Inspection on 10/10/07 for Kent House

This inspection was carried out on 10th October 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 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 30/01/07

Kent House 08/08/06

Kent House 04/10/05

Kent House 10/05/05

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 Mrs Susan Hall Key Unannounced Inspection 09:30 10th October 2007 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 Kent House DS0000023456.V340318.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. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kent House Address Fairfield Manor Fairfield Road Broadstairs Kent CT10 2JY 01843 602720 01843 866943 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) Choicecare 2000 Limited Post vacant Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2007 Brief Description of the Service: Kent House is a detached property situated in a pleasant residential area of Broadstairs. It can easily be accessed by road, and is also on a local bus route. It is near to local shopping and other facilities. It is owned by “Choicecare”, who are providers with other care homes in England, including a number of other homes in the South East region. Accommodation is provided on three floors, and is in single rooms with en-suite facilities, except for one room, which can be shared by two people. A passenger lift provides easy access to all floors. The home has a variety of sitting areas, including two small lounges, a dining room, and a large conservatory at the front of the building. Fees are set according to individually assessed needs, and currently range from £312.81 - £456.74. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection, which includes assessing all key national minimum standards, and takes into account all information received about the home since the last inspection. This was the first visit to the home for this inspector, and she assessed most of the national standards as well as the key standards. The previous manager left the home in January 2007, and a new manager – who was already working in the home – was appointed by the company in May 2007. She has settled well into this role, and residents spoke highly of her competency and her caring attitude. Since the last inspection, CSCI were informed of one complaint, and this was resolved with appropriate action taken by the home. Two referrals had been made to the Social Services Adult Protection department, but both of these allegations were unfounded. The inspector sent out survey forms, and was pleased to receive 10 back, from residents, relatives and staff. She spoke with 5 residents on the day of the visit, and met others briefly. She was also able to have conversations with 2 relatives, 2 visitors to the home, and 5 staff, as well as the manager. The manager was completing the morning medication round when the inspector arrived, as she uses this as an opportunity to meet briefly with all the residents on most days. A resident said, “she knows all of us well, and cares about everyone”. The manager was available throughout the day and assisted the inspector with providing information. The inspector stayed for over 6 hours, and viewed all areas of the home; and examined documentation, which included care plans, medication records, staff recruitment and training records, some policies and procedures, and servicing records. What the service does well: The home has very friendly and approachable staff. The inspector was welcomed on arrival, and noted that other visitors throughout the day were quickly welcomed and able to ask any questions. Prospective residents are given good information about the home, and are invited to stay for the day, or for a meal, prior to moving into the home. The manager usually takes a carer with her to carry out a pre-admission assessment. This carer will be the person’s key worker, and will already be known to the new resident when they arrive. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 6 Residents said that staff are “always there” to carry out personal care tasks, and do not leave them waiting for a long time. Care is given with sensitivity, and with attention to details. Residents enjoy the variety of activities and said that “there is always something going on”. Food is well managed in the home, in spite of the state of the kitchen, which is due for refurbishment. A resident said that the chef “often chats with them, and adds extra things on the menu for them”. What has improved since the last inspection? What they could do better: Some small changes could be made to improve care planning, such as ensuring that property lists are kept up to date. Any resident assessed as being able to manage their own medication must have a lockable facility provided in their room. The complaints procedure is kept on display in the front hall,(as well as the complaints policy), but is very lengthy, and is not therefore easily accessible for visitors to the home. This needs to be reviewed and simplified, so that anyone can access the information easily. The premises are kept clean, but there are many areas which would benefit from improvement. Some of these include: • • • • Exterior painting to the front of the premises. Refurbishment of the kitchen Replacing the carpet in the conservatory. Redecorating the main lounge, and cleaning or replacing the carpet. DS0000023456.V340318.R01.S.doc Version 5.2 Page 7 Kent House • • • • Altering the bathroom on the first floor so that the residents can use the facilities more easily. Altering some en-suite bath facilities, so that these are easier for residents to use. Providing a backwash basin in the hairdressing room. Providing an additional outdoor space which can be accessed by all residents, but is not as public as the area at the front of the building. The inspector was informed that the providers have already measured up for improvements to the kitchen. The previous schedule of works shows that the first floor bathroom is due for alteration to a “wet room” between January-March 2008; and ongoing fitting of radiator covers should be completed by March 2008. 