Inspection on 24/10/07 for Kingly House

This inspection was carried out on 24th October 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

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

CARE HOME ADULTS 18-65 Kingly House 13 - 19 Mount Road Hinckley Leicestershire LE10 1AD Lead Inspector Thea Richards Unannounced Inspection 24th October 2007 09:30 DS0000069859.V348767.R01.S.doc Version 5.2 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 DS0000069859.V348767.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 Adults 18-65. 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. DS0000069859.V348767.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingly House Address 13 - 19 Mount Road Hinckley Leicestershire LE10 1AD 01455 613823 01455 617519 m.newman@kinglycarepartnership.com www.kinglycarepartnership.com Kingly Care Partnership Ltd 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) Mrs Miranda Elizabeth Newman Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places DS0000069859.V348767.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is 8. Date of last inspection Not applicable Brief Description of the Service: Kingly House was first opened in May 2007. It is registered to accommodate up to eight adults with acquired brain injuries and is managed by Kingly Care partnership. The two partners, one of whom is the manager, have considerable experience in the treatment of brain injuries and both work at the home on a daily basis and undertake all assessments themselves. The property is a two-storey Edwardian house that was formerly a school. It is situated in a quiet residential area in the centre of Hinckley town, with shops and facilities yards away. All rooms are single and are en-suite. One room on the ground floor is suitable for wheelchair users. There are self-contained gardens with a patio and a summerhouse where smoking is permitted. There is a car park to the rear of the building and there are good transport links nearby. DS0000069859.V348767.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was the first since the home opened. It was unannounced and took into account any previous information held by CSCI including the service history, pre-inspection questionnaire completed by the manager and residents’ questionnaires sent to the home by the Commission prior to the inspection. The site inspection took place over five hours and consisted of case tracking a sample of residents’ care records and assessing the care given. Some policies and procedures were examined and some records concerning the safety of the home were also seen. Three residents, three care and ancillary staff and one visitor were spoken with. Both owners were present throughout the inspection. At the time of the inspection the home confirmed that weekly fees were £2023 and that fees were dependent upon the assessment of each individual’s assessed needs. Information about these costs as well as the day-to-day operation of the home, is available in the manager’s office. The philosophy of the home, which is printed in the home’s brochure, is that the service is designed to fit the specific resident group, which includes a positive, proactive and responsive approach to care and continuing rehabilitation. What the service does well: The residents were without exception full of praise for the care given them; one said ‘it’s all good’. No resident could think of any improvement that could be made to the home. Kingly House provides a welcoming, comfortable and homely atmosphere where residents are cared for and rehabilitated in a safe and friendly environment. Residents are encouraged to reintegrate with the community and families and friends are made welcome. Care plans are specifically tailored for each individual and goals and aspirations are clearly set out. The staff group is very experienced in the field of acquired brain injury and works very much as a team. Training is comprehensive, well planned and tailored to suit the needs of the current residents. Residents can make valued contributions to the daily running of the home and the owners speak with them on a daily basis to obtain their opinions. DS0000069859.V348767.R01.S.doc Version 5.2 Page 6 Policies and procedures are very clear and up to date. 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. DS0000069859.V348767.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000069859.V348767.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People who use this service have very good information about whether the home in order to make an informed decision about whether the home is right for them. EVIDENCE: The owners confirmed that they always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records confirmed this. Residents and the visitor spoken with had received prior information such as the statement of purpose and service user guide before admission. These were clearly printed and easy to understand. One resident described how he had visited the home several times for the day and overnight stays before he was sure he wanted to move in permanently. The visitor confirmed that the full process took a month to ensure that everyone involved was happy with the arrangements for a long-term stay. Written admission documentation was comprehensive and very clear and gave staff the information they needed to meet the residents’ needs. A staff member described the admission process and the importance of making new residents and their families welcomed. DS0000069859.V348767.