Inspection on 26/04/07 for Kilpeacon House

This inspection was carried out on 26th April 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kilpeacon House 16/04/08

Kilpeacon House 16/06/06

Kilpeacon House 11/01/06

Kilpeacon House 19/07/05

Kilpeacon House 17/01/05

Kilpeacon House 21/06/04

Kilpeacon House 17/01/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Kilpeacon House Grey Road Altrincham Cheshire WA14 4BU Lead Inspector Rukhsana Yates Unannounced Inspection 10:00 26 -27th April 2007 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 Kilpeacon House DS0000005618.V336401.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. Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kilpeacon House Address Grey Road Altrincham Cheshire WA14 4BU 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) 0161 928 2784 Mr James Skeath Mrs Lina Margaret Skeath Mrs Dianne Joan Chapman Care Home 24 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. All service users will be aged 65 or over. Service users will require care by reason of either old age or dementia and may in addition have a physical disability. 24th August 2006 Date of last inspection Brief Description of the Service: Kilpeacon is a care home providing personal care and accommodation for 24 older people. It is owned by Mr. and Mrs. Skeath. The home is located in an established residential area of Altrincham, close to shops, bus and train routes and other amenities. The home is a detached twostorey building and has 14 single and 5 shared bedrooms, most of which have en-suite facilities. There is a dining room, a lounge with dining area, and a conservatory. A passenger lift is available. The home has parking spaces and well maintained gardens within the grounds. The current fees for the home range from £338 to £450 per week, with additional charges for hairdressing, personal toiletries, newspapers and magazines. Further information about the service is included in the home’s Statement of Purpose and Service Users’ Guide. These are provided to people living at, or considering a move to, Kilpeacon and are available to read at the home on request. Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In order to find out about the experiences of people living at Kilpeacon House, an unannounced visit was carried out, with a total of 10 hours spent at the home. The time was spent talking with people about their daily life in the home, watching the ways in which staff supported them, talking with the manager and looking at paperwork relating to care and safety. The findings of the inspection take account of comments made by people living and working there, and also written information received from the manager and from those living at, or visiting, Kilpeacon House. The service was inspected against key standards for homes for older people to see how well it was meeting a range of needs. These standards cover moving in, the care provided, daily routines and lifestyle, complaints, safety, comfort and cleanliness, how staff are employed and trained, and how the service is managed and developed. The term preferred by the people consulted during the visit was “residents”. This term is, therefore, used throughout the report when referring to those living at the home. What the service does well: Before moving to the home, residents, or relatives on their behalf, may visit to look around and ask questions to make sure they are making the right choice. One relative said, “I was shown around and had long conversations about my relative’s needs. I was very satisfied”. Residents feel that the care staff know what they need and like, and are caring. For example one resident said “All my needs are well met by all the staff. The managers are very good and always ask about my health”. Residents have a choice of activities that they enjoy, and visitors are made welcome to the home. They feel that the manager will listen to them if they have any problems, and that the manager and care staff do their best to provide a very good standard of care. Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 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 Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person considering moving to Kilpeacon House is given information about the home, has an assessment of their needs carried out before admission is agreed, and assured that the service is able to meet them. EVIDENCE: Residents have an assessment of their needs carried out, by the manager, before admission. The assessment includes a visit to the person in their own home, or in hospital, by talking with the individual or with family members. One resident new to the home said “she (the manager) asked me things about myself”. The assessment covers a good range of topics, including personal and health care needs. These ensure that admissions to the home only take place if the manager is confident that the assessed needs of the individual can be met. It is recommended that religious, social and cultural needs are identified before admission, so that residents may be assured that their particular needs in these areas are known and will be met within their new environment. Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 9 Those considering moving to the home are invited and encouraged to visit so that they can have a look around, and meet staff and other residents before making a decision. One person whose relative lives at the home said “I was shown around and had long conversations about her needs. I was very satisfied.” Prospective residents or their families are given a brochure and written guide describing the home and the facilities provided. One resident commented that “someone came to the hospital and left some papers”, and that family members had described the home to him. This highlights that it would be of benefit to some residents to have the brochure and guide provided in a different format; for example, in large print, or using photos or other media so that they are better able to access and understand the information. The statement of purpose and service user guide should also better reflect how the service provides for the care and social needs of people with dementia, so that prospective residents and their representatives are better informed. Kilpeacon House DS0000005618.V336401.