Inspection on 12/12/07 for Kingfield Holt

This inspection was carried out on 12th December 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

Kingfield Holt 12/02/07

Kingfield Holt 12/10/05

Kingfield Holt 19/06/05

Kingfield Holt 08/03/05

Kingfield Holt 04/10/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Kingfield Holt 38 Kingfield Road Sheffield South Yorkshire S11 9AS Lead Inspector Mrs Sue Stephens Key Unannounced Inspection 12 December 2007 09:45 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 DS0000002977.V351801.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. DS0000002977.V351801.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingfield Holt Address 38 Kingfield Road Sheffield South Yorkshire S11 9AS 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) 0114 255 3968 0114 255 3968 none Mr Ibrahim Farid Ibrahim Mrs Celia Norma Ibrahim Miss Susan Iris Walker Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places DS0000002977.V351801.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th February 2007 Brief Description of the Service: Kingfield Holt is a home that provides personal care for 25 older people. The home is in the Brincliffe area of the city. The detached building is in its own grounds and it is close to a good selection of local amenities; these include an extensive range of shops, pubs, and a park. The grounds around the home are very pleasant; there is a patio area and well-established gardens. All, but one, of the bedrooms are single and many have an en-suite facility. There are three dining rooms and three communal areas for people to use; this includes a spacious sun lounge. The manager gave us information about the home’s fees and charges on 12 December 2007. The fees range from £395.00 to £485.00 per week. This depends on people’s individual needs. Kingfield Holt’s charges include hairdressing, chiropodist, newspapers and magazines, toiletries and some transport. These charges are variable; the manager can provide more information about this. People who are interested in Kingfield Holt can get information by contacting the owners or manager. The home will also provide a copy of the Statement of Purpose and the previous inspection reports. DS0000002977.V351801.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was an unannounced visit; it took place between 09:45 am and 17:00 pm on the 12 December 2007. In the report we make reference to “us” and “we”, when we do this we are referring to the inspector and the Commission for Social Care Inspection. The owner, Mrs Ibrahim, the manager, Miss Walker, and a deputy manager, assisted us during the visit. During the visit we looked at the environment, and made some observations on the staffs’ manner and attitude towards people. We checked samples of documents that related to people’s care and safety. These included three care plans, and a sample of medication records, staff and health and safety records. We looked at other information before visiting the home, this included evidence from the last key inspection, surveys, and the homes Annual Quality Assurance Assessment (AQAA). An AQAA is information we ask for, about once a year, to show us how the provider thinks the home is performing. We sent out thirty seven surveys to people, relatives and health and social care professionals who know the home. The following number of people replied to the surveys: Fourteen people who live at the home Ten relatives and friends And one professional visitor. One relative contacted us by phone and gave us their opinion about Kingfield Holt. This was a key inspection where we checked all the key standards. We would like to thank the people who live at the home, visitors, the owners, managers and staff, for their warm welcome and help in this inspection. What the service does well: DS0000002977.V351801.R01.S.doc Version 5.2 Page 6 People, their relatives and friends; and professionals who know the home, gave us good feedback about the quality of care at Kingfield Holt. They said, “There is always a warm welcoming atmosphere at Kingfield Holt” “The staff are kind and vigilant” “The home is run professionally and efficiently” “If ever a home deserves 100 this is the one” People told us they were very satisfied with their care, and relatives supported this. People had good information about the home; this helped them decide if Kingfield Holt would be the right place for them. The owners and managers took extra steps to help people choose about the home in their own time. People had contracts so that they could understand their fees, charges and terms and conditions. People had care plans that told staff about their care needs. It included their health and personal care needs. People said the home met their needs well. People said staff treated them with dignity and respect. We saw good examples of this during our visit. People told us they were satisfied with their daily routines. They could choose how to spend their day, and the owners had checked to see if they were satisfied with the homes leisure activities. Relatives and friends told us they always had a warm welcome when they visited. People could tell staff, the managers or the owners their concerns, and they would do something about it. Relatives and friends supported this. The home gave staff training and information about how to identify abuse and bad practice, and what to do if they suspected or saw something wrong. People said they were very comfortable and they liked their rooms. They told us the home was clean. We saw that the home had a good supply of footstools, side-tables, sitting blankets and reading lights for people’s comfort. People spoke highly of the staff team. And we saw that the home had good recruitment, training and supervision to help create an efficient and professional staff team. DS0000002977.V351801.R01.S.doc Version 5.2 Page 7 People told us the quality of care and accommodation was good. We saw that the owners and managers ran the home well; this included asking people their opinion about the home and following safe practice procedures. The home supported people who needed help with their finances and kept clear records to show what the person had received and spent. What has improved since the last inspection? What they could do better: Follow some medication practices better, such as record nutritional supplements and check with pharmacists and