CARE HOMES FOR OLDER PEOPLE
Kilncroft 25-29 Ashburnham Road Clive Vale Hastings East Sussex TN35 5JN Lead Inspector
Jeanette Denereaz Unannounced Inspection 09:00 15 August 2006
th 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 Kilncroft DS0000021149.V300153.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. Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Kilncroft Address 25-29 Ashburnham Road Clive Vale Hastings East Sussex TN35 5JN 01424 434921 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) www.craegmoor.co.uk Parkcare Homes (No. 2) Limited Mrs Valerie Riedel Care Home 15 Category(ies) of Dementia (15) registration, with number of places Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is fifteen (15) Service users must be older people aged sixty-five (65) years or over on admission Service users with a dementia type illness only to be accommodated Date of last inspection 5th October 2005 Brief Description of the Service: Kilncroft is registered to accommodate fifteen older people with a dementia type illness. The property is detached and is set in a residential area of Hastings. The property is on four floors. The first two floors are registered as Kilncroft. The top two floors are separately registered to cater for younger adults with a pre-senile dementia type illness. Both homes operate independently of each other, however the registered manager is responsible for both establishments. The whole building is owned by Parkcare Homes Ltd, which in turn is owned by Craegmoor Healthcare Limited. Local shops and amenities are close by and the home is approximately one mile from the centre of Hastings. The current fee is £366.08 per week. Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection including a site visit, for the year running from April 1st 2006 to March 31st 2007. Time was spent with the manager, residents, staff and an evaluation of gathered information. All staff on duty during the site visit were informally interviewed at their morning break meeting. All service users were sent a ‘Have you say’ survey about Kilncroft, 4 were returned, due to the nature of the home they were completed by staff on the behalf of the residents. From information gathered most service users were happy with the care they received. The surveys invite service users to speak to the inspector, but no service user request to speak, however, during the visit service users chatted with the inspector. Following the inspection visit a selection of family members were contacted by the inspector to gather their views on the home. They all had positive things to say about the home. The pre-inspection questionnaire, business plan, staffing rota and a selection of menus were also received. Due to the nature of some of the service, it is difficult to reliably incorporate accurate reflections of the service in the report. Some judgements about quality of life and choices were taken from direct conversation with service users and their family, information received and observation followed by discussions with the management, service users, staff members and evidencing records held in the home. Within the body of this report service users will be referred to as residents. What the service does well:
The registered manager with the support of the staff team continues to maintain a calm and orderly atmosphere within the home. It was evident that family members are welcome, and the new resident’s husband was telephoned during this inspection process. He confirmed that he visits his wife frequently, and he always finds his wife well, and the staff are always friendly and caring, especially the manager. The Inspector found the home to be clean, relaxed and calm, but unfortunately due to the levels of dementia, it was not always possible to ascertain the views
Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 6 of all residents. However, staff were observed to interact very well, and positively, with the residents. It was evident they were aware of the importance of providing care in a way that maximises residents’ dignity and privacy. Staff spoke positively about the home, and there is a very stable staff team, many having worked at the home for many years. The manager is committed to providing a good quality of care for residents but also ensuring that staff are well supported, the home has a good atmosphere. The manager and staff are always trying new initiatives to involve the residents into the community, and the newest venture has been to encourage residents to go out of the home to have their hair cut. The activity involved the resident with staff support booking an appointment with a High Street hairdresser and the trip includes a visit to a coffee shop. The first few visits have been very successful, and the manager intends the activity to be encouraged further and involve more residents. The home continues to hold the Investor in People Award and there is a strong commitment to staff training. What has improved since the last inspection? What they could do better:
The home is generally very clean and tidy, and provides a homely environment, however there are areas of the home that are in need of modernising and redecorating. The external area of the home is in urgent need or repair and painting. The front steps are in need or repair, because their current poor condition will deteriorate and could become very dangerous for residents, staff and visitors to the home. There has been an outstanding problem of serious dampness in one residents bedroom in the adjacent Kiln Croft unit and this does impact on the deterioration of both homes as they are housed in the same building and the water is running into the roof space of both homes. It is once again recommended that the home review the bathing assessment of all residents, and ascertain if more specialised baths are needed or could be needed in the future, and if so, where the bath could be installed within the home. Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 7 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. Kilncroft DS0000021149.V300153.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 Kilncroft DS0000021149.V300153.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3, & 5 (The home does not offer intermediate care and therefore key standard 6 cannot be assessed) Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Prospective residents, families and other representatives have all the basic information they require to decide whether the home is for them. EVIDENCE: The home has had two new residents since the last inspection. Unfortunately the gentleman died after three months. The second new resident was seen by the inspector and had brief conversation in which it was evident the resident was quite settled.
Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 10 The inspector, as part of the inspection process contacted the resident’s family to ensure they were satisfied with the care their relative was receiving at Kilncroft, which they were. The registered manager confirmed that a pre-assessment took place before the resident moved into the home, and this was evidence from the resident care plan and file. The manager visited the resident at the Council residential home, where the resident was receiving respite care, and contacted the family to gather relevant information. The care plan was comprehensive and has full risk assessments and guidelines in place for staff to follow to ensure the resident’s care needs are met. Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 11 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): 7,8,9 & 10 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents’ general health and personal care needs are met. EVIDENCE: Care plans are reviewed monthly and comprehensive daily records are kept and the Staff had a good understanding of the care needs of residents Medication record sheets had been completed accurately and medication was being stored appropriately. All care staff that dispenses medication have been trained and further medication training is planned for the 22nd September 2006. As well as the organisation’s training the dispensing Pharmacist under takes training within the home. Since the last inspection the manager has organised a medication review with the GPs for all residents, and for some residents medication has been revised and reduced. The Staff on duty at the time of the site visit clearly understood the needs of the residents and treated them with respect and courtesy.
Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 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 & 15 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The daily routines and activities provided meet residents’ needs and are flexible. Residents keep in contact with their family and friends. EVIDENCE: The manager and staff are always trying new initiatives to involve the residents into the community, and the newest venture has been to encourage residents to go out of the home to have their hair cut. The activity involved the resident with staff support booking an appointment with a High Street hairdresser and the trip includes a visit to a coffee shop. The first few visits have been very successful, and the manager intends the activity to be encouraged further to involve more residents. The visitor book indicated that the home has many visitors and many are family members and this was confirmed by diary entries of when family members and friends of the residents had visited and if the resident went out with them.
Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 13 The inspector was present during the residents’ lunchtime and afterwards had lunch with the staff and found the meal to be very good. The home has two cats and a rabbit, and they are very important to the residents. The cats were in the lounge and enjoy being stroked, which many residents did during this visit. The rabbit lives in the garden, but does sometimes come into the home to be stroked and loved by the residents. There are photographs on the wall of these occasions, and the residents looked at if they are enjoying the rabbit sitting on their laps. The residents are encouraged with staff support to look after the pets. Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 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 & 18 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives’ complaints are taken seriously and investigated. Staff will take the correct action to safeguard residents from abuse. EVIDENCE: No recorded complaints or concerns recorded since the last inspection. During the staff break time the inspector joined the staff for an informal interview/chat, the staff team included the cook, laundry, domestic and maintenance persons as well as the care Staff. The inspector asked the question about their knowledge of protecting residents from abuse, they all were confidence with the home’s procedures and policy and had confidence in the management that is they had concerns they would by listen to and action taken. Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 15 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): 19, 21,22,24 & 26 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a clean and comfortable home with private and communal rooms that meet their needs. However there are areas of the home internally and externally that need repair could in time affect the well being of residents EVIDENCE: The home is generally very clean and tidy, and provides a homely environment, however there are areas of the home that are in need of modernising and redecorating. The external area of the home is in urgent need or repair and painting. The approach to the home looks very untidy and not welcoming for the residents or visitors. The front steps are in need or repair, because their current poor condition will deteriorate and could become very dangerous for residents, staff and visitors to the home.
Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 16 There has been an outstanding problem of serious dampness in one residents bedroom in the adjacent Kiln Croft unit and this does impact on the deterioration of both homes as they are housed in the same building and the water is running into the roof space. It is once again recommended that the home review the bathing assessment of all residents, and ascertain if more specialised baths are needed or could be used in the future, and if so where they could be sited within the home. The home was clean and free from offensive odours. Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 17 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 & 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment procedure, and a committed staff team protect residents. EVIDENCE: Since the last inspection the recruitment procedures have been revised and now if a member of staff is transferred to the home from another home within the Creagmoor organisation, they undergo a formal interview with the manager to ensure they are suitable for the post. Also their staff file is updated and a current CRB is applied for. The inspector observed the staff working with the residents and was impressed with the respect and empathy shown by all the staff on duty. When questioned the staff had a good knowledge of the residents, and gave the residents a personal touch to their care, this is achieved by the established staff team working well together. Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 18 Training is very important to the manager and the staff and all are encourage to undertake training. During the informal interview the inspector had with the staff, their confirmed that that they are undertaking NVQ and differing levels and timescales and from the information provided in the Pre-Inspection Questionnaire the home has 48 of the care staff team are trained with NVQ level 2 and above. Also it was evident from the records held at the home that the staff received regular supervision from the manager, and the training matrix held in the home identified on-going training for all staff. The home holds ‘The Investors in People’ award. Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 19 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): 31,33,35 & 38 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well-managed home that is run in their best interests and safeguards their rights. EVIDENCE: The registered manager is well qualified and holds the Registered Manager’s Award (RMA). From the Pre-inspection Questionnaire that was completed and signed by the manager, and records seen by the inspector during this site visit, all the requirements relating to the health and safety of home and issues to do with residents’ finances are up to date, accurate and in order.
Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 20 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 3 X 3 X 3 N/A 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 Standard No Score 16 3 17 X 18 3 2 X 2 2 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 OP19 Regulation 23(2)(o)( n) Requirement It is required that the Responsible Individual/Creagmoor organisation should ensure the external areas of the home, especially the frontage and stairs leading up to the home are maintained, kept tidy, safe and attractive and accessible to residents, staff and visitors to the home. It is required that the Responsible Individual/Creagmoor organisation should ensure there is a programme of routine maintenance for repair and decorating. The outside of the home must be repaired and maintained to ensure the residents are always safe and live in a good environment. The planned repaired with dates for completion to be sent to the CSCI. Timescale for action 31/12/06 2 OP19 23 (1) (a), (2)(d)(p), (5) 16(2)(j) 31/12/06 Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 22 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 OP22 OP21 Good Practice Recommendations It is recommended that the registered manager assess the bathing requirements of the residents and provided the appropriate bathing facilities to meet their current and changing needs. Kilncroft DS0000021149.V300153.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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