Inspection on 25/10/05 for Kenwood

This inspection was carried out on 25th October 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

Kenwood 06/08/08

Kenwood 22/05/07

Kenwood 07/11/06

Kenwood 23/05/06

Kenwood 04/04/05

Kenwood 28/09/04

Kenwood 28/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Kenwood 30-32 Alexandra Grove Finchley London N12 8HG Lead Inspector Daniel Lim Unannounced Inspection 25th October 2005 09:05 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 Kenwood DS0000010457.V251254.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. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kenwood Address 30-32 Alexandra Grove Finchley London N12 8HG 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) 020 8445 5112 020 8343 7992 New Century Care (Finchley) Limited Mrs Judy Camilla Ramnath Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2 Specific service users. 2 Specific service users who are under 65 years of age, one of whom also has a learning disability, may continue to be accommodated in the home. This condition must be reviewed at such times as either of the service users attains 65 years of age or vacates the home. One specified service user who is over 65 years of age and who has a learning disability and dementia may remain accommodated in the home. The home must advise the regulating authority at such times as the specified service user vacates the home. 4th April 2005 2. 3. Date of last inspection Brief Description of the Service: Kenwood Nursing Home is owned and managed by New Century Care (Finchley) Limited. The home has a mission statement, which says that it aims to “provide good quality accommodation, nursing and personal care for vulnerable elderly people, who as a result of loneliness, physical disability or illness are seeking an understanding and caring environment”. The home is a three storey detached house. There are two lifts between the ground and first floor, which are areas occupied by service users. The third floor has a staff room and store room. There is a communal dining room on the ground floor and a lounge on each floor. A small activity room is located on the first floors. There are 22 single bedrooms and 5 shared bedrooms. All the bedrooms have en-suite facilities. There is a small parking area at the front of the building and a large garden at the rear with wheelchair access. The home is situated in a residential area and close to a variety of shops, restaurants and transport facilities located along Ballards Lane, North Finchley. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 25 October 2005 and took three and a half hours to complete. The inspector noted that the overall quality of care provided was satisfactory. However, further improvements are required in the area of health and safety, maintenance of the home and in ensuring that requirements made in previous inspection report is complied with. During this inspection, the inspector was accompanied by the manager of the home (Mrs Judy Ramnath). The inspector was able to interview four residents and a relative. The feedback received from them was positive. Statutory records including four residents’ case records, the maintenance records and fire records of the home were examined. The premises including the bedrooms, laundry, kitchen, gardens, fire exits and communal areas were inspected. Four staff on duty were interviewed on a range of topics associated with their work and staff records were examined. In addition, the minutes of staff meetings and residents’ meeting were also examined. What the service does well: The home was clean and adequately furnished. Arrangements were in place to ensure that the healthcare needs of residents are attended to. Records were kept of visits made by the GP and other healthcare professionals. Monitoring charts for pressure area care had been provided and signed by staff to indicate that the required care had been carried out. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 6 Staff had been provided with most of the essential training required. The staff records examined indicated that staff had been recruited with care. What has improved since the last inspection? What they could do better: The registered person must apply for a variation to the registration of the home to permit the home to accommodate certain service users with dementia. Until approval has been given by the CSCI, the home must not admit any more service users with dementia. The admission procedure needs to be updated to include reference to trial stays / visits to the home. The plans of care for residents need to be made comprehensive to ensure that the mental health and holistic needs of residents are identified and addressed. Training in the care of residents with dementia is required. A review of staffing levels (and the manner in which staff are deployed ) must be carried out with residents, relatives and staff to ensure that the needs of residents are met. A report of this review must be forwarded to the inspector. Urgent improvements are also needed in the area of health and safety. This must include ensuring fire exits are not obstructed and excess items are not stored in bathrooms. Fire drills had been organised. However, none of these fire drills had been organised after dark (dusk). This is required to ensure that staff are aware of the required procedure to follow. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 7 In a addition, the home must have a record of daily health and safety checks.This is required to ensure that any health and safety deficiencies are promptly identified and attended to. 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. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 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 Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4 The manager and her staff had a good understanding of the needs of residents and on the whole, the needs of residents were met. The home had however accommodated residents who had dementia and a requirement is made for the home to stop admitting service users outside it’s category of registration. EVIDENCE: The feedback received from four residents and a relative who were interviewed, indicated that residents were generally well cared for. The case records were well maintained and contained the required assessments and plans of care. Some residents did not have the opportunity to view the home prior to admission, there is therefore a need for an updated admission procedure which encourages this. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 10 The inspector observed that residents were clean and appropriately dressed. The inspector noted that some residents had dementia. This was discussed with the manager. As the home is not registered for service users with dementia, the registered person must apply for a variation to the registration of the home if these residents are to remain in the home. A requirement was made in the last inspection report for residents with dementia to be reviewed with professionals involved (Social Services / Healthcare professionals) to determine if their care needs had been fully met. This is because no recent social services or healthcare reviews of care were available for inspection and the home is not registered for service users with dementia. At this inspection, the inspector was not provided with evidence that this had been done. The inspector further noted that the manager had recently admitted a service user with dementia. The manager reassured the inspector that this resident would be transferred to appropriate accommodation. The registered person must ensure that service users are not admitted to the home unless their care needs are assessed as compatible with the registration and care that the home can provide. A requirement is made accordingly. . Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The personal and healthcare needs of the residents had on the whole, been met at the home. Improvements are however, needed in care documentation. EVIDENCE: Feedback from residents and a relative indicated that residents had been treated with respect and dignity. The sample of six case records examined were up to date and plans of care had been reviewed monthly by staff. Records of medical and healthcare treatment were available. Visits and reviews of medication carried out by the home’s GP had been documented. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 12 The plans of care examined did not always address the mental health needs of residents. This is needed to ensure that the mental health needs of residents are attended to. Residents were observed to be clean and appropriately dressed on the day of inspection The medication administration charts examined had been appropriately signed. The temperature of the treatment room and medication fridge had been monitored daily and found to be satisfactory. Residents interviewed were able to confirm that they had been given their medication. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 The daily life and routines of residents were on the whole, well organised. Improvements are however, needed in the provision of social activities.to ensure that residents are provided with adequate social stimulation. EVIDENCE: The kitchen and arrangements for the provision of meals were examined. These were satisfactory. The menu was varied and balanced. Residents interviewed said they had been visited by their families. The bedrooms inspected had been personalised by residents with their personal items such as photos and souvenirs. The inspector however, noted that no activities had been organised for residents during the morning of the inspection and the programme of activities was not available for inspection or on display in the home. The inspector was reassured that social activities took part in the afternoons and this was documented in the case records. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 14 To ensure that residents are provided with appropriate stimulation and social interaction, the registered person should ensure that social activities are organised for residents during the mornings and the programme of activities organised should be on display in the home. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 There was evidence that the rights of residents were protected and complaints were taken seriously. This protects residents from abuse and ensures that any complaints they have are listened to and acted upon. EVIDENCE: The complaints record was examined. There was documented evidence that one complaint recorded (since the last inspection) had been promptly responded to. Staff who were interviewed were found to be knowledgeable regarding adult protection procedures. The staff records examined indicated that staff had been provided with training in adult protection. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20,21,23,24,25,26 The home was comfortable and adequately furnished. However, some deficiencies were noted. Requirements have been made for these deficiencies to be attended to. EVIDENCE: The premises were inspected and found to be clean and hygienic. The required maintenance and safety certificates were seen by the inspector (during the announced inspection in April of this year). The hot water was tested and found to be within the required safe temperature range. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 17 Residents’ bedrooms were inspected and found to be adequately furnished. Residents interviewed stated that they were happy with the accommodation provided. The inspector however, noted that two of the bathrooms had excess items in them (cot sides and a mattress). These excess items must not be stored in bathrooms for health and safety reasons. The pull cords in some toilets and bathrooms had been shortened. These must be replaced. The blind in the staff room was torn. This must be repaired or replaced. These items were brought to the attention of the manager and requirements have been made for these to be rectified. Kenwood DS0000010457.V251254.