Inspection on 24/04/07 for Kingfisher Nursing Home

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.

Other inspections for this house

Kingfisher Nursing Home 04/05/06

Kingfisher Nursing Home 07/12/05

Kingfisher Nursing Home 04/08/05

Kingfisher Nursing Home 08/06/05

Kingfisher Nursing Home 12/10/04

Kingfisher Nursing Home 20/04/04

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

CARE HOMES FOR OLDER PEOPLE Kingfisher Nursing Home Emmanuel Lodge College Road Cheshunt Hertfordshire EN8 9NQ Lead Inspector Pat House Unannounced Inspection 24th April 2007 11:45 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 Kingfisher Nursing Home DS0000019574.V336306.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 Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingfisher Nursing Home Address Emmanuel Lodge College Road Cheshunt Hertfordshire EN8 9NQ 01992 627 939 01992 632708 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) Westgate Healthcare Limited Franny Fay Ilogon Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home may accommodate 22 older people in need of general nursing care. This home may accommodate 22 older people in need of convalescent care (aged above 55 years). 4th May 2006 Date of last inspection Brief Description of the Service: Kingfisher is a care home providing nursing and convalescent care for 22 older people. The home is privately owned and situated on the ground floor of Emmanuel Lodge, a two-storey complex, which provides supported housing for older people. Emmanuel Lodge is jointly owned by Broxbourne Borough Council and a Primary Care Trust. Kingfisher has eighteen single and two double bedrooms. None of the bedrooms have en-suite facilities. There is level access suitable for wheelchairs throughout the home and lounge and conservatory areas for the benefit of service users. The home has its own laundry but kitchen facilities are shared with Emmanuel Lodge. Service users have access to the gardens and patio belonging to Emmanuel Lodge and there are extensive areas for parking around the home. The building is situated in an area of parkland on the outskirts of Cheshunt, where there are shops, pubs and bus services. The A 10 trunk road, the M 25 motorway and rail links are nearby. Prospective service users are provided with information about the home, in the form of a Service User’s Guide. Copies of this document and the home’s Statement of Purpose are also displayed centrally in the home. Current residential fees for the home range from £528 to £750 per week. Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day with one inspector. The inspection was unannounced and covered all main or “key” areas. The manager was present during the visit and all areas of the home were seen. Residents, staff and visitors were spoken with and an activity session took place in one of the lounges. The mid-day meal was served and observed as part of the inspection and a selection of records was examined. There were 18 residents in the home at the time of the visit. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 3. Standard 6 does not apply to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All prospective residents have detailed information provided about the home and have assessments completed about their needs. This ensures that all parties can be sure that the care provided at the home can meet all individual needs. EVIDENCE: The current Statement of Purpose and Service User’s Guide are comprehensive, are displayed in the home and are also provided to all residents and families. The manager is also updating the information in the documents and will provide copies for the CSCI when they are completed. The residents’ files checked during the inspection had copies of care summaries provided by referring agencies, as well as detailed assessments completed by senior staff in the home. The assessments covered all relevant areas, important to the individuals concerned. Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 8 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): Standards 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual service user records are well kept and meaningful, enabling care staff to provide assistance in an appropriate way. Procedures followed in the home ensure that everyone is treated with dignity and is protected by the system for administering medication. EVIDENCE: Four care plans were tracked during the inspection and, as at previous visits, these records were comprehensive and detailed. Information already noted or commented on by residents spoken with was accurately recorded in the care plans. A wide variety of risk assessments had been completed and all plans had been regularly reviewed. Care plans also included signed property inventories, body charts and wishes regarding death and dying. Records of Health professional visits were documented and residents spoken with confirmed that they saw dentists, chiropodists and other specialists as Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 9 appropriate. One resident has been provided with an alarm mat in his bedroom after a falls risk assessment had been completed. None of the current residents have pressure sores, although most spend much of their time in a wheelchair. The manager also reminds or updates care staff about day-to-day procedures and staff have recently discussed the importance of hearing aids and their proper application. Residents spoken with said that all care was provided in a professional way and that all staff respected their privacy and dignity. One lady was waiting for a telephone to be connected in her room and other residents had already chosen to have this equipment installed. Residents confirmed they could use the phone in the office whenever they wished. Medication storage and administration was checked and no errors were found in the records or in the amounts of drugs stored. All unused medication is returned to the pharmacy monthly and records are being kept of all the returns. Storage was appropriate and storage temperatures were being recorded, at safe levels. Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 10 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): Standards 12,13,14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff at the home are pro-active in providing activities and welcoming visitors and ensure that service users enjoy their daily lives and remain part of the community. Nutritious meals are provided in a way that residents can enjoy and this promotes individual good health. EVIDENCE: An activity co-ordinator had just been appointed to the home at the inspection, which took place almost one year ago. This lady is still working at the home and residents said the activities organised were “excellent”. A list of the week’s events was displayed in the corridor and there were activities arranged for every morning and afternoon in the week. Information about the residents’ “skittles” and “quiz leagues” were displayed and those spoken with said they really enjoyed the extra stimulation of having league tables. Residents also said that the co-ordinator and the care staff provided one-to–one discussion and support for those who do not wish to join in with a group. On the morning of the inspection, residents had attended the weekly cookery session and had made cheese straws and later a group were involved in craft activities in the lounge. Trips out have taken place and residents said they were gong to a local Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 11 flower festival the following week. The home has no transport and so the coordinator organises local specialised transport for some of the more distant trips. The co-ordinator completes records detailing individual preferences and histories and keeps information