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Inspection on 19/05/05 for Kings Court Care Centre

Also see our care home review for Kings Court Care Centre for more information

This inspection was carried out on 19th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There were favourable comments from the residents and relatives about the health care and personal support provided by the staff. Those residents who were frail were receiving appropriate support and were clean and comfortable. Those with dementia were in a safe environment and the staff looking after them were patient and supportive. There were opportunities for social and recreational activity, and the meals provided were good. The standard of assessments both pre, and on admission, indicated that staff were good at assessing any possible risks to residents, such as the development of pressure sores, and then taking appropriate action.

What has improved since the last inspection?

Staffing levels had improved and there had been less staff turnover creating a more stable environment for the residents. There had also been an improvement in the way that staff are checked before starting work in the home. There had been an improvement in assessment procedures and care planning and the home had met the two statutory requirements of the previous inspection regarding this.

What the care home could do better:

The `Service Users` Guide` needs to be made easier to read so that any potential residents or relatives have a clearer picture of the home to allow them to make a more informed choice. Although the home was generally clean and hygienic, there were some odours in certain areas, which need to be dealt with and some bedrooms require redecoration Evidence of safe systems of work need to be in place when bathing residents who are possibly at risk.

CARE HOMES FOR OLDER PEOPLE Kings Court Care Centre Kent Road SWINDON Wiltshire SN1 4NP Lead Inspector Steve Cousins Unannounced 19th 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 Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kings Court Care Centre Address Kent Road Swindon Wiltshire SN1 4NP 01793 715480 01793 715490 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) Life Style Care plc Mrs Helen Marshall Care Home with Nursing 60 Category(ies) of DE(E) Dementia - over 65 - 31 registration, with number OP Old Age - 29 of places TI Terminally Ill - 3 Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum numbers of service users who maybe acommodated in the home at any one time must not exceed 60 of which no more than 29 may be in receipt of general nursing care at any one time and must be accommodated on the ground floor and no more than 31 may be in receipt of dementia nursing care at any one time and must be accommodated on the first floor 2. Of the 29 service users in receipt of general nursing care, up to 8 of these may be in the age range 50 - 64 years at any one time 3. Up to 3 service users of either sex over 65 years of age requiring nursing care by reason of a terminal illness may be accommodated at any one time 4. The minimum staffing levels set in the Notice of Decision dated 28 January 2003 must be met at all times Date of last inspection 2nd November 2004 Brief Description of the Service: Kings Court Care Centre is situated in the Old Town area of Swindon close to the town centre, local shops, churches and local bus routes.The centre comprises of a two-storey purpose built nursing home with general nursing and mental health/dementia nursing units. The general nursing unit is located on the ground floor and provides single accommodation all with en suites for 29 service users. On the first floor is a 31bedded unit, which provides accommodation and care for service users with dementia. All rooms on this floor also have en-suite facilities.The garden has been landscaped and provides a pleasant and attractive environment for service users to enjoy. The home manager is Mrs Helen Marshall. There are registered nurses on duty at all times in both units, supported by care assistants. Ancillary support includes activity, catering, domestic, maintenance and administration services. Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 9.30am and 4.45pm. There were 55 residents in the home. The findings from this inspection are based on a tour of the premises, speaking to residents, relatives and staff, and visiting frail residents. A number of records were inspected, including care plans and staff files. Service users are known as residents in this home and will be referred to as such throughout this report. There were a high number of frail residents in the home, many of who were unable to communicate with the inspector. The findings were discussed with Mrs Marshall, the registered manager, at the end of the inspection. What the service does well: What has improved since the last inspection? Staffing levels had improved and there had been less staff turnover creating a more stable environment for the residents. There had also been an improvement in the way that staff are checked before starting work in the home. There had been an improvement in assessment procedures and care planning and the home had met the two statutory requirements of the previous inspection regarding this. Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 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 Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 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 Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 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) 1,3and 5. Pre admission assessment procedures ensure that admissions are appropriate. The service users guide needs to be improved to enable a more informed choice. EVIDENCE: The service users guide currently contains lots of non-essential information and is not in an easily followed format. The registered manager should refer to the relevant guidance given in the Care Homes Regulations and the National Minimum Standards to amend the document appropriately. A copy of the homes last inspection report was available in the guide. Care plans reviewed contained pre admission assessment documents, which had been completed by the registered manager. Other supporting information was also available, including community care assessments. A new resident confirmed that they had been involved in the assessment process. Residents have the opportunity to visit the home prior to admission, however many are now admitted from hospital and are too frail. Relatives have the opportunity to visit on their behalf, and one confirmed this. Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 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 and 10 The standard of personal and health care delivered meets the assessed needs of residents. Resident’s are treated with respect and their right to privacy upheld. The arrangements for dealing with medication are satisfactory EVIDENCE: The care plans were reviewed on both the nursing and dementia units were found to be a good reflection of assessed needs and were reviewed monthly. This is an improvement on the last inspection. The care given to the many frail residents was reviewed. Pressure relief equipment was in use and staff were monitoring fluid and food intake. Those who were unable to use a call bell were regularly checked. All appeared clean and comfortable. Only one service user had pressure sores, but these had not developed in the home. Care records indicated prompt response to health care needs. A service user was ‘very happy’ with the support given to manage his medical condition. Relatives were complimentary about the staff; ‘ wonderful, mum always well looked after’, ‘no complaints’. Staff were observed to respect privacy and were patient and understanding with those on the dementia unit. The arrangements regarding administration of medicines were satisfactory. Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14 and 15 The social, recreational and nutritional needs of the residents are met and they maintain their own lifestyle as far as possible and with the support of the staff if necessary. EVIDENCE: An activity person is employed and a varied programme of activity produced, copies of which were in residents’ rooms. There is an activity room on the first floor and a group session was held during the inspection. One to one sessions were also held, and included those residents with dementia. A resident said that she was ‘very content’ and able to do what she wanted. Another appreciated the activities available. Both confirmed contact with their families. Residents’ rooms showed signs of personalisation and details of advocacy services were available. There are no restrictions regarding visiting and there were many visitors in the home during the inspection. There were positive comments from residents about the food. Choices were available if required. The meal served appeared well cooked and nutritious. Special diets are catered for. There were four dining rooms available, or residents could eat in their rooms if they wished. Those requiring support to eat received it in an appropriate manner. Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 Stage 4.doc Version 1.30 Page 11 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 and 18 Any complaints are listened to and action is taken to resolve them. As far as possible, service users are protected from possible abuse. EVIDENCE: A complaints procedure is available in all residents’ rooms and in the service users guide. The complaints log indicated that there had been no complaints since January 2005. No complaints had been received by CSCI and no complaints were raised by residents, or their relatives, during this inspection. The residents and relatives spoken to were aware of how to complain. The manager demonstrated good awareness of abuse issues and staff have received training with regard to protection of vulnerable adults and the reporting of suspected abuse. The contact number of the local vulnerable adults unit is displayed in each nursing office and in main corridors. Copies of the local guidelines regarding the reporting of suspected abuse were also available. Records indicated that POVA and CRB checks are carried out on all on staff, and that POVA 1st checks are obtained before they commence employment, which was a requirement of the last inspection Systems are in place regarding the handling of residents’ monies that ensure probity. Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 Stage 4.doc Version 1.30 Page 12 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) 19,20,21,22,26. The environment is safe and generally well maintained. There are accessible communal areas and appropriate bathing and toilet facilities. Specialist equipment is available to meet residents’ needs. The home is clean and hygienic, however some areas have an unpleasant odour. EVIDENCE: Communal areas are provided and are comfortably furnished. There is an accessible garden area. Rooms have en suite facilities and additional toilet and bathing facilities are available. Hot water supplies were controlled and radiators covered. The manager reported weekly meetings with the housekeeper and maintenance person. Bedrooms were mainly satisfactory however some redecoration was required in rooms 7 and 39. Specialised equipment is available and in use and adaptations have been made. The home was found to be clean, however there were some unpleasant odours confined to two areas. The laundry and kitchen were in good order and the laundry person reported that she was able to cope with the current workload. Infection control measures were in place. Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 Stage 4.doc Version 1.30 Page 13 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) 27,29 and 30 The numbers and skill mix of staff met the residents’ needs and staff are trained and competent. Staff recruitment procedures ensure residents are protected. EVIDENCE: Residents and relatives spoken to felt that there were enough care staff on duty during the day and night, and care staff members spoken to felt that levels were generally high enough. Commendably, staffing levels on the day of this unannounced inspection were above those required by the CSCI as detailed on the staffing notice. Nurses with a mental health registration are employed on the dementia unit and staff received training in dementia care. The levels of catering, domestic and activity staff also appeared to be sufficient. A review of recruitment documents indicated that recruitment practice is satisfactory, and required checks and documents were in place. Training is available for nursing, care and support staff and individual training records were kept. Training covered mandatory health and safety topics and appropriate subject such as dementia and abuse awareness. Staff confirmed they had undertaken training. The deputy manager is responsible for training and is an NVQ assessor. It was reported that over 50 of care staff hold an NVQ. An adaptation programme for nurses recruited from abroad is also provided. Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 Stage 4.doc Version 1.30 Page 14 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) 31,32 and 38 The registered manager is fit to run the home and does so effectively. The health safety and welfare of the residents and staff are generally promoted, however current practice regarding bathing residents may put them at risk. EVIDENCE: Helen Marshall, a registered nurse, has been the homes manager since January 2001. A deputy and an experienced administrator support her in her role. She has completed the Registered Managers Award. There were positive comments from residents, relatives and staff regarding the manager and all felt they were able to approach her with any problems. There are regular staff meetings and a monthly newsletter for residents and relatives. Health and safety arrangements were generally satisfactory. Accidents were recorded and reviewed by the manager and there was evidence to suggest actions were taken to reduce any further risk. However, records indicated that staff were not currently checking bath temperatures. The arrangements regarding fire safety were satisfactory, and the home free from hazards. Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 Stage 4.doc Version 1.30 Page 15 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 2 x 3 x 3 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 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x x 2 Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 Stage 4.doc Version 1.30 Page 16 No 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 1 Regulation 5(1,2) Requirement The registered person is required to amend the current service user guide so that it complies with the relevant National Minimum Standard and Care Home Regulation. The registered person is required to ensure that bedrooms 7 and 39 are redecorated. The registered person is required to ensure that all parts of the home are free from offensive odours. The registered person is required to ensure that adequate procedures are in place with regard to the safety of residents whilst bathing. Timescale for action 1.7.05 2. 3. 19 26 23(2,a,b) 16(2,k) 1.7.05 18.5.05 4. 38 12(1,a) 18.5.05 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 Good Practice Recommendations Kings Court Care Centre D51 D01 s15920 KingsCourtCareCentre v225326 190505 Stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection Suite C Avonbridge House Bath Road CHIPPENHAM Wiltshire SN15 2BB 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. 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