Inspection on 15/06/05 for Kenwith Castle Nursing Home

This inspection was carried out on 15th June 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

Kenwith Castle Nursing Home 24/03/09

Kenwith Castle Nursing Home 04/01/07

Kenwith Castle Nursing Home 16/12/05

Kenwith Castle Nursing Home 03/11/04

Kenwith Castle Nursing Home 20/08/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Kenwith Castle Kenwith Castle Nursing Home Abbotsham Bideford EX39 5BE Lead Inspector Susan Taylor Unannounced 15 June 05 09:15 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kenwith Castle Nursing Home Address Abbotsham Bideford Devon EX39 5BE 01237 470060 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) rachel@invicta206.fsnet.co.uk Two Rivers Investments Ltd Vacant Care Home 55 Category(ies) of Old age, not falling within any other category registration, with number (55) of places Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Notice of Proposal to Grant Registration for staffing/environmental conditions of registration issued 14/2/1998 Authorised person in charge Karen McEndoo RGN Date of last inspection 3/11/04 Brief Description of the Service: Kenwith Castle is situated in a rural area of North Devon, a few miles to the South West of Bideford. The home provides 24-hour nursing care to 55 older people.The building is a large two-storey building, which has been sympathetically converted to retain some of the original features. There are extensive grounds surrounding the home, which command fine views to the front. A lake within the grounds provides a haven for wildlife and also a variety of freshwater fish. A long driveway leads to the visitors’ car park at the front of the home. There is level access and automatic doors to the front entrance. Accommodation is provided for service users on both floors with lift access to the upper level. There is level access throughout the home. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took six hours over one day. Two inspectors examined records, policies and procedures. Six resident’s gave their views of the home to the inspectors. Five staff, the new manager and one of the owners were spoken to during the day. The people living at Kenwith Castle told the inspector’s that they preferred to be referred to as ‘residents’. This term is used throughout the report. What the service does well: What has improved since the last inspection? What they could do better: At the last inspection, inspectors told the manager that the statement of purpose does not provide new and prospective residents with sufficient Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 6 information about the home. In view of the change of manager, the inspectors agreed to extend the timescale for this to be done. A requirement is made. Residents told inspectors that their needs were well met, but that sometimes the staff appeared rushed. One person’s comments were typical of the rest “the carers sometimes seem hurried. They meet my needs but I would like a little more time with them.” Staff felt that this was particularly so, around mealtimes. The manager needs to investigate this. Extra support may be necessary to ensure that resident’s don’t feel rushed. A recommendation is made. The home needs to follow good practice with regard to witnessing entries in records that show when medicines have been prescribed by a GP and need to be added to the Mars sheet. A recommendation is made. Similarly, the home needs to follow good practice with regard to witnessing entries in records that show how resident’s money is managed. A recommendation is made. 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. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 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 standard(s) 1,3 The statement of purpose does not provide residents with sufficient information as laid out in the regulations. Resident’s needs are well known, and met for residents by a competent team of carers. EVIDENCE: Rae Vanstone, the newly appointed manager told inspectors that the statement of purpose was in the process of being reviewed. Mr. Cawthorne verified that an application to vary the conditions of registration would be made, which would include the reviewed version of the statement of purpose. In light of this, inspectors agreed to extend the timescale requiring the registered persons to produce a statement of purpose that meets the legal requirements. Comprehensive assessments were seen in three care files that were inspected. For residents who were placed by the local authority the home had obtained a copy of the care management assessment and care plan. In addition to this, qualified staff had completed in depth assessments with the resident, and or their advocate. Residents told inspectors “they asked me what help I needed”. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 9 Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 Kenwith staff are responsive to the changing needs of their residents. They make good use of health and social care resources available to them in the community to ensure that residents receive the best care available. Residents are treated with dignity and respect. EVIDENCE: The inspector saw three care plans, which were well-maintained, accessible to residents and had been kept under review. Good outcomes were observed when the inspector tracked the care for three residents. One person’s care plan clearly identified risks with regard to tissue viability. The resident had been admitted with several broken areas of skin, and staff had successfully healed these by dressing them regularly. Records demonstrated that the home had good relationships with other social and healthcare professionals. Residents made positive comments about their health and social care, which included “I’m very satisfied with everything” , “If you’re unwell you just ask matron to call the GP and she does”, “A chiropodist and dentist regularly visit”. All of the residents seen by inspectors were comfortable and well cared for. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 11 The inspectors observed that staff respected residents in terms of their dignity and privacy by always ensuring that personal care was done behind closed doors. Interactions between residents and staff were caring and respectful. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 The majority of residents at Kenwith are given plenty of opportunity to have a fulfilling social life. Recreational activites are well co-oordinated and are designed to suit a wide range of tastes. Residents at Kenwith are consulted with, thier views are used to make improvements and requests are acted on. EVIDENCE: Three residents were spoken with at length and all mentioned the enthusiasm and creativitiy of the activites coordinator (Jean). Comprehensive records showed that the number of activities have been increased and confirmed the variety of activites offered – at present some residents are taking part in a sunflower growing competition, others were making sailors hats so that they can wear them at a theatrical production arranged for next week. Risk assessments had been carried out for a recent minibus trip. Feedback about how the trip went was also written. A quiz was held in the ground floor lounge where a varitey of seating was available to suit individaul need; fourteen residents attended and the activities coordinator was seen to interact and engage all who were present. Residents spoke of forming a a residents committee, to help provide an effective way of discussing ideas and high-lighting areas for improvement. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 13 Generally, those spoken to said they enjoyed the food, they confirmed that a cooked breakfast is always available and that they always get a choice at meal times. One residents commented that sometimes meals felt a little hurried. The views of residents have been surveyed and as a result improvements have been made – food is not left ‘standing’ for so long and there is more variety of foods offered at suppertime. The Menus had recently been changed to accommodate requests, this was confirmed by a resident. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 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 standard(s) 16,17,18 The philosophy of the home empowers residents and staff so that they can raise issues of concern without fear of retribution. EVIDENCE: Resdients stated that they feel well able to voice their concerns or complaints, although it was mentioned that this sometimes ‘feels uncomfortable’. Care staff spoken to were clear about approaching the nurse in charge or manager if residents had a complaint or if they themselves were not happy with an aspect of their work. Staff said there were not many complaints rasied. Staff spoken with said they had recevied training about protecting vulnerable people from abuse. One of the trained nurses confirmed that adult protection was a topic in the induction process for new staff. Conversation with staff revealed that they believed in people having rights and choice, they were clear about what was good and what would constitute bad practice. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 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 standard(s) None EVIDENCE: Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 Resident’s needs are generally well met by competent staff. Pressures on staff around mealtimes need to be investigated further by the manager, so that steps can be taken to ensure that residents do not feel hurried at these times. The home had followed it’s own robust recruitment procedures, ensuring that residents are safeguarded. EVIDENCE: The duty rosters accurately recorded the names of staff, and duties that had been worked. Residents told inspectors that their needs were well met. One person’s comments were typical of those received “the carers sometimes seem hurried. They meet my needs but I would like a little more time with them.” The inspectors observed that care staff were more pressured around mealtimes. This was discussed with Mr. Cawthorne and Rae Vanstone, who told the inspectors that they were trying to recruit staff to fill vacancies. Rae Vanstone, the new manager, told inspectors that she was looking into the roles and responsibilities of staff. Inspectors recommended that she should establish what the pressures on staff were and try to address these by providing extra support as necessary. Staff told the inspector that they enjoyed their work and felt well supported. The inspectors found that the home’s recruitment procedure had been followed when three staff files were inspected. Satisfactory references, including CRB and POVA checks had been obtained prior to the employment of the new staff. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,35, 38 In the absence of a registered manager, the home was well run. Resident’s financial interests are safeguarded by accurate record keeping, policies and procedures. The health, safety and welfare of residents are promoted and protected by Kenwith Castle’s policies and procedures. EVIDENCE: Since the last inspection, Karen McEndoo the registered manager had left. Inspectors met Rae Vanstone who had been recently appointed as the manager. Residents felt the change of management had gone smoothly and made positive comments such as “She’s a very down to earth person” and “She seems to have her feet on the ground”. Mr. Cawthorne told inspectors that Rae Vanstone would be making an application to the Commission for registration of the manager as soon as possible. An application form has been sent to the home to facilitate this. On receipt of this, the Commission will start the process of registration. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 18 Records showing how money is managed on resident’s behalf were inspected. These were well kept, and accurately recorded the correct balance seen. Entries had not been signed for and a recommendation is made in respect of this. Receipts corresponded with entries for items such as chiropody, hairdressing and newspapers. Secure facilities are used to safeguard resident’s money. Comprehensive Health & Safety policies and procedures were seen. Since the last inspection, a competent person had inspected electrical appliances to ensure conformity and safety. The names of qualified First Aider’s were prominently displayed. Staff on duty had First Aid qualifications. First Aid boxes were accessible to staff. Residents told inspectors “I feel very safe here, their always checking things. My lamp and radio was checked not long ago.” Staff told the inspector that Health & Safety matters were taken seriously in the home, one person particularly made reference to the testing of the fire alarm and training saying “it gets done regularly”. Records showed that staff had received fire training the night before and during the previous week before the inspection. Records of accidents were kept and showed that appropriate action had been taken. The inspector was told that one member of staff is a qualified manual handling trainer. Staff had received regular training about manual handling issues. A recent outbreak had been handled effectively. The inspector saw written evidence showing that the home had sought advice from the infection control nurse specialist, and had followed it. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x x x 3 x x 3 Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4(1) Requirement The registered person shall compile in relation to the care home a written statement (in these Regulations referred to as the statement of purpose), which shall consist of a statement as to the matters listed in schedule 1. [There had been a change of manager at the home, and the statement of purpose had not been reviewed. The inspector agreed to extend the timescale, enabling the new manager to complete this. Timescale for action By 30/7/05 2. 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 9 Good Practice Recommendations It is recommended that for all hand-transcribed entries made on the MAR sheet, there should be two signatures one of the person making the entry and one of a second competent person. Invesigate why staff feel pressured around mealtimes, and take steps to support them so that residents do not feel D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 21 2. 27 Kenwith Castle 3. 35 hurried. There should be two signatures - one of the person making the entry and one of a witness - for all entries where residents money is managed or kept for safe keeping. Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kenwith Castle D54-D07 S61785 Kenwith Castle V225806 160605 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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