Inspection on 11/08/05 for Kesteven Grange

This inspection was carried out on 11th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Kesteven Grange 17/11/08

Kesteven Grange 15/11/07

Kesteven Grange 09/11/06

Kesteven Grange 21/12/05

Kesteven Grange 09/11/04

Kesteven Grange 06/07/04

Kesteven Grange 11/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Kesteven Grange Kesteven Way Kingswood Hull HU7 5EY Lead Inspector Janet Lamb Announced 11 August 2005 09:00 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. Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Kesteven Grange Address Kesteven Way Kingswood Hull HU7 5EY 01482 837556 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) Southern Cross Care Homes No2 Limited Position vacant. New Manager, Linda Pollock, to begin in post on 15/08/05. Care Home 54 Category(ies) of DE(E) Dementia - over 65 registration, with number OP Old age 54 of places Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 To Admit four named service users, aged under 65 Date of last inspection 09/11/04 Brief Description of the Service: The home is registered to provide personal care and accommodation for 54 people of either gender over the age of 65, some of whom may also suffer from dementia. This also includes up to 4 people under the age of 65. Kesteven Grange is a purpose built home situated on a large residential estate on the northern outskirts of the city of Hull. The home has 46 single and 4 double bedrooms. Four bedrooms have ensuite facilities (toilet and wash hand basin). There is a large lounge and separate dining room on the ground floor and a large lounge /dining room on the first floor. There are a number of bathroom and toilets throughout the home and a passenger lift to access the first floor for service users unable to use either of the two stairways. Office accommodation, the kitchen and laundry are all on the ground floor. Outside is a large lawned garden and an enclosed seating area for service users to enjoy the good weather. Regular bus services stop near the home and local community facilities are a short drive away. The home has a large car park for visitors. Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection, one of two required in an inspection year, was carried out over two days due to the home experiencing a serious power cut, and took 12.5 hours to complete. The first day involved interviewing residents, two care assistants, the care manager, talking to some visitors, looking around the home and inspecting some records. The inspection was halted because of the power cut, but the Inspector remained in the home until emergency plans had been put into operation. The second day (a morning only), was spent interviewing three care assistants, inspecting some more records and meeting the newly appointed Manager. On each day the home was adequately staffed although staff reported there have been times when staffing shortages have occurred. What the service does well: What has improved since the last inspection? What they could do better: The service should make sure there are enough staff on duty at each shift to meet the needs of the residents. Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 6 It should inform residents in writing who are wishing to live in the home that their needs can or cannot be met. Staff should think about how they talk to residents, especially in the upstairs unit, ask questions and offer choices or options rather than give directions. The service could offer more activities to the residents in the upstairs unit. It could also make sure residents are better informed about how to make a complaint if they wish. 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. Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 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 Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 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 only. Standard 6 is not applicable. Prospective residents have their needs well assessed before they move into the home, but they could be better informed in writing, that their needs can or cannot be met. EVIDENCE: The home holds a copy of the placing authority’s community care assessment in case files, and also carries out its own assessment of needs. This is on file too. Residents spoken to could either not remember being admitted to the home, or were confused, and one said she had not been properly admitted because she had not had the six-week social service review with her care coordinator. Information from the senior staff in charge on the first day of the inspection revealed the home’s usual practice is to assess prospective residents’ needs and inform them verbally that their needs can be met by the home. This should be done in writing as stated in regulation 14(1)(d). Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10. Residents have their health needs well recorded and well met. They receive respect from carers and enjoy a good level of privacy. EVIDENCE: All residents have a plan of care, which includes health need details and an action plan to meet these. There are records of care given, healthcare professional visits and appointments etc. and charts to monitor health, nutritional intake, weight, etc. if necessary. Only one resident currently selfmedicates, but others could do so if risk assessed as capable and wished to. He is supported to take his medication daily and this is to be reviewed soon. Staff were observed treating residents respectfully, but still engaged in a lively, familiar banter with those they knew well. A simple observation made by the Inspector on the unit upstairs where residents with greater dependencies are accommodated, was that staff tended to give out instructions to residents to do things instead of asking and offering them a choice about doing something. Residents spoken to were quite satisfied with the privacy and respect they experienced. Residents expressed the views that some staff are “a bit strict,” “look after me very well, but were rude to me upstairs,” and “staff have been helpful.” Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 10 All personal care is provided in the privacy of resident’s bedrooms or bathrooms etc. and staff when interviewed, fully understood and followed the principles of the home in terms of respect, privacy and fulfilment. Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 11 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 feel they are well supported in their daily lives and social activities. They are offered a good range of activities to choose from, which those capable of joining in with thoroughly enjoy. Residents less able to join in could be offered alternative pastimes, which best suit their needs. EVIDENCE: Residents’ files contain information on what they should like to do to pass the time of day and diary notes and activity records show who went where, when etc. The activities coordinator plans, advertises and facilitates outings, trips, activities etc. to suit the needs and choices of residents. This is very successful for those residents capable of making a definite choice who are ambulant or have family support etc. Residents in the unit upstairs who are less able to make choices and require intense and specialist care are not so well catered for in respect of outings and pastimes. Those residents spoken to who do indulge in the activities on offer are highly satisfied. Others expressed satisfaction with their quiet lives, while two felt there was not enough to do or happening, but these residents were upstairs. It appears that the home caters for individual needs in respect of entertainment and activity, but needs to concentrate a little more effort in the upstairs unit. Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 12 On both days of the inspection visitors to the home were numerous and were observed being made very welcome by staff. Relatives come and go at all times of the day, some assist in the care of the resident related to them, others merely chat and pass time. All visitors, for social and healthcare reasons, are made welcome, and residents confirmed this. Food provision is according to preferences made clear, set menus in which there is a choice, and any specialist medical diet. Those spoken to were generally very satisfied with the food they receive. The kitchen is clean and well organised, and although the dining rooms are small; do not seat all 54 residents at once, there are many residents who eat meals in their rooms. Residents confirmed mealtimes are flexible if they go out or return late from an event. Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 13 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 somewhat confident their complaints will be acted upon and that they are protected from abuse. Some of the residents could be better informed of the written complaint procedure though. EVIDENCE: There is a complaint and representation system in place, with accompanying policies and procedures. Staff spoken to are aware of the procedures when dealing with a complaint, but residents spoken to are not very familiar with this at all. Work needs to be done to ensure all residents and relatives know how to complain and who to. Residents expressed the view that they would pass on their concerns to someone, either the care managers or one of the staff they like, if they had any problems, but that few actually arise. One resident had made complaints about the staff since her arrival, and had also made an allegation of abuse. Hull City Council complaints department was dealing with all complaints and allegations made under the council’s protection of vulnerable adults team. Systems, policies and procedures are in place to deal with suspected or actual abuse and these were being tested. Records are held of complaints and allegations and any outcomes. Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 14 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) 26 only. Residents enjoy a good standard of hygiene and cleanliness within the home. EVIDENCE: A tour of the home revealed standards of hygiene and cleanliness are good, and residents expressed the view that their rooms are kept in an orderly fashion. Cleaners are employed daily and work according to a roster. Care staff follow policies on infection control and use personal protective equipment and practice was observed to be satisfactory. Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 15 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. Residents are cared for by carefully recruited and selected, suitable staff, according to robust procedures. Staff with the appropriate training to carry out their roles meet residents’ needs. Residents’ needs would be better met if there were sufficient numbers of staff on duty throughout every 24-hour period. EVIDENCE: Staff are recruited according to set policies and procedures within the company, receive Criminal Records Bureau (CRB), reference and health checks before taking up their posts and are inducted and trained according to standards approved by the General Social Care Council. Two staff files showed evidence of this, and discussions with the staff revealed the kinds of courses they do and the opportunities they are given to train. Discussions with staff and residents, and information received on the only two relative questionnaires returned to the CSCI, revealed that the opinion is there are not always sufficient numbers of staff on duty, because of failure to cover sickness, holidays and vacancies. There are currently two staff vacancies; one senior carer of 44 hours and one night carer (hours not determined). The document completed on the first day of the inspection, “Care Homes for Adults Announced Inspection Questionnaire for Registered Establishments,” showed a list of staff having been employed since the last inspection numbering 13 and three of these were bank staff. Staff reported having had staffing shortages on occasion over the last 7 to 8 months and that their morale has been low. The Manager must look at the staffing levels, recruit where necessary and ensure sufficient numbers of staff are on duty at all times. Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 16 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) No judgement was made on the outcomes of these standards. EVIDENCE: No evidence was gathered on the outcomes of these standards. It is prudent to state that under standard 31 the position of Registered Manager is vacant. A new Manager has recently been recruited, was in post on the second day of the inspection, and was introduced to the Inspector by senior managers in the company. The company should submit an application for registration for the newly appointed Manager, as soon as possible. Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 17 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 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 x x x x x x x 3 STAFFING Standard No Score 27 2 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 x x x x x x Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 18 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. 2. 3. Standard OP20 OP3 OP27 Regulation 13 and 23 14(1)(d) 18(1) Requirement Timescale for action 31/03/06 External grounds must be accessible, suitable for, and safe for use by all service users. Residents must be informed in 30/11/05 writing whether their assessed needs can be met or not. There must at all times be 31/12/05 suitably qualified, competent and experienced persons working in the home in such numbers as is appropriate for the health and welfare of residents. 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 Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection First Floor Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kesteven Grange J54_s31929_Kesteven Grange_v230006_110805_stage 4.doc Version 1.40 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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