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Inspection on 24/04/07 for Kingfisher Court Care Home

Also see our care home review for Kingfisher Court Care Home for more information

This inspection was carried out on 24th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

At the last key inspection in May 2006 a number of requirements and recommendations were made. Since then all of these have been met, and this has seen, some redecoration in the corridors, much better activities organised for residents, and the recording of information within care plans much improved. Recruitment practices for staff have improved, which will mean that residents are safer, as staff have been properly checked before starting work at Kingfisher Court.

What the care home could do better:

The resident`s care plans should be reviewed on a monthly basis to ensure that the care that the residents are receiving is based on the latest assessment of their needs. Resident`s wishes in relation to their funerals should be recorded in care plans, and the quality assurance system for reviewing the quality of Kingfisher Court needs to be improved.

CARE HOMES FOR OLDER PEOPLE Kingfisher Court Care Home The Spinney Sturgeon Avenue Clifton Nottingham NG11 8HE Lead Inspector Rob Cooper Key Unannounced Inspection 24th April 2007 10:00 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 Kingfisher Court Care Home DS0000002206.V335694.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. Kingfisher Court Care Home DS0000002206.V335694.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingfisher Court Care Home Address The Spinney Sturgeon Avenue Clifton Nottingham NG11 8HE 0115 940 5031 0115 984 7071 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) Tawnylodge Limited Mrs Debora Karen Millband Care Home 40 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (40) of places Kingfisher Court Care Home DS0000002206.V335694.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No one falling within category OP may be admitted into Kingfisher Court where there are 40 persons of category OP already accommodated within this home. No one falling within category DE(E) may be admitted into Kingfisher Court where there is 1 person of category DE(E) already accommodated within this home. No person to be admitted to Kingfisher Court in categories OP or DE(E) when 40 persons in total of these categories/combined categories are already accommodated in this home. 2nd May 2006 Date of last inspection Brief Description of the Service: Kingfisher Court is a purpose built care home offering accommodation for up to 40 older people. In agreement with the Commission for Social Care Inspection the home has accommodated one person with dementia. The accommodation is sited over two floors with a passenger lift providing independent access for service users. Kingfisher Court shares a site with its sister home, the Spinney; situated on the edge of Clifton housing estate providing easy access to a range of local facilities including public transport links. There is a nature reserve to the rear of the property giving a pleasant outlook and a good-sized car park to the side and rear of the property. The fees for Kingfisher Court range from £298.36 - £307.96. Kingfisher Court Care Home DS0000002206.V335694.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit as part of the key inspection process – so that no one at Kingfisher Court knew that the inspection was going to take place. The visit took approximately four hours through the middle of the day, with one inspector present. The method used to carry out this key inspection was to send out a preinspection questionnaire, which asked questions about the service, to gather statistics, such as how many service users there are, the numbers of staff etc. We also sent out a number of surveys to residents and relatives, however none had been returned by the date of this inspection. This was followed with a visit to Kingfisher Court, where a method called case tracking was used; this involved identifying three residents and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was done by a partial tour of Kingfisher Court, looking at the activities on offer, and talking to staff and three residents about the quality of the service, and their experiences of living and working at Kingfisher Court. On the day of this key inspection there were twenty-nine residents living at Kingfisher Court. The registered manager – Deborah Millband was present throughout the inspection and supplied much of the information provided for the inspection. Since the last key inspection in May 2006, there has been one random inspection of Kingfisher Court. This was in November 2006 and was to check on the progress made with requirements set at the key inspection. What the service does well: Kingfisher Court is situated in a very pleasant environment, with a nature reserve to the rear, and a range of wildlife for residents to enjoy. The activities offered to residents are varied and well recorded in care plans, and there is an effort made to arrange an activity to coincide with the ‘special’ days in the year – St Valentine’s Day, Pancake Day, Halloween etc. The food on offer at Kingfisher Court is mostly homemade, and residents say that the food is “very nice,” and there is plenty of choice. Kingfisher Court Care Home DS0000002206.V335694.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. Kingfisher Court Care Home DS0000002206.V335694.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 Kingfisher Court Care Home DS0000002206.V335694.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): 13&6 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Prospective residents at Kingfisher Court had sufficient information before they moved in to make an informed choice about coming to live there. Current residents are well informed about the services Kingfisher Court offers. Intermediate Care is not on offer at Kingfisher Court. EVIDENCE: Both the statement of purpose and service user guide for Kingfisher Court were seen. Both documents contained all of the information, which Care Homes Regulations say that they should. Evidence from residents at Kingfisher Court, together with observation of copies in bedrooms showed that residents had a copy of the service user guide. Kingfisher Court Care Home DS0000002206.V335694.R01.S.doc Version 5.2 Page 9 As part of the case tracking process three resident’s files were seen. Each file contained an assessment of need, with one containing a Shared Nottinghamshire Assessment Process (A SNAP) – which is Nottinghamshire’s assessment tool for older people. There were also two in-house assessments for residents who did not have a Social worker actively involved in their placement. Care Assessment completed by the individual’s Social Worker. Each of the assessments was dated prior to the resident’s admission to Kingfisher Court. Kingfisher Court Care Home DS0000002206.V335694.