about who attends each event. Visitors spoken with said they were always welcomed in the home, at all times and were provided with refreshments by the staff. Details of advocacy services were displayed in the main area of the corridor. Care staff provide breakfast and tea meals for residents but the main meal is provided by the shared kitchen staff in Emmanuel Lodge. There is a choice of two main meals and these choices were displayed in the dining room. One resident did not want either choice on the day, and had a salad provided instead. Residents spoken with said they enjoyed the food in the home and the meal served during the visit looked nutritious and appetising. Care staff and the activities co-ordinator remained in the dining room with the residents and assistance was given with eating the food, in a discreet and sensitive way. The meal was unhurried and drinks and condiments were provided on tables. Those eating fish were offered parsley sauce with their food and all residents were asked before protective “pinafores” were provided. Some care staff were wearing blue disposable gloves during the meal and it was felt this practice was unnecessary and did not look appropriate. The manager has already asked staff not to wear these gloves at meal times and this instruction was reinforced on the day. The local District Council has recently awarded the home “Four Stars” for Food Hygiene. The manager said staff had stopped using the pack provided by the Council, to record food checks and information, although these records are still being kept. Staff are now using the packs again and hope to be awarded “Five Stars” at the next inspection. Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 12 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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures in the home ensure that any concerns will be listened to and that all residents are protected from abuse. EVIDENCE: The home has written policies on Complaints, Adult Protection and Whistle Blowing which staff said they were aware of. Residents spoken with said they would not hesitate to voice a concern if they had one and Quality questionnaires returned to the home from relatives indicated that families were aware of the home’s Complaints Procedure. The CSCI had been informed of an issue, which was raised by a family member, during the previous year. This concern had been dealt with by the manager and evidence was seen that the family concerned were now satisfied with all aspects of their relative’s care. All staff members have training in Adult Protection, both at induction and later in more detail. Staff are aware of the Hertfordshire Local Authority and National procedures for dealing with any adult abuse concerns. Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 13 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): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The daily lives of service users are improved through residents living in a clean, hygienic and well-maintained environment where they know their personal laundry will be returned to them in good condition. EVIDENCE: An initial tour of the home showed that all areas were clean, bright and well maintained. Residents spoken with said that the home was always kept clean and bedrooms were well furnished and generally spacious. The manager said that her new budget included the provision of new carpets for the lounge and conservatory and that new linen had already been ordered for the home. Residents and visitors spoken with said that the laundry service provided was good and the laundry itself was clean and hygienic on the day. A laundry assistant had just been appointed to the home at the previous inspection and Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 14 this lady was still working at the home, although was on holiday on this occasion. The manager has made links with the County Health Protection Agency and will be attending one of their courses in the near future. Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 15 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): Standards 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents in the home are supported by well-trained staff who are able to meet their needs appropriately and good recruitment procedures help to ensure service user protection. EVIDENCE: Residents and staff spoken with felt that, generally, there were adequate numbers of staff working in the home. The outcomes seen during the inspection confirmed that there was a good staff team working in the home and that the balance of nursing, care and domestic staff was working well. Those residents asked, also said that call alarms were answered in good time and that care staff did not rush their personal care. All staff have completed basic training courses and more updates have been planned by the manager. All staff also complete Dementia and Adult Abuse training. Staff are encouraged to undertake NVQ training and numbers completing this will be checked at the next inspection. The recruitment records of a selection of the most recent staff were examined. Files contained evidence of all appropriate checks and copies of training certificates were also included. Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 16 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): Standards 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well managed home where their views are listened to and acted on. Procedures followed in the home ensure that both service users and staff have their welfare promoted. EVIDENCE: The manager is registered with the CSCI and is currently completing the Registered Manager’s Award. The manager is also a registered nurse. Staff and residents spoken with praised the manager and said how efficiently the home was run. All those spoken with said the manager was approachable, aware of all issues and made sure proper procedures were followed. Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 17 Minutes are kept of both staff and residents’ meetings and outcomes from these are included in Quality Assurance monitoring. There is an established system of Quality Assurance in the home and the manager monitors all the information from this and gives feedback to residents and families. A summary of outcomes and planning was on display in the home, as it was at previous visits. There are also regular visits made from an external consultant inline with Regulation 26 of the Care Standards Act and reports were available on the day. The financial records of one resident were tracked with the home’s administrator and all records were in order, with receipts in place for all amounts spent on behalf of the resident. There had been a fire alarm check that morning and fire drills take place regularly and are documented. There is still some inconsistency between the fire system for the home and for the rest of the building. The Proprietor has written to the Local Council about this and awaits a reply. There are a variety of risk assessments completed for the building and grounds and these are regularly reviewed. The recliner chairs in the home also have individual risk assessments completed. Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 18 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 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 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 3 x 3 x x 3 Kingfisher Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 19 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. Standard Regulation Requirement Timescale for action 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 Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Nursing Home DS0000019574.V336306.R01.S.doc Version 5.2 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!