Inspection on 29/06/05 for Kepplegate House

This inspection was carried out on 29th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kepplegate House 16/11/09

Kepplegate House 26/04/07

Kepplegate House 19/12/05

Kepplegate House 25/10/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE KEPPLEGATE HOUSE Sandy Lane Preesall Poulton-le-Fylde Lancs FY6 0EJ Lead Inspector Jenny Hughes Announced 29 June 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 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 Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) karen@kepplegat.house.fsnet.co.uk 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 F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25 October 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 F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5 hours, and was one of two inspections which must be made each year. Additional inspections may be made if necessary. The inspection was announced, in that the owner was aware that the inspection was to take place. The registered owner/manager was interviewed, and three staff and seven residents were spoken to. Surveys were sent out to residents, relatives, and to G.P’s involved with the home, and all of their views were also taken into account. Staff and care records were inspected, and policies and procedures were viewed. What the service does well: The home has some long-term experienced staff who lead by example with good practices and attitudes. This then encourages the same values in new and younger staff. A resident said, “I like all of the staff, they are very kind”. Care plans for residents are clear for staff to understand how to best look after each individual, showing all areas of need alongside their preferred daily routines, and their likes and dislikes. Meals are home-cooked, varied, with well-balanced choices. They are well presented, with meal times being pleasant and unrushed. Visitors are welcome at any time, making for a relaxed homely atmosphere. Communication between the manager, staff, residents and their families is continuous, with the manager always making herself available. Activities are varied in the home, and individual wishes are catered for as much as possible, whether it be a trip to the shop with a carer, or a bit of gardening. KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home has a comprehensive assessment that is carried out for all residents. This means that a service is provided that is tailored to the individuals needs and preferences. EVIDENCE: Individual records are kept for each of the residents, and there is a set procedure for admitting someone to the home, with a pre-admission assessment form being seen on three selected files. These are used by management to check that staff can give suitable care to each person, before the manager agrees that the home is the right place for them to live. A resident said “I think my family sorted it all out. They came to see this place and said it was nice. I remember speaking to the manager”. The manager has developed an “Overview of Daily Living” for each resident, which clearly indicates to staff how they should care for that person, and covers all of the points raised in the assessment of need. For example, a risk assessment for moving and handling is carried out, a nutritional assessment is KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 9 carried out for dietary needs, an assessment of communication and social needs is carried out, all directing staff in providing care tailored for individuals. These are agreed with the resident and their families, and signed to show that agreement. Staff spoken to were aware of the level of care required by the case files tracked, and could give examples of their individual needs. KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 The health and personal care needs are well met in this home. Residents benefit from the support of healthcare professionals. EVIDENCE: Individual care plans are available, identifying the areas of need for each person, and with clear instructions for staff on what they must do to meet that need. Any risk was clearly identified, followed by what action to take to manage it. Some residents were aware they had a care plan, but stated that they did not need to see it because they were happy with the way they were looked after, “ I can get about a bit inside, but I sometimes just need a bit of help, and the girls are always there for me”. Family members were all aware of the care plans and records kept. Reviews of the care plans are carried out monthly, or as needed. Full detail is recorded on skin checks, nutritional needs, and psychological needs. Discussion with staff confirmed that they were aware of the individual needs, and specialist needs, of the residents, and records of visits by health professionals were kept on the files. “The care plans are always available for us to look at” stated one staff member, “and you also get to know their preferred way of doing things as you go along”. Relatives confirmed that they were KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 11 consulted about the care provided, or any changes to the provision or their relatives needs. All of the residents choose what they wish to do through the day, with some sitting in the conservatories, some watching television in the lounge, and some returning to their rooms. Staff ensured the residents enjoyed their own private space, which was appreciated by the residents. “You can’t go wrong here”, and “Of course, not everyone likes to talk, but we get on don’t we?” were satisfied comments from residents who chose to find a quiet spot to chat together. Staff were seen to be patient, friendly and efficient in carrying out their work. “They’re a good lot of girls”, commented one resident. “I sometimes go and sit in my room if I want to be quiet. The girls are good and knock on my door to come in”. KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents experience a good quality of life in this area. Meals were nutritious, and mealtimes relaxed, which encourages residents to enjoy food and mealtimes. There are plenty of activities, and some residents are motivated and stimulated by joining in. EVIDENCE: The individual information recorded provides a clear picture of each resident for the staff, noting their likes and dislikes, any hobbies or pastimes. Residents are encouraged to suggest things they would like to do, and discussed various activities they joined