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. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Kent House DS0000023456.V340318.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 (standard 6 is not applicable in this home). People who use the service experience good quality outcomes in this area. The home provides detailed information to enable residents to make a decision about moving into the home. Attention to detail assists residents at the time of their admission. EVIDENCE: The statement of purpose was updated in April 2007, and contains all required information. It clearly states the category of residents, and that the home welcomes people from all cultures. Fee levels specify the items included in the fees, and those not included, such as hairdressing, chiropody, toiletries, and newspapers. It includes the complaints procedure, but this did not have the up to date details for local adult social services or for CSCI. The manager said that this would be quickly addressed. The service users’ guide is well produced, and a copy is provided in residents’ rooms prior to their arrival. This document contains all the required information, and is set out in short paragraphs which are easy to read. The Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 10 manager stated that the staff would ensure that new residents are able to read and understand the contents of this as far as possible, including producing it in larger print, or reading it to them if necessary. The service users’ guide did not include the addresses and phone numbers of other professional bodies, and the manager said that she would rectify this. Current residents’ views are available to view in a folder in the office. The home currently has one person who smokes occasionally, and there is a designated smoking room for this person. However, the company are making it clear to prospective residents that they do not intend to admit any more residents who smoke, and this will become a non-smoking home in due course. The manager or deputy carry out pre-admission assessments, and they usually take a carer with them – preferably the carer allocated to be a key worker. This means that when the new resident is admitted, they already know someone. Residents are invited to visit the home for a whole day, or stay for a meal, prior to admission, so that they can get to know some aspects of the life of the home before coming in. The inspector read two pre-admission assessments, and these were suitably detailed. For example, they contain personal and next of kin information; physical health and mental wellbeing (including details such as mouth care, foot care, history of falls); current medication; emotional wellbeing; orientation; lifestyle preferences; diet and nutrition; and communication details. The staff ensure that the home has a welcoming atmosphere on the day of admission, with flowers and fruit bowl in the resident’s room, and personalised items of their own (e.g. own furniture items) where required. Care plans are set up within the first week after admission, and a meeting is held with the resident, relatives and key worker, to check that the content is satisfactory. All residents (or their representative) are supplied with a copy of the terms and conditions of the home. Any equipment or services needed are in place prior to admission (e.g. physiotherapy, pressure-relieving equipment). There is a four weekly trial period, after which a meeting is held to decide if the resident wishes to stay permanently. A resident said “I was given a good report about Kent House prior to moving in, and it has lived up to my expectations”. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7-11 People who use the service experience good quality outcomes in this area. Health and personal care is well managed in the home. Privacy and dignity is maintained. Medication is generally well managed, but some improvements are required. EVIDENCE: Care plans are presented in A4 folders, and are indexed for easy access of information. The inspector was informed that the format had been improved since the last inspection. Some of these did not yet have photos of the residents in them, but all the photos had been taken, and were ready to insert. Care plans are set up within a week of admission, and are person centred, reflecting individual needs. The resident and/or their representative are invited to discuss the care plan at a formal meeting, and sign agreement. Care plans include a page for a property list, but they had not been properly completed in the plans viewed, and there is a recommendation to ensure that these are completed in all care plans. Admission assessments include all aspects of care, including mobility needs, personal hygiene, skin care, mental wellbeing, social preferences, nutrition and Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 12 communication needs (hearing, sight, speech). Assessments are then carried out on a monthly basis, and care plans are evaluated each month by the