Inspection on 25/10/06 for Kenton Hall Nursing Home

This inspection was carried out on 25th October 2006.

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

Kenton Hall Nursing Home 30/05/07

Kenton Hall Nursing Home 09/11/05

Kenton Hall Nursing Home 08/07/05

Kenton Hall Nursing Home 13/12/04

Kenton Hall Nursing Home 30/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Kenton Hall Nursing Home Kenton Lane Gosforth Newcastle Upon Tyne Tyne & Wear NE3 3EE Lead Inspector Suzanne McKean Key Unannounced Inspection 25 October 2006 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 Kenton Hall Nursing Home DS0000000423.V299751.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. Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kenton Hall Nursing Home Address Kenton Lane Gosforth Newcastle Upon Tyne Tyne & Wear NE3 3EE 0191 271 1313 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) Solehawk Limited Althea Miranda Oladuni Morgan Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th November 2005 Brief Description of the Service: Kenton Hall Care Home provides nursing care for up to 60 older people. The home is purpose built and shares the site with the residential home owned by the same company. The home has two floors, which are accessible by stairs and a passenger lift. Both floors have large separate dining rooms and a range of lounges including a separate smoking room. There is a large conservatory on the ground floor, which leads into a large pleasant garden. There are specialist bathrooms, showers and toilets available on both floors. All of the bedrooms are single and have en-suite facilities. There is easy access for wheelchair users and ample car parking. The home is located within a residential area, close to all local amenities and is accessible by local transport. The home charges fees of between £383.52 and £555.62 per week depending upon the needs and requirements of the individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide. A copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a total of 10 hours during two visits. Ten residents and four staff were spoken at some length and others chatted to briefly. Three relatives were spoken to directly as they were in the home. Six care plans, and records for medication were examined. Also staff files, training records and health and safety documentation was looked at. Ten resident and ten relative questionnaires were given out to be completed all of which were returned. The responses have been included in this report. No relative or resident said they wished to speak directly to an inspector. There were five requirements made at the last inspection three of which have been fully met. The two outstanding requirements have been adjusted. The care plan requirement has remained in place, as although they are now completed to a much better standard they need further information regarding social needs. What the service does well: What has improved since the last inspection? Mrs Morgan has been appointed as the Manager since the last inspection and has completed the “fit person process” with the Commission for Social Care Inspection. Improvements have been made to the recording of the medicines. There are now more specialist beds available in the home. Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 6 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. Kenton Hall Nursing Home DS0000000423.V299751.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 Kenton Hall Nursing Home DS0000000423.V299751.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): 3, 5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have written contracts and terms and conditions of residency. These set out the rights, and obligations of all parties. The resident needs are identified during the comprehensive assessments carried out both before and after admission. Residents are able to visit the home before making any decisions to stay and are given information to help them make up their mind. EVIDENCE: Each resident has a contract which gives the terms and conditions of the stay in the home. This included the accommodation to be provided, fees, care and service provision, additional services, and rights and obligations for both the resident and the home. Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 9 The care plans inspected showed that residents have a full assessment carried out by care managers before being admitted to the home. The nurse assessor, home manager or senior nurse also carries out a full assessment of need before anyone is admitted to the home. Potential residents are encouraged to visit the home before admission. They are able to visit for part of a day and have a meal with other residents and join in any activity event in the home. Three perspective residents or their families were visiting during the first inspection visit. All residents have a six-week trial period after which a multi disciplinary review is held with the resident and their representative. Following the review the decision to stay in the home is then made. Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 10 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, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All resident have a care plan and the care is given as it describes in these plans. The residents are having their needs met. They are being given their care with courtesy and in privacy. The social care element of the assessment and care planning is not detailed enough. The residents receive their prescribed medication according to safe working practices. The medicines in the home are well managed. The dignity of some residents is being compromised by the use of lap straps for falls prevention. EVIDENCE: The care plans have improved since the last inspection. Residents have a care plan which includes a detailed assessment and a plan of care. Six care plans were looked at closely during the visit and were a good standard. Relevant risk Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 11 assessments are completed for, prevention of falls, wound care, moving and assisting, and continence promotion. There is an assessment to look at resident’s food and fluid intake. If a resident has any unplanned weight loss a plan is drawn up to address this. In one care plan this included getting advice from a dietician and speech therapist and in another speaking the residents General Practitioner. See standard 15 for information about the changes the Manager has introduced regarding residents dietary needs. Residents access NHS services and facilities as necessary. The care plans showed that specialist advisors are used for individual residents. There are no residents currently in the home who have pressure damage wounds. The care plans show that the personal