Inspection on 23/09/05 for Kerr House

This inspection was carried out on 23rd September 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

Kerr House 25/01/07

Kerr House 22/02/06

Kerr House 17/11/04

Kerr House 18/05/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

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 Kerr House 50 Morley Road Staple Hill Bristol BS16 4QS Lead Inspector Jackie Hargreaves Unannounced 23 September 2005 09:30 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. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kerr House Address 50 Morley Road, Staple Hill, Bristol, BS16 4QS 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) 01454 866295 01454 866297 South Gloucestershire Council Social Services Mrs Linda Dicks Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th November, 2004 Brief Description of the Service: Kerr House is a purpose built Local Authority residential care home that is registered to provide personal care and accommodation for up to thirty one service users aged 65 or over. One room is designated for service users to receive respite care on a regular basis.The home is located on the Kingswood/Staple Hill borders approximately a quarter of a mile from local amenities/shops including banks, a post office and various shops. The home is well served by bus services that stop within easy walking distance from the home. Accommodation is provided on one level and is sited around a courtyard and garden area. All rooms are single occupancy. Rooms do not have en suite facilities. Each room has a wash hand basin set into a vanity unit. Communal rooms are situated on two floors and comprise of five lounges, two separate sitting areas, a large dining room, activities rooms, a small kitchen, a hairdressing room, library area and a designated smoking room. There is a choice of lift or stairs to the first floor. The grounds and gardens are well maintained and are fully accessible to service users from lounges and corridors. All exits have ramps and handrails. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out in one day to monitor the quality of care and services provided at Kerr House under the Care Standards Act 2000. Not all National Minimum Standards were assessed on this occasion. The inspection focussed primarily upon the opportunity to discuss with new and existing residents their experiences of the home and the services provided. Care plans and action plans to meet the care needs of three of these residents were also reviewed. The manager was present throughout the inspection and assisted the inspector to access a number of records relating to the welfare and safety of residents. Procedures and practices concerning admissions, care planning, staffing and management arrangements were also discussed with the manager. The inspector undertook a cursory tour of the premises and spoke informally with several residents, a relative and three staff in different areas of the home and on a more formal basis with one staff member. Their views of the home are included in the report. Feedback was given to the manager on the outcome of the inspection. It was evident that the residents accommodated at Kerr House benefit from good standards of care. What the service does well: The home was clean and fresh and the atmosphere in the home relaxed and welcoming. The service could clearly demonstrate how the needs of residents were being met. All residents spoken with were very satisfied with the general care being provided. The home was well organised and managed by an effective, stable management team that promoted the views and interests of the residents. Admission procedures were resident focussed and supportive to residents. The service was proactive in monitoring residents care needs and in ensuring health needs were being met with input from local health services. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 6 Residents were consulted on the services provided and the home could demonstrate positive results for residents from its quality assurance initiatives. Staff training was well attended and ensured that residents were supported by competent and qualified staff. Residents had the opportunity to participate in a variety of activities both in and outside of the home. 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. Kerr House D56 D05 S35488 Kerr House V228747 230905 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 Kerr House D56 D05 S35488 Kerr House V228747 230905 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) 1,3 Residents had clear information to enable them to decide whether the home suited their needs. Good admission procedures were followed that included a full assessment of a persons needs and preferences and a trial stay. EVIDENCE: Information on the home and the services offered was on display in the entrance to the home to take away. The information was well presented and included a statement of purpose, a user-friendly welcome pack, a copy of the latest inspection report and results of quality assurance surveys. Discussions with two residents recently admitted to the home from hospital confirmed that they and their relatives had been supplied with this information and staff had ensured that the residents were given a welcome pack on arrival. The homes admission procedures involved an initial assessment of prospective residents personal, healthcare and social needs prior to their admission, which could be carried out in the persons home or hospital. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 9 New residents were asked about their experiences at the time of their admission and their corresponding admission records were reviewed. This confirmed that good procedures had been followed. Care had been taken to ensure the residents were welcomed and home comforts provided. The staff team had ensured the residents were assisted to meet their personal and daily living needs in the home. A specialist healthcare service and staff training had been accessed to ensure a residents healthcare need was met. This resident said that staff had been very good and made sure that her health requirements were given full attention. A separate personal safety risk assessment was on file in this respect. The residents commented that staff had been, lovely and helpful and a visiting relative was impressed with the home in terms of the care provided and communications with the home. One resident had completed a months trial stay and a copy of a review meeting to evaluate the stay and the services offered was held on file. This resident confirmed she had four weeks to decide whether she wanted to stay and attended a meeting that involved her family members before she accepted a more permanent stay. Assessment and care planning paperwork held in the residents files evidenced the home had reviewed initial assessments and care plans to correspond with the residents personal care and daily living requirements in the home. Kerr House D56 D05 S35488 Kerr House V228747 230905 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) 7,8,10 The service had good systems for meeting and monitoring residents’ health and personal care needs in consultation with residents. Staff were respectful towards residents when providing assistance. EVIDENCE: Information contained in three residents care records was reviewed and evidenced that these residents had assessments and care plans covering all topic areas for daily living in the home including personal and healthcare needs, leisure and social interests, family involvement and personal safety. All individual needs were listed in care/service delivery plans, together with the action required to meet needs, the person responsible, outcomes and dates. The plans clearly showed the residents’ involvement in putting together the plans and how each resident preferred to receive assistance. The home operated a key worker system (named staff member who related closely with the resident). The key worker role included the monthly updating and reviewing of care/action plans. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 11 A key worker allocated to three residents explained that she sat down with each resident to write monthly reviews of plans. Reviews examined were signed by the resident, key worker and a manager who ensured the residents changing needs and new requests were acted upon. A newly updated care plan accurately reflected the residents personal and healthcare needs this resident conveyed to the inspector. Another resident confirmed that staff provided assistance in the right way for her. All other residents asked about the assistance received from staff were happy with how and when they received help and felt they were treated with respect. Several residents stated that staff were lovely. Observations of staff interactions with residents confirmed the development of friendly, respectful relationships. Residents’ daily care and healthcare needs were recorded and updated on standard written formats and on computer to which all staff had secure access. Discussion with the manager demonstrated that residents’ healthcare needs were closely monitored in consultation with primary health care services. Designated staff had received NVQ level 3 training that included supporting residents with their health needs. There was good evidence that the home had been proactive in obtaining specialist services to assess residents and to ensure that equipment was provided to meet specific needs and enable residents to be as independent as possible. These included speech therapy, occupational therapy, bereavement counselling, equipment to prevent falls and stroke rehabilitation. Falls were being logged and monitored as part of an initiative to analyse and prevent falls. The manager advised that a re-occurring fall would be referred to the residents GP. A new resident said that staff had, seen to how she was walking. Measures to prevent falls and ensure residents’ safety included flexercise classes three days a week to improve muscle tone, strength and balance. Staff leading the exercise groups had received verified training. Kerr House D56 D05 S35488 Kerr House V228747 230905 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 Residents’ daily routines and activities were based upon individual choice and preferences. Visitors were welcomed into the home. EVIDENCE: There was good evidence that time was being devoted to ensure that residents were provided with opportunities to participate in a range of planned activities of their choice both in and outside of the home. Residents’ interests and participation in activities were recorded to ensure consideration was given to all residents. Activities, entertainments and trips out were displayed for the coming month and entertainments booklets were seen around the home advertising a selection of weekly in house sessions such as aromatherapy; nail care, handicrafts and bingo. Residents had access to a library, games and puzzles and several residents had their own hobbies and interests. A hairdresser visited the home weekly and residents were observed choosing appointments. Residents said they were asked to suggest activities and outings and chose whether they wanted to participate. The activities coordinator stated that the home was able to hire transport to meet residents’ mobility needs including a minibus. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 13 A member of staff said there was time during the day to sit and chat with residents and quality time was allocated to provide residents with an opportunity to participate in a one to one activity or spend time with staff doing what they want to do. In discussions with two residents on flexibility of daily living routines in the home the residents stated that you can do things if you choose and can please yourself. The home had an open door policy for visitors. Residents were able to see visitors in the privacy of their rooms and there were several semi-private seating areas around the home. There was a payphone in a quiet area that could also be used in residents’ rooms for full privacy. Two residents spoken with said they were satisfied with this arrangement and could choose to have a telephone installed in their rooms. Visitors were seen at the home during the day of the inspection and were welcomed. A resident said that staff would always make a cuppa for visitors. One visitor spoken with said he was made welcome and was impressed with the home. The relative stated that his mother was well looked after and the home always made contact if there was a problem. Kerr House D56 D05 S35488 Kerr House V228747 230905 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) 16,18 A clear complaints process was in place and had been properly implemented in the home. Procedures to protect residents from abuse were robust and staff were made aware of the processes involved. EVIDENCE: The homes complaints policy and procedures were displayed around the home. The policy was also included in the statement of purpose and welcome pack. Two residents spoken with about the homes complaints procedure stated that they had no cause for complaint and the managers were always available to listen to them. At the homes previous inspection the service was required to ensure that full details of actions to resolve complaints and their outcomes were recorded. This requirement had been fully addressed. Five complaints had been made in the home since the previous inspection. These referred to a resident admitted on a trial basis whose needs could not be met in the home. The manager advised the inspector that this person was supported to move to more appropriate accommodation. The home had policies and procedures on the protection of vulnerable adults. Good evidence was found that South Gloucestershire Council systematically trains its entire staff group on the protection of vulnerable adults and this training is organised as a running programme. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 15 The manager also advised that protection of residents from abuse was covered in NVQ level 3 training and staff had to write aspects of the policy. One member of staff interviewed was able to describe aspects of abuse and procedures for reporting suspected or alleged abuse with emphasis upon the confidential nature of the procedures within a care home setting. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,23,24 Kerr House is purpose built, well maintained and provides safe, comfortable surroundings for residents. Although residents’ bedrooms meet the revised minimum standards space for furnishings is compromised. EVIDENCE: Kerr house is a local authority operated thirty-bedroom purpose built home. Information on the premises and bedrooms is included in the homes Statement of Purpose. There is wheelchair access throughout the building and a choice of stairs or lift to the first floor. Bedrooms are situated on ground floor corridors. The dining room and most lounges are situated on the ground floor. There are facilities for activities, sitting areas and a smoking lounge on the first floor. The inspector did not carry out a full environmental check. However, a transient review of ground floor shared spaces, five bedrooms and the cleanliness and general decor and furnishings was undertaken. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 17 Overall, the premises are suitable for the residents; safe, comfortable and well lit. All areas viewed were domestically furnished, clean and welcoming. There was a pleasant, relaxed atmosphere and the home smelled fresh and clean. Information provided as part of monthly monitoring visits by the provider indicated that continual maintenance and review of the premises is completed on a regular basis. The home has complied with the requirements of the environmental health department and of the local fire service. A great number of redecoration and refurbishment projects have been undertaken in consultation with residents to minimise the institutional effects of the building design and to create a homely environment. Additional homely touches clearly demonstrate the staff teams commitment to making the home as comfortable and homely as possible for the residents. Residents spoken with about their environment conveyed to the inspector that they felt comfortable and were happy with the variety of communal areas. Residents said they could choose whether to join other residents in the lounges or stay in the privacy of their rooms. All bedrooms are single occupancy and meet with the revised minimum usable floor space requirements. Rooms have standard fitted wardrobes and washbasins set into vanity units. However, several rooms have insufficient floor space to enable residents to have a table and two comfortable chairs in their rooms or a larger bed. Two residents seen in their bedrooms commented they would have liked a bit more room for their own possessions. One resident said that an en suite toilet or shower would have been lovely. Keys to rooms were provided. Radiators in rooms had low surface temperatures and preset temperature valves had been fitted to hot water outlets to prevent risks of scalding and to ensure the safety of residents. Water from a hot water tap in one residents bedroom tested at a safe limit. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 The home operates robust staff recruitment practices and ensures residents’ needs are met by a sufficient number of competent, trained staff. EVIDENCE: A review of staffing information held in the home provided evidence that a robust recruitment and employment processes were being followed to ensure the protection of residents. The home had a low staff turnover and discussions with staff and residents throughout the inspection indicated that staff felt valued, moral was high and a good service was being delivered to the residents Staff training was well supported. All except two staff held NVQ (National Vocational Qualification) level 2 in Care. Designated staff were undertaking a specifically tailored NVQ level 3 which incorporated training and shared care in partnership with local health care providers to meet residents health needs. Training records contained details of planned training with updates showing the training required and undertaken. There were four care staff on duty plus the manager on the morning of the inspection. The duty rota for week beginning 24 September 05 showed a minimum of three care staff on duty plus a duty manager except on shifts between 3pm and 5pm when the staffing level may be reduced to two plus a duty manager. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 19 Two waking night staff were on duty each night with a manager on call. The manager advised the inspector that staffing levels were sufficient to meet residents’ needs and this statement was supported in discussion with two staff members. The inspector was shown residents weekly needs/dependency levels charts that were calculated weekly and sent in to senior management. The manager stated that should needs change then additional staff would be brought in. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36, Residents benefit from living in a well managed home. Management involves residents and staff in the running of the home and in planning to improve services. EVIDENCE: The service has consistently demonstrated good, effective leadership and management that relates to the aims and purpose of the home. The home’s registered manager Mrs Lynda Dicks has over twenty years managerial experience working in Kerr House and is well qualified both in management and training. It was evident from discussions with Mrs Dicks and a duty manager that the home has a stable management team that supports a commitment to providing quality care for the benefit of the residents. This was further confirmed in conversations with staff and residents who stated, staff work as a team, this is a nice home, it is well organised. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 21 The staff supervision timetable, written staff handovers, care plan reviews, quality assurance monitoring and residents meetings were viewed and support and supervision was discussed with a staff member. This provided good evidence of staff job satisfaction, effective communication between management and staff in supporting and monitoring staff to meet residents’ needs and improving services to residents. There was an A to Z range of health and safety policies and procedures to promote the health, welfare and safety of the residents both in hard copies and accessible to staff on the homes computer. Safe working practices were not fully reviewed on this occasion. Staff health and safety training was planned and recorded. Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 22 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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 x x 3 3 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 3 3 3 x x 3 x x Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 23 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 Kerr House D56 D05 S35488 Kerr House V228747 230905 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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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