Inspection on 09/11/05 for Kenton Hall Nursing Home

This inspection was carried out on 9th November 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

Kenton Hall Nursing Home 30/05/07

Kenton Hall Nursing Home 25/10/06

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 Mrs Irene Bowater Unannounced Inspection 9th November 2005 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 DS0000000423.V257916.R01.S.doc Version 5.0 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. DS0000000423.V257916.R01.S.doc Version 5.0 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 Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places DS0000000423.V257916.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th July 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. DS0000000423.V257916.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over 6.5 hours. There has been no registered manager for some time, however the deputy manager was available and assisted throughout the day. Part of the day was spent in the office inspecting records, and the majority of the time was spent touring the home and spending time with the residents, staff and visitors. Sixteen residents, 8 staff and 1 relative were spoken to throughout the day. What the service does well: What has improved since the last inspection? DS0000000423.V257916.R01.S.doc Version 5.0 Page 6 The requirements from the last inspection have been addressed apart from one. The food provision and organisation at meal times continues to improve. The content and presentation of the specialist diets also continues to improve. The residents spoken to all commented on the improvement regarding the choices and content of all meals. The manager is in process of completing the process to become registered manager of the home. The recommendations regarding refurbishment of the conservatory have been taken on board and new furniture is being bought. A planned redecoration and refurbishment programme is now in place with many of the communal rooms, corridors and bedrooms benefiting from redecoration. The staff team continue to improve their skills with completion of training programmes and regular meetings. As the team has developed the residents, relatives and visitors are being asked their opinions of the home in order to improve the services. 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. DS0000000423.V257916.R01.S.doc Version 5.0 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 DS0000000423.V257916.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,5, Residents have satisfactory written contracts and terms and conditions of residency, which sets out the rights, and obligations of all parties. The home carries out comprehensive assessments both before and after admission to ensure residents needs can be met. Residents are able to visit the home before making any decisions to stay. EVIDENCE: Each resident has a contract which sets out the terms and conditions in respect of the accommodation to be provided, fees, care and service provision, additional services, and rights and obligations for both the resident and the provider. DS0000000423.V257916.R01.S.doc Version 5.0 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. All 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. 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. DS0000000423.V257916.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, 10 The care planning system is not consistent to provide staff with the information they need to meet residents assessed needs. The health needs of residents are met with evidence of multi disciplinary working taking place. The recording of administration of medicines is not consistent which places residents at risk. Care is delivered in ways that promote and protect resident’s privacy and dignity. DS0000000423.V257916.R01.S.doc Version 5.0 Page 11 EVIDENCE: The care plans showed that the improvements reported at the last inspection have not been maintained. The care plans follow the admission assessments, however they were disorganised, untidy and residents changing needs were not recorded or updated. The use of abbreviations and Tippex made the plans difficult to read and understand. Risk assessments were available but were not always reviewed on a monthly basis. All residents have access to all NHS facilities. The care plans showed that wound care records are comprehensive. Advice from tissue viability nurses is sought when necessary and there is a range of pressure relieving equipment available and in use. Advice from speech therapists, continence advisors and dieticians is sought and acted up on as necessary. Monthly weights are recorded and weight gain or loss is recorded and appropriate action taken. The home has two treatment rooms for the safe storage of medications. The room downstairs is very small and warm. The staff records the room temperatures to ensure the ambient room temperature does not exceed 25C. The medication system in use is the “bottle system”. All medications received and disposed of are recorded. The Medicine Administration Records showed that not all medicines administered are actually signed for. A random audit of the Controlled Drugs found no discrepancies. The register of staff authorised to administer medications has not been kept up to date. The staff have continued to develop and form good relationships with the residents living in the home. They were observed using the residents preferred name and made sure that all personal and nursing care took place in the privacy of residents’ own rooms, bathrooms and toilets. DS0000000423.V257916.