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 recruitment process in place ensures that residents’ needs are met by an appropriate group of staff. Concern was however expressed by three of those interviewed (including one staff member) regarding staffing levels and further staff training is required. EVIDENCE: Staff who were on duty were interviewed and noted to be generally knowledgeable regarding their roles and responsibilities. The records of two staff who were newly recruited was examined. These contained the required documentation such as two references, satisfactory CRB disclosures and evidence of identity. Three of those interviewed indicated that the staffing levels were at times inadequate. This was discussed with the manager and the staff rota and staffing arrangements were examined in detail. This indicated that there was normally a minimum of two nurses and four carers during the day shift and one nurse and two carers during the nigh shift. The manager was supernumerary. The staff member stated that there were occasions when staffing levels were inadequate as some residents had high needs. This was exacerbated when staff do not turn up on duty. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 19 Due to concerns expressed and as the home has residents who have dementia, the registered person is required to review staffing levels with relatives, residents and staff. A report of this review must be forwarded to the inspector. The training records examined, indicated that staff had been provided with most of the essential training required. However, further training is required for all care staff (some staff had already received this training) in the care of residents with dementia. Kenwood DS0000010457.V251254.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): 31,33,38 Systems were in place to ensure that the rights and interests of residents were safeguarded. However, improvements are needed in the area of health and safety. EVIDENCE: The fire logbook examined indicated that fire drills and weekly checks of the fire alarm had been carried out. Fire training had been arranged for staff. When questioned, staff were knowledgeable regarding the fire procedures. Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 21 The home had a recent fire risk assessment. This had been prepared by the company’s fire safety contractors. The inspector however, noted that although several fire drills had been organised, no fire drill had been organised after dark (dusk). This is required to ensure that staff are fully aware of the required procedure to follow. The inspector further noted that one of the fire exits (staircase leading from the first floor to the ground floor) near the lounge was obstructed by three cushions. An immediate requirement was made for these to be removed and for the fire exits to be kept clear. A chair had also been left close to the fire exit under this set of stairs. This area must be kept clear of any obstruction. An immediate requirement was made accordingly. In a addition, a further immediate requirement was made for the home to have a record of daily health and safety checks.This is required to ensure that any health and safety deficiencies are promptly identified and attended to. Kenwood DS0000010457.V251254.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 x 3 2 2 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Kenwood DS0000010457.V251254.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 OP4 Regulation 10(1) 12(1) Requirement The registered person must apply for a variation to the conditions of registration to permit the home to accommodate service users who have dementia. (This requirement is restated) 2 OP4 23(2)(b) The registered person must arrange for the placement and care of service users with dementia to be reviewed to ensure that service users are appropriately placed and their care needs are met at the home. (This requirement is restated) 3 OP4 14 The registered person must ensure that service users are not admitted to the home unless their care needs are assessed as compatible with the registration and care that the home can provide. (This requirement is restated) Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 24 Timescale for action 20/12/05 13/01/06 13/12/05 4 OP4 10(1) 12(1) The registered person must not admit any service users who have dementia unless it has been approved by CSCI. The registered person must update the admission procedure to ensure that prospective service users have the opportunity to visit the home on a trial basis. (This requirement is restated) 13/12/05 5 OP5 12(1)(2) 01/01/06 6 OP7 13(1) 15(1) The registered person must provide comprehensive service users plans which address the holistic needs of service users. (This requirement is restated) 22/12/05 7 OP19 13(4) The registered person must ensure that excess items of furniture and equipment are not stored in bathrooms. (immediate requirement) 26/10/05 8 OP19 23(2)(b) The registered person must ensure that the broken blind in the staff room is repaired. The registered person must ensure that call bell cords are within the reach of someone who may have fallen to the ground. 20/12/05 9 OP19 12(1)(a) 13/12/05 10 OP27 18(1)(a) The registered person must review staffing levels (and the manner in which staff are deployed ) with residents, relatives and staff to ensure that the needs of residents are met. A report of this review must be forwarded to the inspector. DS0000010457.V251254.R01.S.doc 21/12/05 Kenwood Version 5.0 Page 25 11 OP30 18(1)(i) The registered person must ensure that staff are provided with training on the care of residents with Dementia (This is restated) 13/01/06 12 OP38 23(4) The registered person must ensure that fire exits are kept clear (immediate requirement) 26/10/05 13 OP38 13(4) The registered person must ensure that the home has a record of daily health and safety checks. (immediate requirement) 27/10/05 14 OP38 23(4) The registered person must arrange for at least one of the fire drills to be organised after dark. 01/01/06 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 OP12 Good Practice Recommendations The registered person should ensure that social activities are organised for residents during the mornings and the programme of activities organised should be on display in the home. 1 Kenwood DS0000010457.V251254.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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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