Inspection on 07/09/05 for King William Residential Home

This inspection was carried out on 7th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

King William Residential Home 11/04/07

King William Residential Home 13/06/06

King William Residential Home 07/02/06

King William Residential Home 04/11/04

King William Residential Home 21/07/04

King William Residential Home 09/09/02

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE King William Residential Home Lowes Hill Ripley Derby DE5 3DW Lead Inspector Bridgette Hill Unannounced 7th September 2005 09:00 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. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service King William Residential Home Address Lowes Hill, Ripley, Derbyshire, DE5 3DW 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) (01773) 748841 (01773) 748841 Ashmere Care Homes Vacant Care Home providing personal care 28 Category(ies) of Old age, not falling within any other category registration, with number (23), Physical disability (5) of places King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 5th November 2004 Brief Description of the Service: The King William Care Home provides 24-hour staffed care for 28 older people. The Home is a large detached brick building which is situated on the edge of a Derbyshire market town with good shopping facilities and amenities available within half a mile of the Home. The facilities provided at this Home comprise of 24 single rooms and 3 double rooms many of which have en-suite facilities available. The Home provides a garden area with easy access for Service User.Services provided to Service users include personal laundry, home cooked and traditional food, social events and leisure activities. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced one which took place over 6 hours. During the inspection 2 staff members and 3 residents and 1 visitor were spoken with. The acting Manager Gill Wright was on duty at the time of the visit. Various records including care planning records were examined the findings are recorded in the body of this report. What the service does well: 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. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 6 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 King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 7 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) 1,2,3,4,5 Information was made freely to residents and visitors who chose to access it but the statement of purpose did not give accurate information to residents or their representatives regarding management of the home. Service users were given opportunities to make positive decisions regarding admission to the home. EVIDENCE: A Statement of purpose was available. This required updating as there had been changes in the management and managerial structure of the home. Some aspects of Schedule 1 were also missing such as a description of the environmental standards in the home, and arrangements for care plan reviews. A Service User Guide was available which included a Terms and conditions of residency contract and details regarding leisure and social activities. There were no service user views included in this document. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 8 It was evident from care files that pre admission assessments were undertaken by staff from the home and service users had opportunity to visit prior to admission. There was also the option offered to one service user to build up visits to the home on day visits with a bedroom allocated prior to becoming a full time resident. Terms and conditions of residency contracts were included within care files. These contained all the required information and were signed by the service user or their representative. King William Residential Home C52 C02 S20027 King William V246857 070905 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) 7,8,9,10,11 Care plans were in place to describe how service users assessed needs were to met. Healthcare provision was provided by established services and appropriate referrals made where these were considered to be required. EVIDENCE: A sample of three service user care plans were examined to assess how standards were being met. Care files were organised and easy to read. They all contained plans of care based on assessed needs and recorded the choices of service users. There was evidence of care plans being reviewed and service users had signed some care plan reviews. Records indicated that in some cases it was assessed as not appropriate that the service user was able to be involved in the care planning process. A range of risk assessment tools were used including tissue viability falls risk assessment and nutrition. Each plan of care also had any identified risks documented. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 10 One tissue viability trigger tool had been completed and in response to this a referral had been made to the District Nurses however the scoring indicated a weekly review and this had not been implemented. Healthcare input from external professionals was recorded. This included district nurses, GP’s, dentists, opticians and chiropodists. The storage and administration of medicines was inspected. Where medication administration records had been hand written these were not signed and verified by staff members. Topical preparations were found to have been dated on opening. The temperature of the drug storage area was taken daily but during the evening. It is recommended this be completed at the hottest time of the day. A dedicated drug fridge was available which was temperature checked (maximum and minimum) daily and an up to date drug reference book was available. Staff responsible for the administration of medicines had received appropriate training. Care files indicated that there was no information recorded on service users post death wishes this requires work to ensure that service users are consulted and their wishes respected. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 11 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 Whilst a range of activities are offered to service users records are not available to demonstrate that these are part of an agreed plan of care based on individual need with often only a minority of service users taking part. EVIDENCE: Since the last inspection a plan of activities had been developed. It was the responsibility of care staff to organise and arrange activities. A book was held recording which service user had participated in activities, this indicated that often the majority of service users had chosen not to take part. It was not recorded if alternative activities had been offered to these service users. A theme night was held on a monthly basis. Feedback from service users was recorded in the quality assurance plan and this seemed to be a popular event. Three service users attended church regularly and visiting clergy were also arranged for one service user. Some community links were also established with local cubs/scouts. A quarterly newsletter of events/news was published with each home owned by the Provider having a relevant section. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 12 External entertainers visited the home on at least a monthly basis and this has proved popular with requests for this being made through he residents meetings. Service users had personal possessions in bedrooms and the range of lounge areas allowed service users a choice of joining in with activities or having a quiet time to themselves. One visitor spoken to said they always made welcome by staff although it was observed that when the tea trolley came around they were not offered a drink. Some service users have enjoyed trips out to a local concert and for a boat trip. Transport is available this is shared with sister homes. A garden party has also been held at the home during the summer. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 13 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) 16,17,18 A range of policies and procedures were in place for staff to be aware of how to report any suspected abuse however the Protection of vulnerable adults procedure was contradictory in the course of action to be taken following any allegation and knowledge of procedures was poor. This has the potential to lead to inappropriate handling of allegations. EVIDENCE: A complaints procedure was on display in the hallway and in the Statement of purpose. This gave timescales for the resolution of complaints and the address of the Commission for Social Care Inspection. Records of complaints received were examined. These indicated written responses to complainants were given and details of outcomes recorded. There was a Protection of vulnerable adults procedure in place which was contradictory in the procedure to be followed. The Protection of vulnerable adults procedure referred to a booklet, which was available, this advocated locally agreed procedures with Derbyshire County Council. The policy later advocated internal investigation which is not in keeping with the Derbyshire County Council procedures where multi agency strategy meetings are held to determine the appropriate course of action to be taken. Staff spoken to said they had received in house training on Protection of vulnerable adults procedures but were not able to demonstrate a knowledge of the Derbyshire County Council procedures. One staff member spoken was not King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 14 aware that the booklet from Derbyshire County Council belonged to the home and thought it actually belonged to the inspector. Generally there was poor knowledge demonstrated by staff regarding policies relating to Protection of vulnerable adults despite staff stating they had received training. A whistle blowing policy was in place for staff to utilise. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 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 standard(s) 19,20,21,22,23,24,25,26 The home presents as being in generally well maintained with a good range of communal areas for service users to use. EVIDENCE: The home appeared to be well maintained and offered a range of 4 lounges for service users to use including one dedicated lounge for smokers. One lounge had a small kitchenette for service users or their families to use to make drinks. A range of bedrooms were examined. These were found to be personalised with service users effects. Bedroom doors were fitted with appropriate locks and some service users held the keys to their rooms. The home had been visited recently by the Fire officer and fire safety standards were assessed as being satisfactory. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 16 The Environmental Health Officers report from the visit undertaken on 2.9.05 was available this indicated that some works were required within a two month timescale. The kitchen was openly accessible at all times and whilst this had been risk assessed on discussion with the acting manager this was completed with the view of it being a staff area and not of service users potentially having access to the knives and equipment in there. The flooring in the upstairs sluice was split and raised and must be repaired. A staff call system was in place in toilets, bathrooms and bedrooms. Grab rails were sited in corridors. A shaft lift allowed service users access to the first floor. There were hoists available and servicing of these had been completed. A shower facility and over bath hoist were available. Thermostatic mixer valves were fitted on hand basins and bathing outlets to prevent scalds. Window restrictors were fitted on upstairs windows to prevent falls. Checks on water and chlorination of tanks was undertaken since the last visit to guard against legionella. The en suite facility in one bedroom was not fitted with a door this did not afford privacy and dignity to the service user when using this facility. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 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 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) 27,28,29 Service users were being cared by a staff group who were knowledgeable and had access to appropriate training (NVQ’s). EVIDENCE: Staffing rota’s were being kept these indicated that staffing levels were being maintained in relation to the number and dependencies of service users being cared for. A sample of three staff personnel files were examined to assess how recruitment practices were being implemented. These indicated that all required checks and information were in place. There were 16 care staff employed at the home, of these 9 have achieved at least NVQ(National Vocational Qualification) level 2 in care. This slightly exceeds the required 50 of care staff who must hold at least NVQ(National Vocational Qualification) level 2. Whilst training was not formally assessed at this visit staff spoken to said there were many training opportunities available. Staff spoken to appeared to be knowledgeable regarding service users needs. Service users spoken to said staff cared well for them and looked after them ‘champion’. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 18 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) 31,33,34,35,38 The home appears to have well established systems in place to ensure the health and safety of service users is protected. EVIDENCE: Since the last inspection the Manager of the home has been promoted within the organisation. The Commission for Social Care Inspection has not been informed of this change as is required by Regulation 39 This change took place at the end of July 2005. An acting manager was currently in post supported by the previous manager as this was part of the new role they have taken on. Some monies were held safely in the home for service users. Monies were held separately and 2 signatures were evident where transactions had taken place. It was not always evident from records what monies had been used for and receipts were not always available. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 19 An annual development plan was available with identified aspects to be completed each month. This was updated monthly until May 2005 with a summary to record if actions had been completed. Service users and staff meetings were held albeit with various frequency. Minutes of these were available. No service user comments were available and no formal feedback had been sought from service users, relatives or visiting professionals. Monthly visits were completed on the Providers behalf and a report was completed. Some months this was a comprehensive document giving an overview of the home for some months it was briefer. The report for August 2005 was not available at this visit. A valid public liability insurance certificate was displayed. Records for establishing financial viability were not requested at this visit. A range of service records were examined. All relevant checks and servicing had taken place apart from the 5 yearly periodic electrical testing which was slightly overdue having last been completed on 20.8.00. Established systems were in place to check various environmental aspects. Some personal care records were held in areas of the home accessible by service users, relatives or other visitors, these must be held securely. King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 3 2 3 3 x 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 2 x x 3 2 x 2 2 King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 21 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 1 Regulation 4 Requirement The Statement of purpose must be ammended to ensure that it meets the requirements of Schedule 1 Where trigger tools are utilised the guidance for reviews of these must be completed in relation to the score Where medication administration records are hand written these must be signed, checked and counter signed by a second staff member Residents must be consulted regarding their post death wishes This must be reviewed regularly. Where this is considered inappropriate the reasons for this must be recorded The provision of activities must be offered be offered in accordance with service users assessed needs and be included in a pplan of care The protection of vulnerable adults policy must be clear in what action staff must take folowing any allegations and refer to locally agreed procedures where service users Timescale for action 30.11.05 2. 8 15 30.10.05 3. 9 13 30.10.05 4. 11 12 30.12.05 5. 12 15,16 30.11.05 6. 18 13 30.10.05 King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 22 are funded by local authorities 7. 18 18 Staff must receive training and be conversant with policies and procedures relating to the protection of vulnerable adults The requirements described in the Environmental Health Officers report must be addressed The home must undertake a risk assessment of the kitchen and area as it is potentially accessible to service users and ensure all appropriate actions are taken to protect the health and safety of residents The identified en suite facility must be fitted with a door to ensure privacy and dignity to the service user The split flooring in the sluice must be repaired The provider must formally notify the Commission for Social care Inspection of managerial changes as soon as is practically possible A manager must be appointed and an application made to formally register the manger with the commission for Social care Inspection Where transcations are recorded for finances these must record the reason for the transaction any receipts fro purchases retained All records containing persoanl data must be held securely in accordance with the Data Protection Act 1998 The periodic electrical installation must be serviced as is required on a five yearly basis 30.11.05 8. 21 16 9. 19 13 Timescale dictated by report - 2 months 30.10.05 10. 21 12,23 30.10.05 11. 12. 26 31 16 8,39 30.1.05 30.9.05 13. 31 8 30.11.05 14. 35 16 30.9.05 15. 37 17 30.9.05 16. 38 23 30.9.05 King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 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. 2. Refer to Standard 9 33 Good Practice Recommendations The temperature of the drug storasge area should be checked during the hottest part of the day Feedback shoukd be formally sought on the home from service users, relatives and visiting professionals King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby, DE1 3QT 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 King William Residential Home C52 C02 S20027 King William V246857 070905 Stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!