manager. She checks for any changes which have been made, or implements them herself. Residents have a monthly falls risk assessment, and a moving and handling assessment. Residents are encouraged to join in with weekly exercises to aid them in keeping their mobility. Additional care plans are implemented for specific needs such as diabetes or wound care. Staff have been trained in checking blood sugar levels for diabetic residents, and these are clearly recorded. A daily record is completed at the end of each shift, and these were appropriately signed and dated, and contained relevant information. If there is any sign of a pressure ulcer developing, the District Nurses are immediately asked to visit, and they will then carry out any dressings or other wound care. There was no one with a pressure ulcer or wound at the time of the inspection. A separate record is kept for visits from doctors and other health professionals. GPs visit on a regular basis and carry out medication reviews. Written consent is obtained from residents for staff to administer medication. Anyone who wishes to manage their own medication has a risk assessment completed, to check that they can physically manage their medication, and understand the importance of this being kept in a locked place. One resident was currently self-medicating, and kept the bedroom door locked when out of the room, but did not have a lockable drawer or other lockable facility. This is unsatisfactory, and a locked cupboard or other facility must be provided by the home. The self- medication assessment could also be improved to check that residents understand what each item of medication is for. All medication is stored in a medication trolley, which is kept locked in a small cupboard when not in use. The temperature for this was not being checked, and should be done on a daily basis. The drugs fridge is stored in the office, and is kept locked, and the temperature for this is recorded. The medication trolley was in good order, and no out of date items were seen. There is good stock rotation, and no overstocking. No homely remedies are stored. Medication administration records (MAR charts) were viewed and were well completed. They include a photo for each resident, and clearly specify if there are any allergies. Medication is clearly receipted in on the MAR charts, and handwritten entries are signed by two staff. Only senior staff with satisfactory training are allowed to give medication, and there is a good training programme in place. However, only a small number of care staff have completed this training, and this did not currently include night staff. Evening medication is given by the day staff, and if any night medication is required, the manager or her deputy are on call to come in and administer it. The manager was working towards ensuring that there are sufficient Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 13 numbers of night staff trained and competent to give medication, so that residents will not have to wait for someone to come in. The staff ensure that residents are cared for with attention to their privacy and dignity. There is one bedroom for shared use, and this has satisfactory screening between the beds to allow for privacy. Residents were seen to be well groomed, and with clean clothes. The services of a beautician are offered fortnightly, as well as a hairdresser coming to visit. Some residents really appreciate this service, and enjoy beauty treatments including facials and manicures. The sensitive subject of death and dying is usually raised during the admission process, so that if any resident is taken severely ill shortly after admission, there is already some guidance for staff on their wishes – such as which relatives to contact. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15. People who use the service experience good quality outcomes in this area. The home provides a good variety of activities, and there are plans in place to increase these further. Food is well managed, and provides a nutritious and varied diet. EVIDENCE: Activities are planned by the manager, in discussion with other staff and residents. These include day to day activities such as watching videos together, puzzles, games, and reminiscing; and special entertainment such as the visit from a monthly music man. There are also weekly keep-fit and “Pat dog” visits, beautician and hairdresser visits, and weekly bingo. The staff arrange parties for special events, and were planning a Hallowe’en party when all the staff were going to dress up, and some of the residents were planning to dress up as well. The home will have a Christmas party, and other activities specifically for Christmas. There is a good selection of library books, and the home has talking books as well, which are enjoyable for residents with poor sight. Activities in the evenings usually include some TV, videos or music (and might include popcorn!) Church services are held in one of the lounges each Sunday, with two different churches assisting with this. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 15 The home has a payphone in the entrance area, and some residents have their own phone in their bedrooms. Residents had requested a payphone in the lounge, and the manager was looking to implement this. Trips out are arranged on a regular basis, to places such as Kearsney Abbey, the zoo, or shopping. Usually just a few residents will go each time, as this is easier for staff to manage. There are photos of outings and parties displayed in the home. Relatives and friends are invited to join in with activities and outings. Visitors are made to feel welcome in the home, and are always greeted by staff, and treated with courtesy and respect. Drinks are offered, and they can stay for a meal with their relative if they wish to do so. The Inspector talked with the chef in the kitchen, who carries out a good job in a small kitchen, in spite of the fact that it needs refurbishing. The kitchen has been measured up for new fitments, and this is addressed in the section for environment. The chef carries out the cooking for breakfast and lunch, and most tea preparation. This is completed by care staff, with one designated to work in the kitchen until tea is finished. Breakfasts include a choice of porridge or cereals etc., and the chef provides a cooked breakfast on one or two days a week for a change for residents. There are always two to three choices of main meal at lunchtimes, and the chef will offer other dishes to tempt someone’s appetite if they don’t want what is on the menu. Residents said that the food is very good, and is home cooked, and with a good variety. All staff who work in the kitchen have completed basic food and hygiene training. The chef is hoping to carry out intermediate training, and this is a recommendation. Menus are discussed with residents, and the chef will add in new dishes to the menu planner on a regular basis. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People who use the service experience good quality outcomes in this area. Residents are confident that any concerns or complaints will be responded to promptly, and appropriate action taken. The complaints procedure should be amended so that it is easier for people to access the information. Residents are protected from abuse. EVIDENCE: The complaints policy and procedure is displayed in the entrance hall, and is included briefly in the statement of purpose and service users’ guide. These did not contain clear details for the procedure, and the displayed copy would not enable a visitor to quickly find details of names, addresses and phone numbers for the company, Social Services or CSCI. It does include a complaints/concerns form, which could be completed and left in the home. There is a requirement to produce the procedure in a format which is easy for residents/relatives/visitors to access, and to know who to go to in the event of a serious complaint. However, residents said that they can easily talk to staff and the manager, and are confident that any concerns raised are quickly dealt with. The complaints log showed that two minor concerns since the last inspection had been dealt with appropriately, and proper action taken. A resident said “Staff deal promptly with any questions, and are very helpful.” The staff training log showed that most staff have recently had updated training in Adult Protection, and staff are familiar with the recognition and Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 17 prevention of adult abuse. Kent & Medway procedures are easily available in the office. There are good procedures in place for staff recruitment, which also protects residents from abuse. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 People who use the service experience adequate quality outcomes in this area. The premises are suitable for the stated purpose, and are clean and generally well maintained. However, there are a number of areas that require attention to bring the premises up to a better standard. EVIDENCE: The Inspector viewed all areas of the building, including communal rooms, kitchen and laundry, and most bedrooms. The home was clean throughout, and generally well maintained. The main lounge and dining room would benefit from redecoration, and the manager stated that the company have already planned to redecorate the lounge, which has a stain on the ceiling from a previous problem which has now been rectified. The carpet will need deep cleaning or replacing in the near future. The dining room has been redecorated, and could be further enhanced with pictures etc.. The Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 19 conservatory at the front of the building is large and airy, but is spoilt by having a very stained carpet. There is a requirement to replace this. The providers and manager have instigated an ongoing programme of redecoration throughout the building, and the residents will be able to choose the décor for their bedrooms. All bedrooms except one are for single use, and have en-suite facilities. Some of these have small baths fitted, but most of these are unsuitable for use by residents, as there is insufficient space for care staff to help them to get in and out of the bath, and no room for hoisting facilities. It is recommended that the providers consider altering these (for example, to en-suite shower facilities), which could be better used by the residents. The shared room can be offered to couples or others who may wish to share, and is fitted with an en-suite toilet. Bedrooms were seen to be generally clean and tidy, and personalised according to preference. Toilet facilities are adequate. Two of the shared bathrooms are fitted with an integral hoist. A bathroom on the first floor is badly designed, and does not allow enough space for residents to use either the bath or toilet easily. This is due to be altered into a shower room (“wet room”) during January-March 2008. There is a dedicated room for hairdressing, but it is very difficult for a lot of the residents to get their heads over the sink, and would be better with a backwash sink. The home