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The home continues to match residents’ expectations about social, religious and recreational needs. Support links with the community are supported and encouraged. Residents are supported to maintain individual choices and control over their lives. Dietary needs of residents are catered for with a balanced and varied selection of food that meets individual choices, tastes and specialist need. EVIDENCE: There is a designated activities person who organises events inside and outside the home. The home has a planned activities programme, which is displayed, in the home and in each resident’s bedroom. A sample of activities includes board games, chair exercises and reminiscence sessions. The home has its own mini bus and the residents have been out on various trips. On the morning of the inspection several of the residents enjoyed a morning visit to the coast and surrounding areas. DS0000000423.V257916.R01.S.doc Version 5.0 Page 13 Preparations are underway for the Christmas events with events both inside and outside the home. An annual event for Christmas is the pre Christmas lunch, which is arranged for the residents’ families and friends. There were several visitors to the home and they are always made welcome, can visit at any time and can use the various communal areas or visit in the privacy of their relatives’ bedroom. The home has links with the local community including local churches and schools .The home does not have any volunteers at present. Where possible residents are encouraged to handle their own financial affairs. Information and advice is readily available about advocacy services within the local area. A tour of the home found that residents have brought many personal possessions with them making their rooms highly individualised and homely. Evidence from the records show that residents and their representatives are involved and can access the care plans. The food provision and organisation of meal times continues to improve. There is a four weekly menu available, which offers choices and variety. Specialist diets are catered for and the presentation of the soft and pureed diets was good. The dining rooms have been redecorated to a good standard and tables were appropriately set for each meal. Some residents prefer to have meals in their own rooms and this was facilitated for them. Residents who needed help to eat their meals were given assistance in a discreet sensitive manner. The lunchtime meal was an unhurried pleasant occasion with residents having a choice of main course, dessert and drinks. The morning and afternoon drinks trolley provides choices of hot and cold drinks, home made fortified milk shakes, biscuits and cakes. Fresh fruit is available every afternoon. The kitchen had an ample supply of fresh, frozen, tinned and dried food, which was appropriately stored. All of the residents spoken to said “the food has got better”, “I always get what I want”, “the food is always nice and there is plenty”. DS0000000423.V257916.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home has a satisfactory complaints system with some evidence that residents feel that their views are listened to and acted upon. Staff have knowledge of Adult Protection issues, which protect residents from harm. EVIDENCE: The complaints policy and procedures are readily available in the home. Residents and visitors said they knew how and to whom to complain to. The home has a complaints and compliments book available in reception and residents and their representatives can write their concerns in the book if the senior nurse or manager is not available. The complaints are recorded, however it was difficult to follow the action and outcomes taken by the home for individual complaints. Since January 2005 the Commission has received one complaint. This is currently under investigation. The home has policies and procedures in place for dealing with any suspicion of abuse. The staff were able to discuss the steps they would take should there be any allegation or suspicion of abuse. The Protection of Vulnerable Adults training continues for all staff in the home. DS0000000423.V257916.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 19,22,24,25,26 Recent investment is improving all areas of the home creating a safe, clean homely place to live. Further equipment is needed to ensure residents maximise their independence. EVIDENCE: The location and layout of the home is suitable for the residents who live there. The accommodation is over two floors, which are accessed by stairs and a passenger lift. The home continues to redecorate and refurbish the home through a planned maintenance programme. The staff confirmed that new furniture was on order to replace the old lounge chairs. The grounds are easily accessible from the conservatory. The pond area remains safe and has had a new patio area laid. DS0000000423.V257916.R01.S.doc Version 5.0 Page 16 Several of the dining chairs are now looking shabby and worn. The corridor carpets were also looking shabby and stained. Residents have access to all areas in the home via a passenger lift. There are grab rails in corridors, bathrooms, toilets and if required the residents own bedrooms. The home has sufficient mechanical aids, hoists adapted baths and showers to meet the needs of the residents. Call systems with accessible alarms are provided throughout the home. All of the bedrooms are single and have en-suite facilities. The bedrooms are furnished to a satisfactory standard, have a lockable storage space and residents who are able are provided with keys to their rooms. There are no adjustable nursing beds available for residents receiving nursing care. Many of the residents have brought their own small possessions with them making the bedrooms highly individualised and homely. All communal areas and bedrooms are naturally ventilated and centrally heated. Thermostats are fitted in all rooms, which enables residents to choose the appropriate room temperature. All the lighting is domestic in style and sufficiently bright for reading purposes. Emergency lighting is available throughout the home. The maintenance person checks and records the water temperatures .On the day of inspection the water temperatures were satisfactory. On the day of inspection the home was clean, tidy, well maintained and free from offensive odours. DS0000000423.V257916.R01.S.doc Version 5.0 Page 17 All areas of the home are cleaned on a daily basis. Liquid soap and paper towels are provided in all resident areas, which ensures that staff can wash their hands effectively. The staff also has access to alcohol gel to assist in maintaining effective infection control within the home. The laundry was clean and organised on the day of inspection. The requirements from the last inspection regarding providing cords, which are easily cleanable, and replacing the bedpan holder have been actioned. The home has an infection control “link nurse” who has completed an internal infection control audit of the home and she ensures staff follow infection control procedures. DS0000000423.V257916.