G.Ps about unclear prescribed instructions. DS0000002977.V351801.R01.S.doc Version 5.2 Page 8 This will help make sure staff do not make mistakes about doses, and help staff give better information back to medical professionals. People need footplates on their wheelchairs to help prevent foot and leg injuries. If people choose not to use these, the home needs to record and review this regularly to make sure people are as safe as possible. The manager can continue to improve care plans by including people’s likes and dislikes. This gives people more control over their care, and is better for people who may not be able to express their needs freely. Remove dirty hairbrushes from the shower room. This will be better for people’s dignity, and hygiene. People need to have their accidents recorded in a way that protects their confidentiality 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. DS0000002977.V351801.R01.S.doc Version 5.2 Page 9 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 DS0000002977.V351801.R01.S.doc Version 5.2 Page 10 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, 2 and 3. Kingfield Holt did not provide intermediate care at the time of our visit. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Kingfield Holt. People have good information about the home and their fees and charges. EVIDENCE: People told us, during our visit, that they had good information about the home. People told us in their surveys that they had enough information, before they moved in. This helped them decide if this was the right place for them. And people’s relatives and friends said, in their surveys, that the home almost always gives good information to help people make decisions about their lives. One person told us the owners had been very reasonable about giving them time to decide if this home was the right place for them. DS0000002977.V351801.R01.S.doc Version 5.2 Page 11 And a relative commented: They are “very good at keeping me in the picture” People told us in their surveys that they had a contract with the home; and we saw an example of this during our visit. The home’s contracts include people’s fees and their terms and conditions. The owner said they put a service user guide, with information about the home, in each person’s bedroom. We saw these in the bedrooms we visited. This was good practice. However, we found that the typed information was small and the font was not easy to read. This would make it difficult for anyone with sight difficulties to read the information. We have advised the owner that it would be good practice and would benefit people if they produced the information in a better print. The general guidance for printing information for people with sight difficulties is to use a font size 14 to 16 and type style such as Verdana or Arial. We encourage the home to consider this. Since our last inspection the owner and manager had developed a better assessment tool. This gives them better and more thorough information about people’s needs. This is important, especially for people who self-fund, and who may not have an alternative assessment for staff to rely on. We saw examples of people’s assessments, which the home carried out, and these were sufficient to meet the National Minimum Standards. We advise the owner and manager that to improve the assessments further, it would be good practice to include more information about people’s likes, dislikes and preferences. And they should do this with people for each assessment area. This will help people to have more person centred assessments and care plans. DS0000002977.V351801.R01.S.doc Version 5.2 Page 12 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. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Kingfield Holt. People receive good health and personal care. And staff treat people with dignity and respect. Some medication practices are not safe enough. EVIDENCE: People, and their relatives and friends, told us they were very satisfied with the personal and health care at Kingfield Holt. They made comments that include: “Everybody is kind and helpful” “I have every confidence Kingfield Holt look after my father well” “Our mother is very happy and well cared for, we feel very lucky to have found Kingfield Holt” “My mother is very well looked after and treated as an individual, with care and kindness. DS0000002977.V351801.R01.S.doc Version 5.2 Page 13 And people responded in the surveys to say they receive the care and support they need. We noted that staff had a positive relationship with the health professional who visited the home. We saw that staff gave her good feedback about people’s health care needs and staff listened to the professional’s advice. One health professional, who responded to the survey, said the home ‘always’ meets people’s health care needs. They said that they noted that their “patients have been very happy at Kingfield Holt”. We spoke to two care staff; they had good knowledge about how to respect people’s privacy and dignity. We observed the same carers and noted they spoke to, and responded to, people with respect and in a patient manner. Since our last inspection the owner and manager have developed better care plans. We looked at a sample of these; they gave staff instructions about how to care for people. And the plans had a regular review date, this is good practice because it helps the managers and staff recognise people’s changing needs. The plans we saw met National Minimum Standards, and we saw good evidence that the owners and manager had worked hard to improve the plans. The plan format was easy to use and basic; this should work well for people who do not have complex needs. However, the managers should review this if they draw up plans for people with more complex needs, to make sure the information is sufficient enough to give staff clear instructions. The plans did not have people’s likes, dislikes and preferences under each area of care. To do this will give people more say and control over the way they receive care. And help staff to understand people with more complex needs or, who may have difficulty expressing their preferences on a regular basis. We saw that people had individual risk assessments included in their plans. These included mobility and falls, and pressure care. This has improved since our last inspection. The owner said, that for people who need a bedrail, they