and health care needs of the residents are being met. Returned questionnaires from residents and relatives confirmed this. The care being given during the visits also showed this for personal and health care areas. However social assessments were brief and did not describe fully the resident’s social needs. The planning in this area was therefore not in sufficient detail to reflect the way the resident would have their social needs met. There are a number of social opportunities available in the home and this is not fully reflected in the individual care plans. They were dressed for the activities they were undertaking and looked smart and tidy. The four residents who were able to speak to me were positive about the care being given. Comments made included “we get good care here” and “the staff are very kind”. Medicines management was appropriate. The staff record the medicines correctly when they are ordered. The prescriptions are then checked when they are received in the home from the General Practitioners and are then sent to the Chemist for dispensing. The medicines received from the pharmacy are checked against the record of what was ordered and prescribed so that any errors can be picked up. Medicines no longer required are disposed of safely. No resident manages his or her own medication. Two residents sitting in the lounge had lap straps in place. These were fastened around the back of the chair and then secured with a clasp at the front of the resident. These residents had fallen in the past, and were at risk of further falls if allowed to walk around unaided. They were assessed by the home as being likely to try to walk without summoning help. The use of the lap strap was done to protect the resident from further risk of falling and the home had sought “permission” from the General Practitioner and the resident’s family for its use. However the use of these strategies can compromise the dignity of the resident and is a form of physical restraint. Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 12 The residents care plan did not show that the staff had tried any other ways of managing the risk of falling. There were no references to additional supervision, use of hip protectors or a physiotherapy assessment. There had not been a referral for a psychological assessment, if appropriate, to look at whether the risk could be reduced through behavioral management. The Manager acknowledged in one of the cases that the resident had improved significantly and the use of the lap strap was no longer appropriate. However she confirmed that other residents had lap straps in place for prevention of falls. Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 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. 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. The residents are offered some social activities and are encouraged to take part in those they find interesting and able to take part in, and this is being developed further. The residents are being encouraged and supported to maintain contact with their families. The residents are given a balanced, nutritious diet given at appropriate times in a satisfactory environment. EVIDENCE: There is an activities co-ordinator employed. On the day of the first visit she was occupied in accompanying a resident to a hospital appointment in the morning. There was a list of planned activities advertised throughout the home including for traditional events like Halloween and guy Fawkes. See standard 7 regarding the need to assess, plan, record and evaluate the social activities in a more individual way for each resident. On the first visit the main choice at lunchtime was shepherds pie, swede, potatoes and green beans. Pear and almond sponge and custard followed this. Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 14 Alternatives were offered for both the main mean and the pudding/sweet. The food was tasted; it was being served at the appropriate temperature from warmed plates and was tasty. The residents were complementary about the food during the mealtime and appeared to enjoy it. The cooks have a good understanding of the dietary needs of the residents, and how to increase the calories in the food being served for those at risk of weight loss. They confirmed that fresh fruit is served in a variety of ways. Milk drinks with fruit added (smoothies) are also offered as an alternative to tea and coffee on the afternoon “tea trolley”. Residents were complementary about he food being served. Breakfast was especially popular when a full-cooked breakfast, cereals, toast and egg/bacon sandwiches are available. The morning “tea trolley” offered a varied selection of drinks. There was tea, coffee, or cold drinks of either juice or milk. There were biscuits provided. The bedrooms are personalised according to the taste of the resident and where possible they choose their own decoration. Two residents said they were happy with their rooms and that they had a lot their own personal items around them. Residents have visitors at any time and are able to use their own rooms, or the lounges to see them. Three relatives said that they are welcomed into the home. Residents said they were happy with the arrangements for visitors. Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents and relatives know about the complaints policy and how they would make a complaint. There is a system for managing and dealing with complaints. The residents are protected form abuse by staff training, recruitment and selection and effective documentation and training. EVIDENCE: The complaints procedure is available in the service users guide and a copy is displayed in the home. There have been three complaints recorded since the last inspection. The record of complaints made and investigated was looked at. These were detailed and included the outcome and the action taken in response to the investigations. The records were dated and signed by the manager. Three relatives who were visiting the home were aware of the complaints procedure but had not needed to use it. Staff are given protection of vulnerable adults training both as part of the inhouse training package. Kenton Hall Nursing Home DS0000000423.V299751.