Inspection on 17/05/05 for Kings Acre

This inspection was carried out on 17th May 2005.

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

Other inspections for this house

Kings Acre 28/02/07

Kings Acre 10/01/06

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 Unannounced 17th May 2005 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 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 D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kings Acre Address Ermington, Nr Ivybridge, Devon, PL21 0LQ Telephone number Fax number Email 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 831001 Mr Michael Leaves Mrs Gail Richardson Care Home 34 with Nursing 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 D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Physically disabled (50 years and over) Date of last inspection 05/01/05 Brief Description of the Service: Kingsacre 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 D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 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. This was an unannounced inspection and took place on the 17th of May between 10:30 a.m. and 2:30 p.m. Several patients and their relatives were spoken to during the inspection. A walk around the home was completed and some records were inspected. The manager and owner were present during the inspection. What the service does well: What has improved since the last inspection? Some of the patient’s rooms and assisted bathrooms had been redecorated and new flooring provided. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 Page 6 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. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 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 standard(s) 1,3 The manager has provided clear information for the patients to enable them to make an informed choice about the home and services. The residents can have confidence that they care needs will in the holistically assessed. EVIDENCE: A comprehensive assessment processes in use in the home. The assessment process includes risk assessments. One patient stated that they had been asked about the likes and dislikes and had been provided with a specialist chair. Two relatives advised that they had been enable to understand the services offered by the home by the information provided and visits to the home prior to their relative being admitted. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10, The way the patients care is monitored and given allows them to influence their care. They can be reassured that their health, social and personal care needs will be monitored and evaluated by suitably qualified staff to ensure their care needs are met in a way that is acceptable to them. EVIDENCE: The patients spoken to said they were asked about their personal preferences. I can choose the time I get are then go to bed, staff are friendly. Each of the patients rooms entered had a photo of the key worker and their name this enabled the patients to get to know their key worker. Risk assessments are an integral part of the care planning process. Patients who were using wheelchairs with out footplates had been risk assessed. Two patients were using their feet to propel the wheelchairs. One patient commented that this had allowed them to have some freedom to move around the home independently. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 Page 10 The nurse in charge was observed giving medication to the patients during a lunchtime period. These were being given and signed for individually by the nurse, ensuring that the patients got the medication they required. The patience individual health and personal care needs are recorded in the care plan. Care plans include risk assessments for activities the patients wish to undertake. One patients wound care plans seen had a clear record of how wound healing had been promoted. Each of the patients care plans viewed had been reviewed monthly; changes had been made to the care plan when the patient’s care needs have changed. The manager confirmed that she or the deputy manager complete all assessments for the patients. This ensures that patients receive the care they require to meet their needs. Patients care plans include personal likes and dislikes and preferences for food. The activities they enjoy or enjoyed when they were younger had been recorded. One patient advised that they were continuing to complete embroidery since their admission to the home and this is something they really enjoyed. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 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 standard(s) 12, 15, Patients are actively encouraged to choose the activities they undertake, valuing their individuality. Mealtimes at Kings acre are a pleasant social occasion for the patients and staff. EVIDENCE: Lists of activities for the week were provided in the large lounge. An information newsletter is easily available in the reception area, this advised of the patient of the weeks activities and the menus. Six patients asked said they really enjoyed the film had watched that week about Noss Mayo. The manager advised that a different film is provided twice a month. The patients have the chance to choose the type of film that is provided. The months activities listed showed that the patients had a variety of entertainment provided. Those asked said they really enjoyed the entertainment provided and had been asked what they would like. The lunchtime meal and was a pleasant social occasion for the patients and staff. Fresh vegetables and meat were provided; very little wastage was seen at the lunchtime meal. The patients asked said they really enjoyed the food and looked forward to mealtimes. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 Page 12 The patients were eating lunch in the dining area, the lounge and conservatory during the inspection. The patients who had chosen to eat in their rooms were facilitated to do this. Staff assisting the patients to eat their meals were doing so in a sensitive discreet way. Puréed food had been provided separately to allow the patients to experience a different taste of the food separately. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 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 standard(s) 16, The patients at Kings acre can have confidence that any concerns they have will be dealt with sensitively by the staff team. EVIDENCE: No complaints had been received since the last inspection. The patients asked said they were able to speak to sell easily about the concerns and wishes they had. The complaints policy was easily available. The newsletter provided also provided information on how to contact the manager if they had any concerns. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 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 standard(s) 19, 21, 22, 23, 25, 26, The majority of the home is well maintained and attractively decorated enabling the patients to live in a homely environment. However two areas within the home were in need of re-carpeting as the carpets pose a trip hazard for the patients. EVIDENCE: The carpet in one corridor area in the home was still rucked. One patients room had a faded rucked carpet. These presented a possible trip hazard for the patients. The majority of the homes environment, and attractively decorated and well maintained. New carpet and flooring has been fitted to some of the patients rooms and a disabled bathroom. The toilet and bathroom facilities are easily accessible to the patients from their private rooms or the communal areas. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 Page 15 The patients who required nursing have height adjustable beds. This enables staff to provide care for the patients safely. Two patients said they liked the view from their bedroom window. Central heating is adjustable in individual patients rooms. Different patients rooms entered were heated depending on the patient’s preference. The home was fresh and clean and free from odour during the inspection. Staff providing care for patients were using gloves and aprons provided. The domestic spoken to said she worked from 7:30 a.m. till 3 p.m. each day cleaning the home. A separate laundry person is employed. The owner advised that a new washing machine was on order. The patents have a clean fresh environment and are protected form infection as far as possible. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The patients can be reassured that the staff team who provide their care are trained and competent to care for them. EVIDENCE: An external assessor was assessing two of the care staff during the inspection. She reported at the staff she had assessed were very good. The manager has developed a dependency-rating tool that enables her to tailor the staffing to the needs of the patients. The duty rota in place showed that during peak periods such as mealtimes and mornings the staff numbers had increased. The patients asked reported that staff were very helpful and respond as quickly as they can to their calls for help. Four staff were observed assisting the patients to eat their lunchtime meal. This was being carried out in a supportive non-intrusive discreet manner. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33, 35,37,38, The way the home is managed and run allows the patients to have confidence in the services they are provided with. EVIDENCE: There are clear lines of leadership with in the home. The manager is supportive to the staff and encourages their development. There is an open positive atmosphere in the home, which is recognised by patients and their relatives. The patients spoken to said they were more than happy with the staff team at the home. They also said they were kept informed about changes and felt part of the home community. The manager has provided a quality audit tool that gives her opportunity to seek the views of the patients and their relatives regarding the services provided at Kings acre. Copies of these were available. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 Page 18 The records of patient’s money held by the manager were available. The records were checked against the funds available for one patient is correct. Patients spoken to said the staff enabled them to buy the things they wanted. The records viewed during the inspection work to date and accurately kept. The way the patients care was planned and monitored is clearly stated in ensuring their care needs are met. An external assessor was assessing two of the healthcare assistants employed by the home for their understanding of health and safety. The accident records were provided these also indicated what actions had been taken to prevent them stop Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 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 3 13 x 14 x 15 4 COMPLAINTS AND PROTECTION 2 x 3 3 3 x 3 3 STAFFING Standard No Score 27 4 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 4 3 x 3 x 3 3 Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 Page 20 yes Are there any outstanding requirements from the last inspection? 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 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 OP19 Good Practice Recommendations Carpets that present a possible trip hazard should be refitted or replaced. Kings Acre D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 D54-D07 S3591 Kings Acre V225104 170505 Stage 4.doc Version 1.30 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. 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