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The home is adequately staffed with qualifies nurses and care staff to meet residents assessed needs. Arrangements for induction and staff recruitment are currently satisfactory and ensure residents are protected from harm. The training ensures that staff is competent to do their work. EVIDENCE: There is now a designated manager who is to have an interview with the Commission to become Registered Manager of the home. A deputy manager has been appointed since the last inspection. The difficulties with recruiting care and qualified nursing staff are being resolved. Agency staff are only used on an emergency situation. The home benefits from a core staff that have been employed at the home for some considerable time. The current staffing levels for the home are: 3 qualified nurses during the day: 2 qualified nurses overnight. 9 care staff during the day: 4 care staff overnight. The home has a domestic supervisor and 3 domestic staff who work during the day.1 domestic works from 4pm to 6pm each evening. DS0000000423.V257916.R01.S.doc Version 5.0 Page 19 The administrator, maintenance person, laundress and activities organiser are full time and there are chefs and kitchen assistants on duty over a 7-day period. Training to NVQ level 2 standard continues in the home. One member of staff has NVQ level 3 and another 3 staff are completing the training. A sample of personal files were inspected and found to contain Criminal Record Bureau checks, two references, proof of identity and qualified nurses have their Personal Identity Number checked with the Nursing and Midwifery Council to ensure they are registered to practice. There was evidence of induction and ongoing training taking place for staff. Some specialist training has taken place. This includes Protection of Vulnerable Adults, Wound Care, Infection Control, Health and Safety, Risk Assessment for Managers, Challenging Behaviours and Dementia Care. DS0000000423.V257916.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The current management of the home is satisfactory and run in the best interests of the residents who are safeguarded by organised financial procedures. The homes health and safety procedures minimise the risk of injury and harm. EVIDENCE: The home has been without a registered manager for some considerable time. The previous deputy manager is in process of applying to the Commission to become the Registered Manager. The senior nurse has been promoted to deputy manager. DS0000000423.V257916.R01.S.doc Version 5.0 Page 21 During this period the senior staff have communicated a clear sense of direction to all staff, which has improved the service provision for all of the residents. A management report is now available to the Commission for Social Care Inspection. Regular meetings are held with residents, staff and relatives. These meetings are recorded and action taken should there be any concerns raised. The home is in the process of sending Quality Assurance questionnaires out to residents and their representatives’ .The results are to be published in the Service User Guide. There are detailed accounting systems in the home. All transactions and receipts are available and a random audit found no discrepancies. The staff have received fire, food hygiene, first aid, moving and handling and health and safety training. A fire risk assessment has been completed for the home. Accident recording is satisfactory and the staff carry out a monthly analysis of accidents. The door to the staff room was not fitting into the frame and would not shut properly. This was brought to the attention of the staff on the day of inspection for action. The contact maintenance certificates were available and up to date. DS0000000423.V257916.R01.S.doc Version 5.0 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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 DS0000000423.V257916.R01.S.doc Version 5.0 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 The care plans must set out in detail the action to be taken to ensure all aspects of the health, personal and social care needs of the residents are met. All risk assessments and care plans must be reviewed and updated at least monthly to reflect residents changing needs. The use of abbreviations and Tippex must not be used on the care plans. The home must ensure that all medicines administered are signed for on the Medicine Administration Record. The home must maintain a register of staff who are authorised to administer medication. The home must ensure corridor carpets are deep cleaned or replaced. The dining room chairs must be revarnished. The home must provide adjustable beds for residents receiving nursing care. The home must progress with DS0000000423.V257916.R01.S.doc Timescale for action 31/01/06 2 OP9 17 09/11/05 3 OP19 23 31/01/06 4 5 OP24 OP31 16 9,10 31/01/06 02/12/05 Page 24 Version 5.0 the recruitment of a suitable manager. Outstanding since 8/7/05 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 OP20 Good Practice Recommendations It is highly recommended that the conservatory be refurbished. DS0000000423.V257916.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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. 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