Inspection on 20/10/06 for Kenwyn, Ashburton

This inspection was carried out on 20th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 30/12/05

Kenwyn, Ashburton 14/10/05

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 Unannounced Inspection 20th October 2006 10:00 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 Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kenwyn Address Western Road Ashburton Devon TQ13 7ED 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) 01364 652243 01364 652245 alison.lyon@devon.gov.uk http/www.devon.gov.uk/adoption.htm 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 DS0000032506.V305488.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 30th December 2005 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 can provide 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 or 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 are registered as double rooms), sited in this part of the home, are now not accessible to residents. The situation will be ongoing until the lift is replaced. The home also provides a day care service for up to two service users per day. The home is both well established and well known within the local community. Devon County Council has recently made all interested parties aware that kenwyn, along with some other Local Authority owned residential premises, are the subject of a review under the Devon County Council Modernisation Programme to determine the future of each service. Very recently, (October 2006), various external private organisations were given the opportunity, by the Local Authority, to view Kenwyn and it is anticipated that, by June 2007, some decision will have been reached as to the future of the home. Residents’ current weekly fees at Kenwyn are £556.00. The manager makes the home’s inspection report available to all interested parties and it is located within the home’s entrance hall. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place on Friday 20th October between 10.00a.m and 4.00 p.m. Opportunity was taken to observe the general overall care given to current residents. The care provided for one respite stay resident was also followed in specific detail, from the time they were admitted to the home, which involved checking that all elements of their identified care needs were being met appropriately. A second resident’s details, who was to be admitted on the day of inspection, but who unfortunately got delayed, was also inspected. A tour the premises, examination of the home’s records and policies, discussions with the manager, two assistant managers, residents, staff on duty, as well as two visitors to the home, all informed this inspection. Staff on duty were also observed, in the course of undertaking their daily duties. Other information about the home, including the receipt of several questionnaires from residents, residents’ relatives/advocates, staff members and other professionals associated with the home, has also provided further feedback as to how the home performs, and this collated information has been used in the writing of this report. All required core standards were inspected during the course of this inspection. What the service does well: There continues to be a very relaxed, family atmosphere within the home which the management and staff should be commended on for maintaining, as this helps create a comfortable, pleasant environment for the residents to live in. The staff continue to fully maintain residents’ dignity and rights to make personal choices and ensure that residents are always treated with respect and their individual needs known and met. The care staff group remains mostly stable and very well trained. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 6 They work well together as a team, which helps ensure that residents’ needs are known and well met, whilst residents have a sense of continuity and security due to most staff remaining in post for long periods of time. The management and staff are maintaining a very positive attitude in respect of the possibility of change arising form the Devon County Council Modernisation Programme. This is helping residents remain calm and settled with any feelings of anxiety being kept to a minimum. All interested parties including the residents, residents’ families/advocates, staff and any other interested parties are being kept fully informed by the Local Authority as to what stage the modernisation programme has reached. Having this awareness and being included in the consultation process has aided residents and their families/advocates to have an understanding of what possible changes that may take place. This has helped relieve some uncertainties. What has improved since the last inspection? Since the last inspection the management of the home have improved and streamlined their recording and filing systems within the home. In particular the residents’ care plans have been fully amended and are now very detailed and concise with information presented in an easily accessible format. This aids all who need to access the information and, ultimately, helps ensure that all staff are aware of how best to provide care for the residents by allowing them easy and quick accessibility to all records. Some general upgrading has taken place including new carpeting in a resident’s bedroom, completion of the repainting of the home’s internal corridors, redecoration of the home’s dining room and other routine general upgrading. The result of which is that the home continues to maintain a very comfortable and well maintained environment. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 7 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 Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 8 contacting your local CSCI office. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 9 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 Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 10 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 (6 is not applicable). The quality in this outcome area is good. The admission process continues to be well managed with any respite residents’ needs well known prior to admission, to ensure that the client is certain that their needs will be met whilst at the home. EVIDENCE: The home is not currently admitting further permanent residents (currently there are thirteen permanent residents within the home) but will offer placements for up to five respite residents, bringing the total resident numbers accommodated to eighteen (however it should be noted that the home is presently only accommodating up to sixteen residents due to some recent staffing shortfalls). By doing this the management are ensuring that there are sufficient staff available to be able to fully meet the needs of the sixteen residents who will be at the home. By looking at the records for a resident, who had been admitted, as an emergency admission a few days before the inspection, for a respite stay, it Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 11 was noted that a full and detailed admission procedure had been undertaken, even when time was of the essence. This had ensured that Kenwyn was an appropriate respite placement for the resident. The majority of respite clients are already known to the home, as was the case with the emergency placement, either having come for day care or had a previous stay at the home. This helps residents settle well and allows staff to be very familiar with their needs. It was pleasing to hear the comments about two residents who had met in hospital and who were both now in receipt of short stay breaks at the home. The management try to accommodate both of these residents in adjoining rooms, if at all possible so that they can enjoy each other’s company whilst at the home. The home does not provide intermediate care. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 12 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 quality in this outcome area is good. All residents are looked after well in respect of their health and personal care needs. Residents’ privacy and dignity is upheld and their life style choices respected. EVIDENCE: Care plans were seen in respect of the two respite clients whose care was inspected in detail. These were noted as being thorough and covered all required care needs as well as social and psychological needs. Care plans have recently been upgraded at the home and now form a very concise and informative document. Residents were noted as being involved in their care planning processes. The thirteen permanent residents have been at the home for significant periods of time and their needs are well known, documented and reviewed regularly with the resident themself and/or their relative/advocate (evidence seen). Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 13 Staff were given training days, by the management of the home, to ensure that they were familiar with the new care planning processes/documentation and now have a larger role in maintaining the resident’s care plane. For some staff it remains a challenge, to find the time available to maintain the care plan accurately, however, having such involvement, does ensure staff are fully involved in the delivery of the care. It was noted that, although there were detailed entries on each resident, these had not in all cases been written on a daily basis. In the case of the resident whose care was inspected there was a forty-eight hour period where no entry had been made. This could lead to some small observation not having been recorded, which could prove to be useful information in maintaining the resident’s care needs. The residents’ health care needs were being fully met, including any specialist needs. One resident was noted as being treated appropriately for an infectious condition with the home having an up to date risk assessment, and ensuring proper care measures are in place to be able to offer excellent care whilst fully protecting other residents and staff from the risk of cross infection. Other professionals had been, and continued to be, involved in the care for this resident. There were many positive feedback comments received from residents such as: “I am very happy with my care”: “They couldn’t look after me better”: “Marvellous care, very happy here, I don’t want to go anywhere else”. Clinical needs are noted as being well provided for and the home has a hoist, mobile stand aid and other lifting equipment including lifting belts, slide sheets and disabled toilet and assisted bathing facilities are provided. Medicines were well managed within the home with the management only being responsible for this. Drug records were inspected and seen to be in order. Stock control was regularly monitored. There are no controlled drugs in use at present. The home’ medication policies were in order. Initial medication training has been provided to those staff that are involved in this area, however discussion with the assistant manager on duty confirmed that she had not had any updated medication awareness training for over two years. This could mean that she may not be fully familiar with any new procedures. A recommendation was made for all staff, involved in drug administration, to receive regular updated training to ensure residents remain fully protected. There is also one nursing bed in use and it was noted that this bed did have attached cot sides, which were being used. A risk assessment was not seen to be in place regarding the use of the cot sides however following on from a discussion regarding this, it