in with, such as music afternoons, quizzes and trips out. A T’ai Chi instructor called on one of his regular visits, and the majority of the residents were keen to join in. The other residents were happy to watch. Staff joined in the session, and the residents were relaxed and laughing and joking with the instructor as he guided them through gentle exercises. Some residents like to go to the shops, and arrangements are made for staff to accompany them to do this safely. Other trips to the local sea front café are also enjoyed. One resident had a small patch of garden at the rear of the home where she was growing tomato and strawberry plants, and proudly showed the KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 13 fruit to the inspector. Library books are exchanged when needed, and there are regular hair and nails sessions. One staff member was seen chatting quietly with a resident, while others encouraged people to join in the general banter. “Yes, we sit and have a good talk and some fun. The staff join in, and know us all very well I think”, commented one resident. “I’d go if I didn’t like it”, said another. Visitors are welcomed at all times, with a full visitors book recording all callers to the home. Regular communication is encouraged, and photographs of residents enjoying activities, some with family members, are displayed. The dining area is light, neat and tidy, creating a relaxing atmosphere in which to enjoy the meals. Residents confirmed they could eat their meal in their room if they wished, or if they were unwell, as one resident was doing at this time. Menus are changed on a four weekly basis, and residents said they sometimes suggested something new, and the cook would willingly try it, but generally they were happy with the set menu. “The food’s good. I’ve put that much weight on since I’ve been here”, stated one resident. KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents are confident their concerns will be listened to and acted upon. Staff have an understanding of Adult Protection issues, which protect residents from abuse. EVIDENCE: There is a complaints procedure in place, with a complaints book to record any complaints, which may come to the manager’s attention. The home’s complaints book has no records of complaints. A resident said she would “tell any of the staff” if she was not happy with something. Staff spoken to knew about the Adult Protection procedure, and what to do if they had any concerns. They said they would always act if they thought a resident was at risk. Also if it was a member of staff causing concern they would inform the manager. Abuse awareness training is attended by all staff. KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected at this visit. EVIDENCE: These standards were not inspected at this visit. KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The home operates a good recruitment policy, which ensures that only people who are suitable for this type of work are offered an appointment. Training is provided and this means that residents are provided with appropriate care and attention. EVIDENCE: Two new staff files showed that the necessary recruitment checks had been carried out to ensure the protection of residents. References and Criminal Records Bureau checks were available, and notes of the interview were made. All new staff have induction training, and are given guidance and information on their terms and conditions, and working practices in the home. The staff group are a mix of long term experienced and younger enthusiastic carers. Training is ongoing, with moving and handling, food hygiene, first aid, medication awareness and fire safety being priorities. National Vocational Qualification in Care courses are being attended by eight of the care staff, with two already successfully achieving them. Staff commented “We know the manager always keeps up to date with the latest information on care provision, so we know we can always ask her if we aren’t sure of something”, and “The owner is good support”. Domestic staff are an important part of the overall care team, and the manager says she ensures they are kept informed of any changes and KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 17 particular needs of the residents. “My room is lovely and clean” was a comment. The rota showed which shifts care staff were working each day. KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 The systems for consulting with residents and their families are good, with a variety of evidence that shows that resident’s views are both sought and acted upon. Systems and practices in the home promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: There are systems used in the home to regularly audit and monitor standards, and to get feedback from residents and their families on their level of satisfaction with the service. The manager is a good communicator, and relatives confirmed that they are always kept informed of important matters affecting their relative’s care. The home is small, with a small staff group, and therefore visitors are regularly seen by the manager, and good relationships and communication develop. KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 19 A formal meeting for relatives is now arranged once a year. Due to the regular ongoing communication, attendance at more regular meetings was minimal, and therefore reduced to the one. The manager sees the staff most days, and also has formal supervision sessions with each one, followed by annual appraisals of their work. These provide the manager with information on the standard of the care provided in the home. The manager is not responsible for handling any residents finances, and they either manage them themselves, or family help in this area. Clear records are kept of any personal allowances. Records and staff confirmed the fire training for staff, with a visit from the fire officer who confirmed safety standards in the home were correct. All maintenance and servicing checks of equipment were correct. KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 21 NO 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 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. 1. Refer to Standard Good Practice Recommendations KEPPLEGATE HOUSE F57-F09 S55105 Kepplegate House V211611 290605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection North Lancs Area Office 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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