Inspection on 29/08/07 for Kings Lodge

This inspection was carried out on 29th August 2007.

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.

Other inspections for this house

Kings Lodge 29/09/08

Kings Lodge 28/03/07

Kings Lodge 23/05/06

Kings Lodge 20/02/06

Kings Lodge 26/05/05

Kings Lodge 15/11/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Kings Lodge 50 North End Higham Ferrers Northants NN10 8JB Lead Inspector Irene Miller Unannounced Inspection 29th August 2007 13:00 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 Lodge DS0000061540.V341149.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 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 Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kings Lodge Address 50 North End Higham Ferrers Northants NN10 8JB 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) 01933 315321 01992 710401 Mr Claude Fonseka Mrs Viola Fonseka Mrs Patricia Jeffs Care Home 21 Category(ies) of Dementia - over 65 years of age (21), Learning registration, with number disability (1) of places Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person within the category DE (E) can be admitted where there are already 21 persons of category DE (E) already in the home. A named service user within the category of LD may be admitted to the home for a period of not more than 6 weeks. 28th March 2007 Date of last inspection Brief Description of the Service: Kings Lodge provides personal care and support for up to 21 people over the age of 65 years who have a dementia related condition. The home is situated on the outskirts of Higham Ferrers, with public transport links to neighbouring towns. The home is a conversion of a large residential property, with 2 larger communal lounges and 2 smaller sitting rooms. Bedrooms are located on the ground and first floors and a shaft lift provides access to the first floor. There is a garden at the rear of the property, which contains an aviary. The home has been in the hands of the current owners since 2004. The current fees are in the region of £364 per week, with additional charges for hairdressing, chiropody, newspapers, transport and dry cleaning. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is based upon outcomes for people using the services and their views of the service provided. This visit was unannounced and focused on the ‘key standards’ under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for older people. The care of two people living at the home was looked at in depth this involved looking through written information available on their care, such as their individual care plans (a care plan sets out how the home aims to meet a residents healthcare, personal, social and emotional needs). Sample checks were carried out on the homes policies and procedures, staff recruitment records, and the homes medication and quality assurance systems. Records on the general maintenance and upkeep of the facility were viewed, and general observations on the environment were made. Prior to the visit the Commission for Social Care Inspection sent out to the provider a quality assurance tool called an Annual Quality Assurance Assessment (AQAA) to enable the provider to self assess the quality of care provided for people living at the home. The AQAA was returned back to the Commission for Social Care Inspection prior to the unannounced visit taking place, and provided information on the range of services provided at the home, areas that were self assessed as doing well and areas assessed for improvement. Time was spent prior to the visit reviewing information about the home such as the previous inspection report and the homes service history, (the service history details all contact with the home including notifications of events reported by the home, telephone calls, letters, and details of any complaints and concerns received). The registered manager Patricia Jeffs was not available on the day of the visit however the registered provider Mr Claude Fonseka was available throughout the whole of the inspection visit. What the service does well: Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 6 Daily group and individual activities are provided, that are based upon the individual residents preferences, and residents are encouraged and supported to move around the communal areas and have independent and unrestricted access to the enclosed garden. Residents were seen to spend time sitting chatting with each other or listening to music and spending time outdoors. The care plans had sufficient information available for staff to follow to ensure person centred care is provided and that the individual resident’s health, personal care and emotional needs are met. Dementia care training had been provided and general observations of staff interactions were good, staff were seen to treat residents with dignity and respect. In discussion with staff they said that the dementia care training they had been provided with had been very useful in understanding the condition and associated behaviours much better. What has improved since the last inspection? What they could do better: The homes statement of purpose outlined the services available at the home, however there was some factual inaccuracies that needed amending, such as the contact details of the Commission for Social Care Inspection and the organisational structure table still had staff members listed that no longer worked at the home. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 7 The information sheets on the resident’s notice board need to have the information provided to ensure that residents and visitors are aware of when the ‘next visit’ is due by the hairdresser, chiropodist, church visitors, and outside entertainers. Some of the residents living at the home have advanced dementia and verbally communication was difficult in an effort to assess the satisfaction with the service provided, the registered provider is advised to consider the use of established dementia care observation tools to assess the quality of care residents receive and the general state of well being. Some work had taken place to improve the hairdressing facility, however this area was also being used as a storage/clothes drying area, and clothes drying above the boiler posed a possible fire hazard. Work is needed to clear the room of clutter to make it a more pleasant environment. The enclosed courtyard had a bench available but would benefited from having suitable outdoor furniture and container plants to make it a more pleasurable outdoor seating area, as it looked sparse in comparison to the landscaped garden 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 Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 8 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 Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 (standard 6 is not applicable to this service) Quality in this outcome area is good. People planning to use the service can be assured that a full assessment of their healthcare, social and emotional needs will be carried out. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Pre assessment documentation was available within the care plans viewed, which identified the health, personal and emotional needs of the prospective residents. Due to limited verbal communication skills, many of the residents were unable to verbally confirm their views about living at the home the home, however one resident spoke highly of the home and its staff saying that they loved their bedroom and that the staff were very kind and caring. Residents appeared relaxed and free to move around the home as they pleased. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 10 The homes statement of purpose outlined the services available at the home, however there was some factual inaccuracies that needed amending, such as the contact details of the Commission for Social Care Inspection and the organisational structure table still had staff members listed that no longer worked at the home. Contract of care were in place that had been signed by the residents representatives acting on their behalf. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 & 10 Quality in this outcome area is good. People using the service can be assured that their health and personal care needs will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans viewed had current information available on the health and personal care needs of the residents, and there were assessments on the residents dependency levels and capabilities, moving and handling, nutrition, pressure area care and continence management needs. The care plans had been regularly reviewed. There were records available to demonstrate that residents have access to healthcare support and screening, such as the district nurse, general practitioner, optician, chiropodist, dentist and audiologist. Records indicated that changes to the residents healthcare conditions, were followed up and that the appropriate healthcare professionals had been involved. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 12 There were records available on what pressure relieving equipment required for individual residents and pressure-relieving equipment was seen to be in use. Within one of the care plans viewed there was a comprehensive risk assessments in place for the use of bedside rails, however there had been an oversight in not entering the residents name or the date of when the assessment was carried out. In addition to the bedside rails risk assessment the consent of the resident or where this was not possible, their representative had been sought for the use of the equipment. The medication storage and administration records were viewed and were in order and safe systems for the management of controlled medications were being followed. The training records demonstrated that medication training was provided and staff verbally confirmed that they had completed medication training. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 & 15 Quality in this outcome area is good. People using the service have opportunities to pursue their own hobbies and interests and exercise choice and control over their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the afternoon of the visit a group of residents were taking part in a bingo session, and other residents were observed to spend time out in the courtyard or moving around the home as they wished. Residents were seen to spend time sitting chatting with each other or listening to music. During the week an activity person visit’s the residents each afternoon to facilitate group activities. The registered provider explained that he was seeking to employ and activity co-ordinator, however the position remains vacant. On the notice board within the entrance hall there was an activity board on display that had laminated information sheets, with the intention of informing residents on when the ‘next visits’ were due by the hairdresser, chiropodist, Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 14 church visitors, and outside entertainers, however all the dates were blank and served no purpose. Staff training had been provided on Dementia Care and general observations of staff interactions were good, staff were seen to treat residents with dignity and respect. In discussion with staff they said that the dementia care training they had been provided with had been very useful in understanding the condition and associated behaviours much better. Within the main kitchen there was documentation available to demonstrate that menus contained a variety of meals, and choice were offered on an individual basis. There was information on each resident’s lifestyle preferences, hobbies and interests and previous work occupations and there were records of resident’s individual preferences in relation to the type of activity they wished to participate in. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. People using the service can be assured that any concerns they may have will be listened to and acted upon by the registered provider, however systems could be improved to gain feedback on the service from people with advanced dementia and limited verbal communication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within the front entrance to the home there was comment leaflets and a comment box available for residents or visitors to put any comments they have in writing either to the home or direct to the Commission for Social care Inspection. However the leaflets were out of date displaying the ‘National Care Standards Commission’ and the Northampton address, the registered provider removed the leaflets during the visit. Some of the residents living at the home have advanced dementia and therefore were unable to verbally communicate their satisfaction with the service provided, discussion took place with the registered provider on how the home could use established dementia care observation tools to assess the quality of care residents received and their general well being. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 16 Since the last inspection visit one concern had been raised about the home, which the registered provider had carried out a full investigation. No other concerns had been raised with the Commission for Social Care Inspection. Training had been provided on safeguarding vulnerable adults, and on checking the homes annual training plan further training in this area was planned to take place. In discussion with staff they had an awareness of the importance of safeguarding the residents within their care from any abuse and should they have cause to witness or suspect any abuse within the home, they were aware of the reporting procedures. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is good. People using the service are provided with a clean homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During a limited tour of the building the residents rooms viewed had personal items available such as televisions, photographs, pictures and small items of furniture. The communal areas were clean and tidy and to assist in reducing the risks of cross infection.there was hand sanitiser available within the entrance of the home. Some work had taken place on improving the hairdressing facility, however this area was also being used as a storage/clothes drying area, and clothes Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 18 drying above the boiler posed a possible fire hazard. Work is needed to clear the room of clutter to make it a more pleasant environment. Improvements to the garden have created a pleasant outdoor faciity, to include a large log cabin/garden room, fish pond, aviary, gazebo seating area, paved walkway with handrails, flower borders and raised vegetable garden. The fish pond was fully enclosed to ensure the safety of residents and visiting children accessing the garden. The garden is shared with the care home next door, which is owned by the same provider and cares for people with a learning disability. The weather on the day of the visit was warm and sunny and residents were observed accessing the small courtyard garden independently, and access to the main garden was through a wrought iron gate, the staff were asked if many residents independently accessed the main garden they said that residents used it more when accompanied by staff. The courtyard had a bench available but would have benefited from having suitable outdoor furniture and container plants to make it a more pleasurable outdoor seating area, as it looked sparse in comparison to the landscaped garden Risk assessments had been carried out for 1st floor windows that did not have window restrictors fitted. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 & 30 Quality in this outcome area is good. The staff team are trained and competent to carry out their duties. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of inspection there were eighteen residents at the home supported by three care staff, one domestic and one cook. There was a commitment to staff achieving a National Vocational Qualification (NVQ) level 2 and 3 and the home has met the National Minimum Standards target of 50 of staff being trained to this standard. On the day of the visit there was an induction session taking place for staff that was to embark on NVQ training with assessors from a local college. The recruitment files of two newly appointed staff were viewed and documentation available within the files demonstrated that improvements had taken place in recruitment practices. There was evidence of criminal records bureau clearances (CRB) and protection of vulnerable adults clearances (POVA 1st) having been obtained prior to staff taking up employment at the home. The homes annual training plan was viewed that identified individual staff training needs. There was records of staff induction training and ongoing Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 20 training to include, dementia care and management of challenging behaviour, medication management, fire safety, food hygiene, moving and handling and safeguarding adults. There were records of one to one staff supervision being provided that demonstrated supervision is an ongoing process within the home. In discussion with staff they confirmed that they had ‘lots of training’ provided, and that help and support had been provided on literacy skills where required in order to achieve further qualifications. Observations of staff indicated that the staff spend time with residents to provide support and to promote well being. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35 & 38 Quality in this outcome area is good. Improvements have been made in meeting requirements set from the previous inspection to ensure that residents live in a home that promotes their health, safety and welfare. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From the care records looked at and through discussions with staff and observations of care practices it was demonstrated that the home is run and managed in the best interests of residents. Kings Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 22 There is has been a commitment to fully meet the requirements set following the previous inspection visit, and improvements have been made to ensure that residents live in a home that promotes their health, safety and welfare. Risk assessments were in place to identify and manage environmental hazards to residents and based upon understanding and capabilities, the assessments were closely monitored and reviewed which demonstrated that there was a proactive approach to risk management. In discussion with staff they said that there had been a significant reduction of falls accidents. The system in place for gaining feedback from residents was in the form of written surveys, discussion took place with the registered provider on how the home could further improve in this area by using recognised dementia care observation tools to record the well being of residents who are unable to communicate verbally. Money held on behalf of residents was stored securely and records of accounts kept. There was a commitment to staff training and development, there was an annual training plan in place and records were available of mandatory training and vocational training that had been provided. . Kings Lodge DS0000061540.V341149.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 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 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 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 3 X X 3 Kings Lodge DS0000061540.V341149.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 Lodge DS0000061540.V341149.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Lodge DS0000061540.V341149.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!