Inspection on 10/05/05 for Kent House

This inspection was carried out on 10th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Kent House 10/10/07

Kent House 30/01/07

Kent House 08/08/06

Kent House 04/10/05

Kent House 17/02/05

Kent House 28/09/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Kent House Fairfield Manor Fairfield Road Broadstairs Kent CT10 2JY Lead Inspector Brenda Pears Unannounced 10 May 2005 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. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kent House Address Fairfield Manor Fairfield Road Broadstairs Kent CT10 2JY 01843 602720 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) Choicecare 2000 Limited Mrs Cathleen Langley CRH 25 Category(ies) of Care Home for Older People over 65 (25) registration, with number of places Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17.2.05 Brief Description of the Service: Kent House is a detached Home with accommodation for residents provided on three floors. The Home is situated on the outskirts of the town in a residential area close to schools, local supermarkets and also on a local bus route. The home is registered for 25 older persons, there is a shaft lift and two small lounge areas, plus a dining room and a large conservatory to the front of the building providing an additional light and bright lounge area. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was found to be clean and free from any unpleasant odours. Eight service users stated they are happy and well cared for. Service users appeared happy and comfortable talking about the home and the care received. The home is continuing with the maintenance programme and some additional areas now benefit from brighter lighting, creating a welcoming and safer environment. There are marks and scuffs on the flooring outside the kitchen area, this is to be replaced and will be safer and more comfortable for service users. The bathroom on the first floor level is very old and not practically designed, this is to be totally redesigned on the ongoing programme. This will ensure safety and provide privacy and comfort for service users. Food looked and smelt appetising, the menu was clearly written and on display for all service users. A choice of meal is offered, special diets are catered for and home-made cakes are regularly made. Service users are able to discuss their needs with the chef at any time. Menu plans and individual meal preferences are clearly recorded to ensure anyone assisting with cooking is aware of special requests and needs. What the service does well: There is currently no laundry person and only one domestic member of staff but the home continues to be found clean and odour free. All bedding, service user rooms and other areas examined around the home were also clean and orderly. Nine service users were spoken to at this inspection and eight of these stated they are well cared for, that staff are caring and always there when needed. One visitor stated that her mother had been supported with gaining access to health professionals in a bid to help with some complex medical needs. A choice of menu if offered and special diets are accommodated. Food given at lunchtime looked colourful, fresh and appetising. All nine service users spoken to said they enjoyed the food and they could have snacks or drinks whenever they wished. Some service users take meals in their own room as this is their choice. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 6 Some service users had been taken out for lunch at a local pub. Staff assist with such outings in their own time to ensure service users are able to make trips out. Service users are able to speak directly to the manager at any time and did so during this inspection. What has improved since the last inspection? What they could do better: The Statement of Purpose and Service User Guide do not meet current requirements and do not provide sufficient information for prospective service users to be sure the home can meet their needs. The current care planning system for recording information is not clear or well set out to provide staff with information they need to meet service user needs. This information must be clearly identified on care plans and easily accessed at all times. When service users administer their own medication, records must be continually monitored to ensure medication is always available when needed and does not run out. A complaint was received regarding the stocks of mediation for one particular service user. A new system is to be put in place to ensure this does not occur again and the new system has been agreed with the service user. This continues to ensure the full safety and well being of the service user while supporting choice and independence. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 7 While the matter of very hot water in some rooms is being addressed, risk assessments are required for each service user to ensure full safety and well being at all times. 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. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 The Statement of Purpose and Service User Guide have been produced but do not contain all the required information. These do not support service users when deciding if they should move to the home or assist a service user when a decision has been made to move into the home. Service users needs and goals are assessed and recorded prior to admission. Independence is promoted and goals and aspirations are supported by the home. Specific information in records are not easily accessed, the formatting of files and care pans needs to be better planned. This will support staff in their access of vital information to ensure all service user needs are met. EVIDENCE: The Statement of Purpose and Service User Guide have been produced and discussed on several occasions but still does not contain all the required information. This was discussed in depth with the manager who noted all areas that require attention and additional information. It is noted there is no Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 10 copy of the National Minimum Standards available in the home for staff to ensure full compliance. Records sampled contained contracts, terms and conditions and full pre admission assessments. Records are currently not supporting staff to obtain information quickly and efficiently. A new format is currently being reviewed, but some documentation in this new format still does not provide full and clear recording systems. The home is trying to ensure that all records can enable information to be found quickly when needed. This will then help staff to deal efficiently and appropriately when supporting service users. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 The home supports and meets the health, personal and social care needs of service users. Professional health care needs are met within the home and alternative health care support and advice is obtained when necessary. The home supports independence and arranges for service users to deal with their own medication. This decision is made after risk assessments have been undertaken. The home treats service users with respect and privacy and dignity is upheld. EVIDENCE: A sampling of care plans shows full recording of all health needs, appointments and tracking of information was found to be complete. Records evidenced access to health care professionals and stated the health needs to the individual. One particular service user with complex health needs explained the home has obtained as much information as possible to support Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 12 this person. All avenues have been pursued to assist the service user to be more comfortable and have a better quality of life. This was also confirmed by a visitor spoken to at this time. All medication is appropriately stored. Records were seen to be up to date and clearly completed. One service user is currently self medicating and enabled to be as independent as possible. This decision was made following a full risk assessment. This has caused a problem regarding the continued supply of medication as staff were not always aware of when medication ran out until the person was left with no medication at all. This is to be corrected by additional records to monitor the individual use of medication. The manager stated that an additional recording system is to implemented to ensure a full record is kept of quantities of medication in all areas of the home. An additional supply of medication is now always available in case of any emergency situation. This has been implemented with the full consent of the service user. Service users stated they are well cared for, staff are always available when needed. Although staff are often busy, they attend to service user needs when requested and are very kind and caring. The manager has discussed record keeping with staff and records are now completed in an appropriate way with acceptable language. This shows respect for the dignity of each service users. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14, 15 The home encourages visitors and contact with family, friends and the local community. Activities are regularly undertaken with service users. Service users are given choices and supported to maintain control over their lives to achieve maximum potential. Food offered is appealing, appetising and home cooked where possible. Service users are given a choice, food is cooked to their own preference and eaten where each person chooses. EVIDENCE: The manager stated that visitors are encouraged and welcomed into the home and contact is maintained with friends and family. Visitors were seen to be welcomed into the home and appeared comfortable and relaxed. One visitor stated that staff are always welcoming and available when needed. Service users confirmed that choices are given and days are spent as each person wishes. The manager stated that bed times are dictated by the individual and their wishes are respected. One service user, who cannot move independently around the home, stated that she decides each day where she Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 14 would like to sit. If she feels she would like to be taken to an alternative area during the day, staff always support her wishes and are ready to assist her. As previously stated, service users can choose to administer their own medication, following discussion and a risk assessment. The manager stated that a music man entertains once a month, one day a week craft activities are undertaken, story reading and painting are enjoyed by some service users and outings are also undertaken in the good weather. Food was seen to be well presented at lunch time, to be colourful and appetising. Menus were clearly displayed in the dining area, some service users were taking lunch in their rooms and people choose if they eat in the dining room or in a lounge area. Service users expressed their pleasure after eating lunch and stated the food is always good. The kitchen was seen to be clean and orderly which supports good practice and hygiene when dealing with food. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Service users know their complaints will be listened to and acted on. EVIDENCE: There is a complaints policy in place in the home. A complaint received by the home and at the Commission for Social Care Inspection was dealt with immediately and appropriately. Action has been taken to address any areas needing additional attention and issues were discussed with the service user. This issue is fully outlined under Standard 9 above. The manager dealt with this matter in a professional and open manner. Consultation with CSCI was fully undertaken at all times and supporting paperwork was sent out quickly. Service users stated that staff listen to them and give support as requested. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25, 26 The home is continuing with the maintenance programme to provide a safe and well-maintained environment. The home provides a number of large communal areas and has an external seating area for use in good weather. This supports service user choice with regard to how each day will be spent. There are sufficient toilet and bathroom facilities to meet the needs of service users. However, one bathroom area is currently not suitable or practical for current service users. Also, the hot water is still too hot in some areas and this is still causing a serious hazard to service users. Rooms are personalised, with personal items that include photographs, furniture and ornaments. Floors and bed linen were all clean and fresh. EVIDENCE: Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 17 Some areas are in need of attention and these have been listed on the ongoing maintenance programme. Lighting has improved along one corridor that was previously very dark and dangerous for service users. The manager stated that flooring is to be replaced outside the kitchen area. This is currently very marked and damaged, giving a very shabby appearance to this area that is used constantly by visitors and service users. One bathroom area that is very dark and dull, with bath and toilet in unappropriate positions is to be totally gutted and redesigned to suit the current service user needs. There is a small lounge on the first floor and the large conservatory provides a bright additional lounge area. Service users seated