Inspection on 22/05/07 for Kingfisher House

This inspection was carried out on 22nd May 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

Kingfisher House 12/01/10

Kingfisher House 17/05/06

Kingfisher House 25/11/05

Kingfisher House 02/08/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Kingfisher House 171 Yardley Green Road Bordesley Green Birmingham West Midlands B9 5PU Lead Inspector Ashley Fawthrop Draft - Unannounced Inspection 09:30 20th November 2007 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 House DS0000063702.V354687.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 House DS0000063702.V354687.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingfisher House Address 171 Yardley Green Road Bordesley Green Birmingham West Midlands B9 5PU 0121 753 0333 0121 771 4190 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) home.fxg@mha.org.uk Methodist Homes for the Aged vacant post Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That the home can accommodate 38 service users over 65 who`s needs fall within the stated purpose and function of the home. The home can accommodate up to 5 service users under the age of 65 whose needs fall within the stated purpose and function of the home. 17th May 2006 Date of last inspection Brief Description of the Service: Kingfisher House Nursing home is a purpose built, single storey home and provides nursing care for up to 38 older people. It is situated in a residential area within the boundary of Heartlands Hospital. It is close to shops and local amenities and is accessible to public transport. The home is warm and homely and furnished to a high standard. It is very well maintained, with pleasant well maintained private gardens to the rear of the property. There are adequate parking facilities at the front of the building. Information relating to the range of fees were not available to people who live in the home on the 20th November 2007 Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out without prior notification and was conducted by one inspector over the course of one day. The inspector would like to thank everyone who took the time to talk to them and express their views. Before the visit, accumulated information about the home was reviewed. This included looking at the number of reported accidents and incidents, adult protection issues, reports from other agencies, i.e., the Environmental Health Officer, and correspondence following the last inspection. This information was used to plan this field visit. The inspector case tracked three people’s care plans. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. Where appropriate, issues relating to the cultural and diverse needs of residents and staff were considered. Using this method, the inspectors assessed all twenty-one key standards from the Care Homes for Older People National Minimum Standards, plus other standards relevant to the visit. We spoke with identified people who live at the home and relevant members of the staff team who provide support to them. Documentation relating to these people was looked at. Where possible, contact was also made with external professionals to obtain their opinions about the quality of services provided at the home. What the service does well: There is comprehensive information available for all prospective residents and their families to enable an informed choice to be made about whether they wish to live in the home, however the special needs of people the home can cater for is not included. All the people living in the home appeared well presented and their clothing was clean and well cared for. People undertake a range of activities, and visitors are made welcome to the home. Where possible, people are encouraged to go with the friends or families. Efforts are made to improve peoples self esteem and a beauty therapist has just been employed. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 6 Kingfisher House provides a clean and homely environment for the residents to live in, and they are encouraged to bring in small personal items to enhance this. The number of care staff trained to NVQ2 exceeds the required standard. The health and welfare of residents and staff are promoted and protected. The home manages residents’ money well with good accurate records. 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 House DS0000063702.V354687.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 House DS0000063702.V354687.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 5 People using the service experienced good quality outcome. We made this judgement using a range of evidence including a visit to the service. All the practices and procedures surrounding the admission of people were adequate and appropriate to make sure that the home is able to fully meet their needs. People wanting to move into the home are provided with information to enable them to make a choice about living in the home, but the home does not give enough information on what special needs can be cared for. EVIDENCE: There continues to be a Statement of Purpose and Service Users Guide that has been produced by Methodist Homes and has been personalised to the service that Kingfisher House provides. Copies are available for prospective residents and their families. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 9 The home is registered to care for people with terminal illness but on reading the information there was no information on how these needs can be met. Where specialist services are offered how these are to be met by the home should be explained before the person moves into the home. . The pre admission satisfactory and there was evidence that a comprehensive assessment of the individual prospective people continues to be carried out prior to the person moving into the home. This makes sure that their needs can be fully met by the service that the home currently provides. People who had recently moved into the home said that staff were sensitive to their needs and explained what would be done for them. They also had the chance to visit the home before moving in. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experienced adequate quality outcome. We made this judgement using a range of evidence including a visit to the service. The arrangements for care planning and monitoring physical and emotional health had is adequate. The medicine administration in the home is of a good standard, robust auditing will prevent potentially poor outcomes for some residents. People are treated with respect and their right to privacy is upheld. EVIDENCE: Four people’s care plans were case tracked. In one case a risk had been identified in the daily records due to increased level of inappropriate behaviour. However, this had not been followed up in the care plan. The home must make sure that the reason the person was admitted to the home remains the greatest risk if people develop other special needs or they Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 11 increase the home must make sure they can meet their needs or consider alternatives in the best interests of the individual. A range of risk assessments continue to be carried out including moving and handling, pressure sore risk and nutrition. Monitoring charts for weight, nutritional intake and healing progress of wounds were present. There continues to be evidence that people have access to GP’s and other health professionals as required including a physiotherapist, optician and dentist. As reported at the last inspection of one person had a bed rail assessment but it was not clear whether the risk identified was greater with them or without them, nor was there any history recorded of falling out of bed. Care plans need to be updated regularly there was information o one care plan relating to pressure area care. An audit of the medication management within the home was carried out. The overall medicine management in the home is of a good standard. A Monitored Dosage System continues to be is used within the home although some boxed medicines are also kept. There is a separate fridge for the storage of medicines requiring refrigeration, and the temperature is recorded regularly and was within normal ranges. There is cupboard for the storage of controlled drugs this continues to comply with regulations, and the three drug trolleys are secured to the wall when not in use. As recorded in the last inspection a safeguard system is in place to make sure that mistakes do not happen. All the counts for current CD’s were correct. There continues to be photos of the people and copies of the prescriptions are kept for cross-referencing purposes. All MDS counts were correct. On inspecting the medicine administration sheets it was noted that gaps in the recording the manager said on these instances the medication was not required or the person had refused the medication. This is not good practice because there is no evidence of why the medication was not given or that the staff had forgotten to sign. Staff must make sure that if a medication is not given the reason why must be recorded on the sheet. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 12 There did not appear to be any issues regarding privacy and respect accorded to the people. People said that the home was comfortable and that the care was good and the staff kind and caring. Staff were observed to carry out care task in a professional and caring manner. They were approachable and knowledgeable about the needs of people living in the home. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 13 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 using the service experienced adequate quality outcome. We made this judgement using a range of evidence including a visit to the service. People are encouraged to exercise choice. The quality of the meals is varied, although the selection of food available helps to promote people’s well-being. The activities provided for people matches their expectations and preferences, thus contributing to their quality of life and independence. EVIDENCE: There continues to be a list of activities on display in the house groups, and People confirmed that activities took place. People said that entertainers came to the home and at the time of the inspection, an outside person was taking some of the people through movement to music in one of the house groups. During the course of the inspections relatives were seen to come and go, people said they can visit at any time and have the opportunity to take their relatives out into Birmingham for shopping and lunch. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 14 A wheelchair taxi continues to be available and is organised by the home. On the day of the inspection people said that they enjoyed watching television and reading, books and a newspaper. Several visitors were in the home, and spoke to the inspectors. Feedback given was generally positive, with one saying that staff continue to be very friendly and welcoming. The home is gathering information relating to what is important to people such as anniversaries in their lives, what they like in relation to pass times and food and what they still wished to do. This information should enable staff develop social activities that are individual and meaningful and better meet the diverse needs of people. During the course of the inspection the lunch time routine was observed, people were helped appropriately people were not rushed and staff did not hover around tables waiting for people to finish. People continue to make their choice the day before, but if on the day they do not want it, an alternative is offered. Salads are also available. People said they enjoyed the food it was always hot and there was plenty if you wanted more. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 15 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 using the service experienced good quality outcome. We made this judgement using a range of evidence including a visit to the service. The homes complaints procedure is accessible and protects people living in the home. Policies and training relating to Guardianship protects people in the home from potential abuse. EVIDENCE: There continued to be a complaints policy and procedure that meets the required standard. There have been three complaints investigated by the home this year. All were well documented and there was evidence that the complaints had been taken seriously with an investigation and a response to the complainant. However, the manager said that she does not always acknowledge complaints in writing we recommended that all complaints are formally acknowledged by doing this the home can be sure it has met the 28 day response time. The Adult Protection policy and procedure follows the Birmingham Local Guidelines, and a copy of the guidelines were available. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 16 Staff were able to explain the procedures and who they would report to if they suspected abuse. People visiting said that if the had any concerns they would speak to the manager or the person in charge at that time. Staff continue to do training in safeguarding people. