Inspection on 10/11/05 for Kiln Lodge

This inspection was carried out on 10th November 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

Kiln Lodge 08/06/07

Kiln Lodge 27/06/06

Kiln Lodge 11/04/05

Kiln Lodge 27/10/04

Kiln Lodge 02/06/04

Kiln Lodge 26/04/04

Kiln Lodge 04/08/03

Kiln Lodge 11/09/02

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Kiln Lodge 66 Kiln Road Fareham Hampshire PO16 7UG Lead Inspector Laurie Stride Unannounced Inspection 10th November 2005 10:20a 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 Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 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. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kiln Lodge Address 66 Kiln Road Fareham Hampshire PO16 7UG 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) 02380 233 808 Mr Christopher Cowling Mrs Jean Cowling, Mr Mark Cowling, Mr Steven Cowling Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th April 2005 Brief Description of the Service: Kiln Lodge provides care for older persons and older persons with mild to moderate dementia. Service users are encouraged to maintain their independence but assistance is given when help with personal care is required. Accommodation is provided in an older house converted to meet the needs of the service users. Bedrooms provide a mix of shared and single accommodation, some with en suite facilities.The home is situated in a residential area on a busy road. The gardens provide a pleasant seating area for service users. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two annual statutory inspections of the home and was unannounced. The visit lasted approximately 6 hours and included speaking with four residents, two visitors and the day-to-day manager of the home. Feedback was also received from a number of residents and visitors via comment cards. The visit finished with an inspection of samples of the home’s records. Progress had been made in meeting the majority of the previous requirements. There was one new requirement identified as a result of this visit. Reference is made in this report to an additional visit to the home on 21/07/05 to monitor progress in meeting the requirements identified during the first annual inspection on 11/04/05. A copy of the additional visit report is available upon request. What the service does well: What has improved since the last inspection? What they could do better: Further development of the Service User Guide and staff induction programme is needed. The home provides some recreational activities to suit service users’ needs and interests but this area also needs to be further developed. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 6 Service users would be better protected through staff having relevant training in adult protection issues and through the home having a written policy on dealing with verbal/physical aggression. 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 Lodge DS0000012314.V258982.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 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 the following standard(s): 3 Service users have their needs assessed and have opportunities to visit the home prior to admission. EVIDENCE: The home’s Statement of Purpose was on display in the hallway. A previous requirement for a Service User Guide to be made available to service users and other stakeholders had been partially met. The home has a brochure that contains useful information about the service, but needs to include specific details such as a summary of the complaints procedure, the contact details of the Commission for Social Care Inspection (CSCI) and terms and conditions of residence. Service users needs are assessed prior to being admitted to the home. A sample of two files containing records of recent admissions was inspected. The home’s manager had conducted an assessment of each person’s needs based on a checklist, for example washing and dressing, medication, mobility, orientation, appetite, sleeping patterns and social history. In both cases a full care management assessment had also been obtained from the local authority. Individual care plans were being generated from the information gathered in Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 9 this way and included details such as special dietary requirements, religious and cultural needs. The involvement of the service user, relatives and other relevant professional agencies in the assessment process was also confirmed through speaking with the manager and visitors to the home and viewing records. Prospective service users and their relatives and friends have opportunities to visit the home prior to a decision being made and a place offered. In relation to standard 6 the home does not provide intermediate care. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 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 the following standard(s): 8 Service users have access to appropriate healthcare services and professional support. EVIDENCE: Through discussion with service users, the manager and inspection of records it was apparent that service user’s health care needs were being met. Day staff had received training in oral healthcare and the home keeps a supply of spare toothbrushes, toothpaste and steradent tablets. The district nurse is asked to assess service users for pressure sore aids and equipment if a risk of the condition is identified. A continence advisor is available to give guidance to staff on assisting service users and two members of the staff team had been trained in catheter care. Psychological health is monitored and referral to the community psychiatric nurse can be made through the GP or by direct contact. Some opportunities were available for gentle exercise facilitated by staff members. Nutritional information is gathered as part of the initial assessment process and weight monitoring is carried out as and when the need is identified. Most service users are registered locally with a GP. All service users have hearing and sight tests at least once a year. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 11 A number of service users indicated through conversation or comment cards that they feel well cared for and visitors who provided comment confirmed they were satisfied with the overall care provided. One service user had oxygen prescribed by a doctor and the manager reported that she had informed the fire safety officer about where it was stored in the home. It is advised that the home also refers to the Royal Pharmaceutical Society guidelines with regard to the storage of oxygen. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14 and 15 The home provides some recreational activities to suit service users’ needs and interests but this area needs to be further developed. The home enables service users to maintain contact with relatives and friends and working practices support service users to exercise choice and control in everyday living. The dietary needs and preferences of residents are well catered for with a varied selection of food available. EVIDENCE: Service users confirmed that the routines of daily living in the home were flexible and gave them opportunities to exercise choice, for example with regard to meals and mealtimes, visiting times, when to get up and what to wear. All who commented indicated that staff treat them well and are kind and efficient. Some service users expressed their opinion that the home provides suitable activities, while others indicated that this was sometimes the case or that they would like more in the way of activities and entertainment. Two service users said that staff found time to sit and talk with them. Another service user commented that they would like to speak to someone on a oneto-one basis in private sometimes. Activities for service users were discussed with the manager, who reported that information about activities was circulated as they occurred. These included a musical entertainer who visited the home on Fridays, a company Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 13 who occasionally visit to offer music and exercise sessions, bingo and quizzes organised by the staff and a number of bookings in the run up until Christmas, including visiting bell ringers and a choir, a carol service, Christmas dinner for service users and staff and a party. Service users interests and hobbies are recorded in their care plans. It is recommended that the home reviews with service users the programme of activities and provides information about these to service users in suitable formats. Service users confirmed that they are able to maintain contact with their family, friends and representatives and the home’s visiting policy states that visitors are welcome at all reasonable times. Opportunities for developing and maintaining community links will be assessed at the next inspection. It is advised that the completed Service User Guide includes information about the home’s policy on maintaining family and community links for service users. Service users confirmed that they can exercise choice and control, for example whether or not to have company and at what time to go to bed. It was also confirmed through discussion with service users and the manager that service users are entitled to bring personal possessions with them, to an extent agreed prior to admission, for example items of furniture. The home supports service users to handle their own financial affairs if they wish to and have the capacity to do so (see also standard 35 Management and Administration). Service users have a copy of their personal care plan to keep in their room. It was advised that the home obtain information with regard to local advocacy services who will act in service users interests, so that this is available should it be needed. The home had recently had the kitchen refurbished and the dining area was well presented. Service users commented that the food was very good and confirmed that alternative meals were provided if requested and that drinks and snacks were available between meals. Staff gave appropriate support and assistance if needed at mealtimes. Evidence was seen that religious and cultural dietary needs are catered for. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 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 the following standard(s): 16 and18 The recording of complaints and subsequent actions has improved since the last inspection. Adult protection policies are in place but service users would be better protected through staff having relevant training. EVIDENCE: The home has a complaints policy and a formal system of responding to complaints within timescales. A previous requirement that a record of complaints and action taken by the registered person is kept in the home had been met. Records showed that a recent concern from a stakeholder had been addressed appropriately and a satisfactory outcome reached, demonstrating that stakeholders’ concerns are taken seriously and acted upon. The local authority multi-agency vulnerable adults protection policy was available as was the department of health guidance No Secrets. An abuse awareness training pack was available, however the manager had recently come into post and had not had up-to-date relevant training to cascade the training to all staff. It is a requirement that staff receive appropriate guidance in recognising types of possible abuse and how to respond to adult protection issues. It is also recommended that the home develop a written policy on dealing with verbal/physical aggression from service users, stating how staff will approach any instances of this. The home has a policy regarding staff receiving gifts and gratuities from service users. Service users comments indicated that they feel safe in the home. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 15 Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 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 the following standard(s): 26 The provision of effective infection control systems ensures that residents live in a safe and comfortable environment. EVIDENCE: Two previous requirements in relation to the environmental standards had been met. The manager confirmed that screening in double rooms had been replaced to ensure service user’s privacy and a new alarm call system had been fitted to ensure staff can hear it in any area of the home in which they are working. The home has systems in place to control the spread of infection. A policy and procedure gives guidance in relation to the disposal of bodily waste, protective clothing, infectious disease and infections that cause concern. Staff were awaiting certificates for recent infection control training. Alcohol cleaning gel dispensers are fitted throughout the home. The laundry area is sited so that items for washing are not carried through areas where food is stored, prepared, cooked or eaten and do not intrude on Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 17 service users. The floor to the laundry room had an impermeable finish and the walls were readily cleanable. The washing machine had a hot wash programme suitable for disinfecting soiled linens and the home has a sluice facility. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Service users are supported by suitable numbers of staff and benefit through the home encouraging staff to undertake relevant care qualifications. Staff recruitment procedures and records have improved since the last inspection in order to better protect service users. The staff induction programme needs further development in order to ensure that new staff have the knowledge and skills to do their jobs. EVIDENCE: The staff rota showed three care staff were on duty on each of the early and late shifts and two awake staff were on duty at night. The home also employs a cook and a domestic staff member. The manager is on duty in the home Monday to Friday and in addition to the staff numbers. The manager reported that ten out of eleven care staff were starting their NVQ2 qualifications. A sample of three staff personnel records was seen and these indicated that a previous requirement was being met. Records contained proof of satisfactory Criminal Records Bureau (CRB) and POVA First checks (Protection of Vulnerable Adults), photographic identification and two written references. The manager stated that she would be obtaining character references in cases where it was not possible to obtain previous employment references. It is advised that the home asks all future applicants for full employment histories. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 19 A previous requirement regarding the home’s induction training programme has been partially met, with evidence that the manager has been reviewing and developing the programme. This was discussed and it is advised that the Skills for Care induction and foundation standards are referred to in order to ensure that the induction of new staff meets the standard. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 and 38 Service users’ are protected through the home’s policies and procedures for the safekeeping of money and safe working practices. EVIDENCE: The day-to-day manager has previous experience of running a care home for older people and those with dementia and confirmed that she is now applying to the Commission for Social Care Inspection (CSCI) for registration. The manager has regular meetings with the registered provider to discuss how things are within the home. Neither the registered provider nor the manager are appointees for any service users. Written records of all transactions are maintained in all cases where the home looks after service users’ money. The inspector checked a sample of two balances against current records and these were found to be correct. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 21 A written policy and procedure for managing service users’ money was available. Access to service users money is currently restricted to the manager and senior care worker who are normally on duty at most times during the day. The manager agreed to look into ways of ensuring that service users can access their money at all reasonable times. A previous requirement that staff are appropriately supervised and records are kept had been met and further formal staff supervisions were due this month. There is information on relevant health and safety legislation and a policy covering area such as accidents and emergencies, fire safety and lifting. The manager keeps records of staff training and confirmed that staff had regular training updates in first aid, moving and handling, fire safety and infection control. An up-to-date fire safety risk assessment had been completed for the home and the logbook showed when the fire officer visited, the dates of staff training and those who attended. Records were also kept of fire equipment tests including for example the fire alarm, emergency lighting and magnetic door releases. Service and appliance test certificates are held on file and the manager reported that the gas appliance testing was overdue and this was being chased up. Portable electrical appliances, the stair and passenger lifts had up-to-date certificates. The home’s accident book was seen and had been completed correctly. It is advised that the home has water systems checks against the risk of Legionella. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 X X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 23 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 OP1 Regulation Requirement Timescale for action 31/12/05 2 OP18 3 OP30 5(1)(2)(3) A Service User Guide is made available to each service user and includes a summary of the complaints procedure. (This is a partially repeated requirement of 21/07/05). 13(6) Staff receive appropriate training and guidance in recognising types of possible abuse and how to respond to adult protection issues. 18(1c) Staff receive induction training in line with the Skills for Care induction and foundation standards. (This is a partially repeated requirement of 11/04/05 and 21/07/05). 31/03/06 31/12/05 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 OP12 Good Practice Recommendations The home reviews with service users the programme of DS0000012314.V258982.R01.S.doc Version 5.0 Page 24 Kiln Lodge activities and provides information about these to service users in suitable formats. 2 OP18 The home develops a written policy on dealing with verbal/physical aggression from service users, stating how staff will approach any instances of this. Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Kiln Lodge DS0000012314.V258982.R01.S.doc Version 5.0 Page 26 - 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. 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