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Care plans give a very clear picture of residents’ needs. The staff group meets these needs with sensitivity and regard for residents’ privacy and dignity. EVIDENCE: The care plans for the two residents selected were clear and comprehensive. There was evidence of residents’ participation throughout, including how they keep their monies and agreement to risk assessments. Goals and aspirations were clearly recorded and measured. Reviews took place on a 3-monthly basis, with other professionals taking part where necessary. Residents were part of these reviews and their contributions were signed to demonstrate their agreement with decisions made. The AQAA stated that independence was encouraged wherever possible and records confirmed this. The owners described how they ate all main meals with the residents and staff. This has provided them with an opportunity get feedback and opinions on all DS0000069859.V348767.R01.S.doc Version 5.2 Page 10 matters concerning the running of the home, as well as essential and in depth knowledge of the residents’ needs. Information on advocacy for residents needing support is freely available and discussed with residents. Each resident had a key worker who spent a great amount of time with the resident and the owners were careful to ensure that the right key worker was selected and changed if need be. The ethos throughout the home was one of making collaborative decisions with residents and residents spoken with confirmed this. Staff members were observed communicating with residents sensitively and with regard for their dignity, allowing them freedom of choice wherever possible; a resident said ‘they’re fine, they’re good people’. DS0000069859.V348767.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. There is a wide range of activities for residents to participate in, led by the residents’ wishes. Meals are flexibly arranged to suit residents’ choices and preferences. EVIDENCE: The owners described how they made every effort to enable the residents to come to terms with the adjustments to their changed circumstances. This included supporting through accessing educational, vocational or paid employment, re-visiting old hobbies and developing new ones. Each resident had a weekly programme, devised by themselves and with the assistance of their key worker. One resident described how he and his key worker regularly went into town, where he shopped for food and then brought it back to cook himself. He often invited his family to the home where he cooked them a meal. He went regularly to college, where courses included cooking, art and computers. Other residents’ records showed that courses DS0000069859.V348767.R01.S.doc Version 5.2 Page 12 included Feng Shui, beauticians and some attended a ‘riding for the disabled’ stables. One resident attended the local gym where they had a personal trainer. Information about local events is displayed on the notice board and neighbours have invited the residents to their homes for coffee. The owners said that as yet no resident had expressed interest in practicing their religions, but that they would be supported in doing this if they wanted to. DS0000069859.V348767.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The health care needs of the residents are met by having an educated staff team who have received the appropriate training. EVIDENCE: Care plans seen recorded all aspects of healthcare including visits to opticians, dentists, hospital consultants and GPs. A visitor spoken with said that their relative was supported in attending these by their key worker. Weight and medication records were clear and the Boots blister pack system of medication was used. The pharmacist had not yet visited the home since its’ opening in May, but was due to visit in November. The owners said that only certain senior staff members were allowed to distribute medication and these staff members confirmed that they had received medication administration training. Residents spoken with said they felt safe and well looked after; one resident administered his own medication with regular checks from staff and this was well recorded. DS0000069859.V348767.R01.S.doc Version 5.2 Page 14 One resident has a wheelchair and has had the support of a physiotherapist to allow them to transfer safely. The staff team has been trained in supporting this resident in carrying out exercises to increase physical independence. DS0000069859.V348767.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The complaints procedure is clear and gives residents and their supporters the confidence that complaints and comments will be listened to. Residents are kept safe from harm by clear policies and procedures concerning safeguarding adults and staff members are clear on the action to take in the event of this happening. EVIDENCE: The owners said that the complaints procedure was discussed with residents when they were admitted – a copy of the complaints form is in the residents’ handbook. Residents and the visitor spoken with said they knew how to make a complaint and all said they had no wish to make one. One resident said ‘I’d see my key worker – he’s really good at helping me with things like that’. Records showed that there had been no complaints since the home opened. Staff members spoken with said they had received training in safeguarding adults and records confirmed that all staff received training on adult protection issues with induction. The owners said that they planned to undertake some training on the Mental Capacity Act to ensure that all staff were aware of the impact of this on the residents in their care. DS0000069859.V348767.