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): 19, 21, 23, & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and well organised and the staff are knowledgeable regarding the ways to prevent the risk of cross infection in the home. The environment is well decorated and maintained the only exception to this being the need to replace the corridor carpet on the ground floor. Good records are maintained of the health and safety practices and maintenance of the building and facilities. EVIDENCE: A tour of the home was conducted both with staff and alone; the home is clean and was odour free on the day. The home is generally well decorated and maintained. The Manager is aware of the need to continue the redecoration Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 17 programme to deal with any wear and tear occurring. The residents’ and relatives who were asked about the bedrooms said they were happy with the decoration and that they were kept clean by the staff. There was a requirement made at the last inspection to have the corridor carpet on the ground floor either deep cleaned or replaced. This was deep cleaned but has become very dirty and stained again. The laundry was clean, organised and well equipped. The laundry staff use gloves and aprons as necessary. There are three washers, which have a sluice facility and two dryers. The laundry is equipped with a roller press and domestic type iron. The sluices were tidy and clean and the disinfectors operational. Staff follow infection control policies and use appropriate equipment. The kitchen area was clean and well organised and there is an up to date cleaning schedule which identifies all areas to be cleaned, how often they are completed and who was responsible for undertaking it. There are three bathrooms and one shower on each floor and there were tidy and clean. Kenton Hall Nursing Home DS0000000423.V299751.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): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an effective recruitment and selection system, which ensures that residents are cared for by well-trained, skilled staff and are in safe hands. The training programme is up to date and covers a large spectrum of both clinical and statutory areas with the exception of moving and handling. EVIDENCE: Staff records are completed according to the company policies and procedures, including two references and a completed application form. The requirement to have a CRB and POVA check is applied to all of the staff in the home. On both of the visits there were sufficient staff to meet the needs of the residents. The first day of the visit there was the Manager, two qualified nurses, nine carers, four domestic, the cook, two kitchen assistant, and the administrator. The training records were looked at. There is training in both statutory and clinical areas and staff are given training in line with the company policy. Training provided includes Health and Safety, skills for care induction, first aid, medicine awareness training, food hygiene, infection control and customer Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 19 care. Fire training is not up to date but the training arranged for November will address this. Moving and handling training has been provided to the staff but the annual updates are not up to date. These updates had been arranged by the second inspection visit. Nineteen of the care staff have achieved NVQ 2 and three have a NVQ level 3 out of 30 employed. Kenton Hall Nursing Home DS0000000423.V299751.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): 31, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mrs Morgan has been appointed as the Manager since the last inspection and has completed the “fit person process” with the Commission for Social Care Inspection. She has put in place systems manage the home effectively taking into account the needs and wishes of the residents. The home effective health and safety systems, which include staff training and risk assessments. Staff supervision is not up to date. Resident’s personal finances are managed appropriately. EVIDENCE: Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 21 Mrs Morgan has achieved the registered managers award. There is a system and records to review health and safety; it involves all of the staff. There are records of regular staff meetings and the contents suggest that there is broad spectrum of relevant issues discussed. The Manager also arranges meetings with the relatives and residents as appropriate. Health and safety risk assessment in place for a wide range of activities and areas of the home. The Manager continues to consult the residents, staff and other interested parties to review the service provided and manage the staff in a way to improve care delivered. In December 2005 the manager conducted a resident and relative survey as part of the quality assurance process. The Manager feels that she has addressed the issues raised in these although there were no serious concerns. She is planning to repeat this soon and may look at targeted surveys to look at specific areas of care. Audits are carried on care planning, infection control, and medication. The manager has meetings with families 6 monthly, not well attended last one in 26 April due one now. She uses the complaints book as a means of looking as issues raised and described the “open door” policy of being available to residents and relatives. There is a system in place for undertaking staff supervision and some of the staff files contained completed forms. This was not up to date for all staff and the staff records for three staff were last formally supervised in June 2006. A last fire service inspection identified some remedial action, which has been almost completed. The personal records kept in the home of residents who are receiving assistance to manage their finances were examined and are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the service user were in place. (See staff section of report for requirement regarding moving and handling training.) Kenton Hall Nursing Home DS0000000423.V299751.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 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 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 2 X 3 X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 Requirement Care plans must include a detailed social care assessment with a plan of way these needs are to be met. The home must review all residents who have a lap strap in place to ensure that they are maintaining their dignity and protecting their rights as well as maintaining their safety. The home must replace the corridor carpet on the ground floor. Moving and handling training updates must be provided annually for all staff. The supervision programme in place must be followed as planned to ensure that all care staff are receive 6 supervision sessions per year. Timescale for action 31/01/07 2. OP10 12 31/12/06 3. 4. 5. OP19 OP38 OP36 23 13 (5) 18 (2) 31/01/07 31/01/07 31/01/07 Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 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. Refer to Standard Good Practice Recommendations Kenton Hall Nursing Home DS0000000423.V299751.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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. 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