommodated. The main communal areas are a quiet lounge, a main lounge and conservatory, and there is a patio garden to the front of the property which is due to be developed into a sensory garden. Seven bedrooms were visited, and were found to have a good standard of furnishing and decoration, safe hot water and covered radiators. There were an adequate number of electric sockets in the bedrooms. People had personalised their bedrooms, and some had brought some furniture with them. The laundry room has suitable equipment to ensure hygienic washes, and the floors are impermeable and washable. The kitchen was clean and orderly, and the Safer Food system is followed by kitchen staff. All areas of the home visited were clean and hygienic. Kensington Lodge DS0000068624.V331920.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s needs are met by the numbers and skill mix of staff. A minimum ratio of 50 trained members of care staff has been achieved. People need to be better supported and protected by the home’s recruitment practices by the provider ensuring that PoVA checks are carried out for all staff employed after April 2005. Staff are trained and competent to do their jobs. EVIDENCE: There are 13 care staff employed, 8 of whom have NVQ2 or above. 13 staff have a first aid certificate. Staff rotas submitted to the Commission indicated that agency staff are not generally providing cover in the home. Staff rotas seen indicate that 3 care staff are usually employed between 8am and 4 pm, and 2 or 3 care staff are employed between 2pm and 8 pm. 2 care staff are on duty between 8pm and 8 am. Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 19 Ms Chant said that she is now able to bring in extra staff for particular shifts when the need for this arises. Training records seen indicate there is an active training programme for staff. Residents interviewed said that the staff team were doing a very good job, and one resident observed that staff are very patient with residents. Staff interviewed said they had found training in dementia, manual handling, first aid and fire most useful. Induction training includes fire policy and a fire officer provides regular training. Three sets of staff recruitment records were sampled. Reference numbers for staff checks were noted on the staff records sampled. Ms Chant said she saw each check received, and none had indicated the need for a risk assessment. One member of staff has not their clearance check returned, and Ms Chant advised that until the clearance check is received the member of staff would not have unsupervised access to residents, and would be working with another member of staff. The inspector noted that there were no records to indicate if staff had received a PoVA check. Ms Chant said that PoVA checks were had not been requested for staff. It is the provider’s responsibility to ensure that all staff commenced after July 2005 have been checked against the PoVA register, and PoVA First checks need to be carried out before a member of staff commences work. Subsequent to the inspection, Ms Chant advised the inspector that PoVA checks will now be carried out for staff commenced after July 2005. Staff records seen indicate that induction training is being undertaken with new staff, and annual staff appraisals are in place. Staff records included copies of staff training certificates. Ms Chant said that a 12-session course in Dementia care is being planned for staff. Kensington Lodge DS0000068624.V331920.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People 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. The home is run in the best interests of residents. The health, safety and welfare of residents and staff would be better promoted and protected by ensuring all required checks for staff are carried out. EVIDENCE: Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 21 The registered manager Ms Chant is experienced, qualified and capable, and continues to update her training and learn from how other services are operated. Ms Chant said that as the home now had a computer, she was able to access information helpful to the running of the service more easily. Ms Chant said that staff were encouraged to identify specific tasks they would undertake in the home, and that senior staff take responsibility for keeping an eye on things. Staff are supported through supervision and the annual staff assessment. The home seeks views on the service provided, and surveys were distributed to staff, family and friends in October 2006, and Ms Chant said there had been a good response. Outcomes from the survey are that an activities programme is now on display and a copy of this is sent out to relatives. Relatives and friends are asked for their ideas. GPs and district nurses also received survey forms. The provider has advised of the most recent checks, services and inspections carried out in the home. Records indicate that regular safety and maintenance checks are carried out, include room by room checks. There is a system in place for recording accidents in the home, and for monitoring these to ensure that anything that can be done to minimise risks will be done. Since the previous inspection visit by the environmental health department, the Safer Food system has been introduced into the home, and records of food purchases are now held. A fridge has been replaced since the inspection, and anti-bacterial spray is now in use for kitchen surfaces. Kensington Lodge DS0000068624.V331920.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 2 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 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Kensington Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement The provider must ensure that the service user plan includes clear guidance for staff on how they are to meet all the resident’s needs The provider must ensure that all staff commenced after July 2005 have received a clear Protection of Vulnerable Adults register check before their employment is commenced Timescale for action 29/06/07 2 OP29 19 01/06/07 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 Lodge DS0000068624.V331920.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Lodge DS0000068624.V331920.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. 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