now carry out a risk assessment to make sure the decision is safe and appropriate for the individual. This has also improved since our last inspection. We looked at the homes medication systems. We looked at the storage, records and administration. In the main staff followed safe procedures. The managers kept the storage clean and in order, and the records up to date and easy to understand. DS0000002977.V351801.R01.S.doc Version 5.2 Page 14 When we looked at a sample of the records we found that staff had not signed to say whether someone had had a prescribed nutritional supplement, or not. This means that staff cannot show that they follow the prescribed instructions, and would not be able to feedback accurately to medical professionals the amount of nutritional supplements the person has used. We also found that some information on a prescription was confusing, it read as if it was a regular prescription, but the manager said it was an ‘as required’ prescription. We advised the manager to discuss this with the GP and pharmacist to make sure the person was getting the correct medication doses. We found that some people had extra medication (as prescribed) but staff had not recorded the reason why, over leaf, on people’s medication records. For example: for a person who needs pain relief. This means that it is more difficult for the following staff to assess future administrations. The information also helps staff to keep consistent records about the amount and frequency, and why people need the extra medication so that staff can feed this back to medical professionals. If someone needs support with controlled medication, the home now has the right storage and recording facilities. This has improved since our last inspection. DS0000002977.V351801.R01.S.doc Version 5.2 Page 15 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. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Kingfield Holt. People follow the routines they prefer, have access to stimulating activities and they have good quality and nutritious food. EVIDENCE: People told us they were happy with their daily routines. They said they could choose when to get up and retire to bed, and choose how to spend their day. One person told us they had health and personal care needs that affected their daily routines. They said the managers and staff “were very understanding”, and they listened to and followed the person’s preferences throughout the day. Relatives and friends also told us that the homes visiting times were “very flexible” and “relatives and friends are made very welcome”. Most people, in the surveys, said that the home usually arranges activities that they can take part in. A couple of people told us they chose not to join any activities. People made the following comments, “They have just increased the activities, and I have much enjoyed them so far” DS0000002977.V351801.R01.S.doc Version 5.2 Page 16 “There have been more activities since September, but the reliability of activities can vary because of other carer commitments that have priority” And a relative told us, “On Bonfire night they had fireworks, it was excellent, and the Salvation Army come to play music”. The home told us that they had asked people, in a questionnaire, about their thoughts on the home. From this, the managers found that most people felt the leisure activities were either excellent or good. One person felt activities could improve for them. The owners told us the assistant manager had attended meetings outside the home to share information and experiences with other care services about leisure and activities. They had also contacted age concern for their advice about activities for older people. The home provides ‘Sherry and Chat’ meetings for people and their relatives and friends, and had addressed on one of these occasions the issues raised by people about the homes activities. The owners and manager continue to develop a range of leisure activities and events for people. This has improved since our last inspection. People told us they were very satisfied with their meals. They said the meals were ‘always’ and some said ‘usually’ tasty and nutritious. People told us, “The food is delicious” “The food is good quality and well cooked and presented, they make alternatives if we prefer” “Good wholesome food”. One relative told us that their family member had difficulty eating. And the home had made simple adaptations to avoid their family member getting embarrassed at meal times. This is good practice; it shows that the managers and staff are sensitive about people’s dignity. We joined a group of people for lunch. We observed staff and people gave us their views. They said they liked how staff served the meals and they said the food was good quality. People had their meals in small groups in a choice of dining rooms. This made the event relaxed and had a family atmosphere. Staff served the meals in a professional and dignified manner, they offered people choice and extra food if they wanted, and they encouraged drinks. During the meal we noted that staff spoke to people in a sociable and friendly way. DS0000002977.V351801.R01.S.doc Version 5.2 Page 17 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. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Kingfield Holt. People can express their views or concerns and the owners, managers and staff listen to them and take positive action. EVIDENCE: People told us that they were able to complain and the managers and staff listen to them. They told us they knew how to complain and some people told us they had the information in a folder in their rooms. Two people said in their surveys they did not know how to complain. We have not made a requirement or recommendation about this; but we advise the owners and managers to periodically remind people about the home’s complaints procedure. We saw evidence that the home records and takes action on any complaints that people make. We noticed that the complaints procedure, on display, in the entrance hall was in small writing, and not very easy to see and read. This would not be appropriate for people, or visitors, who may have sight difficulties. We advised, Mrs Ibrahim, the owner, that it would be better practice to produce the procedure in an easier to read text. The general guidance for printing information for people with sight difficulties is to use a font size 14 to 16 