in this area said they enjoyed the open space, could see visitors coming and going and enjoy watching the trees and birds outside the home. There is a dining room that is adjacent to the kitchen area. This area is also used by some service users during the daytime, for reading and craft work. All rooms are very personalised and contain individual items and are also kept as the service user wishes. Even if a room gives an untidy appearance, the wishes of the individual are respected. The manager stated that some items stored on top of a wardrobe need to be moved for safety. This is to be discussed with the service user. Bed linen, floors and en suite areas were seen to be clean, fresh and well maintained. Hot water is very hot in some areas and this is to be addressed with restrictors. The manager has completed a risk assessment for the building regarding this matter but there are no individual risk assessments in place. The manager stated that these would be undertaken to ensure the safety and well being of each service user. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 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 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, 28, 30 Staff currently meet service user needs and provide a safe environment through updated training. EVIDENCE: The current staff group meet the needs of service users. Service users stated that although staff are often busy, they always have time to help and support individuals when needed. The manager stated that staff are sufficient at the current time to meet needs, that additional staff are on duty at busy periods of the day and the staff group currently work well together. This was confirmed by service users who stated they are well cared for and staff have time to attend to their needs when required. While there is only one member of domestic staff and no laundry person, the staff group work together to ensure all areas are clean and fresh around the home. This situation requires constant monitoring, as the changing needs of service users or a new admission may draw on staff time and require additional staff to be appointed. The manager is currently just completing her NVQ level 4. Six members of the care staff team have NVQ level 2 and three staff are currently undertaking NVQ level 3. Fire safety training is booked and due to be undertaken for new staff and a refresher for other staff. The manager stated that the head office Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 19 send out training updates and book all other courses, only NVQ training is booked locally. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 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 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) The manager is a fit person to undertake her full responsibilities in the home. Management time must be allocated and reflected clearly on the rota to ensure the manager is given appropriate time to undertake her role as the registered person. While there are some areas needing attention and action, in the main, the manager and staff group do consider the health, welfare and safety of service users. EVIDENCE: The staff rota shows the manager has a full time working day on the care rota, while this gives insight into the staff and needs of the service users this does not allow for management tasks to be undertaken. Things to be covered by the manger would include recruitment, induction, supervision, pre admission assessments, review of service user needs, service user meetings, staff Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 21 meetings, review of care plans and written records, checking medication storage and records, inspections, to name but a few. The manager was open and professional in her discussions and both staff and service users appeared comfortable when approaching her to discuss anything. The manager displayed appropriate knowledge of service user needs and was open to suggestions and advice regarding procedures in the home. While there are requirements regarding some areas in the body of this report, in the main, the home does ensure the safety and well being of service users. There are signs around the home giving advice to service users and visitors regarding areas that currently need extra care to be taken. There are clear signs for emergency and fire exits, fire extinguishers are appropriately placed, clearly signed and serviced. There were no COSHH items in evidence to cause harm and staff were dealing with service users with consideration and due concern. Records are kept up to date, are clearly completed and are duly signed and dated. Accidents are recorded and an audit trail was undertaken with a sample of records. The front door has to be opened by staff to ensure awareness of all persons entering the building to provide a safe and controlled environment. The hall has a notice board with current information, thank you letters and photographs of events and outings undertaken in the home. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 1 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 2 3 2 x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 x x x x 3 Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 23 yes 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 OP1 Regulation 4&5 Requirement Timescale for action 31/07/05 2. OP9 & OP38 3. OP19 & OP 21 OP25 & OP 38 4. To review and amend Statement of Purpose and Service User Guide to reflect details required in Schedule 1 of the National Minimum Standards. (Previous timescale of 03/03/05 not met) 12, 13, 17 That a policy be developed to reflect new developments regarding the self administration of medication. Specifically with regard to additonal records now required as described under this standard. 23 That the maintenance and refurbishment programme continue until all areas of concern have been addressed 12, 13, 17 That all taps have thermostatic & 23 controls to deal with the hot temperature of water being experienced in some rooms. Risk assessments must be carried out for each service user to ensure safety and well being. 30/06/05 31/12/07 31/05/07 Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 24 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 10 Good Practice Recommendations That the manager continues to review records to ensure appropriate language is being used. That appropriate support continues to be given to staff to achieve this outcome. Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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 Kent House H56-H05 S23456 Kent House V226049 100505 stage 4.doc Version 1.30 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. 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