Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 08/05/07 for Kilkenny Residential Care Home

Also see our care home review for Kilkenny Residential Care Home for more information

This inspection was carried out on 8th May 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Kilkenny Residential Care Home 6 Third Avenue Frinton On Sea Essex CO13 9EG Lead Inspector Marion Angold Key Unannounced Inspection 8th May 2007 11:15 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 Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kilkenny Residential Care Home Address 6 Third Avenue Frinton On Sea Essex CO13 9EG 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) 01255 672253 F/P 01255 672253 Mr Rajalingum Valaydon Mrs Christine Joan Emmamdeen, Mr Mamode Farouk Emmamdeen Mr Rajalingum Valaydon Mrs Teresa Rosaline Jones Care Home 11 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (11), Old age, not falling within any other of places category (11) Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 11 persons) Persons of either sex, aged 65 years or over, who require care by reason of dementia (not to exceed 11 persons) One person, under the age of 65 years, who requires care by reason of dementia, whose name was made known to the Commission in April 2005 The total number of service users accommodated in the home must not exceed 11 persons 27th June 2006 Date of last inspection Brief Description of the Service: The Kilkenny is situated in a residential area on the outskirts of Frinton on Sea town centre, close to the sea front and within walking distance of all local amenities. Bedrooms upstairs can be accessed by means of a chairlift. There is a hard-standing area at the front of the home, with a seat and space for two or three cars. An enclosed, paved garden is at the rear of the property. The home provides care for 11 older people, aged over 65 years, who may have dementia. The current weekly charge for a room is between £350.00 and £375.00 per week. Additional charges are made for chiropody, manicures, hairdressing, toiletries, newspapers and confectionary. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, covering the key National Minimum Standards, took into consideration all recent records and contacts relating to the service, including an Annual Quality Assurance Assessment, completed for the Commission by the managers, and surveys completed by the relatives of people living at the home. It also included site visits to the home on 8 May and 31 May 2007 lasting around 9 hours. The visits involved speaking with residents, a relative, the manager and staff, as well as a partial tour of premises, observation of care practice and the sampling of records. Of the 23 Standards inspected, 16 were met and 6 presented minor shortfalls and one gave cause for serious concern because it posed a risk to the safety of people living at the home. What the service does well: What people living at the home and their relatives had to say (these quotes have been made anonymous): • • • • • • • • I am happy, have all I want and good support. From what I have witnessed, they do give a very personal level of care. Care is well tailored to individual needs and maintained at a good level. The care home gives (my relative) a choice of when s/he gets up and goes to bed. (My relative) can even have breakfast in bed if s/he wishes. The home provides a service that allows (my relative) to live with a high level of dignity. I feel the staff know exactly how to care for (my relative) – s/he has dementia. Since moving to The Kilkenny (my relative) looks like a different person – s/he eats well (face has filled out) and is healthier. S/he is taken out for walks to the front where s/he enjoys sitting and watching the sea and people on the beach. I can’t think of a nicer place for my (relative) to be!! Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 6 • • • • • I have found communication with care staff to be excellent. Staff inform us of illness and doctor’s visits etc. The home looks after residents with well-trained, caring staff, in a calm and ‘homely’ atmosphere. The home is kept very clean. The home provides excellent care for people of all different abilities. I feel the care home promotes a very homely and happy atmosphere. Whenever I visit, s/he is always clean and tidy and relaxed and happy. It is a pleasure to visit. What has improved since the last inspection? • Teresa Jones is to be congratulated for having achieved the National Vocational Qualification in management and care, Level 4, in November 2006. The manager and some staff had updated their knowledge and skills in particular areas through relevant training. The front entrance and lobby has been refurbished, including new doors. • • What they could do better: Most people expressed satisfaction with the care provided and said they could not think of any way the home could improve. One person thought that the home should be more flexible about putting the heating on in spring and autumn when temperatures fluctuate considerably. This is what the inspector found: • The home was not following all the required procedures for recruiting and selecting staff. They must do this to protect people living at the home from people who might not be fit or suitable to support them. Some staff had not received all the training they needed for their work of supporting and keeping people safe. It is important that there is always someone on shift, who can give first aid. The duty roster of persons working in the care home did not specify the hours actually worked by the activity coordinator. This is important for DS0000017862.V342901.R01.S.doc Version 5.2 Page 7 • • Kilkenny Residential Care Home security purposes and to show how much support people living at the home are receiving. • Staff must not work a whole night on awake duty and then carry on working through the day as this puts at risk the health and safety of people they are caring for, as well as their own. The privacy of people’s en suite facilities was not always respected. They should not be used by anyone other than the occupants of the bedrooms. Staff should make sure that what they say about people living at the home promotes their dignity. There was evidence that personal items and toiletries in the first floor bathroom were being shared. This did not promote people’s dignity and individuality and could spread infection. Lack of suitable adaptations, such as ramps, meant that some people had difficulty going outside, on foot or in wheelchairs. The back garden was not entirely suitable or safe for the needs of people who were infirm or physically disabled. • • • • Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. NMS 6 did not apply at The Kilkenny. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People thinking about coming to live at the home would have a full assessment of their needs to determine whether The Kilkenny was able to offer the required care and support. EVIDENCE: The home’s Annual Quality Assurance Assessment (self-audit) indicated that people were admitted to the home on the basis of a full needs assessment, that they were offered trial visits, and that a contract was prepared, setting out the terms and conditions of their residence. A sample of records for three people living at the home showed that the manager had carried out detailed assessments before they moved in to determine whether the home could meet their needs. Individual records also provided evidence of trial visits and confirmed the issue of contracts. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care, which people received, was based on an individual plan of care. The principles of respect, dignity and privacy were not always put into practice. People benefited from the home’s procedures for dealing with their medicines. EVIDENCE: Records sampled for three people living at the home included comprehensive care and risk management plans, based on the original assessments of need. They gave clear guidance to staff about the particular needs and preferences of the individual and showed insight into the underlying conditions and difficulties that people were experiencing. Relatives responding to the Commission’s survey expressed satisfaction with the care provided, in several cases, noting the positive impact on the person being cared for. People said things like, ‘(Person’s) care is well tailored to his/her individual needs and maintained at a Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 11 good level’. Another person said, ‘I feel the staff know exactly how to care for my (relative) – s/he has dementia’. Records showed that care plans were evaluated monthly and management said that they consulted with the person’s key worker and family in the process. Relatives, responding to the Commissions survey confirmed that the home did involve them. One person said, ‘Care home staff do regularly tell us how (relative) is doing. All issues are discussed with us.’ Care plans, records of contact with medical professionals and surveys (including one returned by a health care practitioner) showed that people’s health care needs were understood and met. Care plans contained instructions and guidance to staff on particular conditions, such as diabetes and eating disorders and avoiding risks, such as pressure sores. Staff were observed monitoring one situation as instructed in the care plan. One person living at the home described the efforts that had been made to get help for their condition. Relatives described the marked improvement in their family member’s health since coming to the home. Records evidenced that people had medication reviews, appointments for sight and dental checks, and foot care and incontinence advice, as appropriate. Procedures for ordering, storing and administering medication were found to promote safe practice. Inspection of medicine stocks showed that the manager was meticulous in her approach to ordering and returns, as the only medicines held were the ones in use. This meant that that medication was not wasted and the process of checking medication against the records was simplified. Care plans contained lists of people’s medication. These should always be dated so that it is clear whether they refer to the current situation and can be used to check the accuracy of medication delivered to the home. Records showed that a number of staff had attended training in the safe handling of medicines. A list of people trained and authorised to administer medication, with their signatures, should be kept with the Medication Administration Records so that is easy to check their identity and status. Relatives responding to the Commissions survey were positive about the manner in which people were cared for. One person said, ‘The home provides a service that allows my mother to live with a high level of dignity’. This was confirmed by observation. Discussion with one member of staff showed that the home was sensitive to people’s preferences with respect to who assisted them with personal care, particularly any gender issues. Staff interacted appropriately with people living at the home, respecting their individuality. There was one exception to this. Asking a person whether they wanted to use the toilet, a member of staff said in the person’s hearing, ‘She doesn’t like the toilet, prefers to go on the floor’. This comment compromised the person’s dignity and showed a lack of understanding of their needs. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 12 During the site visit, when the toilet near the lounge was occupied, a visitor was advised to take a person living at the home to use the en suite in the adjacent bedroom. The person concerned was not one of the occupants of this shared room. The visitor indicated that they had used the en suite before, if the communal toilet was occupied. Whilst the arrangement might be expedient for some people living at the home, it infringed the rights and privacy of the people who shared this room. Various toiletries belonging to different people living at the home, a basket of combs and a powder bowl were on display in the bathroom. This suggested some infringement of people’s privacy and dignity. A person-centred approach would enable residents to keep their personal belongings in their bedrooms until needed in the bathroom, and would avoid the risk of toiletries being used communally. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The quality of people’s daily lives was enhanced by flexible routines, support with activities, a warm, welcoming atmosphere for their visitors, and nutritious meals. EVIDENCE: It was evident from discussion with people living and working at the home that people’s preferred morning and evening routines were respected. Relatives confirmed this in their responses to the Commission’s survey. One said, ‘(My relative) is able to go to bed when s/he wants and get up when s/he is ready.’ Another commented, ‘Dad can even have breakfast in bed if he wishes’. The activity coordinator was not on duty during the site visit but the roster showed that they supported people with activities several times between Monday and Friday. It was evident from talking with people living at the home, and observation during the site visit, that when the activity coordinator was not there people tended to sit and watch television or listen to the music that was playing. There was evidence of people also being supported to do the Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 14 things they enjoyed, such as puzzles and games, reading newspapers and watching DVDs in their rooms. Not everyone wanted to be involved in activities. One person said that the home had tried to find things to interest them but they preferred not to get involved. Another person indicated that they were also happy remaining in their room, with their things around them. It was evident from conversations and surveys that people enjoyed being taken out by the activity coordinator; one person went swimming, others to the shops, for refreshments or simply a walk to see the sea. Records maintained by the activity coordinator did not appear to reflect all that they were doing to provide people with stimulation and interesting activity and this should be addressed. One person living at the home had lots of visitors and said their relatives could come whenever they liked. The inspector also spoke with a relative, who visited frequently and was able to come and go as they pleased. Relatives described a welcoming atmosphere at the home and said things like, ‘I enjoy going to see (my relative). Everyone makes me feel very welcome.’ A quiet lounge was available for people to go aside with their visitors but, on the day of the site visit, it was cluttered with bags and belongings and would not have been suited to this purpose. All eight relatives, who responded to the survey, indicated that they were always kept up to date with important issues about their family member and that, where applicable, the home helped them stay in touch. The managers stated that they tried to keep people’s outside contacts active and provide links with the community through outings and professional entertainers. Comments from staff, people living at the home and their relatives indicated that people were encouraged to make choices and maintain their independence. One person said, ‘(My relative) has dementia but is always given the choice of what s/he would like to eat and when s/he is going out, When it is not possible to make the choice, I feel the home make appropriate and responsible decisions on his/her behalf. People living at the home told the inspector that they mainly enjoyed their meals. Lunch was prepared from basic ingredients, with fresh vegetables. One person expressed reservations about the cottage pie but indicated that it was good enough to eat. One person said they could ask for an alternative if they did not like what was on the menu. People did not know in advance what they would be having and this could be addressed by displaying a menu for the day. A picture menu was available to help people talk about their meals and express their preferences. Drinks were available in the lounge and people’s rooms throughout the day and staff were attentive to those who were not able to help themselves. Some had lunch at a dining table but residents with poor mobility continued to have their meals at individual tables in their usual armchairs. Staff said that people chose to remain in their armchairs but one person indicated they would not mind going to the dining table. Although it may be expedient for people to remain where they are to eat, they should be Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 15 encouraged to sit at a dining table, as this gives them a change of scene, exercise and opportunities for socialising. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home and their representatives could be confident that the home would listen and respond appropriately to their concerns. More could be done to protect people from abuse in terms of robust recruitment and selection procedures and staff training around attitudes. EVIDENCE: The managers said they had not received any complaints since the last inspection and there were none known to the Commission. Relatives responding to the Commission’s survey were confident about the procedure for making a complaint and most indicated that they had never had any concerns. Others indicated that the home had always responded appropriately, if concerns had been raised (one person said ‘usually’). Staff had access to up to date and locally agreed procedures for safeguarding adults and records showed that all but one had attended safeguarding adults (protection of vulnerable adults) training in 2006. People living at the home, who spoke with the inspector, were positive about the way staff treated them. Relatives indicated a high regard for the staff and the way they cared for people. One wrote, ‘I know the care staff are trained in dementia care and always show patience and understanding with the residents’. Interactions observed between people living and working at the home were constructive Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Kilkenny provided people with a clean, comfortable and homely environment but lack of suitable adaptations meant that some people had difficulty going outside. EVIDENCE: The Kilkenny presented as homely and comfortable, with traditional style of decoration and furnishings. A new front door had been fitted since the last inspection and the entrance area refurbished. During the visit one