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Kingly House offers a very comfortable and homely place for residents to live and where they are can work towards independence in safety. The needs of residents with a physical disability are met. EVIDENCE: The building is in a good state of repair externally. Internally, the premises have undergone a complete renovation and modernisation before opening. The decor is still in immaculate condition and retains many of the features of the Edwardian school it had formerly been. The owners have gone to much time and trouble to create a very homely atmosphere with furniture, decorative art and soft furnishings all to a very high standard. Residents were able to choose some of the furniture. Rooms were of a good size and well personalised; one resident, who assisted with the tour of the building, said she had been able to choose her room as she was the first in the home and had chosen it because of the brass double DS0000069859.V348767.R01.S.doc Version 5.2 Page 17 bed it contained. Two residents said they had everything they needed including TV, video, DVD, and computer gamers in their rooms. There were two kitchens, one of these being specifically for the use of residents and their visitors. All rooms were en-suite but there was also a bathroom designed for use by those with mobility difficulties. The resident with a wheelchair had a room on the ground floor that had been adapted to accommodate the wheelchair comfortably. Staff members said that it was a part of the rehabilitation programme for residents to manage their own laundry and housework, with assistance where needed. The patio and garden area were enclosed and contained a summerhouse for smokers. DS0000069859.V348767.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 34,35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent. EVIDENCE: The staff rotas showed that there were enough staff members to meet the needs of the residents. Staff members spoken with said they had enough time to complete their tasks. On the day of the inspection there were four staff members plus the two owners, who were ‘hands-on’, involving themselves in all aspects of the daily routines of residents. Staff files contained evidence of CRB checks, recruitment and induction procedures. A staff member described being interviewed, giving references, obtaining a CRB check and completing an induction course on being appointed. Training records showed that all mandatory training was completed, with staff also being trained in specialist issues for people with acquired brain injuries. A staff member spoken with had achieved training in moving and handling, infection control, fire safety and first aid, medication and supervision. Records DS0000069859.V348767.R01.S.doc Version 5.2 Page 19 confirmed this. She was also due to undertake training in safeguarding adults in 6 weeks. Four staff members had achieved the National Vocational Qualification [a nationally recognised qualification] at level 3, with a further two at level 2. All other staff members were enrolled on the NVQ and the aim was for all staff members to have achieved this qualification. Staff supervision records showed that formal supervision was every two months and from these a rolling training plan was developed to suit the training needs of staff. DS0000069859.V348767.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home is well managed and the health, safety and welfare of the residents are promoted. The views of residents and their supporters are listened to and they are consulted about the running of the home on a daily basis. EVIDENCE: The registered manager shares ownership of the home. She has over 25 years’ experience in the specialist field of brain injuries and has managed a care home. She has NVQ at Level 4 in care and a diploma in Healthcare Management. Her partner has a degree in Behavioural Science and a postgraduate qualification in Health Psychology. Both hold NVQ 4 Registered Manager’s awards. Staff members said they had confidence in the owners and that they were approachable and accessible. Some of the staff had been with the owners in a DS0000069859.V348767.R01.S.doc Version 5.2 Page 21 previous home and had moved to this home in order to stay with the owners; one said this was because she had always felt valued and supported by them. Residents were full of praise for the staff and the owners; one said ‘they’re absolutely fabulous’ and compared the home very favourably with other homes he had lived in. The home has a clear and comprehensive set of policies and procedures, which is up to date and will be reviewed annually. Fire training was evident in records, with the local fire officer visiting to offer advice on areas of fire safety Staff members confirmed that they received regular supervision and there were regular staff meetings. There is a Human Resources consultant who supports employment law compliance and general staffing requirements and there is accountancy and book keeping support for the home. Residents are part of an ongoing quality assurance system and their opinions are sought on a daily basis at mealtimes and via their key workers. Although at the moment this system is informal, as some of the residents having been at the home for less than a month, they will be asked to complete questionnaires, which will then be acted upon by the owners and staff. DS0000069859.V348767.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 4 X 4 X X 3 X DS0000069859.V348767.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Not applicable 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 DS0000069859.V348767.R01.S.doc Version 5.2 Page 24 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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