Inspection on 24/10/05 for Kingland House

This inspection was carried out on 24th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Kingland House 18/01/08

Kingland House 01/10/07

Kingland House 21/06/06

Kingland House 06/06/05

Kingland House 27/09/04

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Poldhu

Queensmount

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Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Kingland House 30 Kingland Road Poole Dorset BH15 1TP Lead Inspector Gloria Ashwell Unannounced Inspection 24th October 2005 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 Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 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. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kingland House Address 30 Kingland Road Poole Dorset BH15 1TP 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) 01202 673124 Buckland Care Limited Miss Leanne Natalie Buckland Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th June 2005 Brief Description of the Service: Kingland House is a care home registered to provide accommodation and care to a maximum of 22 older people. It is situated within Poole Town centre and is close to local shops and public transport services. There are views of nearby Poole Park with its picturesque lake and level walks. The home has off-road parking for 6 cars; on-road parking is available but local restrictions apply. Resident accommodation is on the ground and first floors. There are 22 single occupancy bedrooms on the ground and first floors, 17 have en-suite hygiene facilities (including 8 with showers). All bedrooms contain a wash hand basin. To the rear of the home is a well-maintained garden. During 2004 the home was registered to Buckland Care Limited, which owns a number of other care homes in the south west of England. The general manager of the company is Mrs Pownall. The registered manager of Kingland House is Miss Leanne Buckland. During late 2005 and 2006 Buckland Care Limited intends to enlarge the home to provide additional rooms. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was one of the two statutory inspections required in accordance with the Care Standards Act 2000. The previous inspection took place during June 2005; since that inspection no complaints against the home have been received or investigated. The Lead Inspector was Gloria Ashwell accompanied by Joanne Pasker who has subsequently become the inspector for the home. The inspectors arrived (unannounced) at 10.00. They spoke to 12 residents, 3 members of staff and the visiting relatives of 1 resident and together with the manager considered other evidence relating to the National Minimum Standards, as described in this report. The inspectors observed staff interaction with service users, the carrying out of routine tasks and toured the premises, departing at 14.45. Additional information used to inform the inspection process included formal notifications of events and monthly reports provided to the Commission by the registered provider. Standards assessed and found met during the previous inspection were not reassessed during this inspection. The duration of the inspection was 4 hours and 45 minutes. What the service does well: The home provides good care to residents who are mainly of low and medium levels of dependency, and thereby able to remain actively involved in decisions regarding their lives and activities. Residents are assisted to maintain as much independence as possible and are encouraged to maintain contact with the local community. Meals are appetising and of good quantity and quality. The premises are comfortable, with a lounge, conservatory and a dining room; there are car parking spaces at the front of the house and attractive gardens at the rear. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 6 Staff are kind and helpful to residents. Residents are treated with respect, their privacy is protected and staff understand and meet their needs. Residents feel safe and well cared for. The home provides a good range of social and recreational activities, including occasional excursions. Medicines prescribed by doctors are safely stored and carefully administered to residents by staff thereby protecting residents from risks of medicine errors. Residents wishing to do so may store and administer their own prescribed medicines. 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. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 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 Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standards 2, 4, 5 & 6 were assessed and found met at the last inspection) Prior to admission, the needs of each proposed resident are assessed and the home then writes to prospective residents confirming the ability to properly care for them. EVIDENCE: Following pre-admission assessment, if the home decides to offer a place to a new resident, they then write to the person stating that Kingland House will be able to meet their assessed needs. The inspectors were shown the copy of a letter sent to a recently admitted resident. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 (Standard 10 was assessed and found met at the last inspection) Staff do not have all written information necessary to ensure the provision of correct care to each resident. Care needs are briefly and sometimes inadequately described in a written plan of care. Many care plans are significantly out of date and inaccurate. Since the previous inspection the home has implemented an audit system intended to identify and minimise risks to residents prone to falling or other accident but has failed to develop and implement a safe system for the use of bedrails. Medicine storage, handling and recording is properly carried out to ensure that residents receive medicines as prescribed. EVIDENCE: Care plan documentation is not suited to recording changes in condition/circumstance and in consequence aspects of care plans are frequently out of date and no longer accurate. The high risk health aspect of one resident was inadequately described in the care plan although other Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 10 records indicated that appropriate attention had been provided to this person during a recent health emergency. All accidents are recorded and since the previous inspection the home has periodically audited accidents to identify any trends or patterns (e.g. in time, place, person or activity) and subsequently introduced some measures to reduce the risks, but has implemented the use of bedrails without a related written policy/procedure and risk assessment. In consequence, bedrails may pose additional risks to the safety of those residents they are intended to be protecting. Medicines prescribed by doctors are safely stored and carefully administered to residents by staff who have received appropriate training, unless the residents have chosen to store and administer their own medicines. Risk assessment has been recorded for those who self-administer. Warning signs are displayed where oxygen is stored and used. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 were assessed and found met at the last inspection EVIDENCE: Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): (Standards 16 & 18 were assessed and found met at the last inspection) EVIDENCE: Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25 & 26 With the exception of a defective double glazed window of one bedroom, the home is attractive, comfortable and well maintained. Resident’s bedrooms are suitably decorated and furnished; many residents have brought items of their own furniture and a number have private telephones installed, thereby enabling them to conduct private conversations and maintain contact with persons outside the home. Bedroom doors are not all fitted with locks of approved type so not all residents are able to key-lock their bedroom doors for privacy, when they temporarily leave the room. There are pleasant communal use rooms – a lounge, separate dining room and a conservatory lounge, and well maintained gardens to the rear of the home. The hot water and central heating system did not appear to be adequate on the day of inspection. There is a laundry, used by staff to wash and dry residents’ household linen (towels, sheets etc.) and personal clothing. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 14 EVIDENCE: There is a lounge, dining room and conservatory. The conservatory is used as a quiet area whilst the lounge is equipped with a large screen television. These rooms are suitably decorated and appropriately furnished and the home has a cosy and relaxed atmosphere throughout. There is an ongoing programme of refurbishment and upgrading and work is expected to commence during December 2005 to construct additional rooms. As noted in the report of the previous inspection a double glazed window in one bedroom is defective and cloudy from inner condensation and should be replaced or repaired. Not all bedroom doors are fitted with locks of appropriate type, for which the resident can hold a key. Some doors are fitted with two lever style handles, one being obsolete and non-functioning; the unused handles should be removed to ensure simplicity of use of the functioning handles. Resident’s bedrooms contain a variety of personal belongings; many residents provide items of their own furniture. At the time of inspection wash hand basins were without hot water and some residents commented that the home was not always comfortably warm; some external doors allowed draughts of cold wind to enter the home. During the inspection these matters were notified to the manager who confirmed they would receive urgent attention. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The home employs enough staff to meet the needs of residents and to ensure their safety and comfort. Recruitment practices ensure the protection of residents from potentially unsuitable staff. The home must endeavour to provide more reliable evidence that staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: Staffing levels are provided in accordance with the assessed needs of residents and are recorded on a rota. During most mornings there are 4 care staff on duty, during most afternoons there are 3 and at night there are 2 care staff on wakeful duty. The inspectors spoke to three staff, all expressed satisfaction with their employment, standards at the home and opportunities for training. The records of a recently employed staff member were examined and found to contain required information, indicating the use of a reliable recruitment procedure; to further improve the process it was recommended that the records should include a full history of past employment with dates. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 16 Individual staff members have training in various subjects including Health & Safety, Protection of Vulnerable Adults, Control of Infection and First Aid. 3 staff are at present training for National Vocational Qualifications; 2 of the 16 regularly employed care staff already hold these awards. Usually new staff undertake induction training, in accordance with TOPSS standards; however, there was no record of any training having been provided to a recently employed care worker. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Staff have good leadership from the registered manager. Residents are generally satisfied with the home and feel staff care for them well and put them at their ease. The home should reinstate ‘user satisfaction’ audit systems to ensure that residents remain satisfied with all aspects of the home. The home does not manage the finances of any service user. The premises and equipment are generally maintained in a safe condition, to ensure residents, staff and visitors are protected from harm and injury, but the home must provide evidence of the safety of the gas installation. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 18 EVIDENCE: Miss Leanne Buckland has been the registered manager of Kingland House since July 2005; she possesses a Diploma in Management and is suitably experienced. A Residents Meeting took place during Summer 2005 and it is intended to periodically issue residents and their families with a newsletter. During 2004 a quality assurance questionnaire was issued to residents and other stakeholders; to ensure that the current opinions of these persons are identified and taken into account the home should develop and implement an ongoing quality assurance system. Residents indicated they are generally satisfied with Kingland House; they said they feel safe and well cared for. The home does not manage the finances of any service user; residents either manage their own monies or have relatives or lawyers undertake this on their behalf. At all times there are staff on duty in the home trained in First Aid and with knowledge of how to deal with accidents and health emergencies. Records of fire safety equipment checks and tests, staff fire safety training and fire drills show that these essential aspects receive appropriate attention, although the frequency of emergency lighting tests must be increased. The inspector was shown records indicating the safety of the passenger lift and the electrical installation. Records indicated that a ‘warning notice’ regarding the gas installation was issued during February 2005 and there was no written evidence that the necessary remedial work had been completed; a related requirement is included in this report. A comprehensive Health & Safety assessment of the premises is at present being compiled. Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 19 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 X X 2 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP7OP7 Regulation 17 Requirement A comprehensive care plan must be recorded for each resident. Previous timescale of 01/08/05 not met. Written details of current medical conditions (with particular regard to diabetes) and guidance on emergency action must be comprehensive. There must be recorded evidence of the induction training of all new staff. Emergency lighting must be tested at all required frequencies i.e. monthly tests must be carried out and accurately recorded. There must be written evidence confirming the safety of the gas installation. Timescale for action 01/12/05 2. OP8OP8 13 01/11/05 3. 4. OP29OP29 OP38OP38 18(1) 23(4) 25/11/05 10/11/05 5. OP38OP38 13 01/12/05 Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 21 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 OP7OP7 Good Practice Recommendations Care plan documentation should be amended to provide more space for review outcomes and changes to needs and circumstances. This recommendation is repeated from the previous report. Doors to service users private accommodation should be fitted with locks suited to service users capabilities and accessible to staff in emergencies. Service users should be provided with keys unless their risk assessment suggests otherwise. This recommendation was also included in the report of the last two inspections. The defective double glazed bedroom window should be repaired or replaced. This recommendation is repeated from the previous report. Records of employment should include a full history of past employment with dates. The home should reinstate ‘user satisfaction’ audit systems to ensure that residents remain satisfied with all aspects of the home. 2. OP24 3. 4. 5. OP25 OP29OP29 OP33OP33 Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingland House DS0000060603.V260313.R01.S.doc Version 5.0 Page 23 - 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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