and type style such as Verdana or Arial. DS0000002977.V351801.R01.S.doc Version 5.2 Page 18 Since our last inspection we received a complaint about the home. The owners worked with us, and the person giving the information, to resolve the complaint. The home have taken action and have concluded the complaint. The manager and owner told us in their AQAA (annual quality assurance assessment) that they make all staff aware of the policies and procedures on abuse and protection of vulnerable adults. And make them aware how to respond to evidence or suspicion of neglect. We saw evidence that staff cover safeguarding adult (adult protection) information in their induction and National Vocational Qualification training. We spoke to two staff; they had a lot of good knowledge about people’s care needs and they said the home gave them good training. They understood what whistle blowing meant (about employees reporting areas of concern) and said they could tell the managers if they had any concerns or saw bad practice. However, we feel that the staff need to have more confidence about understanding and describing safeguarding adults procedures (adult protection). This is because they were not as confident explaining this as they were about other areas of their duties. We have not made a requirement because we have other evidence that staff receive the right information. But we advise the owners and managers to look at ways to help staff be more confident about safeguarding adult information. This will benefit people, because it will help protect them further from the risk of harm or abuse. DS0000002977.V351801.R01.S.doc Version 5.2 Page 19 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, 24 and 26. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Kingfield Holt. People live in comfortable and suitable surroundings. EVIDENCE: People told us they found the home warm and comfortable, and the environment suited their needs. We saw people spending time in different parts of the home, such as the conservatory, lounge and their own bedrooms. People told us this is where they liked to be and we saw that they had footstools, side tables, reading lights and blankets to help keep them comfortable. People said they were happy with their bedrooms; and they could personalise them as they wished. People told us their beds were comfortable and their rooms were the right temperature for them. DS0000002977.V351801.R01.S.doc Version 5.2 Page 20 One person told us “My bedroom is fine, it has plenty of storage space and everything I need”. People told us the home is clean; we saw this when we visited. We found no offensive odours and rooms were tidy, clean and inviting. They had homely touches such as ornaments and pictures. One person said, “The staff make the home a pleasant place in which to live in” Relatives and friends said they thought the environment was suitable for their family members; relative told us, “The home is slightly old fashioned making it ideal for older people” “Cleanliness is excellent and on the whole doesn’t smell” Staff told us that they were responsible for cleaning the home. They said they did this in between their care duties. They said they had enough time to do this and they had good equipment and a good supply of cleaning agents. A visiting hairdresser uses a spacious shower room as a salon when the room is not in use for showering. We felt this was appropriate and people who live at the home said they also felt this was ok. However, we found hairdressing products and two dirty brushes left on shelves in the room. This does not respect people’s dignity, it put people at risk of using communal hairbrushes and toiletries and it does not promote good hygiene practices. DS0000002977.V351801.R01.S.doc Version 5.2 Page 21 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. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Kingfield Holt. People receive care and support from an efficient staff team. EVIDENCE: People, and their relatives and friends, spoke very highly about the staff team. They made comments such as, “The staff are kind and vigilant” “Everybody is kind and helpful” “The staff are very good” “I have confidence Kingfield Holt can look after my (family member) well; staff are brilliant with them.” “Staff mostly very caring” One relative told us “all the people I have met at the care home are elderly and have expressed to me how well they are looked after”. We checked the staffing levels; staff told us they felt there was enough staff to complete all their tasks; and people told us staff were available when they needed them. The owner told us they did not use agency staff, the staff team covered each other when a staff is absent and this helps people to always get care from staff they know well. The manager and relatives told us some staff DS0000002977.V351801.R01.S.doc Version 5.2 Page 22 had been at the home a long time and therefore knew people’s needs very well. About 50 of the care team had a National Vocational Qualification in care and a further three staff had enrolled on the course. This means that staff have studied good care practices and understand the essentials of providing safe and consistent care and support. We looked at a sample of staff recruitment files. These were in good order and showed us that the home had followed good procedures to make sure they employ suitable staff to care for people. The care home regulations require providers and managers to keep a photo of the staff they employ. We found that some staff photos were illegible because they were photocopies of other documents. We have not made a requirement about this because other records were in good order, however we have advised the owner and manager to put in proper photos. We will check this again on our next visit. Staff also had access to other training associated with elder care, such as foot care awareness. However, although training information was available in staff files, it was difficult to see how much training staff had as a team because there was no training matrix. A training matrix records staff names, training subjects and training dates all on one record. This would make it easier for the managers to audit and plan team and individual training needs. We explained this to the manager and we advised the manager to do this as good practice. DS0000002977.V351801.R01.S.doc Version 5.2 Page 23 