Inspection on 10/01/06 for Kings Acre

This inspection was carried out on 10th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Kings Acre 28/02/07

Kings Acre 17/05/05

Kings Acre 05/01/05

Kings Acre 20/07/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

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 Kings Acre Ermington Nr Ivybridge Devon PL21 0LQ Lead Inspector Rachel Proctor Announced Inspection 10th January 2006 09:30 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 Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 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. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kings Acre Address Ermington Nr Ivybridge Devon PL21 0LQ 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) 01548 830076 01548 831470 kingsacre@tesco.net Mr Michael Leaves Mrs Gail Richardson Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (6), Physical disability over 65 years of age of places (28), Terminally ill over 65 years of age (4) Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Physically disabled (50 years and over) Date of last inspection 17th May 2005 Brief Description of the Service: Kings acre is a 34-bedded care home set in its own grounds on the edge of Ermington Village. The house has been converted and extended but still keeps its original charm, with views of the local countryside. The atmosphere within the home is warm and friendly, the registered Provider makes every effort to maintain a family feel to the home whilst providing nursing and personal care to its elderly, physically disabled service users. Registered nurses are available on duty 24 hours a day to monitor Service Users health. The home admits persons over the age of 65 years of either gender. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The commission for social care inspection has introduced key standards to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that previous reports also be taken into consideration. The inspection took place on the 10th of January 2006 between 9:45 and 3:30. A tour of the home was completed and some records were inspected. Five patients, two relatives and four members of staff were spoken to during the inspection. Five patient comment cards received all indicated that they liked living at Kings Acre, felt well cared for and staff treated them well, respecting their privacy. Five relatives comment cards received all indicated that they were satisfied with the overall care provided at Kings Acre. All five indicated that they were kept informed of important matters affecting their relative. 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 Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 6 contacting your local CSCI office. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 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 Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 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): The key standards in this section had not been assessed on this occasion. Both key standards were fully met the last inspection. EVIDENCE: A revised statement of purpose and service users guide was provided as part of the pre-inspection information. These had been updated since the last inspection and provided clear information for the patients, their relatives and staff. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 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 The patients continue to have their health, social and personal care needs assessed and provided for by a competent caring staff team who have their best interests at heart. EVIDENCE: The patient’s health, personal and social care needs are set out in their individual plans of care. Three patients were case tracked during the inspection. Two of these patients told the inspector that staff had discussed their care needs with them and they had been able to influence the way their care was delivered. All three care plans had been reviewed monthly or sooner if the patient’s care needs have changed. One patient who had been unwell over the last few weeks had had their plan of care updated to reflect their new care needs. This patient was being cared for in their own room. The room was bright and fresh and the patient had been positioned to allow them to see out of the window when in bed. This patient commented that staff were very kind and made sure they were looked after. The manager has continued to use a comprehensive health and social care plan for each of the patients. These address the individual’s health care needs Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 10 in a way that promotes health. How one patient’s nutritional requirements and reduced mobility functions were managed had been well documented. This patient had access to a specialist hoist and staff had a clear manual handling plan to follow. High dependency pressure relief airflow mattresses were in use for those patients who had been identified at high risk of pressure sore development. The manager confirmed that one patient who had pressure sores when admitted to the home had now healed. Clear wound care planning was in place for this patient, which demonstrated how wound healing was progressing. The manager has ensured that staff have the relevant information regarding the disease processes and conditions of the patients within the home. Reference materials were seen to be easily available for staff in the office. The patient’s medication is stored in a locked treatment room. A lockable drug trolley is available for the registered nurse to take patients medication around the home. The records of medication given to the three patients case tracked had been completed and signed in line with good practice. Where patients medication had been changed by the GP this had been recorded on the patients medication sheet, signed and dated. The controlled drug book was checked against the stock for one patient, as correct. This had been completed as expected. The new system for disposing of unwanted medication had been put in place since the last inspection. The nurse in charge provided a list of disposed of medication. Each drug had been itemised on the list and signed for each days entry. One patient who required crushed medication to enable them to take it had a record of discussion with the pharmacist regarding the medication to be crushed. However this was not easily available with the patient’s medication. The manager confirmed that only registered nurses administer the medication for the patients. The nurse in charge confirmed that none of the current patients have been assessed as able to self-administer their medication. A risk assessment template for self-medication was seen during the inspection. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 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): 12,13,14 The routines of the home and activities are provided in flexible way that endeavours meet the individual needs of the patients being cared for. EVIDENCE: Visitors were coming and going throughout the inspection. Patients were seeing their visitors in the privacy of their own rooms or in one of the communal lounges. The newsletter was available for patients and the visitors in the reception area of the home. This provided information on planned activities, patients birthdays and any professional visitors due i.e. chiropody. Information was also recorded on a notice board in the main lounge; this was printed in large type to make it easier for the patients to read. One patients family commented that the staff had been very supportive during their relative’s recent illness. They further commented that the manager had enabled them to stay at the home for longer periods to be with the relative during this time. The patient’s personal choice for activities had been recorded in the plan of care. One patient who enjoyed knitting had been enabled to continue to do this; others who enjoyed reading had access to a variety of books. The Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 12 patients asked said they really enjoyed the weekly video provided by the home manager, which covered places of interest in their local area. A local animal welfare organisation was providing entertainment for the patients on the morning of the inspection. The organiser had brought in a barn owl, Chinchilla and a dragon lizard for the patients to see and touch. 