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 10 & 11 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. The residents have their health and personal care well managed and supported by the staff at Kingfisher Court, although the recording of information is not being done in a timely manner, and should be extended to cover funeral arrangements for all residents. EVIDENCE: Each of the three resident’s files seen as part of the case tracking process contained a clear plan of care, with care plans to meet the resident’s needs. However in some files the care plans had not been reviewed since November 2006. The National Minimum Standard for care plans for older people is that they are reviewed monthly. Reviewing care plans is important, as they are a method of ensuring that the current care an individual is receiving is based on the latest assessment of their needs. Each of the resident’s files contained care plans relating to the resident’s health. Evidence was seen in the care plans, that information relating to Kingfisher Court Care Home DS0000002206.V335694.R01.S.doc Version 5.2 Page 11 resident’s health is being recorded, and the Outside Clinic come into Kingfisher Court to test resident’s eyes, and provide a basic opticians service – if residents wish to take advantage. A chiropodist also visits Kingfisher Court on a regular basis, and residents are able to make an appointment if they wish. Boots the chemists supplies the resident’s medication at kingfisher Court. They use a monitored dosage system (each resident having their medication dispensed into a blister pack on a series of cards), which makes dispensing the medication easier. The documentation relating to medication administration was seen, and there were no obvious errors or omissions. Currently one resident self-medicates, and they have a risk assessment in place within their care file covering their self-medication. Storage was secure, and there were clear records for medication coming in and out of the building. Two residents were spoken with, and each one said that they felt the staff treated them very well, and treated them with respect. During the inspection a number of staff interactions with residents were observed, and these were seen to be polite and caring. Staff were observed knocking on resident’s doors before entering, and the issue of residents having keys to their bedroom doors was addressed in individual files, so that residents can have them if they wish. Some of the files that were seen had identified the resident’s wishes at the time of their death. One resident had a specific care plan in place, and there was also information relating to whom to contact within the family at that time. Identifying funeral wishes, is very good practice and should be extended to all residents at Kingfisher Court. Kingfisher Court Care Home DS0000002206.V335694.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 & 15 Quality in this outcome area is excellent; this judgement has been made using available evidence including a visit to this service. Residents at the Kingfisher Court have a lifestyle that reflects their cultural, social and religious interests, and needs. EVIDENCE: In the past twelve months Kingfisher Court has begun taking photographs of activities that residents take part in. This pictorial evidence adds to the written records outlining the activities, which take place. Discussions with two residents about activities showed that there is usually an attempt by the staff to mark events such as Pancake Day, Halloween, plus the usual Easter and Christmas holidays. The photographic evidence showed that the staff entered into the spirit, and the enthusiasm of the residents showed was a good indication of the success of the events. Two residents when asked said that their families were able visit when they wanted to (within reason), and that the staff always made them welcome. One relative was spoken with who was visiting, and said that they were more than happy with the arrangements for visiting their relative. They also said Kingfisher Court Care Home DS0000002206.V335694.R01.S.doc Version 5.2 Page 13 that they thought the care their relative was receiving was very good, and they were quite happy with the service being offered at Kingfisher Court. Two residents were asked about choice and both said that they thought there was a lot of choice at Kingfisher Court. This was a range of choices at meal times, choices over activities and choices about where to be and what to do. Observations of staff talking to residents showed that choices were offered in a number of different ways, which supported the resident’s view that they were able to make choices at Kingfisher Court. Two residents were asked about the food at Kingfisher Court and both said that the food was very good, and that they got enough to eat, and that there was always a choice. A tour of the kitchen found it to be well organised, and all of the documentation relating to cooking and food storage was found to be complete and correct. The main choice for lunch was homemade toad-in the hole, or there was a vegetarian option as well. There is a four-week menu in place, which offers plenty of variety, and a good selection of fresh fruit and vegetables. Kingfisher Court Care Home DS0000002206.V335694.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 & 18 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Kingfisher Court are safe, and their complaints are taken seriously and dealt with. EVIDENCE: Since the last key inspection Kingfisher Court have received one formal complaint, a review of this complaint showed that it was dealt with in line with Kingfisher Court’s complaints procedure. None of the residents who were spoken with, said they had ever made a formal complaint, but they all had copies of the procedure, as it formed part of the service user guide, and was also on display in the foyer. The relative spoken with also said that they knew about the complaints procedure, but had never needed to make a formal complaint. A review of the staff training records showed that the majority of staff at Kingfisher Court had completed training in safeguarding adults, which will ensure that staff are up-to-date with the latest practice, and are also aware of the issues involved, so that they can safeguard residents from abuse. Discussions with three members of staff confirmed that staff had received training in safeguarding adults. Currently most Kingfisher Court’s staff are working through in-house safeguarding adults training while they wait to access more in-depth formal training. Kingfisher Court Care Home DS0000002206.V335694.