Inspection on 08/08/05 for Kingsclear Nursing And Residential Home

This inspection was carried out on 8th August 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.

Other inspections for this house

Kingsclear Nursing And... 31/01/08

Kingsclear Nursing And... 14/06/06

Kingsclear Nursing And... 22/11/05

Kingsclear Nursing And... 09/12/04

Kingsclear Nursing And... 28/07/04

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The Shelley

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Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Kingsclear Nursing & Residential Home Park Road Camberley Surrey GU15 2LN Lead Inspector Mavis Clahar Announced 8 August 2005 @ 9:00am 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. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Kingsclear Nursing and Residential Home Address Park Road Camberley Surrey GU15 2LN 01206 828290 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) Kingsclear House Limited Susan Mary Allen CRH - Care Home 72 Category(ies) of DE(E) Dementia - over 65 (7) registration, with number LD(E) Learning Disability - over 65 (1) of places OP Old Age (72) Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 - 52 beds providing nursing care for elderly people from the age of 60 years. 2 - The number of persons for whom residential accommodation with both board and personal care is provided at any one time shall not exceed 20. 3 - Of the 72 service users accommodated up to 7 may be in the category DE(E) Dementia over 65 and one in the category LD(E) Learning Disability over 65. Date of last inspection 9 December 2004 Brief Description of the Service: Kingsclear is a privately owned residential and nursing home located in an exclusive area close to the town centre of Camberley. The main house was originally built as a private residence, and in 1958 it became a Home for Elderly Gentle Folk under the auspices of the Frimley and Camberley Old Folks Association and the Urban District Committee. The home, an Edwardian house is set in approximately 7 acres of land, partially laid to lawn and surrounded by its own woodlands, is owned by Caring Homes Ltd., a private company and operated as Kingsclear House Ltd. The home benefits from a blend of traditional and purpose built accommodation spread over three floors, to 52 older people who are in need of nursing care, and 20 older people who are in need of personal care. Of these up to 7 older people may be in need of dementia care, and one older person who has a learning disability.The home is divided into five operational units, Ash, House, Lower Meadowcroft, Meadowcroft and Wellard. All areas are wheelchair accessible. The majority of bedrooms are single rooms ten of which have en-suite facilities. There is one double bedroom for husband and wife.There are five lounges and a main dining room, but dining areas are provided on all upper floors as an extension of the lounges. Additionally there is a conservatory, and Activities room and special hair dressing/therapy room all situated on the ground floor. Lifts are available for the use and comfort of service users.There is ample car parking facilities at the home. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection to be undertaken in the Commission for Social care Inspection year April 2005 to March 2006. This inspection was announced and was carried out on the 6th August 2005. There were notices displayed over the home advertising this inspection visit, and requesting any one who would like to speak with the inspector to visit the home. On the day of inspection the inspector saw only one visitor who had no desire to speak with the inspector on matters regarding the home. However, there were two senior employees from Caring Homes who wanted to be involved in the inspection. The inspection lasted eight and one half hours. The first part of the inspection was spent discussing the new inspection and report format, reviewing service users files, care workers files, in particular new care workers training records. Some time was spent discussing the reasons for the high turnover of staff since the last inspection. A list of staff leaving and the reasons for leaving was presented. The majority of leavers went on to improve their caring skills. The second part was spent visiting with service users, gaining an insight into their lives at the home from their perspectives, and observing service user/carer interaction. Time was also spent talking with care workers. This was followed by a tour of the home. Feedback on the inspection was given to the Manager of the home. Service users and care workers spoken to on the day of inspection were happy about the conduct and management of the home. What the service does well: The home has a very good training system, which is well documented. The training is the responsibility of the regional training manager, but the home has appointed one of their Registered Nurses to be the training co-ordinator for the home. Self-monitoring of work carried out in the home is given high priority. An independent company achieves this through questionnaires sent to service users, relatives and staff. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 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 Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 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 2 3 The home was found to be working well in respect of the standards inspected. EVIDENCE: The statement of purpose and service users guide has been recently updated to reflect the change of staff. Random review of service users files each revealed a contract of terms and conditions of the home, including extras that service users will have to pay for. The files also revealed that service users are assessed prior to coming into the home. A care plan is drawn up from this assessment. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 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 9 The health and personal health care needs of the service users are met with evidence of good care planning and documented delivery. EVIDENCE: Review of service users files demonstrate that a comprehensive plan of care was drawn up from the assessment. Care workers spoken to were aware of the service users’ assessed needs, and worked in accordance with care plans and risk assessments. On the day of inspection only one service user was risked assessed as capable to self-administer their medication. A locked container was made available for service users to keep their medication. Medication to all other service users in the home is administered by a Registered Nurse in line with the Nursing and Midwifery Council’s guidelines on administering of medication. Service user who said, “I have my medication three times per day and I am sometimes woken up to take them, also supported this. They put them in my hand and give me a drink of water”. Random review of medication records found medication given were signed and dated. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 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) 12 13 14 15 The home was found to be working well in respect of these standards. EVIDENCE: Service users spoken to on the day of inspection were very happy and contented with their life at the home. One service user said, “After being cared for at home for thirty years I was very apprehensive about coming in here, but the nurses are so kind, they make me feel at home. There is nothing they would not do for me to make my life more comfortable. The other day I was taken out into the garden, the first time I have spent time outside for many years”. Both the full and part time activities co-ordinators have resigned. The manager informed the inspector she is having problems filling these posts with the right individuals. A third advert is due to go out later this week. In the meantime outside entertainment is bought into the home, and staff do some work with the service users. The inspector did not observe any activities being carried out with the service users. It is documented that all the service users excepting one has contact with their relatives. However, on the day of inspection the inspector saw one visitor who was sitting in the garden with the service user. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 Page 11 Service users are encouraged to make choices and control their lives as documented in their care plans. During discussions the manager identified an area where greater effort could be made in involving the service users to become more fully involved in the menu planning with the chef. Meals are served three times per day, with a hot meal always for lunch except in the very hot weather. Snacks and drinks are served throughout the day. Should a service user request food at night, the staff on duty have all undertaken food hygiene, which equips them to make a simple meal for the service user. Meals are served in the dining room down stairs and in the lounges upstairs which double as dining rooms. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 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 standard(s) 18 Care workers files demonstrated that they are trained to recognise and report all incidents of suspected or actual abuse to service users. EVIDENCE: All new care workers have had or are undergoing induction, which includes an introduction to recognising abuse, and how to report any actual or suspected abuse to service users. Care workers spoken to on the day of inspection were aware of their role in protecting service users from abuse, knew what was meant by whistle blowing, and knew where to find the homes copy of adult protection policy. The manager informed the inspector that the home has not received any complaints since the last inspection. The complaints book supported this statement. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 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 standard(s) 19 22 23 The standard of décor in this home is good with evidence of continued improvement through maintenance and future planning. EVIDENCE: Service users live in a clean and well-maintained home. In one unit of the home there is a strong smell of cheese. This was discussed with the manager who accepted there is the cheese smell and that she had various people in but they are unable to find the cause. She is continuing to investigate this. The grounds and gardens are in excellent condition. The Manager and service users are vociferous in their praise of the maintenance person, whom I was informed will be leaving. The home has a wide range of specialist equipment in good working order suitable for the needs of the service users. From service users files it was shown that service users are risked assessed for the use of bed rails. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 Page 14 The company furnishes Service users bedrooms. However, the inspector noticed that many of the service users had personalised their bedrooms with their favourite paintings, family photographs and soft furnishing. Service users informed the inspector that they were very comfortable with their bedrooms. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 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 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 30 The service users needs are not always being met with the number and skill mix of staff on duty, EVIDENCE: Care workers files reviewed demonstrated up to date and continuing training and development. It was obvious the home placed training and development of care workers on a high priority. The manager informed the inspector that staffs move on as soon as the home enables them to achieve their NVQ L2, which has resulted in the high staff turn over and the low percentage of carers with NVQ qualifications. Currently the majority of care workers are from overseas. They need Basic English, which the home is providing before they can be put forward to undertake the TOPPS induction programme before they can be put forward for the NVQL2 course. The inspector noted that in one lounge, there were no carers with the service users, and one of the service users was asking to be taken to the bathroom urgently. It was soon made clear by one care worker returning to the lounge that her and another carer were covering the unit and that they were attending to another service user in the bathroom. The other carer was with the service user in the bathroom. The carer explained to the service user that it needed two people to get her to the bathroom and that she would be taken to the bathroom as soon as the other carer was available. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 Page 16 The off duty rota for May and August were reviewed, and although it was documented that regularly there are nine care workers and three Registered nurses on duty during the day shift, it is the opinion of the inspector, based on observation of service users needs and available care workers to meet these needs that due to the frailty of the service users the manager needs to re-think the staffing levels based on the health and care needs and mobility of the service users. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 38 The manager is well supported by senior staff within the company in providing clear leadership throughout the home. EVIDENCE: Documentations within the home such as recruitment, recognising and reporting of abuse, updating of knowledge, moving and handling all provide evidence that service users and care workers safety and welfare are crucial to the smooth running of the home. The inspector was informed that the home holds regular residents meetings for which minutes are kept. The home conducts quality audit on a yearly basis. This is done through the use of questionnaires to service users, relatives and staff. This is monitored by the marketing department of the company and is analysed by a private company. A copy was not available on the day of inspection, as this years’ survey is not yet complete. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 3 3 x x x STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x 3 x x x x 3 Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 Page 19 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 27 Regulation 18 Requirement Ensure that at all times suitable qualified, competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of service users. Timescale for action 8.11.05 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. 2. Refer to Standard 14 27 Good Practice Recommendations Encourage and enable service users to become more involved in making choices. To train care workers in Dementia Care. Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Kingsclear Nursing & Residential Home H58 H09 S17620 Kingsclear V234156 080805 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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