person, being taken out in a wheelchair by their relative, had to get out in order for the wheelchair to be taken over the threshold. Management have indicated that the home is accessible through a door into the back garden but this was obstructed on the day of the site visit. The inspector and two staff on duty were unable to find a ramp in the house or Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 18 garden shed. This meant that a number of people, who could not safely negotiate steps, would not have access to the outside. The back garden was on two levels, with a ramp for people who could not manage steps. The crazy paving was very uneven and presented trip hazards in places. A fence panel needed securing and could injure someone if it fell down. A number of baby toddler toys were about, including a Wendy house, baby walker, 2 mini slides, scooter, tricycle and paddling pool, so the garden looked more suited to children than older people. Although the home is said to have a quiet lounge, in addition to the main lounge/dining room, this was being used on the day of the site visit to store staff bags, clothes and shoes. It was untidy and not suitable for people to relax in or see their visitors. No one was seen to use the quiet lounge during the site visit. Since the last inspection the standard bath in the first floor bathroom had been replaced by a new bath with shower attachment and suitable for the needs of people with poor mobility. Information sent to the Commission spoke of plans to replace all toilets and washbasins and continue the ongoing programme of replacing window frames and doors. Records showed that no contraventions were noted during recent inspections by the Environmental Health Department in respect of the premises or food safety. The home was found to be clean in all areas inspected and the laundry facilities fit for purpose. A relative commented that the home was kept very clean. The presence of a hand towel and bar of soap in the first floor bathroom, as well as a basket of combs and powder bowl, presented a risk of cross infection. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People living at the home were supported by adequate numbers of care and ancillary staff but their well-being and safety were compromised when care staff worked excessively long shifts, and by omissions in the areas of recruitment and training. EVIDENCE: The long service and low turnover of staff provided continuity for people living at the home. Staff indicated that present staffing levels enabled them to meet the needs of people living at The Kilkenny. Relatives described the home as ‘calm’, ‘relaxed’ and ‘happy’ and the care as ‘excellent’. Staff did not appear to be under pressure during the site visit, although it should be noted that the home does not have an alarm system, whereby people can summon help. This means that closer monitoring of people may be required. Management recognised that a minimum of two care staff were needed at all times. They indicated in their Annual Quality Assurance Assessment that they were planning to introduce additional support at peak times, in recognition of people’s increasing frailty. This may apply to the weekends when management, ancillary and activities staff are not available to help out and care staff have to take on additional tasks. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 20 Examination of two weeks roster showed that the activity coordinator’s hours were not specified. This is necessary to show when people are on duty for security purposes and to determine the exact level of support people are receiving. The rosters for a two-week period also showed two examples of people covering a daytime shift (7:30 – 15:15) immediately following an awake night duty. This arrangement signified a risk of staff becoming overtired and not able to sustain their best working practice for such long periods, putting people living at the home at risk or at a disadvantage. One person, described as being no longer employed by the home, was rostered for sleeping duties. Information provided by the managers showed that 3 out of 11 care staff had attained the National Vocational Qualification (NVQ) Level 2, in care; this meant the home had not achieved the recommended 50 ratio of qualified staff. However, 2 staff were working towards the qualification and comments from relatives, responding to the Commission’s survey were positive about the skills and experience of staff. They said things like, ‘All staff appear to have the right skills to care for (relative with dementia) and, ‘The Kilkenny provides well trained, experienced staff’. Records were inspected for 2 staff, who had been recruited since the last inspection. These showed that not all of the required procedures had been followed. One applicant started work with a satisfactory POVA First check but at least one of their references was dated over 2 months after their start date. The other reference was not dated. The person concerned had not given a reference from their previous employment in a care home. They had also not given a full employment history and there was no record to show that any gaps had been explored at interview. There were also none of the documents on file required for proof of identity. These omissions placed people living at the home at risk. Similar omissions had been identified at the last inspection. Training records showed that some staff had covered most of the required topics and others had a number of gaps in their training. There were no induction records for a relatively new member of staff but, in the past year, they had attended training on health and safety, fire safety, the protection of vulnerable adults and dementia. They had also commenced training for NVQ Level 2. Records showed that the other new member of the team had experienced some induction training on their first day of employment, but this had not conformed to the standards, set by Skills for Care. There was no evidence of how the person’s competence had been assessed in any of the areas covered. An audit of staff training showed that most staff were involved in regular training, covering the required topics. Records evidenced that one member of staff had significant gaps in their training, having only attended a safeguarding adults course; only two people had a first aid certificate, and these were almost out of date. Most people had attended some initial training on Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 21 dementia in 2005. As a home specialises in dementia care, staff should have periodic dementia training to build on their knowledge and skills. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management ethos and style fostered positive working relationships and good outcomes for people living at the home. The health safety and welfare of people living and working at the home would be promoted through additional training and work on aspects of the back garden. EVIDENCE: The home’s Annual Quality Assurance Assessment identified good working relationships between management and staff. This was achieved by the management being involved in the actual care of people living at the home and working as part of the team. Staff spoke about the managers being very supportive and approachable and this was observed during the site visit. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 23 Respondents to the Commission’s survey were also positive about the way the home was run. Teresa Jones is to be congratulated for having achieved the National Vocational Qualification in management and care, Level 4, in November 2006. Since then she had continued to update her knowledge and skills in the areas of fire safety and occupational health and safety. The home’s quality assurance surveys had introduced more detailed questions in December 2006 and responses were coming in for analysis by management. The home’s policies and procedures had been reviewed this year. The managers had duly completed the Annual Quality Assurance Assessment, required by the Commission, identifying areas for future development, such as regular meetings of people living at the home with their relatives, a regular pattern of training with at least 3 courses annually, and additional staff at peak times. The Commission considered that the home’s responses to questions about equality and diversity could have been more strongly linked to their plans for meeting the individual and diverse needs of people through a personcentred approach to care. The managers reported no change to the way they supported people with incidental expenditures. They continued to hold small amounts of personal money on behalf of some residents. Records receipts and balances, sampled for one person, for whom this applied, were found to be in order. Staff had continued to update their knowledge of health and safety but the home lacked staff, who were qualified in first aid and this could affect people’s chances of recovery in the event of an accident or medical incident. Policies relating to the health and safety of people living and working at the home had been updated. Records showed that installations and appliances were routinely inspected and serviced, with the testing of electrical installations being due in September 2007. No environmental risks were identified, apart from trip hazards in the garden and the use of communal items that might spread infection. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES 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 OP10 OP18 Regulation 12 (4) (a) Requirement Timescale for action 02/07/07 2. OP19 23 (2) 3. OP19 OP20 OP22 OP29 13 (4) 23 (2) 13, 17 Sh 419 Sh 2 4. The home must be conducted in a manner to promote people’s privacy and dignity. This relates to how staff speak about people living at the home. It also means that only the occupants of a bedroom may use its en suite facilities. Suitable adaptations, such as 31/07/07 ramps, must be used so that people living at the home can go in or out on foot, or in wheelchairs. External grounds must be made 31/07/07 suitable, safe and accessible, and appropriately maintained for the people living at the home. Staff must be recruited according 02/07/07 to procedures required by regulation to protect people living at the home from people who might not be suitable to work with them. The home must also obtain for each person, prior to their appointment, full and satisfactory information and documentation, as per Regulation 19, Schedule 2 and Regulation 17, Schedule 4. DS0000017862.V342901.R01.S.doc Version 5.2 Kilkenny Residential Care Home Page 26 This requirement has exceeded the timescale agreed following the last inspection. 10 OP26 13 (3) People must not share toiletries, 02/07/07 towels or combs as this undermines their dignity and poses a risk of cross infection. The duty roster of persons 02/07/07 working in the care home must specify the hours actually worked by each member of staff so that there is a record of who was working at any time, for security purposes, and of how much care and support was being provided to people living at the home. This requirement has exceeded the timescale agreed following the last inspection. There must be sufficient numbers of people available to work in the care home to avoid staff doing double shifts, without sleep, as this compromises the wellbeing and safety of people they are supporting as well as their own health and safety. 31/08/07 All persons working in the home must receive appropriate training for their work of supporting and keeping people safe. This requirement has exceeded agreed timescales for action since the inspection on 05/01/06. This requirement includes the need for every shift to be covered by a person who is trained to give first aid. 6. OP27 OP37 17 (2) 7, 18 (1) (a) 8. OP30 OP38 OP18 18 (1) 13 (4) (c) Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 27 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 OP1 Good Practice Recommendations The registered persons should continue to revise the Statement of Purpose and Service Users Guide to remove typing and grammatical errors and present the information in a manner, which is easier to follow. These documents were not inspected on this occasion. Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kilkenny Residential Care Home DS0000017862.V342901.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!