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 & 26 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Kingfisher Court live in a safe, clean and comfortable home, with their personal possessions around them. EVIDENCE: A partial tour of Kingfisher Court showed it to be well maintained, and comfortable. Since the last key inspection some redecoration has taken place, and this has lightened some of the corridors, which rely on artificial light. There is a good range of different bathing options, with both assisted bathing and showering available. The fixtures and fittings were found to be of a good quality. Two residents who were asked said that they thought Kingfisher Court was very comfortable. Outside and to the rear of Kingfisher Court there is a nature reserve located around a small lake, with plenty of wild life for residents to watch. Kingfisher Court Care Home DS0000002206.V335694.R01.S.doc Version 5.2 Page 16 During the inspection Kingfisher Court was found to be clean and tidy, with domestic staff seen to be cleaning in different areas. Discussions with the domestic staff showed that there were specific cleaning routines in place, and that the staff thought they had enough cleaning materials to be able to do their job properly. Kingfisher Court Care Home DS0000002206.V335694.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 & 30 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Staff at Kingfisher Court have been recruited professionally, and are competent and trained to do their jobs. EVIDENCE: A review of the staffing rota and staffing levels at Kingfisher Court showed that there was enough staff currently employed to meet the resident’s needs. Two residents were asked about staffing levels, and both said that they thought there were enough staff, while each of the three members of staff who were asked the same question said they too thought that staffing levels were sufficient. The recommended standard training course for staff working in care is the National Vocational Qualification (NVQ) level II. Of the seventeen care staff on the team, three people have their NVQ level II, five are currently studying for the qualification, while two more are about to start. In addition one further member of staff has their NVQ level III. Ideally there should be 50 of the staff team qualified to a minimum of NVQ level II. The indication is that while this 50 has not yet been achieved, however Kingfisher Court is working towards achieving it. Kingfisher Court Care Home DS0000002206.V335694.R01.S.doc Version 5.2 Page 18 Three staff files were seen, and each one contained all of the necessary documentation to indicate that staff had been recruited in a manner, which would protect residents – this would include: written applications, formal interviews, two written references, and a criminal records bureau check. Each of the three members of staff who were spoken with said that they had been through a formal recruitment process, and had supplied references, and been criminal records bureau checked. A review of the staff training records showed that Kingfisher Court does have a training plan for its staff, and that there are staff training courses planned for the coming months. The records showed that staff were receiving the skills training to be able to do their jobs, and discussions with three members of staff supported this view, and provided evidence of the different training courses staff had attended. Kingfisher Court Care Home DS0000002206.V335694.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 36 & 38 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Kingfisher Court is a safe, well-managed care home with good systems for ensuring it’s quality in place. EVIDENCE: The registered manager has been through the Commission for Social Care Inspection’s ‘fit person’ process, and has been judged to be fit to manage a residential care home. Evidence was seen that the registered manager will be attending an eight day management course in the near future, and she is due to complete her Registered Manager’s Award qualification in June 2007. Kingfisher Court has a quality assurance system based on questionnaires being sent out, and the comments received, however the questionnaires that had Kingfisher Court Care Home DS0000002206.V335694.R01.S.doc Version 5.2 Page 20 been returned were not dated, which meant that it was not possible to tell how current the comments relating to the quality of care were. There was also no clear evidence that the questionnaires had been reviewed, and an action plan produced. Resident’s meetings take place at Kingfisher Court on a monthly basis, and the minutes of several meetings were seen, and clearly evidenced that residents were being consulted with, and were being informed about developments at Kingfisher Court. Resident’s at Kingfisher Court have a small cash needs system for their cash needs. This is operated on their behalf by the staff, and five resident’s finances were sampled at random and checked. All cash balances tallied with the records, and receipts were kept, which enabled a clear audit trail of resident’s expenditure. Kingfisher Court operates a supervision system, with staff having formal supervision approximately six times a year. Records relating to the staff’s formal supervision were seen and these indicated that staff members were properly supervised. Three staff members were spoken with about formal supervision and said that they were having a formal supervision session approximately every eight weeks. All of the staff spoken with said they felt they were well supported. Many different health & safety records were seen, including the fire safety records – weekly tests, emergency lighting tests and extinguisher maintenance records, and the Control of Substances Hazardous to Health (COSHH) records, all were found to be correct and up-to-date, which evidenced that the residents and the staff are living and working in a safe environment. Kingfisher Court Care Home DS0000002206.V335694.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 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 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 2 X 3 3 X 3 Kingfisher Court Care Home DS0000002206.V335694.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 Requirement Timescale for action 31/07/07 Regulation Resident’s care plans should be 15 reviewed on a regular basis, to ensure that their needs are being met, and they are receiving the best care. 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. 3. 4. Refer to Standard OP7 OP11 OP33 OP33 Good Practice Recommendations Resident’s care plans should be reviewed on a monthly basis, to ensure that their changing needs are being met. Resident’s wishes in relation to their death should be recorded in care plans, and where possible there should also be a funeral plan in place. Quality Assurance questionnaires should be dated so that it is possible to effectively review them and take the necessary action. As part of Kingfisher Court’s quality assurance system, questionnaires should be reviewed, and there should be evidence to show that the comments received have been noted, and where necessary actioned. Kingfisher Court Care Home DS0000002206.V335694.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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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