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 17 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, 20, 22, 24 and 26 People using the service experienced good quality outcome. We made this judgement using a range of evidence including a visit to the service. The standard of the environment within this home is good providing people with an attractive, safe and homely place to live that meets their individual needs. EVIDENCE: A tour of the home was undertaken, all communal areas were seen, and a sample of peoples bedrooms. The home is divided into four units each having its own lounge dining areas bathrooms and toilets. The lounges and dining rooms are bright and appropriately decorated. The furniture is comfortable and homely. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 18 The dining tables are nicely presented with table cloths place settings and matching cutlery. Bedrooms were clean and there were no unpleasant odours. People have the opportunity to bring their own personal items to decorate or furnish their rooms this gives the feel of individuality and ownership. People were seen to enjoy the privacy of their own rooms and people said that they have the opportunity to entertain their family and friends in their rooms if they wish. The bathrooms and toilets are easily accessible to people they were clean and everything required for personal hygiene was available. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 19 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 using the service experienced good quality outcome. We made this judgement using a range of evidence including a visit to the service. The staffing levels of staff are sufficient to meet the needs of the people to make sure health and wellbeing is maintained. The recruitment procedure are robust and protect the people living in the home. EVIDENCE: The numbers of qualified nurses on duty continue to be at 3 in the morning, 2 in the afternoon and 1 at night. Numbers of care staff are stated as 8 in the morning, 7 in the afternoon and 4 at night. The home continues to use relief staff to cover shifts should their be a shortfall. The manager continues to be supernumerary as are some of the hours of the deputy manager. A team of ancillary staff are employed including housekeepers, a head cook, assistant cook and kitchen assistant, dedicated laundry staff, a maintenance officer and administrator. Staff continue to do NVQ training at levels 2 and 3. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 20 Staff continue to undertake training in the statutory areas of moving and handling, health and safety and fire training. Staff continue to have training in Palliative Care. Training in Tissue Viability is also provided, and a trainer comes into the home. A sample of 4 staff records were examined. The required documentation was present, and evidence seen that PIN number checks for trained staff had been carried out, and that staff have CRB and POVA checks carried out. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 21 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 and 38 People using the service experienced adequate quality outcome. We made this judgement using a range of evidence including a visit to the service. The home consults with people living in the home their views are both sought and acted upon. The management style of the home engenders an open and inclusive atmosphere. However, the lack of consistency in having a long term manager does not guarantee that the home is run in the best interests of the people who live there. The policies and procedures relating to health and safety protect the health and welfare of the people living in the home and the staff. EVIDENCE: Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 22 The new acting manager has been in post since August 2007, she has the qualifications and experience to manage the home. People living at the home said that the new manager as approachable and that She acted on the queries and suggestion. Staff were also happy with the new managers style, but some were concerned that the turn over of mangers was so high that when they got used to one way of working a new manager would start and the style of management would change. This is very demoralising for some of the staff. There continues to be evidence that there has been an increased a people centred ethos in the home, and the peoples views and comments are sought and acted upon whenever possible. The Quality Assurance programme operates in the home, to make that standards are being improved, and this was evidenced as being the case. Staff meetings have been held to ensure that their views are aired and as a forum to improve the communication between the staff in the home. The records of formal staff supervision were varied, some staff having more than others, and the presentation was confusing and not easy to follow. Overall the standard of documentation and record keeping were seen is good particularly in the areas of care planning, pre admission procedures, and general policies and procedures. An accident audit tool continues to be used to identify the number, frequency, time and place of accidents and falls, and it was evidenced that there has been a dramatic fall in accidents month by month, as appropriate action has been implemented. An audit of the management of the peoples personal allowance management was carried out and a robust system was evidenced. Maintenance and safety checks were evidenced as being carried out at the appropriate intervals, including fire safety, PAT testing, Gas safety, and Electrical wiring checks. Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 23 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 2 X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 24 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 15(1) Requirement The care plans must be audited regularly to make sure that the information within is the most up to date and reflects the needs of the person. The manager should develop activities that are meaningful and meet the needs of the individual. Timescale for action 29/02/08 2. OP7 15(1) 29/02/08 3 OP16 17(2)Sche The manager must make sure dule 4 that all complaints are (11) acknowledged appropriately 18(1) The registered person must make sure that the management of the home is consistent and make sure that the person in charge applies for registration. 29/02/08 4 OP32 31/01/08 Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingfisher House DS0000063702.V354687.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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