CARE HOME ADULTS 18-65
Kings House 1 Earle Road Westbourne Bournemouth Dorset BH4 8JQ Lead Inspector
Trevor Julian Unannounced Inspection 19th October 2006 10:30 Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Kings House Address 1 Earle Road Westbourne Bournemouth Dorset BH4 8JQ 01202 764455 F/P01202 764455 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) www.together-uk.org Together Working for Wellbeing Mrs Sheila June Shutler Care Home 19 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (19) of places Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Five named adults (names known to CSCI) over the age of 65 years may be accommodated until such time as their assessed needs cannot be met by the home 7th March 2006 Date of last inspection Brief Description of the Service: Kings House is situated in a quiet residential area of Westbourne and is easily accessible to shops, local amenities and beaches. It is a red brick detached property with a conservatory, pleasant rear garden and summerhouse. It is registered under the category mental disorder (MD excluding learning disability or dementia) for up to 19 male and female service users. There are 3 bedrooms on the ground floor rooms all single occupancy, on the first floor there are 6 singles and 2 shared rooms, on the second floor there are 5 single rooms. To the rear of the premises, a self contained unit provides accommodation for one person assessed, as suitable for more independent living. Kings House is operated by Together a mental healthcare association and accommodates individuals with enduring mental-health problems. Those living at Kings House receive 24-hour emotional and practical support from a team of experienced residential care workers. The day-to-day running of the home is undertaken by the project manager Mrs Shutler. The service aims to provide ongoing support to ensure service users stability and help those who are able to progress to more independent living. To facilitate this, service users are encouraged to carry out a range of domestic tasks including laundry, meal preparation and cleaning. A number of service users use day care services all have a range of activities, which they pursue independently. In October 2006, the weekly fees ranged between £430 - £515. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 19th October 2006 between 10:30 and 15:30. The project manager, Mrs Shutler, was on duty throughout the visit. Before the visit, the residents and others involved with the home were invited to complete surveys giving their views of the home. A good level of responses were received from the residents, care managers and community health teams. All were very positive and none identified any areas of concern. The purpose of the visit was to monitor the homes performance against key standards. Information was gathered through discussion with the residents, staff, visitors and management, a tour of the premises and a review of some care records and procedures. What the service does well:
All the comment cards received showed good levels of satisfaction in the way Kings House is operated. The staff were described as approachable and supportive. The admission process allowed new residents time to consider if the placement was suitable for their needs. The first six weeks was identified as a trial period allowing further time for the new resident to assess the home’s suitability. One new resident confirmed that he had been given information and had visited the home several times before moving in. During the visit, a good rapport was noted between the staff and residents. Residents said that the staff were supportive and helpful when they needed advice and guidance. The home provided the residents and visitors with information about how to register a complaint. Staff were trained in responding to concerns and allegations of abuse. The residents were advised on admission of the range of personal records kept on individual residents and how those records could be accessed. None of the residents spoken to had asked to see their own files. Plans were in place to create a residents file which would be kept by the resident. Care planning was of a good standard and there was evidence that the individuals were involved in the process although the files seen showed that they had declined to sign their finalised care plan. There was evidence of regular reviews involving healthcare professionals as needed. The records of financial transactions were up to date and included receipts for expenditure.
Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 6 The home offers a range of activities and pastimes and supports residents to be active within the community. There were daily tasks and routines for the residents but the residents said they were the same tasks that would need to be completed if they lived independently and they were not restrictive. The menus in the home were developed with input from the residents. The food was described as very good with a good variety of food available. Menus were posted in the dining area. The home had good links with the community healthcare teams ensuring that health needs were met. Since the last inspection, Occupational Therapist assessments on the premises had been completed some specialist equipment had been provided to help maintain individual residents’ independence. Following the assessment plans were being developed to provide a “walk-in” shower room on the ground floor. The premises were well maintained and clean. Individual rooms visited had been personalised by the occupants. The management team complete monthly supervision meetings with the care staff in order to monitor standards and identify areas for staff development and training. The organisation has a thorough recruitment process to ensure that the prospective staff had the required clearances and references before being offered a position. The home is well managed by the management team. The organisation carry out monthly visits to the home and seek the views of the residents and staff about how the home is run, the resultant report is provided to the manager and the Commission. The home has effective health and safety procedures helping to provide the residents and staff with a safe environment. What has improved since the last inspection? What they could do better:
Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 7 There were no new requirements or recommendations made following this visit. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home’s admission procedure allows the individual to make informed decisions about the suitability of the placement. EVIDENCE: The records of a recent admission to the home showed that he had been invited into the home on three occasions before having to decide on the home’s suitability. The home used the Care Programme Approach (CPA) and the visits to assess the home’s ability to meet the individual’s needs. It was also used to develop the home’s care plan. Following admission, the first six weeks were a trial period to allow the placement review to take place. During the visit, a new resident confirmed that they were given sufficient information about the home and the services offered and had visited before accepting the placement. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments involved the individuals to ensure they agreed with the plans put into place. Individuals at Kings House are encouraged to make choices in their daily lives with support available from staff and other agencies. EVIDENCE: The care plans seen were comprehensive and of a good standard. There was evidence that residents had been involved in the care planning process and where a resident had declined to sign the care plan the reasons were noted. The care plans seen, included information on spiritual needs, basic nutritional assessments and individual risk assessments. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 11 The comment cards and discussions with staff and residents showed that the staff do respect the ideas and wishes of the individual. One person commented that help was available from the key worker when decisions were needed. Another commented that although there were restrictions and daily tasks they were not excessive. All the responses showed that the residents enjoyed a good degree of freedom and were able to make decisions about their lifestyles, while support and advice was available within the service or through the other agencies the residents’ were accessing. The home assisted three people with their finances, each has their own account and records were kept. A sample of three personal allowances showed there were records of expenditure and income and copies of receipts. The balances checked matched the recorded balances. The residents are advised of the range of records held during the admission process and there is also information on how they can access their own personal records. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to maintain activities, social interests and relaxation in order to assist them to gain fulfillment. Residents maintain links with their families and friends and are encouraged to seek support and friendship in the wider community. Residents’ rights are respected and they are encouraged to exercise as much control over their daily lives as their circumstances allow. Meals offer choice and variety to encourage a good nutritional intake. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 13 EVIDENCE: The residents at the home have access to a range of activities e.g. cake making, quiz nights, karaoke, exercise sessions, arts and crafts, picnics, boat trips, excursions, adult education, day centres, voluntary work. One person said that she attended a day centre and joins in activities in the home. A notice board in the dining area showed there was an arts evening planned for the weekend. Several people said they enjoyed walking and most were able to walk into the centre of Westborne although a bus service was accessible from outside the house. Resident meetings were a monthly feature and allowed the residents to express their views and ideas. One resident said she was a regular churchgoer and that the staff assisted those people who wanted to attend. The comment cards from relatives and friends showed that the home encouraged residents to maintain links with family and friends. The residents said that there were routines and tasks around the home to be completed they were fairly distributed and they felt they were contributing the communal life of the home. Staff were seen chatting with the residents in a supportive and warm manner. Menus in the home were operated on a four-week rota. The menus were discussed during the monthly meetings allowing the residents to contribute their ideas. The menus showed a good variety of choices with vegetarian options. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of the individuals are considered when the care plans are developed to ensure that they are supported in an appropriate manner. Community healthcare teams are involved with the home to manage the health needs of the residents. The organisation’s medication procedure helps to ensure that risks to residents are minimised. EVIDENCE: As previously stated the care plans seen showed that the residents were involved in the development of the care plans. There was evidence of regular reviews. Residents accessed several local GP practices. If they were new to the area staff assisted them to find a suitable practice. The records showed dental and
Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 15 optical appointments. Residents said that the staff arranged appointments if needed. Comment cards showed the home maintained good links with the community mental health teams. Medication in the home was safely stored and administered. Most medication in the home was supplied in monitored dosage systems by a local chemist who also provided an audit of the system. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home operates a keyworker and a complaints system to ensure that the views of the individuals using the service are taken into account. The organisation has procedures for responding correctly to concerns or allegations of abuse. EVIDENCE: The home’s welcome pack provides residents with information on the complaints procedure and it included contact for the Commission and other agencies. The complaint record had no complaints recorded, none had been received by the Commission. Residents said they were able to raise concerns with the staff. The home had a adult protection policy which was updated in April 2005. There was a policy for whistle blowing. The policy and procedures were accessible to all staff. The staff spoken to were aware of their responsibilities in responding to allegations and signs of abuse. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Kings House provides a safe comfortable and clean environment for the residents and staff. EVIDENCE: Since the last inspection there had been alterations made to reduce the number of shared rooms. Another resident who had been in a shared room had expressed the wish to have her own room and this request had been granted temporarily and progress had been made to make the arrangement permanent. During the tour of the premises two rooms were visited they were clean and well maintained. The rooms, including bathrooms and toilets, had appropriate locks allowing privacy but were accessible to the staff in case of emergency. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 18 Officers from the Fire Service regularly inspect the premises. There had been no recent inspections from Environmental Health. The home’s original laundry area had been converted into a project room providing the residents with an area where they can undertake cooking tasks and arts and crafts. The new laundry was sited away from the food storage and preparation areas. The residents have cleaning responsibilities for their own areas and are also supported by a part time cleaner. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. To meet the needs of the residents the home is staffed by a competent team who receive appropriate training. Staff supervision is a regular feature helping to maintain good standards and identify areas of staff development. EVIDENCE: There had been no staff changes since the last inspection this helped with continuity for the residents. There is a core staff team of 10 people with vacant shifts covered by the home’s own relief workers. The home does use agency staff to cook duties. The files for two staff showed that the recruitment process was completed thoroughly before the member of staff worked in the home. There was also evidence of monthly supervision meetings this was confirmed by the staff seen during the visit. All new staff complete a “Skills for Care” induction programme.
Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 20 The organisation has a comprehensive training programme covering key and specialist subjects to ensure that the staff have the skills and training to meet the needs of the residents. Half the care staff team had started or completed NVQ level 3 in care. The manager had completed NVQ level 4 and the Registered Managers Award. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed for the benefit of the residents and staff. The organisation encourages the residents to be involved in the day-to-day running of the home The health, safety and welfare of service users and staff are protected by suitable policies, procedures and practices at the home. This means that they can be confident of management support and guidance whilst living or working there. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 22 EVIDENCE: The home has a stable workforce and an experienced management team. The organisation has a system of monthly visits to the home to monitor the standards. Resident meetings were held monthly. There was an annual quality assurance survey. Where the residents and other stakeholders were invited to comment on life in the home. The annual review is then used to identify areas for future attention. The homes business plan covered a three-year cycle and was due for review after the next quality assurance survey. The home had arranged for an Occupational Therapy assessment of the residents whose mobility was reducing. Some items of specialist equipment were identified and provided. It was also decided that to improve facilities a walk-in shower room would be provided on the ground floor which will be included in the next business plan. Fire safety inspections and training were in place and up to date. The fire risk assessment was not examined on this occasion. Approved contractors regularly inspected fire safety equipment. Accident and incident reports were monitored locally and by the organisation to check for trends. Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 24 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. Refer to Standard Good Practice Recommendations Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kings House DS0000003951.V316480.R01.S.doc Version 5.2 Page 26 - 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!
