Inspection on 16/05/08 for Kenyon Lodge

This inspection was carried out on 16th May 2008.

CSCI found this care home to be providing an Adequate service.

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

Kenyon Lodge 18/08/09

Kenyon Lodge 25/02/09

Kenyon Lodge 25/05/07

Kenyon Lodge 15/06/06

Kenyon Lodge 02/03/06

Kenyon Lodge 04/12/04

Kenyon Lodge 28/06/04

Kenyon Lodge 31/01/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Kenyon Lodge 99 Manchester Road West Little Hulton Manchester M38 9DX Lead Inspector Elizabeth Holt Unannounced Inspection 16th and 19th May 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kenyon Lodge DS0000006713.V363946.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. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kenyon Lodge Address 99 Manchester Road West Little Hulton Manchester M38 9DX 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) 0161 790 4448 Trees Park (Kenyon) Ltd Ms Carol Lambert Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (58), Physical disability (2) of places Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home accommodates a maximum of 60 service users requiring either nursing care or personal care only. Two named service users who are out of category by reason of age may be accommodated. Should either of these service users no longer require their places at the home, or reach the relevant age, the category will revert to old age (OP). 25th May 2007 Date of last inspection Brief Description of the Service: Kenyon Lodge is a registered care home providing nursing care and personal care and accommodation for up to 60 older people. Care is provided to 30 residents assessed as needing personal care only and 30 people who require nursing care. All personal care beds are located on the first floor. The home is set in its own grounds with a designated parking area and a large secure garden area to the rear with patio area. The home is situated on a main route in Little Hulton enabling easy access to Manchester, Salford and Bolton. The current scale of charges at the home is £355.52 -£525.00 per week. Costs in addition to the fee are hairdressing £3.50-£16.00, Chiropodist £10.00 per visit, newspapers-varied and toiletries which are charged on an individual needs basis. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This visit was undertaken as part of a key inspection, which includes an analysis of any information received by the Commission for Social care Inspection in relation to this home prior to the site visit. Prior to the inspection the provider completed an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment and a dataset that is filled in once a year. It is one of the main ways that the CSCI obtains information from providers about how they are meeting outcomes for people using their service. The AQAA also provides the CSCI with statistical information about the individual service and trends and patterns in social care. Service user, staff and relatives surveys were provided for distribution before the inspection and eleven were returned from service users/relatives and 1 from a member of the staff team. Comments from these surveys have been included in this report where possible. The visits were unannounced and took place over the course of 9.5 hours on Friday 16th and Monday 19th May 2008. During the course of the visit time was spent sitting and chatting with people who use the service, some of the staff including the registered manager and visitors to the home. Records were looked at in relation to the running of the home and health and safety and a partial tour of the premises was made. The term preferred by the people consulted during the visit was “residents”. This term is, therefore, used throughout the report when referring to those living at the home. What the service does well: The home ensures that prospective people are assessed properly before an offer of a place is confirmed and have written information about the home. Staff were seen talking and generally having positive relationships with the people living at the home. It appeared that the privacy and dignity of the people was protected. Relatives and some of the people who could express a view said, “the staff are friendly and attentive”. The home had an open visiting policy and relatives spoken to said they were made to feel welcome whenever they visited. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 6 A choice of food is available at each meal and the residents spoken to were happy about the choice and quantity of food. The procedures in relation to the administration and recording of medication were satisfactory at the time of this visit. The procedure for people living at the home and/or their representatives to raise any concerns or complaints was displayed in the entrance hall and was easy to follow. The people living at Kenyon Lodge benefited from the commitment and leadership of the manager. What has improved since the last inspection? What they could do better: Some shortfalls in the recording of appropriate information in the care plans may put people at risk of not having their needs fully met. Information in the care plans must be followed to ensure people’s health, personal and social care needs are met. Where individual care plans are made these should be addressed and action taken to support the resident appropriately. The care plans were not always adequately reviewed, the lack of monitoring of residents’ overall condition and well being means that residents’ needs are not being met. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 7 Risk assessments should be fully completed. Particularly in relation to the nutritional needs of the people accommodated. The systems in place for recording the care and attention people require must be improved. Although changes had been made to the type of charts used, the shortfalls in filling these in may lead to peoples needs not being fully met. The management and staffing arrangements need to be looked at to make sure the staff are trained and competent to meet the residents’ needs. A recommendation was made for the manager to be given some additional guidance and support to enable her to manage the care home in the best interests of the residents. 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. The summary of this inspection report can be made available in other formats on request. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 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 Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to choose a home, which will meet their needs. They can be confident they will have their needs properly assessed as part of the admissions procedure. EVIDENCE: A Statement of Purpose and a Service User Guide was available in the reception area and a copy of the Service User’s Guide was available in each resident’s bedroom. Prospective residents and their relatives were encouraged to visit the home before making a decision to move into Kenyon Lodge. The AQAA stated that all prospective residents were seen by a senior person from the home to obtain relevant information about them before admission and the nurse in charge confirmed this. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 10 Four pre admission assessments were looked at. The assessments were varied in the detail provided following an assessment of their needs. For one resident the information was confusing as the Moving and Handling assessment recorded the resident requires a wheelchair and the support of two staff for assistance because she is not able to walk or stand. The pre admission assessment states, “can walk and stand with assistance”. I discussed this conflicting information with the nurse in charge who said, “Oh yes she can walk” and the resident was seen walking with the assistance of two staff members. In order to make sure the residents needs can be appropriately met it is important that the assessment information is accurate. For another resident the assessment of needs contained a range of detailed information about the person’s personal and healthcare needs. Included in the resident’s files were copies of the assessments from the purchasing local authority. Two residents who were new to the home felt they were settling in well to Kenyon Lodge and commented that the staff were “looking after us quite well, thank you”. Eleven surveys were returned to the Commission from residents and or their representatives. All eleven felt they received enough information about the home before they moved in so they could decide if it was the right place for them. One relative wrote, “I visited the home at several different times to see what was going on and every time staff were working hard. I was told about all the facilities.” The home did not provide intermediate care. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some shortfalls in the systems and practices for monitoring the healthcare needs of the residents may lead to residents needs not being fully met. EVIDENCE: The previous inspection report highlighted concerns regarding the need to improve care plans to show the changing needs of the residents and to make sure the pressure relief and dietary intake charts were well recorded for residents with complex needs. Samples of resident’s care plans were looked at and showed that some improvements had been made. Each resident had a detailed care plan and the care plans looked at showed the support individuals needed. The updating of the care plans to show the changing healthcare needs of residents was not always done. There was not always evidence that the resident themselves or their representative had been involved in the care planning process. Each care plan was monitored and reviewed on a monthly basis. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 12 Although residents who could express a view said they were happy with the care they received, a number of shortfalls were noted: At the time of the visit on the first day eight residents were being cared for in bed due to their healthcare needs and poor health status according to the manager and the nurse in charge. As raised at the last inspection the pressure relief charts and the dietary intake charts for these residents had not been kept up to date and the staff were not seen to check on these residents over periods of time. One resident was seen to be on her back at 8.45 and at 1.35pm she was still on her back and had not had her position changed. The staff commented she was able to move herself however this resident had not moved. This resident had a wound that had nearly healed and was now on a lower grade pressure-relieving mattress where regular pressure relief would be more important to continue the healing process. One of the staff commented that the reason one of the residents was cared for in their bedroom was due to the noise they caused and upset to others. The amount of time the staff went in to engage in conversation with this resident was for a very short time only during the few hours observed. For another resident who was cared for in bed on the morning of the visit, the nurse said the resident had been unwell the day before. The daily statements for this resident did not record any episode or reason why the resident should stay in bed and the resident appeared quite unsettled sitting in bed on her own. At approximately 2pm this resident was assisted to get dressed and was walked to the day room with the support of two staff and she was bright in mood. In relation to oral hygiene there was no evidence to show that regular mouth care was being carried out. One resident’s mouth looked so dry and unclean that the manager was asked to look at it. This resident’s relative did comment this was quite regularly the case when she visited and although her relative could be challenging to care for it was not pleasant to see her mouth in such a poor state. One residents relative wrote in the survey that, “My grandfather wears pads due to incontinence through dementia. On occasions I have visited and found him very wet and stinking of urine. I feel more could be done to address this by checking and changing his pads and clothing, if need be on a more frequent period.” On the first floor, a resident who was in receipt of personal care only had been in the home for approximately six weeks on respite care. His care plan stated to weigh regularly, weekly or monthly as necessary and to liaise with the dietician. It was of serious concern that shortfalls in the monitoring of this residents weight and action taken to refer this resident to the GP and the dietician led to his dietary and health needs not being fully met. During the visit a recording of his weight was requested which showed he had lost just under 7kgs. Action was taken immediately by the senior care worker to make Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 13 the appropriate referrals. Although this residents care plan was detailed it did not fully reflect an appropriate audit trail of his healthcare, personal and social care needs. For other residents there was a record to show the GP and dietician referral had been made following the recording of a resident’s weight loss and poor appetite. Discussion with a resident highlighted that action had been taken by a senior staff member to stop a resident’s regular social alcohol intake. This was clearly distressing to the resident. It was of concern that the staff member felt they were acting in the best interest of the resident and the resident considered this a restriction of his choice. The residents themselves and or their representatives must be involved in any changes to their care plan. Surveys were received from 11 residents and or their representatives. From the responses, eight people felt the care home meets the needs of their relative, 3 said they usually met their friends/relatives needs. One relative added, “Maybe more showers or baths as Mum has mentioned this and if she feels the carers are busy she will not ask.” Risk assessments were in place for nutrition, pressure care and falls. Guidance for the safe use of bed rails was included as part of the care plan. Input from Community nurses, continence nurses, General Practitioners and others were recorded in the individual’s files. Residents with diabetes, for example were supported to access appropriate community services, for example chiropody. The residents looked appropriately dressed and their fingernails looked clean and at a comfortable length. Medication was appropriately stored in a clinical room. A sample of medication records was looked at and it appeared that residents were receiving their medication appropriately. Controlled drugs were appropriately stored and recorded. From observations made and discussions with the staff during the two days of the visits it appeared the staff were respectful to the residents in the way they spoke with them. A number of the staff clearly knew the residents well and had positive communication with them. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social, cultural and recreational activities generally meet the expectations of people living at the home. EVIDENCE: Relatives and friends are able to visit the home at any time during the day and a policy was available regarding open visiting. For nighttime visiting relatives are requested to inform the home for security reasons. A number of relatives/friends were seen visiting people at the home during the site visits and whilst one visitor spoken to was very positive about the care their relative received, two expressed some concerns about their relative. These concerns were discussed with the manager during the visit and action was taken as necessary. One of the relatives wrote in the survey, “Staff are always willing to help and care for Mum in more ways than they can. They are always there for her. Very good levels of service and kindness.” People accommodated at the home said their relatives and friends were made to feel welcome and were encouraged to visit the home and take their relative Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 15 out on excursions. The people living at the home could see their relatives in the communal lounges or in the privacy of their own bedroom. Meals are served at certain times in the communal dining rooms. On the day of the visit the lunch was fish, chips and mushy peas followed by sponge and custard. The food looked generally wholesome and appealing and three residents said, the food was good and there was enough to eat. One resident who responded in the survey said they usually liked the meals at the home and “the meat was sometimes a bit gristly and a bit more money to the food budget would be a good idea.” Staff were seen to be supportive of the residents who required assistance during mealtime and attempts were made to make this a pleasant sociable occasion. Residents who chose to sit for a lengthy period of time after lunch were encouraged to stay round the table and chat. Since the last inspection a new activities organiser was in post. A newsletter was available which showed the events and activities provided in April and May 2008. A discussion with the activities organiser and the manager and a look at the activities notice board showed some of her ideas for the near future and recent events/activities. As well as carrying out some group activities and games, the activities organiser spoke of the time she was spending with residents on a one to one basis to find out their likes and dislikes. One of the residents had recently done some arts and crafts work which she had enjoyed. Another resident had been helping out in the potting of some plants to enjoy on the patio area outside. The care plans included some social history and their likes and dislikes but did not include a record of any activities they had joined. Whilst it recognised that residents vary in their capacity and choice to involved in social activities, this should be recorded in their individual care plan. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident their concerns and complaints will be taken seriously and staff were competent to deal with any allegations of abuse. EVIDENCE: The complaints procedure was available on display and information on how to make a complaint was included in the Service User Guide to the home. From a review of some of the training records some of the staff have received training in Safeguarding Adult procedures and when questioned staff aware of the course of action to take in the event of an allegation of abuse and had read the home’s policy and the local procedure. Some further dates for abuse awareness training were being put forward to those staff that had not yet received this training. Responses in the residents/relatives surveys showed that ten out of the eleven people knew how to make a complaint about the service and felt the manager or senior staff were approachable. Since the last inspection the manager has made an appropriate referral to the Salford Council’s Safeguarding team and this resident care needs were reassessed. Two other safeguarding referrals have been investigated. One of these highlighted shortfalls in the staff accessing prescribed medication for a resident, which had the potential to contribute to their poor health status and Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 17 the second referral showed that the home’s daily record keeping did not clearly reflect the support given to the resident. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, comfortable and homely environment. EVIDENCE: The home was clean and tidy and odour free on both of these visits. The corridors were bright following a redecoration programme and painting to the outside of the home was planned. A cleaning programme was in place. A partial tour of the premises took place, which showed bedrooms, bathrooms and communal areas to be pleasantly decorated. Residents who could express a view were pleased with their bedrooms and a number of residents had personal effects including photographs and pictures in their rooms. One of the residents had just had a fish tank put into her bedroom and another resident said, “I like spending time in my room around my pictures and belongings, it feels homely”. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 19 There was no evidence to show that the use of orientation aids was used to assist residents living at the home who have a dementia type illness. Procedures are in place for infection control practices and the staff were aware of the importance of good hand washing practice. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Consideration is needed to ensure the staff have the skills, competence and knowledge to meet the resident’s needs at all times. The procedures for recruiting staff were robust and provided adequate safeguards to protect people living at the home. EVIDENCE: On the day of the visit there were twenty-eight residents in receipt of nursing care and twenty-five residents in receipt of personal care only. One resident was in hospital. On the day of the visit the registered nurse and the four care staff on the nursing floor were permanent members of the staff team. On the personal care only floor there was one senior care worker, two care workers and one agency care worker. Although the numbers of staff appeared sufficient to meet the resident’s needs and the staff were supported by the home’s manager, administrator, domestic, catering and the activities organiser, it was of concern that resident’s needs were not attended to fully (see health and personal care). The homes manager should review how the staff are spending their time during the shift. Staff did comment when questioned about the pressure relief charts and the food and fluid charts not being completed fully and that they had not done Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 21 their job properly because the inspector was in the home. In view of the high number of residents spending the day in their bedrooms the manager must review the deployment of staff to make sure the needs of the residents are met in full. A review of the duty rotas over two months and from information provided in the AQAA showed there is use of temporary staff and agency staff in each unit on a regular basis. Information provided by the manager showed that twentytwo staff had left the home since the last inspection. This has the potential to lead to a lack of continuity of care for the residents although the manager commented that some new staff had been recruited recently. A review of three staff files showed that recruitment practices were robust and appropriate pre employment checks were carried out. Pre inspection information supplied by the manager stated that 50 of the care staff had completed NVQ Level 2 or above and a further 7 staff were currently working towards NVQ Level 2 or above. Staff spoken to felt the manager was supportive and encouraging of their training needs and the one staff member who completed a survey commented that, “I feel proud to work at Kenyon Lodge and have enjoyed the training courses. If we don’t know anything the manager always gives us the information we need. It is a friendly place to work and to live for the residents.” A review of staff training showed that although the manager had an annual planner for courses a training matrix would show clearly that staff have received all mandatory training. Since the last inspection two staff had attended a training course on dementia care and training on health and safety had been booked for two staff. Some of the issues raised in this report in relation to meeting the needs of the residents accommodated highlight the need for staffs training needs to be reviewed constantly. It is recommended that staff are guided and supported to promote the health and well being of the resident’s accommodated. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements continue to have been made in management practices since the last inspection, however some practices did not promote and safeguard the health, safety and welfare of the residents accommodated. EVIDENCE: The residents accommodated benefit from a committed and experienced manager who is a qualified nurse. She has undertaken a range of training and has now completed the Registered Managers Award. The manager clearly takes her responsibilities seriously and is keen to review and improve the service provided. The comments made in the surveys showed the manager was approachable and felt she listened to and acted upon comments made. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 23 The nurse in charge on the day of the inspection has been at the home for approximately ten months and is competent in the care of older people and the management arrangements for the personal care only residents have recently changed. Because of the observations made during this visit and the concerns raised at the last inspection in relation to the ongoing monitoring of the residents care needs, the conclusion is that following the shortfalls identified, the manager needs more guidance and support to effectively manage the home on a daily basis. There is a quality monitoring system in place and there was evidence of a service user satisfaction survey, which the manager had sent out in March 2008 and had developed an action plan for improvements following this. The manager had the policies and procedures in place to ensure the financial interests of the people living at the home are safeguarded, a sample of individual records were looked at during this visit and were satisfactory with evidence of receipts for any monies spent. The manager has an open style of communication and encouraged families and friends to express any concerns or issues that need addressing. Relatives meetings were arranged to discuss any issues and minutes were available of these. The fire logs were seen and the required checks had been made. Water temperature checks were recorded and records showed adjustments were made as necessary to the thermostatic mixer valves. Any reported accidents/incidents were recorded in an appropriate log book. The manager had an accident report log which showed the monitoring of accidents in the home. The Commission are notified under Regulation 37 of the Care Homes Regulations of notifiable incidents/accidents that have taken place in the home. Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 24 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 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 2 X 2 X 3 X X 2 Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 13 Requirement The assessed and changing needs of the people accommodated must be reflected in the care plans so that staff are aware of changes and the actions to take to meet those needs. The daily entries must be clear and detailed. Failure to address this puts residents at risk of not having their health, personal or social care needs met. This remains outstanding from the 01/08/06 and the 25/0707. The nutritional risk assessments must be clearly recorded to ensure people receive support with their diet as needed. Food and fluid records and pressure relief charts must be clearly recorded to ensure people’s needs are met. This remains outstanding from the 31/07/06 and the 13/07/07 Timescale for action 25/07/08 2. OP8 15 13/07/08 Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 26 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. 2. Refer to Standard OP19 OP12 Good Practice Recommendations In order to assist residents with dementia, it is recommended that orientation aids be provided in the home. A record of the resident’s preferred social activities and those they have participated in should be recorded in the care plan to show how resident’s individual social needs are being met. It is recommended the registered manager is supported and guided appropriately to manage the care home in the best interests of the residents. 3. OP31 Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Kenyon Lodge DS0000006713.V363946.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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