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 adequate. This judgement has been made using available evidence including a visit to this service. Up to date, informative care plans ensure that the health and personal care needs of residents are met, but adequate risk assessments to ensure the safe use of specialist equipment was not in place. EVIDENCE: Residents’ care plans include information about a wide range of personal and health care needs, and a summary that informs staff members about the preferred care of the resident. The summary is written in consultation with the resident and shows respect for the individuality of each person living at the home. The manager is developing “Family Tree” information for each resident. This is helping staff members to gain a greater insight into each resident’s life experiences, and therefore better able to understand their needs and support them in recalling significant people and events. Care plans are regularly reviewed and updated, by the manager and by care staff, so that everyone involved in providing support is aware of each person’s current needs and how they should be met. Safe medication procedures, and Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 11 good arrangements for monitoring residents’ nutritional needs help to promote residents’ health. Residents’ satisfaction is reflected in comments made, such as “I have no complaints. They look after me alright” and “All my needs are well met by all the staff day and night. The managers are very good and always ask about my daily health. Generally I am very satisfied”. Although residents are provided with the equipment they need to help with their mobility and to prevent pressure areas from developing, there are two areas of concern. These are the use of footplates when assisting residents in wheelchairs, and the use of bedrails on residents’ beds to ensure that they are necessary, safe and suitable. There were several examples of positive ways in which the service seeks to maintain the privacy and dignity of residents. However, care staff should be reminded of the need to use each person’s preferred term of address so that residents feel that their wishes are being respected at all times. Kilpeacon House DS0000005618.V336401.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. 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. Residents social needs and choices are respected and met, but menu planning does not provide for adequate variety and choice at mealtimes. EVIDENCE: There is a recognition that residents vary in their capacity and wishes to be involved in social activities, and this is reflected in their individual care plans and activities provided. These are confirmed in residents’ comments such as “I do my best to join in certain activities which I enjoy at all times” and “They are available. I choose not to take part”. Small scale outings are encouraged that promote participation in the local community. There was evidence that the manager and staff are willing to address the religious and cultural needs of residents, and to work closely with family members to ensure residents’ individual needs are met. Visitors spoken with said they are made to feel welcome during their visits and are kept informed of the wellbeing of their relative or friend. Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 13 The mealtime observed showed that residents are provided with the assistance they need and are encouraged to eat if their dietary intake is poor. However, the mixed survey responses and comments made by residents, such as ““Its always the same things”, supported by staff comments, indicate a need for more variety in menu planning. Menus show a limited range of meal provision over a two week period. For example two meals are repeated, and on one day, roast pork at lunch is followed by pork pie for tea. In order to provide a varied diet that all residents enjoy, there is a need to review menus following proven consultation with residents. Kilpeacon House DS0000005618.V336401.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and visitors are confident that any issue they raise will be dealt with promptly, and they are safeguarded by the staff knowledge of adult protection policies. EVIDENCE: The complaints procedure is given to residents when they move in, or to their families. The atmosphere in the home is open and friendly. People know they can raise any complaints and appropriate action will be taken to address their concerns, and this was apparent in the complaints record. The manager and staff are familiar with the procedures regarding the protection of residents. Guidance on the local multi-agency procedures is available for reference. This knowledge, along with safe recruitment processes, help to safeguard residents. Kilpeacon House DS0000005618.V336401.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26: Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents live in clean and homely surroundings, but inadequate attention to environmental safety issues gives rise to potential hazards for residents and staff. EVIDENCE: Residents’ bedrooms are clean and tidy, and have been personalised with residents’ own belongings to varying degrees. There is adequate seating in lounge and dining areas for people to socialise. A written maintenance programme is not kept, so a brief tour of the premises was carried out with the manager. This identified a large number of areas that need to be addressed in terms of repair and maintenance. In addition, there are issues outstanding in relation to fire safety. For example, the fire safety officer wrote in 2004 that a risk assessment not been carried out as required. Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 16 The in-house assessment, with no issues identified, was carried out in 2006 but no arrangements made to have this validated. During this visit, the laundry door was open with washing hanging on the closure making it ineffective, and a walking frame was blocking a fire exit, (addressed during the visit), despite laundry issues and other matters highlighted in the last fire report. Some selfclosing devices on bedroom doors were ineffective. There is a clear need to address the fire safety issues identified, produce a comprehensive environmental risk and maintenance assessment, and to prioritise and address matters arising from these to ensure the safety of all residents and staff. There was no evidence that orientation aid were in use throughout the home despite there being a number of residents with dementia. Kilpeacon House DS0000005618.V336401.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for employing, training and supporting care staff ensure that the needs of residents are met. EVIDENCE: There are three care staff on duty during the day to meet the needs of 23 residents. Domestic staff are also employed and a cook is on duty until 2pm. Staffing levels appeared sufficient to meet the care needs of residents. Several staff members have worked at the home for a long time and this provides good continuity of care for residents. Staff records indicate that robust recruitment procedures are followed, with all necessary background checks carried out prior to employment. Good training and supervision arrangements are in place with most care staff having NVQ qualifications in care. At present the induction checklist was seen to be completed in one day. The manager was advised to introduce a gradual and comprehensive induction for new staff so that they develop a good understanding of the home’s policies and practices. Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 18 One resident said, of care staff, that, “They are always available whenever I need them”. Another said, “Some of them are very good”. Visitors said that the manager and staff are very friendly and approachable. Kilpeacon House DS0000005618.V336401.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. 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. The manager is competent and caring, and strives to manage the home in the best interests of residents. However, some safety checks had not been completed within timescales, putting residents at risk. EVIDENCE: It was clear from discussions and observations that the manager of the home fosters an open and friendly atmosphere in the home, and that residents, visitors and staff find her approachable. There was also evidence that the manager continually seeks to make improvements in the home for the benefit of residents and has a very good knowledge of their individual personalities and preferences. This enables her to guide care staff in their approach, ensuring that the care and support provided is sensitive. Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 20 There is a system in place for obtaining the views of residents, relatives and visiting professionals, and using these to identify improvements for residents. The manager is planning to provide questionnaires to staff so that their views may be taken into account in future plans. Most appliance and equipment tests at the home are up to date, but testing of electrical equipment, including portable appliances, had not been carried out in the timescale set out at the previous inspection. Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 21 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X 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 2 Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 13(5) Requirement There must be clearly documented, comprehensive risk assessments for the use of specialist equipment for individual residents. Fire and environmental safety must be clearly risk assessed, with strategies put in place to reduce identified risks to residents and staff. Testing of electrical equipment, including portable appliances must be carried out, at the frequency stated by the testing electrician, so that the environment is safe for residents and staff. Timescale for action 21/05/07 2. OP19 23(4) 21/05/07 3. OP38 13(4) 21/05/07 Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 23 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 statement of purpose and service user guide should better reflect how the service provides for the care and social needs of people with dementia, so that prospective residents and their representatives are better informed. It would be of benefit to some residents to have the brochure and guide provided in a different format; for example, in large print, using photos or other media, so that they are better able to access and understand the information. Care staff should be reminded of the need to use each person’s preferred term of address so that residents feel that their wishes are being respected at all times. In order to provide a varied diet, menus should contain a wider variety of meals and choices. Residents should be consulted when planning menus by means of using photos, sampling, and using staff members’ knowledge of preferences. Menus should be provided in a format residents understand so that they are better able to exercise choice at mealtimes. In order to assist people with dementia, it is recommended that orientation aids, such as a large clock, pictorial notice-board, and other aids are provided in communal areas. The manager was advised to introduce a gradual and comprehensive induction for new staff so that they develop a good understanding of the home’s policies and practices. 2 OP10 3 OP15 4 OP19 5 OP30 Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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 Kilpeacon House DS0000005618.V336401.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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