Inspection on 14/10/05 for Kenwyn, Ashburton

This inspection was carried out on 14th 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

Kenwyn, Ashburton 20/10/06

Kenwyn, Ashburton 30/12/05

Kenwyn, Ashburton 16/12/04

Kenwyn, Ashburton 06/08/04

Kenwyn, Ashburton 09/12/03

Kenwyn, Ashburton 10/09/03

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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 Kenwyn Western Road Ashburton Devon TQ13 7ED Lead Inspector Judy Cooper Announced 14 October 2005 th 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. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Kenwyn Address Western Road, Ashburton, Devon, TQ13 7ED 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) 01364 652243 01364 652245 info@devon.gov.uk Devon County Council Vacancy Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16/12/04 Brief Description of the Service: Kenwyn is a large detached building, situated within walking distance of Ashburton. The home is approached via a steep driveway and there is adequate parking. The home benefits from a large level garden that, thanks to the provision of a ramp and the raising of a patio area at the side of the home, is accessible to all residents. Currently the home provides accommodation for up to 18 residents who are 65 years of age and over (OP category). The home does not admit residents with any severe mental of physical frailty. At present the home is only utilising accommodation within the purpose built wing. This is because the passenger lift accessing the first floor of the original house has been decommissioned and, therefore, the four rooms (two of which were registered as doubles) on the first floor of this part of the home, are now not accessible to residents. The situation will be ongoing until the lift is replaced. A meals on wheels service operates from the premises (currently supplying approximately five meals per day).The home provides a day care service for up to two service users per day. The premises also currentlyincludes a completely separate suite of training rooms for Local Authority staff (however these are shortly to be decommisionned and the accomodation given back to the home for residential use). A further room designated for an employee counsellor is sited completely separately from the residential areas of the home.The home is both well established and well known within the local community. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day. Five standard written feedback forms were received prior to the inspection from residents and their relatives. Opportunity was taken to tour the premises, examine records and policies and talk with the newly appointed manager, the two newly appointed assistant managers, residents and staff. Two visitors to the home were also very happy to give verbal feedback as to their level of satisfaction regarding the care given to their relative. The majority of the residents were spoken with during the inspection. Staff on duty were also observed and spoken with, whilst in the course of undertaking their daily duties. What the service does well: What has improved since the last inspection? Since the last inspection the Local Authority (Devon County Council) have appointed a permanent, experienced manager at Kenwyn, along with two new part time assistant managers to complement the existing full time assistant manger, already in post. This means that the management team is now complete and so the variety of changes that resulted from the previous managers, either leaving or retiring can be halted. This will allow residents to feel a further degree of security and continuity. The new manager has built up a bank of experienced, known relief staff to use if there are any staff shortfalls within the home. This allows residents to be cared for by staff that are both familiar with their needs and known to the residents. Existing staff hours have been better utilised to allow staff to be on duty where there is an identified need, either, to deliver personal care or to provide some Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 6 form of social interaction to the residents. This has had the effect of allowing staff to spend time just talking or spending personal time with the residents and gives staff time the ability to meet both the social and emotional needs of the residents. The new manager is in the process of streamlining the existing recording systems within the home, to allow all information to be easily available and “user friendly”. This should in turn save staff time and allow staff to be able to be aware of relevant care details, as necessary, and enable them to deliver a good service. Redecoration has also taken place in within the home’s ground floor corridors, and the Local Authority has re-deployed a maintenance member of staff from another home for a temporary period, to allow further upgrading to be undertaken. A new assisted bathing facility has been installed into the home’s communal bathroom on the first floor to allow residents easy access when having a bath. 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. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 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 Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 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) 3,(6 is not applicable). The admission process is appropriately managed with residents’ needs explored and known prior to admission to the home. EVIDENCE: The resident group at Kenwyn has remained very stable for some time. Since the last inspection there has only been one permanent resident admitted to the home. Kenwyn also offers a respite facility for up to three service users. By looking at the records for two residents, one being the permanent resident and one being a recently admitted short stay resident, it was noted that a full and detailed admission procedure was undertaken in both instances that had ensured that Kenwyn was an appropriate placement. One of the residents, for whom records were inspected, was able to confirm that they had been made to feel comfortable, both on admission and since, and that all their needs were being well met. The other resident was unavailable to talk with, but it was noted from documentation, that the manager made available, that this resident’s needs were also being well met. The home does not provide for intermediate care. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 9 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 Residents’ health and personal care needs are well known, documented and met. Residents are treated with dignity and respect and their individuality and independence maintained as much as is possible. EVIDENCE: Care plans contained all relevant details appertaining to providing for individual residents’ care which allows staff to be aware of the residents’ individual needs. The manager has spent some considerable time stream-lining the recording systems within the home, including resident information, to ensure that that it is relevant and easily understood by all parties including the residents and staff. Residents’ physical well being is monitored and maintained, as directed by other professionals such as G.Ps and District Nurses etc with whom the home has good relationships. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 10 The home’s policies and procedures, regarding the administration of medication, remain in order and the medication cupboard and medication records were inspected and found to be satisfactory. The newly appointed manager has further tightened the home’s medication administration process to fully ensure that any potential mistakes, regarding the administration of medications, are now completely minimised. There are also adequate measures in hand should any controlled medications be prescribed. All staff that administer medication have received training in the same. It was noted during the inspection that residents were always treated with respect and that their dignity was upheld. Such evidence that supported this was noting the gentle, sensitive way that staff spoke to residents, taking into account their individual levels of ability and all residents were nicely dressed, clean and well presented. Resident feedback was very positive with such comments as “the staff are more than helpful and can’t do enough for me”. One resident described how a simple clinical matter had been handled sensitively and appropriately leaving the resident feeling reassured and confident in the staff’s ability to meet their needs. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 11 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 Residents enjoy a pleasant and supported lifestyle at the home, which helps them maintain a good quality of life, with visitors welcomed and encouraged. Various informal activities, such as music, cooking etc are made available and good meals are provided. EVIDENCE: Staff are encouraged and provided with the time to undertake activities with residents, both individually and as a group. This can involve in house activities or residents being taken out on a trip etc. to the local town or places of interest. Each resident has an allocated “key worker” and it was noted that one key worker went and discussed shopping arrangements with their resident whilst another resident praised both the staff group as a whole and their key worker stating that “I am well fed and looked after and the carers are so kind and helpful, I don’t go shopping but all I have to do is ask my carer and she will get what I want”. Residents’ comments are considered to a very important way of ensuring that the home is meeting their needs. Residents’ meetings are held regularly and comments/ideas acted upon. This was seen by noting the content of the residents’ meeting when reading the minutes and noting what action had been taken to implement any changes etc. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 12 The home operates an open visiting policy and during the day it was noted that visitors were welcomed into the home and were obviously comfortable within the home’s environment. Two spoken with verbally confirmed that they felt their relative was being well looked after, and their individual way of life maintained, which gave them peace of mind. They also said that they were always made very welcome when visiting. The visitor’s book clearly showed that the residents had many visitors at varying times throughout the day. A small, currently little used, room is about to be refurbished to allow residents an area where they can entertain their guests in private, away from the home’s communal rooms and their own bedrooms. The home’s two cooks have been at the home for a number of years and are very familiar with the residents’ individual needs, likes and dislikes. It was noted that the meal served on the day of inspection was of a very good standard, being both appetising and hot and was enjoyed by residents. It was also particularly pleasing to note that staff can now also eat a meal with the residents if they choose to have a hot lunch. This was seen to be a positive step allowing both staff and residents the opportunity to eat together in a communal manner. A written comment received from a relative stated that “the food is very high quality”. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 13 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) 16,18 Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The home’s complaint policy remains in order with all residents and/or their families having received a copy of the complaints procedure, which is contained in the home’s service user guide. The complaint policy is also displayed communally within the home. There have not been any complaints within the past twelve months either received by the home or by this Commission. The manager is currently looking at ways to actively encourage residents to voice any concern/complaint they may have and to feel free to do this in a positive manner, as the manager feels this will allow the home to improve and build on its general delivery of care. Devon County Council have now made financial arrangements that allow residents the opportunity to have the Local Authority hold a small amount of their monies safely in a banking system which also ensures that any appropriate interest payments is paid to each individual resident. Residents can have instant access to their monies from this account known as the Devon County Council suspense account. Residents also hold their individual own bank accounts for larger sums of money. The home continues to maintain appropriate, updated adult protection policies which staff have easy access to, including Local Authority guidance and the “No Secrets” video. All staff have either attended, or are attending, the Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 14 vulnerable adults training made available from the Local Authority. Staff spoken with, were aware of the issues surrounding different areas of abuse and knew what to do if they suspected abuse within the home. New members of staff are taken through adult protection issues during their induction programme. These measures ensure that residents are protected by having an aware staff group. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 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) 19,26 Kenwyn is comfortable, clean and, in some areas, well maintained, however general upgrading of the environment and the upgrading of some worn and dated furniture and fittings in residents’ bedrooms would further improve the residents’ environment. The home provides a safe place for residents to live in. EVIDENCE: Overall the home presented as very comfortable, clean and welcoming. The home is currently suitable for its purpose, in so far that the registered provider is only utilising the purpose built rooms for resident occupancy, whilst communal facilities are sited on the ground floor of both the original building and the purpose built wing. The tour of the building evidenced that the registered provider has recently agreed to the commencement of an upgrading programme, including redecoration of the homes’ corridors will be ultimately aimed at providing a good standard of accommodation throughout. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 16 Bedrooms have been personalised as desired and residents can bring in personal items with them if they wish to. The lounge and dining areas provide adequate space and are well appointed. The management maintains the day to day home’s fire precautions in line with the requirements of the local fire department. With the provision of a new ramp and, the raising of an adjoining walkway, residents have easy access from this area to the home’s very attractive gardens. The home does not yet have definite plans to address the physical shortcomings of the building as identified within the summary of this report, as well as replacing the passenger lift that is currently out of action and therefore stopping access to the first floor of the original building. It was also noted that the radiators within the residents’ bedrooms have not yet been provided with individual thermostats to allow residents to monitor the heating within their own rooms to a temperature that they are individually happy with. The registered provider has provided window restrictors on all windows accessible to residents. A new assisted bathing facility has been provided in the first floor bathroom, which aids those residents with mobility problems. The home was clean, and there were infection control measures in place, which protects residents from the spread of any infections. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 17 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) 27,29,30 Staff at the home are both well trained and employed in sufficient numbers to meet the residents’ needs. The staff recruitment programme continues to ensure that suitable staff are employed to work with the residents, thereby ensuring residents are fully protected. EVIDENCE: There are seventeen residents currently living at Kenwyn (fourteen permanent and three short stay, and one resident currently in hospital). This is the home’s full occupancy. Staffing levels were seen to be in sufficient numbers to ensure that residents’ needs could be met at all times of the day and night. The staff group remains very stable with minimal staff changes, although there has been a few staff changes due to retirement, life changes etc. A staff file was inspected and it was noted that a full recruitment programme was followed through. Residents said that they felt confident with, and well looked after by, the staff and that staff were always available if needed. Positive feedback was received from the residents, and two of their relatives, as to the standard of care received generally, and the manner the care was delivered. The manager has changed the staffing rota to provide extra time for staff to spend some periods with residents in a personal individual manner i.e. talking to them, escorting them, providing activities etc. Training continues to be well planned, including providing NVQ training in care as well as other work related areas. Recognised external and internal training Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 18 opportunities are also provided, which staff confirmed supported them in providing for the varied needs of the residents. The manager is further intending to broaden the training programme to take account of existing staff members personal training interests. This ensures that all residents are cared for by staff, who are aware of their needs and have the knowledge and skills to meet them. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 19 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) 31,33,35,38 The home is managed efficiently and well with the manager seeking residents’ views as to the running of the home. The home is providing a safe environment for the residents, by ensuring the required health and safety standards are met and maintained. EVIDENCE: The manager has been in post for approximately six months. She has many years experience of working with this service user group and has successfully completed her Registered Manager’s Award and her NVQ level 4 in care. She is currently applying to be the registered manager of Kenwyn and will undergo all necessary checks/interview with this Commission to verify that this would be a suitable appointment. This process should be completed by November 2005. The manager has undergone a lot of work in relation to streamlining existing systems as well as giving the home, and residents, the benefit of her Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 20 experience to help increase the residents overall quality of life by providing a good and efficient management structure. The home has a programme of thorough internal quality monitoring systems with residents’ and staff feedback invited as part of the overall process. This has allowed the home to maintain the ISO 9001:2000 quality assurance system award which is being reviewed again next week. Maintaining this ensures that the manager and staff, within the home, are always aware of the need to ensure residents receive a service with which they are satisfied and to which they have contributed ideas etc and seen them acted upon. A representative from the Devon County Council undertakes a monthly visit where several aspects of the running of the home are examined and reported on, including consultations with the residents. This ensures that all practices within the home are regularly, internally reviewed and that the care continues to be of a good standard and as residents would expect/want. Routine health and safety issues are well managed within the home with some required records being made available including the home’s accident book and fire log book which were seen to be up to date and confirms that residents are cared for in a safe and secure environment. Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 21 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x 3 x x 3 Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 22 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 23 Regulation OP26 Requirement The responsible person must explore ways of upgrading and re-siting the home’s laundry room to ensure that soiled linen does not pass through the home and, in particular, past the kitchen entrance (previous timescale given of the 05/08/05 not yet complied with). Timescale for action 14/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP22 Good Practice Recommendations The registered provider should continue to ensure that the recommendations contained within the Occupational Therapist’s Environmental Assessment of September 2004 continue to be acted upon. Consideration should continue to be given to replacing/upgrading residents’ bedroom furniture as necessary/desired. Temperature controls should be in place within service users’ bedrooms to allow them to individually control the temperature setting within their rooms. 2. 3. OP24 OP25 Kenwyn D54-D07 S32506 Kenwyn V225876 120705 Stage 4.doc Version 1.40 Page 23 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. 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