CARE HOMES FOR OLDER PEOPLE
Kiln Court Lower Road Faversham Kent ME13 7NY Lead Inspector
Graham Cummings Announced 08/11/05 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. Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Kiln Court Address Lower Road, Faversham, Kent, ME13 7NY 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) 01795 532183 01795 530942 Kent County Council Mr Michael Philip Roberts Registered Care Home 30 Category(ies) of Care Home for Older People, 29, Service User registration, with number with a Physical Disability, 1 of places Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: PD is restricted to one (1) person with a PD (frail elderly) whose D/O/B is 16/01/1945 Date of last inspection 26/04/05 Brief Description of the Service: Kiln Court is situated in the village of Ospringe, Faversham. Kiln Court is owned and run by the local authority, Kent County Council and supports older people over 65 years and one person between 55 and 65 years of age for long term, short term and respite care. The Home has one storey with level access throughout the building. There are 30 single bedrooms with wash hand basins and a call bell system fitted. Two bedrooms are available with en suite facilities suitable for people who may use a wheelchair. The Home has a number of lounges and dining rooms. A Registered Manager, Deputy Manager, Senior Team Leader, Team Leaders, Care Staff, Maintenance man, Administration assistants, Cook and Domestic staff, are employed at the Home. The Home provides 2 waking night staff from 9pm to 7am.The Home has pleasant grounds and garden and is within walking distance of local shops and bus stops.There is a day centre as part of the Kiln Court site. Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Graham Cummings carried out the Announced Inspection on the 8th November 2005. The Inspector arrived at 09:30 and left at 17:00. The Inspection consisted of discussions with the Manager, Michael Roberts who had only been in post for 2 months, Pam Lloyd Deputy Manager, the Pre Inspection Questionnaire, 3 Relative Comment cards, 16 Service User Comment cards, meeting with 3 staff, 4 Residents, looking through staff files Service User plans and paperwork. The home is split into 3 groups, Ospringe, Abbey and Davington and was spacious and in good decorative order and free from any odours. The staff and residents were very welcoming. The Inspector was informed by some of the Residents that ‘they were ‘more than happy’ another said ‘I came here for a short time (emergency placement) and then had to move but I did a bunk and returned the next day because I love it here so much’ ‘If I don’t like something I tell them straight’. Comments from staff included ‘we are well supported’ ‘our views are listened to’. The Inspector was aware that with a new Manager having only started in September 2005 that they were still gathering information on how the home was running and they were reviewing all the practices within the home in consultation with the Deputy, Team Leaders, Residents and staff, one issue was that some staff would like to spend longer in each group than the present rota of 2 weeks, as some of the Residents, mainly in the Recuperative care group of Abbey, sometimes found the change of staff group unsettling during their 6 week stay. Residents are free to join in any activities that are run at the attached Day Centre and are also able to go on any outings arranged. A complaint received by the previous Manager had not been written in the complaints book but the Deputy did recall the incident and informed the Inspector that it had been dealt with by the Manager with a positive outcome for all concerned but would appear not to have recorded it in the Complaints book. The Inspector was aware that the Providers, Kent County Council have an off site Personnel Department which held the Majority of staff information, the Inspector felt that copies of items listed in Schedule 2 of the Care Home Act 2001 should be kept on the premises, with regard to the Criminal Records Bureau checks the number of the Individual staffs certificate could be kept on the computer in a separate file with a password. Staff Supervision needs to be carried out at regular 6 weekly intervals. The Inspector left the home with no cause for the concern for the Residents health, safety or welfare. What the service does well:
The staff are dedicated, professional and well trained, with access to the Kent County Council central Training Department who run and organise all statutory and relevant course required to enable staff to perform their duties to a high standard. The staff and Management team are good listeners and offer a
Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 6 consistent approach of care to the Residents. No Resident attends any Doctors, Dentist or Hospital appointment on their own if family are not able to attend unless they choose to do so. The quality of food is good, healthy and varied. The homes Recuperative Care group was very responsive to admissions and need. Plans are underway for the Xmas decorations to be put up, the Xmas show and Residents, family and friends Xmas dinner. 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. Kiln Court H56-H05 S37750 Kiln Court V248152 081105 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 Kiln Court H56-H05 S37750 Kiln Court V248152 081105 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) 1,2,3,5,6 Prospective Residents have access to information that may help them to make an informed decision. Residents have written contracts. Residents move into the home having had their needs assessed. Prospective Residents have the opportunity to visit the home before placement. Recuperative care Residents are helped to maximise their independence. EVIDENCE: Prior to any placement taking place the home ensures they have a Care Managers assessment and that the home has all the required information, the prospective Resident is invited to visit the home with their family or friends and a visual and verbal assessment is carried out, the Resident is given a copy of the Service User Guide. If a placement is agreed the Resident signs a written contract and a copy put on file. The Intermediate care group have programs in place and daily access to Occupational Therapists that maximise their independence and enable them to return home quickly. Kiln Court H56-H05 S37750 Kiln Court V248152 081105 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) 7,8,9,10 Residents all have individual plans of care. Residents health care needs are fully met. Residents self-medicating are protected by the homes policy and procedures. Residents are treated with respect. EVIDENCE: The Inspector was informed that all Residents have an individual care plan, the Inspector looked through 6 care plans and found them to contain all the required information in a detailed and informative manner. All of the permanent Residents are registered with a Doctor, the short term recuperative care Residents if they are local keep their own Doctor or are temporarily registered with Dr Kesson if out of the local area. Residents who are able to self-medicate are risk assessed by the Doctor, Home Manager and a decision taken based on the results of the Risk Assessment, if a Resident is selfmedicating a program of monitoring needs to be made and regularly evaluated. Residents informed the Inspector that they were treated with respect and dignity by staff, one Resident said ‘staff are so kind and helpful’ ‘the door is always closed when staff are caring for me’. Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Residents lifestyles in the home matches their expectations. Residents maintain contact with family and friends. Residents are helped to exercise choice and control over their lives. Residents receive a wholesome appealing balanced diet. EVIDENCE: Residents have the opportunity to participate in activities within the individual groups or at the attached Day Centre, activities include number and musical Bingo, word games, card schools (Rummy), Basketball and a musical entertainer Chirpy Tunes on a weekly basis. Ospringe group is very quiet through the choice of the Residents. All of the above is voluntary and some Residents prefer not to participate in any activities at all. Family and friends are welcome at any time, in the recuperative group visits are encouraged to take place in the afternoon or evening as the rehabilitation programs take place in the morning. Residents are encouraged to participate in making choices in their lives and taking responsibility wherever possible for washing, dressing and activities they wish to do or participate in. Meals are provided through a central kitchen and are taken to the groups on a heated food trolley, the Inspector saw a lunch menu on display for the day of Gammon, potato and vegetables followed by a pudding. Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Residents and Relatives are confident that their complaints will be listened to and acted upon. Residents are protected from abuse. EVIDENCE: Residents are confident that their complaints will be listened to and acted upon, 2 complaints have been received in the last 2 months since the new Manager has been in post, these were written in the Complaints book with Investigation and actions taken, however the Inspector did find a written complaint from July 2005 on a staff file that had not been entered into the complaints book, the Deputy Manager assured the Inspector that the previous Manager had dealt with the issue but must have forgotten to log it in the Complaints book. All staff in the home have attended Adult Protection training apart from the last 4 staff employed. Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26 Residents live in a safe well-maintained environment. Residents have access to safe and comfortable indoor and outdoor communal facilities. Residents have sufficient and suitable lavatories and washing facilities. Specialist equipment is available to maximise independence. Residents rooms meet their needs. Residents live in safe comfortable surroundings and their bedrooms are furnished with their possessions. The home is clean, pleasant and free from offensive odours. EVIDENCE: The Residents have access to a secluded sensory garden that is now almost complete, the home is well decorated and spacious corridors and numerous lounges. Each group has 2 toilets and a bathroom and there are 2 bedrooms that have en-suite facilities. Specialist equipment is available with 2 track hoists, 1 mobile hoist, wheelchairs, wheeled walking frames, walking frames and railing along all corridors. The Inspector viewed 3 bedrooms and found them to be well furnished and decorated, Residents had personal possessions on display. The Inspector was informed by 1 Resident that their Tall Boy wardrobe meant that their blouses were laying on the bottom, the Manager is
Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 13 to arrange for the maintenance person to see if the bar holding the hangers could be raised to address the problem. The building appeared to be safe and the surroundings were comfortable. The home was clean, tidy, hygienic and free from offensive odours. Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 Residents needs are met by the numbers and mix of staff. The record keeping of information kept on staff files needs to be improved. Staff are trained and competent to do their jobs. EVIDENCE: The Inspector was sent a rota with the Pre Inspection Questionnaire that showed each group was adequately covered with staff, the Home is presently using some agency staff but it is hoped that this will be reduced to zero within the next 6months following a recruitment drive. The staff team have access to the training of Kent County Council who run rolling courses that cover the essential training requirements, 50 of staff have achieved NVQ level 2, other training carried out over the last 12 months includes 1st Aid, MRSA, Health and Safety, Hoist training, Fire, Moving and Handling, Medication and Accident and Investigation plus numerous other courses. The Manager is looking to arrange training in the near future for all staff to complete the CERRUS Saturn electronic home management program that covers care plans, risk assessments, evaluations, appointments, daily notes and all relevant documentation relating to care homes. Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31,33,35,36,37,38 Residents live in a home that is run and managed by a Manager fit to be in charge. The home is run in the best interests of the Residents. Residents financial interests are safeguarded. Staff are not supervised in line with the standards. Residents best interests are safeguarded by the homes record keeping and policies and procedures. The healthy, safety and welfare of Residents and staff are promoted and protected. EVIDENCE: The new Manager has been in post for almost 8 weeks and is still in the process of getting to know the home, Residents and staff. The Inspector spoke to staff regarding the Manager and comments made indicated that he was being well received, such as ‘he appears to listen to us’ ‘he is approachable’ ‘he hasn’t come in and changed everything and is asking us for our thoughts and listening to us’. The Manager and Deputy both agreed that the home is run in the best interests of the Residents, ‘it is their home and they should be able to live the life they want’. There is only one Resident that has any financial
Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 16 dealings with the home being responsible and this is well controlled and recorded by the homes policies and procedures. The records and Policies and Procedures seen were of a good standard and safeguarded Residents and staff. The Inspector looked through 4 staff files and did not find a consistent trail of Staff supervision, the Manager and Deputy will follow this through and ensure that this is now implemented. The Inspector was satisfied that the Residents health, safety and welfare were promoted and protected. Kiln Court H56-H05 S37750 Kiln Court V248152 081105 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 3 3 3 x 3 3 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 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 x 3 x 3 2 3 3 Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 18 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 16 Regulation 22(3) Requirement The Registered person shall ensure that any complaint made under the complaints procedure is fully investigated and recorded The Registered person shall not allow a person to whom paragraph (2) applies to work at the Care Home in a position which paragraph (3) applies, unless (b)(i) the employer has obtained in respect of that person the information and documents specified in paragraphs 1 - 7 of Schedule 2. The Registered person shall ensure that the persons working at the home are appropriately supervised; that is at least 6 times a year and records kept. Timescale for action March 2006 March 2006 2. 29 19(4)(b) (i) 3. 36 18(2) March 2006 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.
Kiln Court H56-H05 S37750 Kiln Court V248152 081105 Stage 4.doc Version 1.40 Page 19 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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