CARE HOMES FOR OLDER PEOPLE
Kepplegate House Sandy Lane Preesall Poulton-le-fylde Lancashire FY6 0EJ Lead Inspector
Ms Jenny Hughes Unannounced Inspection 19th December 2005 1:30 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 Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Kepplegate House Address Sandy Lane Preesall Poulton-le-fylde Lancashire FY6 0EJ 01253 811957 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) Kepplegate Ltd Mrs Karen Louise Shaw Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 29th June 2005 Brief Description of the Service: Kepplegate House is a purpose built two-storey home, located in the village of Preesall, just a short drive from the sea front at Knott End. There are attractive garden areas at the front and rear of the home where residents can enjoy sitting in the better weather. Car parking is available either at the side of the home, or in the road alongside the home. The home provides personal care for older people, and is equipped to suit the needs of its residents. For example, there is a stair lift to the upper floor, grab rails, raised toilet seats and ramps for easy access. All of the rooms are single rooms, and toilets and bathrooms are conveniently situated. There is sufficient communal space, with a large lounge/dining room and conservatories at the front and rear of the home. Staffing is provided over 24 hours, every day of the year. Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 2 and a half hours, and was one of the two inspections which must be made each year. Additional inspections may be made if necessary. The inspection was unannounced, in that the owners were not aware that the inspection was to take place. A tour of the home was made, and rooms were inspected at random. Staff and some records were viewed. The manager and three staff on duty were spoken to. What the service does well: What has improved since the last inspection? What they could do better:
The manager is aware that there is always room for improvement, and is continually looking at ways forward to further improve the quality of life for the residents. Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 6 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. Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 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 the following standard(s): These standards were not inspected at this visit EVIDENCE: These standards were not inspected at this visit Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 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 the following standard(s): 9 The medication at this home is well managed, promoting good health EVIDENCE: All medication is stored securely in a dedicated trolley, which is attached to the wall in the dining room. Medication records were available for all residents, and were seen to be clear and up to date, with photographs of residents identifying these records further. The manager stated that she regularly monitors the records to ensure they are complete, and medication issues are regularly on the agenda at staff meetings. All staff have had medication awareness training, and are due to have refresher training. Constant professional guidance is also present as the manager is a qualified nurse. Patient information leaflets are kept for staff information on each individual’s medication, and there is regular liaison with the local pharmacist. Risk assessments are carried out, and waivers signed, by any resident wishing to take charge of taking their own medication, which they then keep in a secure place in their own room. One resident self medicates at present.
Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 10 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): These standards were not inspected at this visit EVIDENCE: These standards were not inspected at this visit Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 11 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): These standards were not inspected at this visit EVIDENCE: These standards were not inspected at this visit Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 12 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 and 26 The standard of the environment in this home is good, with the aim to constantly improve it. It provides residents with an attractive and homely place to live. EVIDENCE: The front and rear garden areas are well maintained, with seating in both places for residents to spend their time in good weather. One resident was feeding visiting ducks in the front garden, while another watched from the warmth of the front conservatory. A small rear conservatory is a pleasant place to sit, and gives another alternative for visitors to see their relatives in. The environment is homely, comfortable and warm, with a large lounge dining area having comfortable seating alongside nicely set tables and chairs, with matching table linen. All of the individual rooms seen held the personal possessions of the resident staying there, with photographs, favourite pictures and ornaments, and small
Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 13 pieces of personal furniture where possible. “ It’s lovely. I like my room. It’s cosy”, commented a resident. The manager stated that she had identified that some of the décor was starting to look a little tired in some of the rooms. She stated that the aim was to try and get these rooms refreshed, with as little disturbance to the residents as possible. One of the rooms has parquet flooring, with which the resident is quite happy, along with the ‘safe’ rugs placed on it, which are made so as not to slip. The manager confirmed that any new resident in that room would have the choice of a carpet if they wished. The home was clean, bright and fresh smelling at the time of the visit. Any maintenance noted as required by staff during their daily work, is recorded on a maintenance record, and dealt with by the owners as soon as possible. The laundry area is away from the kitchen and dining area, and was clean and tidy. Staff spoken to were aware of the correct way to work to prevent and control infection. Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 14 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): These standards were not inspected at this visit EVIDENCE: These standards were not inspected at this visit Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 15 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): These standards were not inspected at this visit EVIDENCE: These standards were not inspected at this visit Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 16 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 17 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kepplegate House DS0000055105.V273081.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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