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 37 and 38. People who use this service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to Kingfield Holt. People live in a well-run home that provides good quality care and support. Some people may be at risk of injury because their wheelchairs do not have footplates. EVIDENCE: People said the quality of care at Kingfield Holt was good. When we asked relatives and friends what do they think the home could improve, most said nothing, or replied, “I don’t think it can really” “I feel they do an outstanding job already” “I cannot fault the home, and I think my (family member) has excellent care” DS0000002977.V351801.R01.S.doc Version 5.2 Page 24 One person who lives at the home said, “All at Kingfield Holt are kind, dedicated people, who ensure the home is run professionally and efficiently”. The manager had suitable qualifications and experience to run the home and the owners were very involved in the day-to-day running of Kingfield Holt. People told us they saw, and spoke, with the owners often. And we noted one of the owners spending time in the lounge reading with people; people told us this was usual and they enjoyed the owner’s company. The owners, Mr and Mrs Ibrahim, had carried out their own surveys to find out people’s opinion about the quality of the care and accommodation. They showed how they had improved services following the surveys, for example: someone’s comment about activities. The home now has an up-to-date safety certificate for electrical systems. This has improved since our last inspection. During our visit we saw staff transporting people in wheelchairs that did not have footplates on. This is dangerous because it puts people at risk of injuries; for example, by staff still pushing the chair if someone’s foot has dropped to, or caught, on the floor. The owner told us people did not like the footplates. However, there was no evidence of this in people’s care plans. For example, risk assessments and consultation notes, to show that staff had discussed this, made people aware of the risk, and noted their preference. If someone is adamant they do not want the footplate, or if for some physical reason they cannot use a footplate, the managers should review this on a regular basis to check the person’s safety. The manager told us they encourage people, or their families, to manage their own finances. However, where this is not possible the home will do this for people. We looked at a sample of records belonging to people who needed support. The records were in order and up-to-date. They showed where money had come in, withdrawals, and receipts to support the withdrawals. Two staff had signed and dated withdrawals. We looked at a sample of accidents recorded at the home; we could see where the accident record correlated with information in the care plan. And the information recorded what action staff had taken to assist the person or get them medical help. This showed the home followed good accident procedures. However, the home kept all the information in one book. This meant that any authority looking at an individuals accident details could not view them independent to other people’s information. To avoid this there is a recording system available that allows the information to be kept with people’s personal records. DS0000002977.V351801.R01.S.doc Version 5.2 Page 25 We saw a sample of staff supervision notes, these showed that the managers supervised staff on a regular basis, and staff had the opportunity to discuss concerns and working practices. Supervisions also included a theme, for example infection control; this helped staff understand what they needed to do and work in a consistent way. Staff had training in safe working practices. (See standard 30 for comments about a training matrix) and the manager said she had organised further update training. We saw a sample of health and safety procedures and the staff we spoke to had a good understanding about following safe guidelines. Staff had also had infection control advice from the manager. DS0000002977.V351801.R01.S.doc Version 5.2 Page 26 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 X X X X 3 X 2 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 2 2 DS0000002977.V351801.R01.S.doc Version 5.2 Page 27 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 OP9 Regulation 13 Requirement Staff must sign to say if people have had their prescribed nutritional supplements or not. This will then show that staff have followed the correct prescribed instructions, and it will give more accurate feedback to medical professionals about the amount of nutritional supplements the person has used. The manager, or person responsible for medication at that time, must follow up, with the G.P and pharmacist, prescriptions that give confusing information, or do not give the expected instruction. This is important to make sure people do not receive incorrect medication and doses. 2 OP38 13 People must have footplates available on their wheelchairs. If people choose not to use them DS0000002977.V351801.R01.S.doc Version 5.2 Page 28 Timescale for action 31/01/08 31/01/08 the managers must record, risk assess, and review this regularly. 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 OP7 Good Practice Recommendations People should have their likes; dislikes and preferences recorded in each area their care plans. This will give people more control over their personal care and give them better person centred care plans. The manager and staff could look at attending care plan training to help them develop the plans even further. This may benefit people who have deteriorating or more complex needs. 2 OP9 Staff should record overleaf on the medication record the reason why they have administered prescribed ‘as required’ medication. This will help the following staff to assess future administrations and provide a good record to feedback to medical professionals. Remove dirty hairbrushes. Find better storage for the salon products. Make sure staff understand hygiene practices and monitor the shower area more carefully. People should have their accidents recorded in a way that protects their confidentiality better. 3 OP26 4 OP37 DS0000002977.V351801.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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. 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