was noted that the management staff subsequently went to great lengths in discussing the use Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 14 of the bed and the cot sides with the residents’ two sons who happened to be visiting at the same time. The management also contacted the resident’s G.P surgery during the inspection to confirm correct usage of the cot sides. It was also noted that the management team all had an excellent awareness of this resident’s overall individual needs, which they discussed with the sons who subsequently said: “You all have looked after ----- so well and you all spoil him. We are quite confident that the care you give will be the correct care”. The sons were also fully aware of which member of staff was the resident’s identified key worker and they knew that their relative responded well to this member of staff. All residents’ individuality and dignity was noted as being upheld by staff at all times during the inspection and all residents spoken to confirmed this to be the case. An example of this in practice was how staff responded when a telephone call was received from a husband of a resident. Staff took the resident to a private area where she could speak in private, rather than bringing the mobile phone to her in the communal lounge. Although this took time as the resident uses a wheelchair for transportation, great patience, respect and sensitivity was shown by the staff dealing with the situation. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 15 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 quality in this outcome area is excellent. Residents continue to enjoy a peaceful, pleasant yet varied life at the home, with visitors encouraged and links encouraged and maintained with the local community. Various activities are made available. Good meals continue to be provided. EVIDENCE: All of the residents were spoken with and, without exception, all stated that they were comfortable at Kenwyn and enjoyed living or staying there. One resident stated that they felt Kenwyn was: “the best home in the South West, as the staff are kind and helpful, the food is great and I have a nice room with beautifully clean bedding and towels”. Feedback from residents also indicated that they were satisfied with the level of activities provided and staff fed back that they felt that residents benefited from the outings, trips, social events and activities provided for them. The home has recently been left a legacy from a previous resident, which is being used to enhance the residents’ lives. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 16 Resident’s were discussing at the residents’ meeting, which was being held on the day of inspection, whether or not to purchase a new T.V and a full Sky subscription, which would allow then to access films and sport. It was agreed that this is what residents would like to do and during individual discussions with them later it was clear that they were looking forward to this new addition to their lives. It was also agreed to purchase a new musical organ as the residents enjoy having a sing along. On the day of inspection one afternoon staff member was hosting a sing-a-long to which a number of residents had come to and were clearly enjoying. The residents themselves were choosing the songs to be sung and then all enjoyed joining in. A new organ would certainly add extra pleasure to these musical afternoons!! (For the couple of residents who preferred to be quiet the home’s other lounge was available and was also noted as being warm and cosy with staff socially interacting with the residents’ in this room as well). Finally a Christmas shopping trip was also discussed and it was agreed to plan one for those residents who wanted to participate. Two small examples of how staff maintain a resident’s quality of life was noted in the very kind manner and unobtrusive manner in which a resident, who had been sat for some time, was quietly asked if they wanted to be lifted to have their clothes rearranged be made comfortable. This took a little time, had not been requested by the resident yet when offered was much appreciated. It had been a resident’s birthday the day before the inspection. Cards were displayed with one signed from “all your friends at Kenwyn”. Flowers were also beautifully displayed, from the birthday, in the main lounge for all to see. Library books, jig saw puzzles (and trays to do them on) were noted as being easily available. There was a photograph board with recent photographs of the residents at various activities. A notice board gives an indication of what activities will be made available in the forthcoming month. There is a water cooler available in the communal hallway for residents, visitors and staff use Equality and diversity was noted as being maintained routinely during the day to day care of the residents. A small example of this was the way that choice was offered, and time given, for a resident to think about what choice of biscuit they may want. One frail resident had been brought in some new biscuits by their family. These were different to the usual ones the resident had. When asked if a biscuit was wanted, staff waited and listened to the reply which was the resident really would prefer to have one of the new biscuits. This was not easy to understand immediately as the resident does have some communication difficulties, but the resident was treated with equal respect and given equal opportunities throughout the inspection, as were all other residents. During the inspection two visitors spoken with confirmed that they were always made welcome and could visit as and when they wished. The home had a visitors’ book, which had many entries at differing times. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 17 Meals provided remain good. All residents spoke highly regarding the quality of the meals they received, whilst the meal on the day of the inspection was appetising and had been enjoyed by the residents. Choices are made available and staff are familiar with the residents’ individual likes and dislikes. Special dietary needs were being met. One resident feedback comment stated: “Alternate food is available to me as I am a diabetic.” One resident has liquidised food and, after consultations with the resident, the cooks prepare this in the manner the resident has chosen, in other areas the resident still wishes to have “normal” food i.e. bread and butter with the crusts on, again this is facilitated. All menus are displayed within the home and resident participation is encouraged as to what menu choices are to be provided and residents given the opportunity to voice these at the regularly held residents’ meetings. The two cooks at the home have been there for several years and have the responsibility for the planning and serving of the meals. The majority of the staff have recently undertaken, and been successful, in a distance learning course in food hygiene which further informs them as to how to protect residents in the serving/storing of food. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 18 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 quality in this outcome area is good. Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The home’s complaint policy remains centrally displayed and is also contained within the home’s statement of purpose. The home has not received any complaints via the Commission or internally within the past twelve months. Residents spoken with confirmed that they would feel confident to voice any concern they had and verbal and written feedback from residents also confirmed that they knew how to complain. The complaints procedure was also reiterated at the resident’s meting held on the day of inspection. All staff receive vulnerable adult training and are made aware of the Local Authorities polices and procedures in relation to adult abuse issues. Staff confirmed that they would know what action to take if they had any concerns over the way a resident may be being treated. Ultimately this ensures that all residents remain protected whilst at Kenwyn. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 19 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): 19,26 The quality in this outcome area is adequate for the residents currently accommodated at the home. Although Kenwyn continues to provide comfortable, clean and well maintained accommodation, in respect of the areas currently being used by the residents, some areas of the home still remain unsuitable for residents at this present time due to access problems. However upgrading to all areas of the home, still needs to be undertaken to ensure residents live in an environment which fully meets the requirements of National Minimum Standards for care homes for the elderly. 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, within the home, for resident occupancy, whilst all communal facilities are sited on the ground floor of both the original building and the purpose built wing. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 20 The tour of the building evidenced that continued upgrading, including the redecoration of the homes’ corridors and dining room and some refurbishment of the home’s furniture and fittings, had been undertaken since the last inspection which ensures a good standard of accommodation is maintained as far as possible throughout. However the Registered Provider does not yet have definite plans to address the physical shortcomings of the building, as identified within the summary of this report, including the replacing of the passenger lift which is currently out of action and therefore continues to prevent access to the first floor of the original building. The radiators within the residents’ bedrooms have not yet been provided with individual thermostats to allow residents to be able to monitor the heating within their own rooms to a temperature that they are individually happy with. An alternative access to the home’s laundry room, to help prevent the risk of cross infection, has not yet been identified. It is understood that these environmental shortcomings have been considered in Devon County Council Modernisation programme as previously discussed in the summary of this report. However the management confirmed that regulation of hot water to a safe temperature is in place throughout the home, and those tested at the inspection, were in order. Bedrooms, although small in some cases, 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 home’s fire precautions were noted as in line with the requirements of the local fire department. With the provision of a ramp and, the raising of an adjoining walkway, residents have easy access to the home’s very attractive gardens. The manager confirmed that the Registered Provider has provided window restrictors on all windows considered to be a risk. An assisted bathing facility is provided in both communal bathrooms, which aids those residents with mobility problems. The home was very clean, and there were general day to day, as well as specific, infection control measures in place, to protect residents from the spread of infections. Staff were noted as ensuring they maintain polices to help prevent the risk of cross infection such as changing their clothing when serving food, wearing protective clothing and washing hands as needed. Clinical waste is disposed of correctly and the home has adequate laundry equipment. The security of the home has been enhanced following a recent theft from the home of some donated monies (the police were immediately involved). All fire exits are now kept locked as well as the front door, which is only opened when the door bell is rung and the staff entrance has been provided with a key pad lock and a door bell. The fire exit that is used for easy access for wheelchair users is also kept locked has been provided with a door bell. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 21 Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 22 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 quality in this outcome area is good. Staff at the home are well trained and supported, and employed in sufficient numbers to meet the residents’ needs at all times. EVIDENCE: There are up to fifteen residents currently living at Kenwyn, thirteen are permanent and three are respite residents. 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. An agency staff member was being used on the day of the inspection to ensure that the staffing numbers remain met. The staff group remains mostly stable with only a few staff changes. Residents again confirmed that they felt confident with, and well looked after by the staff and that staff were always available if needed. There is sufficient rotered time for staff to spend periods with residents in a personal individual manner i.e. talking to them, escorting them, providing activities etc. The minimum number of staff, employed during the morning shift, are three carers, in the afternoon there are two and in the evenings three. There are also adequate ancillary staff employed, including a full time daily cook, domestic staff and management cover at all times. Two waking night staff and one sleep-in member of the management staff provide nighttime cover. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 23 The manager has employed one new staff member since the last inspection. The recruitment records were inspected and were noted as being up to date and showed evidence of a fully robust recruitment procedure which protects residents. The new staff member was spoken with and as able to confirm that she had been taken through a rigorous recruitment process. She was now settled at the home, enjoying her work and felt supported by other experienced staff. She had been made aware of the need to respect residents’ dignity at all times and felt that she was able to help the residents generally to have a good life at the home. Induction training had been made available to her, as had other statutory training and she confirmed that she was now also considering undertaking her NVQ level 2 award in care. Training generally continues to be very well planned for all staff. Recognised external and internal training opportunities are also provided. This training ensures that all current residents are cared for by staff who are aware of residents’ needs and have the knowledge and skills to meet them. All staff receive adequate supervision to ensure that they are fully able to carry out their roles and are supported in any area where they identify a need. Staff comments received including one that stated that the staff: “worked well together as a team”, whilst another stated: “that the home were up to date about courses”. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 24 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): 31,33,35,37,38 The quality in this outcome area is good. The home is mostly managed efficiently and well. The home’s quality assurance systems are such that they ensure that the home is run in the best interests of the residents. The accommodation currently being utilised provides a safe, secure environment where residents’ safety and well being is maintained. EVIDENCE: Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 25 The previous registered manager resigned from her post in March this year. The current (non registered) manager has many years experience of working with this service user group and has successfully completed her Registered Manager’s Award (December 2004) incorporating NVQ level 4 in care and management. Currently she is managing two Devon County Council care homes, including Kenwyn (where she previously worked for several years). She divides her time equally and is supported in this, at each home, by a team of assistant managers. This was agreed by this Commission following the reduction of resident numbers at both of the homes and the uncertainty as to the future of both of the homes. Feedback as to the manager’s role within the home indicated that staff and residents have confidence in her (with many already knowing form when she worked permanently in the home) and feel confident that she has their best interests at heart. At Kenwyn there are a team of four assistant managers, supporting the manager, two of whom are very experienced. The other two assistant managers were appointed fairly recently. There was some mixed feedback from staff as to how the management team perform over all. One comment received back stated: “The management and staff, working as a team, provide good care by trained staff for all service users and meet their physical needs and social needs in a happy atmosphere”. However there was also some feedback from staff to indicate that the staff felt that one of the newer members of the management team did not always appear as fully aware of the day to day running of the home, on occasions, as they would wish. They also felt that communications between themselves and the management team generally could be better, particularly as the home was going through such a time of change. This was discussed fully with the manager at the inspection, who would now address the matter in an open staff meeting. (The manager later gave confirmation that a staff meeting had taken place a week after the inspection where these issues had been fully discussed and actions put in place to address the concerns of the staff). It is to the manager’s credit that she has been able to help keep staff motivated to provide a continuous good standard of care for the residents currently at the home as staff did make such comments as: “ feeling unsettled” and “disappointed”, that the future of Kenwyn has not yet been decided. Feedback from staff also stated that this affected their morale generally. Feedback from a relative also stated the following: “Our concern is for the future of Kenwyn”. However it was clear from evidence gathered and used within this report that the residents themselves continue to feel well cared for and enjoyed living at Kenwyn. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 26 A senior representative from Devon County Council undertakes a monthly, in depth, quality audit visit where several aspects of the running of the home are examined and reported on, including consultations with the residents. A new representative is to be shortly appointed, following the resignation of the previous person, who will then continue with this practice. This helps ensure that all practices within the home are regularly reviewed and that the care continues to be of a good standard and as residents would expect/want. The previously identified Responsible Individual for Devon County Council has also resigned and the Local Authority has recently appointed Ms Wendy Price who is the Assistant Director for Older People and Physical Disability for South Hams and Teignbridge, and the Commission has now been made aware of this change. The management of the home conducts regular surveys and holds regular staff and residents meetings to obtain feedback from all parties as to the running of the home, which is acted upon if possible. The information from these surveys was seen and is made available to residents and visitors to the home to allow them to know their views are known and will be acted upon. The most recently collated results from the questionnaires were presented to the residents at the residents’ meeting held during the inspection. There were sixteen responses to the questionnaires. Such questions asked were: “What do you feel about the way staff talk to you?” “What do you think about the service you receive?” “Are the staff helpful and courteous?” and “Are you given a choice of what time you go to bed?” It was noted that there was almost hundred percent satisfaction to these particular questions. The home has always run a good quality internal auditing system, which meets with the requirements of the ISO900-2000 standards. This helps ensure that the service continues to provide the best care possible based on the feelings of those that use or have contact with the service. The manager stated that routine health and safety issues continue to be well managed within the home, and records inspected such as the fire log book and the home’s accident reporting indicated this to be the case. It was also pleasing to note that items such as fire awareness are discussed routinely with the residents, as had happened on the day of inspection at the residents’ meeting. Devon County Council have developed a system to manage any residents’ monies, that need to be held by the home, to ensure residents have individual access to their monies but that the monies are also secure. It was noted that the home’s communication book held collective personal information about several residents on each page which does conflict with the principles of ensuring certain records are maintained in a confidential manner in line with the Data Protection Act 1998. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 27 However, all other records inspected were noted as being up to date, concise and professionally maintained. Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 28 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 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 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 3 x x x 3 x 2 3 Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 29 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 OP26 Regulation 23 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 timescales given of the 05/08/05 and subsequently 14/04/06 not yet met). Timescale for action 20/06/07 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 OP7 Good Practice Recommendations Any use of restraint measures such as cot sides should be risk assessed and advise sought as to the use of such restraint from other relevant professionals. Staff should record a daily entry for each resident. Updated medication awareness training should be provided for staff who routinely administer medication. DS0000032506.V305488.R01.S.doc Version 5.2 Page 30 2 3 OP7 OP9 Kenwyn 4 OP22 The registered provider should continue to ensure that the recommendations contained within the Occupational Therapist’s Environmental Assessment of September 2004 are acted upon. If the first floor of the home’s original building is to be utilised again, adequate repairs to the existing lift, or a replacement lift must be provided to ensure safe and easy access for residents. Consideration should continue to be given to replacing/upgrading residents’ bedroom furniture as necessary/desired. Temperature controls should be in place within residents’ bedrooms to allow them to individually control the temperature setting within their rooms. All records, within the home, should comply with the Data Protection Act 1998. 5 OP24 6 OP25 7 OP37 Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Ashburton Office 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 Kenwyn DS0000032506.V305488.R01.S.doc Version 5.2 Page 32 - 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. 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