Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 05/12/05 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 5th December 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

The home meets the physical and social needs of the elderly admitted for nursing care and those with dementia. Frail residents are well looked after and those with dementia are safe. There were positive comments about the meals and the social activity provided. The home is well managed, there are adequate numbers of staff and there is an on going commitment to their training. Recruitment procedures are good. The home is purpose built and was clean. Residents have single rooms with en suite facilities.

What has improved since the last inspection?

The home was free from odours and some bedrooms had been redecorated. More pressure relief equipment has been purchased.

What the care home could do better:

Although the monitoring of residents health was generally good, care needs to be taken to ensure residents who lose weight are properly reviewed and referred for professional advice if required. Those who have knocked their heads as the result of falls also need to be monitored more closely. Consent for the use of bedrails had not been obtained in all cases. Locks need to be fitted to toilet and bathroom doors.

CARE HOMES FOR OLDER PEOPLE Kings Court Care Centre Kent Road Swindon Wiltshire SN1 3NP Lead Inspector Steve Cousins Unannounced Inspection 5th December 2005 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 Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kings Court Care Centre Address Kent Road Swindon Wiltshire SN1 3NP 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) 01793 715480 01793 715490 manager.kingscourt@lifestylecare.co.uk Life Style Care Plc Mrs Helen Marshall Care Home 60 Category(ies) of Dementia - over 65 years of age (31), Old age, registration, with number not falling within any other category (29), of places Terminally ill (3) Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 The maximum numbers of service users who may be accommodated 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 The minimum staffing levels set in the Notice of Decision dated 28 January 2003 must be met at all times 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 19th May 2005 3. 4. Date of last inspection 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 dementia nursing units on separate floors. All rooms are single and have en suite facilities. The garden has been landscaped and provides a pleasant and attractive environment for service users to enjoy. The home is part of the Life Style Care group and the registered 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 DS0000015920.V269739.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken by two inspectors and took place between 9.30am and 4.30pm. There were 58 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 inspectors. The manager was not present during this visit and the findings were discussed with the homes administrator at the end of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Although the monitoring of residents health was generally good, care needs to be taken to ensure residents who lose weight are properly reviewed and referred for professional advice if required. Those who have knocked their heads as the result of falls also need to be monitored more closely. Consent for the use of bedrails had not been obtained in all cases. Locks need to be fitted to toilet and bathroom doors. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 6 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 DS0000015920.V269739.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4. Standard 6 does not apply to this home. Resident’s needs are assessed before they enter the home. The home has the capability to meet the needs of those admitted. EVIDENCE: Care plans reviewed contained pre admission assessment documents that had been completed by the registered manager. Other supporting information was also available, including community care assessments. The relative of a new resident confirmed that they had been involved in the assessment process. The home is registered to provide nursing care for the elderly and those with dementia or mental health problems. On the evidence of this inspection the home is able to meet the needs of these client groups and the overall environment meets the standards. The home is suitably equipped and accessible. Residents with dementia are looked after in a safe environment. The home is well managed and staff receive appropriate training. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8. The standard of personal and health care delivered generally meets the assessed needs of residents. 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. The care given to many frail residents was reviewed. Pressure relief equipment was in use and staff were monitoring fluid intake where indicated by assessment. Those who were unable to use a call bell were regularly checked. All appeared clean and comfortable. There were good records of wound care assessment and treatment. Records indicated prompt response to health needs and the involvement of health care professionals when required. Consent for the use of bedrails had not been obtained in all cases. Nutritional assessments were undertaken and residents were regularly weighed, however in one case of continuing weight loss no action had been taken and the resident’s nutritional intake was not being monitored. This was discussed with the nursing staff during the inspection. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 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 the following standard(s): 12 and 15 The home is providing residents with a flexible routine and life style that strives to meet their religious and recreational interests. Mealtimes are relaxed and offer a wholesome and balanced diet. EVIDENCE: A new activities coordinator has been appointed at the home since the last inspection. Discussion with the member of staff confirmed activities are normally provided each day. Residents who were able to express their views confirmed there are a variety of in house and external activities. A list of activities is displayed throughout the home and participation recorded. In addition to the daily activities, entertainment is also brought into the home. Local clergy visit each week to meet residents spiritual needs. Residents have a choice of where to eat their meals, either in one of the communal dining rooms or the privacy of their bedroom and they were generally satisfied with the quality of meals provided. One commented that the ‘meals were good’ while another stated ‘they know what I like’ when discussing choices. The home operates a four-week menu, which does not routinely offer a choice at meal times. However the cook confirmed that residents’ likes and dislikes are catered for and alternatives are provided when required. Evidence to Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 11 demonstrate alternatives are being offered was not available, as they were not being recorded. The cook was advised of the need to record all meals and a new recording system was implemented before the end of inspection. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Any complaints are listened to and action is taken to resolve them. As far as possible, residents are protected from possible abuse. EVIDENCE: A complaints procedure is available in residents’ rooms and in the service users guide. The complaints log indicated that there had been four complaints since the previous inspection in May 2005. The manager had handled these promptly. Those residents spoken to who could offer an opinion felt that they would complain to the manager, or the nurse in charge, if they had to. A relative who had made a complaint felt that it had been satisfactorily resolved. Staff receive training with regard to protection of vulnerable adults and 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 are also available. The manager has experience in using local and national procedures regarding the reporting of suspected abuse. A review of staff files indicated that CRB checks had been carried out and POVA checks are obtained prior to new staff commencing employment. Systems are in place regarding the handling of residents’ monies that ensure probity and four residents ‘accounts’ were checked and found to be satisfactory. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23, 24 and 26. The environment is generally clean, safe and well maintained though more attention is required to ensure minor repairs and promptly dealt with. EVIDENCE: The inspector’s viewed all areas of the home including residents’ bedrooms and communal living areas. The home was clean well maintained and free from offensive odour. Furnishings and fittings were of a good standard. Residents confirmed they were generally happy with the standard of accommodation. One commented they ‘had everything they needed’ in their bedroom. There were stair gates on three doors on the dementia unit. The reason for their use was discussed with Mrs Marshall following the inspection and subsequently, one has been removed. The use of these gates is regularly reviewed to ensure they do not unnecessarily restrict the resident’s rights and access to all parts of the home; and that the reason for their use is clearly documented. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 14 Residents’ bedrooms have the benefit of en suite facilities and additional toilets and bathrooms are sited close to communal living areas. Suitable locks had not been fitted on all bathroom and toilet doors to ensure residents’ privacy is respected. Minor repairs are required to the walls in two bedrooms and door handles in another two bedrooms. A number of light bulbs needed to be replaced. The laundry room is situated in the basement and is staffed each day by a laundry person. Residents were generally satisfied with the laundry service. One said that their laundry was washed and returned promptly, however another report that on occasions some of their clothing does ‘go missing’. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. The numbers and skill mix of staff met the residents’ needs and staff receive relevant training. Staff recruitment procedures ensure residents are protected. EVIDENCE: Staffing levels on the day of this unannounced inspection were above those required by the CSCI as detailed on the staffing notice and there appeared to be enough staff to meet residents’ needs without any undue delays. Residents and staff spoken with confirmed this and duty rotas indicated a compliance with the homes minimum 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 and domestic staff also appeared to be satisfactory. Staff training records indicated that there was a good level of regular, relevant training undertaken. Care staff undertake NVQ training and currently 70 hold an NVQ qualification. Regular staff meetings are held and recorded. Staff recruitment records were reviewed and found to be satisfactory and required checks and documents were in place. Induction training is provided. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33 and 38 The registered manager is fit to run the home and does so effectively and the home is run in the best interests of its residents. The health, safety and welfare of residents and staff are promoted. 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 and is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. Mrs Marshall was not present for this inspection. Residents and relatives views are sought via a satisfaction survey and also during monthly visits by a representative of the registered providers, Life Style Care. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 17 Health and safety arrangements appear satisfactory. Accidents are recorded and audited on a regular basis and action is taken to reduce any risks identified. It is recommended that when a resident has had a fall, which results in a knock to the head, neurological observations be recorded. The arrangements regarding fire safety were satisfactory and the home free from hazards. Essential equipment and services are being maintained regularly. An Environmental Health Officer had held a food safety inspection in November 2005, which was satisfactory. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 19 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. 1 Standard OP7 Regulation 13 (7) Requirement The registered manager is required to ensure that, where possible, consent is obtained and documented with regard to the use of bedrails. The registered manager is required to ensure that suitable locks, that allow access to staff in the event of an emergency, are fitted to all bathroom and toilet doors. Timescale for action 05/01/06 2 OP21 13(4)(a) 05/02/06 Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 20 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 2 3 Refer to Standard OP19 OP19 OP38 Good Practice Recommendations It is recommended that the door handles in bedrooms 41 and 32 be repaired It is recommended that the wall in bedroom 30 be repaired. It is recommended that neurological observations be carried out on residents following any head injury. Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham 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. Extracts may not be used or reproduced without the express permission of CSCI Kings Court Care Centre DS0000015920.V269739.R01.S.doc Version 5.0 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!