18 patients participated in this with enthusiasm during the morning. Each of the patients rooms entered had been personalised with items of their choice. These included family pictures ornaments and small items of furniture. Each patient’s room had a photograph of their key worker and name provided. The manager advised that this enabled the patients to get to know their key worker. One comment card received stated the staff are very caring and never seemed to rush to talk to the patients or relatives. Other comments received included the staff are unfailingly kind and patient, he is well looked after here and well fed, the matron and her staff are excellent. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 13 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): 18 The patients at Kings acre are cared for by a staff team who understand them. They can have confidence that any concerns they have will be dealt with sensitively. EVIDENCE: The patients were seen to be expressing their concerns and wishes freely to the staff who were caring for them. The complaints policy and procedure was easily available for the patients, staff and visitors to the home. This contains the name and contact numbers of the Commission. Policies and procedures are in place to advise staff how to respond to suspicions, evidence of abuse or neglect to ensure the safety and protection of the patients. A record of training staff had received for adult protection was available for inspection. Further training session’s dates planned were also recorded. The manager confirmed that all recruitment practices within the home prevent unsuitable staff from working there. Two staff records were seen during the inspection this confirmed the robust recruitment practices are in place to protect the patients. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 14 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): 19,26 The patients live in a homely, well maintained and attractively decorated environment, which is kept clean and fresh. EVIDENCE: The carpets in one corridor area and one patients room, which had been identified as possible trip hazards for patients have been replaced since the last inspection. The manager confirmed that a program for replacing the resident’s room’s carpets was continuing. The homes environment is attractively decorated and reasonably well maintained. The toilet and bathroom facilities are easily available to the patients from their individual private rooms and the communal areas. The patients who required them for nursing are provided with height adjustable beds. Access for staff is available at both sides of the bed to provide care safely for the patients. Central heating is adjustable in individual patients rooms, which allows them to have the room temperature of their Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 15 choice. During a tour of the home different patients rooms were of different temperatures, which suited the individuals, housed in those rooms. The home was fresh and clean and free from odour in all areas accessible by the patients during the inspection. Staff providing personal care for the patients were following good practice guidance for the prevention of infection. Policies and procedures are in place for the prevention and control of infection. The domestic spoken to during the inspection advised that she liked to make sure that all the patients had fresh clean bedrooms. Individual residents were wearing personal items of clothing of their choice. The laundry lady advised that she liked to make sure that the individual patients clothes were cared for and pressed in a way that kept the individuals looking smart. Individual residents spoken to said the home is always beautifully fresh and clean and their clothes are cared for in a way that they would do themselves if they were able. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 16 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): 28,29,30 The patients at Kings Acre are cared for by a competent caring staff team who are trained to meet their care needs in a way they would do themselves if they were able. EVIDENCE: Staff have access to training helps them to care for the patients. This includes specific disease processes, palliative care, continence care and infection control. The manager confirmed that she ensures information regarding the conditions/health problems the patients have is available to the staff. Staff spoken to during the inspection said they felt supported to do their work and had access to training that help them do their jobs better. The pre-inspection questionnaire advised that currently two of the healthcare assistants have achieved NVQ level 2 or above and a further nine are in the process of completing this award. The manager confirmed that once the nine staff had completed their NVQ level 2 this will achieve more than 50 of the staff with NVQ level 2 or above. Two staff files were reviewed, one healthcare assistant and one registered nurse. The information provided in the staff files contains the relevant employment checks and contract. The manager confirmed that all staff have photographs taken and these are kept on staff files. The manager provided an audit graft, which showed the staffing levels achieved in October 2005. She confirmed that these grafts are completed on a monthly basis and enable her to easily review how staff compliments are achieved. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 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): 31,38 The patients benefit from the leadership and management approach adopted by the home manager, which endeavours to ensure that the home is run in their best interests. EVIDENCE: Both the manager and the deputy have completed an NVQ level 4 in management in August 2005. The manager provided information about the training completed by herself and the deputy since the last inspection. The manager advised that she would be leaving to take up another job and the deputy manager would be put forward to be the registered manager of Kings acre. The information provided in the pre-inspection questionnaire provides information regarding the health and safety policies in place at Kings acre. The tour of the home revealed that hoist services and fire extinguisher checks had been completed in line with good practice recommendations. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 18 The manager confirmed that 14 staff had completed a first aid certificate, fire training and manual handling. Two of the staff spoken to during the inspection confirmed that they had had manual handling training. Health and safety notices regarding hot water or other hazards were displayed in the home. Comprehensive risk assessments have been completed for the environment as well as individual patients. The pre-inspection questionnaire outlines the management responsibilities and allocations within the home. The visitors, patients and staff were aware of the lines of accountability within the home and who was responsible for what. The manager advised that she regularly checks the accident books to see if there are any trends or individual patients having more accidents than usual. She reported that this enabled her to ensure that identifies risks were removed as far as possible. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X X X X X X 3 Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 20 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. 1. Refer to Standard OP9 Good Practice Recommendations The information available for staff regarding the need to crush medication for individual patients should be clearer. Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Kings Acre DS0000003591.V263818.R01.S.doc Version 5.1 Page 22 - 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!