is equipped with hand rails, raised toilet seats, mobile hoists and other suitable equipment for this category of care. There is a passenger lift which provides access to all floor levels. All hot water outlets accessible to residents have been fitted with thermostats to prevent the possibility of scalding, and the water temperatures are checked every month. Not all radiators have been fitted with guards yet, but all uncovered radiators have been risk assessed by the company, and the company have informed CSCI that all radiator covers will be fitted by March 2008. The laundry room has been redecorated and fitted with non-slip flooring. White sheets are sent out for laundering, and all other laundry is done on the premises. There is one washing machine and one tumble dryer. A red alginate bag system is used for soiled items, and this promotes infection control. A laundry assistant is employed five days per week, and an extra carer is employed at weekends, with one allocated to manage the laundry. The kitchen has unsatisfactory units and flooring, and has already been measured for refurbishment. There is little room for work space, and this has been taken into account, and the refurbishment should improve this. The cooker hood is not big enough, and this is included in the plans. There is a requirement to inform the inspector of the proposed dates when this work will be carried out. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 20 There is a small paved garden area at the front of the property. This did not look very inviting, as flower tubs had died, and the paving needed cleaning. The front of the building would be improved with re-painting. The front area is quite public, and may not be the preferred option for residents who wish to sit outside. There is an unused outdoor space adjacent to the lounge, and it has been mentioned that this could make a suitable decking or patio area. There is also a space at the side of the kitchen, but this requires going down steps, which may be unsuitable for some residents. There is a recommendation to consider how to increase the outdoor space for residents, and providing a choice of areas. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 People who use the service experience good quality outcomes in this area. Staffing levels are well maintained, and recruitment practices are well managed. The need for ongoing staff training has been recognised and is being addressed. EVIDENCE: Staffing levels are set at 3 carers and the manager throughout the weekday shifts, with additional help from one domestic, a laundry assistant, one chef, and a maintenance person. At weekends, there is an additional carer. There are 2 carers on duty at night. These levels work out well in practice, and are usually sufficient. If there is any time when the dependency levels rise above the normal (e.g. a resident is particularly ill), the manager has the authority to arrange for additional care staff. The home currently has enough staff to cover for most holiday/sickness times, but occasionally use agency staff. If this is for several shifts in a week, the manager tries to arrange with the agency for the same agency carer to cover each shift, so that there is continuity for residents. The company promote training for NVQ level 2 and 3, and there are currently 6 carers out of a total of 14 who have completed NVQ 2/3 (42.8 ). There are 4 others who are in the process of training, and 2 others due to start. This should bring the numbers of staff trained to NVQ level 2 above 50 before long. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 22 The inspector examined 2 staff recruitment files, and found that there are good recruitment procedures in place. One did not have a full employment history recorded, and there is a recommendation to ensure that application forms state that a full employment history is required. Other checks – POVA first, CRB check, criminal declaration, proof of ID, 2 written references with one from last employer – are all in place. Staff files are well maintained, and indexed. Files include an interview record, and a health check questionnaire. The home uses the “Skills for Care” induction programme, and staff commented on survey forms that they had found this helpful. The staff training log showed that some care staff were not up to date with mandatory training. The manager had already recognised this, and a lot of training had been booked. Training was booked for infection control, food hygiene, health and safety, moving and handling, and fire safety (but most were up to date with this), and medication training. Nearly all staff have attended training in adult protection during 2007. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31-33, 35-38 People who use the service experience good quality outcomes in this area. The manager shows competency and skill in running the home, and residents are confident in her ability to deal with any issues that arise. EVIDENCE: The previous manager left in January 2007, and the current manager took over as acting manager at that time. She was appointed as manager a few months later. She has good records of experience in care for older people. She has commenced NVQ 4 and Registered Managers’ Award training, and has applied to CSCI for registration. She shows good knowledge of all aspects of the life of the home, and competency in dealing with different situations. She is assisted by an Area Manager, and finds it helpful to meet up with other home managers in the same company. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 24 The manager leads the way for other staff, and ensures that she carries out some time each day working alongside care staff. This enables her to keep familiarised with residents’ needs and to maintain good contact with them, as well as observing how well other staff are carrying out their duties, and giving them ongoing training and encouragement. She has implemented more staff meetings, and residents/relatives meetings, and has an open door policy. This enables continual feedback about how well the home is running. Minutes from staff and residents’ meetings showed that action is taken in line with points discussed, so that there is ongoing improvement. Questionnaires are distributed to residents from time to time, commencing shortly after admission, to facilitate quality assurance monitoring. Questionnaires are also given to people associated with the home, such as delivery people, visitors to the home, and students on work experience. House keeping audits are carried out every week, checking the state of each room, and noting any maintenance needed. Other audits are carried out for care planning, medication, falls records, accident records and residents’ pocket monies. The home only looks after small amounts of money for residents, and these are stored individually in a suitable safe place, and records are kept of all debits and credits. Receipts are retained for all purchases. Residents or their authorised representative can view these records at any time on request. The manager has implemented individual staff supervision for all staff, and is currently carrying this out herself. She is arranging training for her deputy and two senior care staff, so that they will take part in this too. Formal supervision will be carried out for all staff every two months, but is not yet up to date. Records are generally well maintained, and appropriate storage protects confidentiality. The inspector viewed a number of servicing records, including passenger lift and mobile hoist servicing; gas safety record; and PAT testing for electrical equipment. These were all up to date. Fire safety records are well maintained, and show that the fire alarm is tested weekly, and that the manager arranges for fire drills for staff on a regular basis. This includes night staff. Staff have had training in COSHH, and chemicals are stored safely. Accident records are maintained according to health and safety, and data protection legislation. The manager has implemented a format for carrying out a full health and safety audit of the building, but this had not yet been carried out. Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 25 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 1 2 2 3 3 2 2 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 2 3 2 Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES 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 OP9 Regulation 13 (2) Requirement To improve medication administration and management in the following ways: • To ensure that any resident who is self medicating has a lockable facility in their room, and a detailed competency check; To check the room temperature where the medication trolley is stored on a daily basis; To ensure that sufficient numbers of care staff are trained to administer medication, including some night staff. 10/11/07 Timescale for action 10/12/07 • • 2 OP16 22 To review the format for the complaints procedure, and make this easier for people to access and follow; and to include correct details of relevant professional bodies. DS0000023456.V340318.R01.S.doc Kent House Version 5.2 Page 27 3 OP19 23 (2) (b) To inform the inspector of the details of the proposed refurbishment for the kitchen; and the dates when this work is planned to be done. To replace the carpet in the conservatory 30/11/07 4 5 OP20 OP25 16 (2) (c) 13 (4) (a,c) 30/11/07 To complete the fitting of guards 31/03/08 to all radiators, and to inform the inspector when this work has been completed. A health and safety audit of the building is to be undertaken to ensure all areas and rooms meet with regulations. Previous requirement dated for 31/03/07. New timescale given. 31/12/07 6 OP38 13 (4) (a,c) 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 OP7 OP15 OP19 Good Practice Recommendations To ensure that property lists are properly completed for all residents. To enable the chef to carry out training to intermediate level. To continue with the programme for redecoration of internal décor and exterior painting. To carry out the alteration of the first floor bathroom to a shower room as already planned. To consider making more outdoor space available for residents, providing them with a choice of places to sit. 4 OP20 Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 28 5 OP21 To review the en-suite facilities where there are small baths which cannot easily be acessed by residents, and form a plan to replace these with more suitable facilities (e.g. shower units). To consider fitting a backwash sink in the hairdressing room which would be more comfortable for residents to use. To ensure that application forms clearly state that a full employment history is required. To ensure all staff keep up to date with all mandatory training. To ensure that formal one to one supervision is given to all staff on a regular basis. 6 OP21 7 8 9 OP29 OP30 OP36 Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Kent House DS0000023456.V340318.R01.S.doc Version 5.2 Page 30 - 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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