Inspection on 25/04/07 for Kingscourt

This inspection was carried out on 25th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingscourt 27/10/06

Kingscourt 16/11/05

Kingscourt 12/07/05

Kingscourt 02/03/05

Kingscourt 12/10/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Kingscourt 100/102 Kings Drive Bishopston Bristol BS7 8JH Lead Inspector Sarah Webb Unannounced Inspection 25th April 2007 09:30 Kingscourt DS0000040011.V339675.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 Kingscourt DS0000040011.V339675.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. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingscourt Address 100/102 Kings Drive Bishopston Bristol BS7 8JH 077680 94473 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) Supported Independence Ms Nicola Jane Stanworth Ms Catherine Twine Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate up to 11 persons with Learning Disabilities aged 19 to 64 years. The shared management arrangements will be reviewed no later than one year from the issue of the certificate. 27th October 2006 Date of last inspection Brief Description of the Service: Kings Court is registered with the Commission for Social Care Inspection as a care home for up to eleven people with a learning disability. The home is able to accommodate people aged 18 to 64. The home is based in two adjoining semi detached houses in a residential area in North Bristol. It is approximately a quarter of a mile to local shops and a variety of community facilities. Public transport links (buses) are available in Kings Drive close to the home. All people have to be physically able as the home is based over three floors with stairs being the sole means of access to each floor. There are three ground floor bedrooms. The home has four services under the umbrella of Supported Independence including Kings Court. The other services are for people who wish to live within more independent housing. Kings Court is presently the only service registered with the Commission for Social Care Inspection as personal care is offered to one or more people. The philosophy of care for Supported Independence is that a continuum of care is available to provide people with an opportunity to progress towards greater levels of independence from within a consistent and planned environment. The cost of placement at the home is £700-1000 per week, and additional charges are made for hairdressing, toiletries, some activities and holiday spending money. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out without prior notification and was conducted by one inspector over 2 days. Before the visit, accumulated information about the home was reviewed. This included looking at the number of reported accidents and incidents, a pre inspection questionnaire, and a complaint made by a family regarding the care of their relative. This information was used to plan the inspection visit. Three people using the service were case tracked to assess whether they receive good quality care that meets their individual needs. Where appropriate, issues relating to the cultural and diverse needs of people and staff were considered. There was an opportunity to view some areas of the home and examine a number of the records. This included the homes assessment and care planning processes, reviews of the care for people using the service and records relating to the general safety and the running of the home. The views of the people using the service were gathered through face- to- face discussions and by surveys; staff spoken with included the Director of the organisation, the Operational Manager, the Home Manager and a senior staff member, all of whom were helpful during the course of the inspection. What the service does well: The home provides comprehensive information for prospective people to make a choice whether to move to the home. Staff are provided with comprehensive information in order that they can meet peoples assessed needs. People are supported well in accessing individual opportunities to lead active and fulfilled lifestyles that are both appropriate and reflect their levels of independence; people are offered a wide range of meaningful activities to live a varied and fulfilling life with the support of staff. They are encouraged and supported to live as a part of the local community. People benefit from good working relationships the home has built with professionals and external agencies so that people are supported and their needs met. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 7 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 Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 8 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): 1, 2, 3, 4 & 5 People who use the service experience good quality outcomes in this area. We have made a judgement using a range of evidence, including a visit to this service. People who use services have suitable information to make a decision on whether to move to the home and can try out services prior to making a decision. The needs of people living at the home are assessed to ensure that their needs can be met. EVIDENCE: The Statement of Purpose has been reviewed together with ‘A Guide to Living at Kings Court’; the guide is given to prospective people referred to Kings Court. The Statement of Purpose contains sufficient information and informs prospective people and their representatives so that they can make a choice about living at the home. It covers areas including the aims and objectives of the home to the admission process, accommodation, social and leisure activities, staffing and consultation processes. Since the inspection, and following a review of all registration certificates, a new certificate has been discussed with the Director. This has also been amended to reflect a recent increase in the number of people receiving a service. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 9 The ‘Guide to Living at Kings Court’ provides detailed informative as to how a referral is made and visiting the home, to the house rules of the home. People are expected to adhere to the house rules and have to sign these to agree as part of their contract. The Manager and Director said that the house rules are explained to people before they are placed. This is acceptable if people have an understanding of the rules and the consequences if they are broken, however it would be difficult for staff to evidence that those prospective people who may need specific communication support understand the outcome of the rules. The issue of the homes house rules have also been looked at under ‘Individual Needs and Choices’ - Standard’s 7 & 8. The home completes a comprehensive assessment of individuals care needs and information for the staff to follow in relation to how people should be supported. The Manager said assessments carried out by funding authorities and information gathered from families and professionals involved in their care inform the home’s plan of care. There have been 2 new people who have been admitted to the home since the last inspection. Both people visited and had a meal prior to being placed and 1 person had an overnight stay so that they can try out the home. There were assessments and care plans carried out by both the placing authorities, and the home. A 3 month trial period is offered after which a review is held to determine that this is the right choice of home and that the home can meet their needs. Examination of 3 peoples care plans indicated that their care needs are met. This was also indicated through discussion with external professionals both placing and supporting people living at the home. A survey returned by a specialist service stated that if the home “ was not meeting needs it is identified quickly and alternatives are sought” and “ on one occasion when a placement did not work out the service user was listened to and supported in finding alternative options.” Two family members spoken with stated they are happy with the care and support offered by the home and that their relatives needs are met fully. This was also reinforced by surveys returned from 6 families. Kingscourt DS0000040011.V339675.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, 8, & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are consulted and participate in all aspects of life in the home through the involvement of the daily running of the home; they are able to take assessed risks as part of an independent lifestyle. However some of the ‘house rules’ inhibit peoples’ independence and in making decisions about choice. EVIDENCE: Plans of care examined contained information through profiles, daily routines and how individuals are supported. Specific areas of care included daily living skills, self care, risk factors, occupation/leisure and relationships. People are involved in the review of their care with care plans signed by individuals indicating their involvement. A person spoken with had a good knowledge of what was included in their care plan and how this supported them with their personal development. The Manager is aware of the need to promote and improve person centred accessible formats for those people who need support in understanding written Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 11 documentation; she said she has started to investigate differing formats and showed the inspector a symbolised communication system she has received. People have 1: 1 supervision with their key worker, who play an important role in ensuring their general welfare is maintained. The Manager said these meetings encourage people to say how they feel. A member of staff also said this is an active practice in supporting people to speak up and keep an ongoing review of their care. A record of the meeting is kept and both parties sign their agreement of the notes made. Individual daily diaries also record peoples activities during the day and their general welfare. Minutes of house meetings held identified that people make decisions and are consulted about activities, holidays, choice of food and the routines of the house. The Director said that the organisation also plans a yearly meeting with all people receiving a service through the organisation. This gives people an opportunity to discuss any issues and to inform the organisation of any changes that need to be made. The Director said the meeting also involves speakers and gives people relevant information. Both the Director and Manager said ‘house rules’, as set out in the ‘Guide to Living at Kings Court’ are guidelines and are based on the ethos of respecting others. It was evident that some of the house rules do respond to this philosophy, such as asking people to use their televisions and stereos at a low volume and that any form of bullying will not be tolerated. However it was also evident that some of the rules can restrict peoples’ choice as there is an expectation that people retire to bedrooms at 10.00pm. Through discussion with one person it was identified that they had been unhappy with this rule and they have ‘negotiated’ that they now stay up in the communal lounge until they are ready to go to bed. The Director said this rule is also flexible and that people do sometimes stay up to watch television programmes as long as the staff on duty is happy for this to happen. It was evident this rule is dictated through staffing as there are only 2 staff on duty till 10.00pm. After 10.00pm 1 staff member sleeps in on site. The Director said that if anyone wanted to be able to stay up after 10 on a regular basis then this would need to be presented to their funding authority for an increase in their care package. A person spoken with said they felt the house rules should be “flexible.” An incident regarding a person leaving the home during the night was discussed with the Manager. There were specific procedures recorded that were followed by staff when they left the premises, and staff were satisfied that they knew areas in the local community and were able to complete journeys safely. The Manager said levels of risk were identified and discussed with this person’s placing authority. This person has now left the service. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 12 Care records of those people currently living at the home evidenced risk assessments are carried out so that people are supported in taking risks within a risk management strategy to help them to be kept safe; these also did not appear to stop people from any being involved in differing activities. A professional supporting the placement of an individual, visited during the day to agree with the review of risk assessments carried out by the home. This is good practice identifying that the home is working with external agencies within a multi disciplinary approach. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 13 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, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from an environment that encourages personal development and independence. People are well supported to take part in a range of appropriate activities and are encouraged and supported to be a part of the community. Staff help to maintain their family relationships. EVIDENCE: People are offered varied opportunities to join in with meaningful and appropriate activities. These include attending college placements, day services, and gardening projects and work. Discussion with an individual identified that they enjoy their life at Kings Court and that people have active lifestyles. From talking with staff, the Manager and people using the service it is clear that the home supports individuals to be as independent as possible with some people moving to independent settings within the organisation. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 14 However the Manager said there are also some people living at Kings Court who regard this to be their home and will not necessarily move on. A care file of an individual reinforced this view indicating their ongoing support needs. This raises issues regarding those people who live at the home on a permanent basis, and who may see constant changes with people moving in and out of their home on a regular basis and whether they are happy for this to happen. This was discussed with the Director who stated that a review of the service is being planned. The organisation provides activities for people when college courses and day services are shut. People are consulted on social activities both in the home and the community. Discussion with an individual spoken with, indicated that people have access to regular social outings in the local community including the theatre, cinema, swimming, and various trips. It was evident that the home offers a wide range of activities to suit individuals’ lifestyles. People have the opportunity to go on two holidays a year- one of which is paid by the organisation and is part of the contract. The second holiday people are expected to pay for themselves and people are encouraged to save towards this. Holidays are discussed at house meetings and one person said they were looking forward to going on holiday this year; they said they have been talking about going to Tunisia and Butlins. The Manager said she brings differing brochures in for people to look at to help people decide themselves. This was also reinforced by individuals spoken with. The Manager said peoples’ needs are respected; a holiday last year was unsuccessful for an individual and they were supported to return to the home. The home provides transport for people as and when necessary and if they are unable to access public transport; however people are encouraged to be independent and use public transport as much as possible. The Manager said the home do not charge people for transport used by the home as transport charges are included in the cost of the placement. Those people using public transport use bus passes. Discussion with two relatives identified that people are supported to maintain friendships and family members are welcomed into the home at any time. On the day of the inspection a relative visited unannounced and was made welcome. It was evident that the has developed good relationships with families; this was also identified through surveys returned by relatives A person spoken with explained the routines of the home and their involvement in household chores; several people were also observed carrying out specific cleaning tasks. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 15 There are two kitchens available for people to prepare and have support with cooking meals; one is considered a ‘training’ kitchen and is used more for those people who want to increase their independence skills. A midday meal was had with several people. An individual confirmed they take part in the cooking and the cleaning of the home and went into detail their involvement in the making of bread. Menus identified that people have access to a varied and nutritious diet. From the records it was evident that individuals were encouraged to make choices on what to eat and are offered alternatives. It was also noted that people had agreed not to have a pudding during the week days but was relaxed at the weekend. In response to the issue of choice and people learning to take responsibility for their own action the manager said that individuals had spending money during the week and they could buy themselves anything they wanted. People are expected to stay at the table for the duration of the main meal and until people have finished their meal. The Manager said this is to make people aware of ‘etiquette’ when accessing the community. A person spoken with said that they found this restrictive and that this can sometimes last for some time as some people take there time with eating. The Manager said people are able to leave the table when the majority of people have finished their meal. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 16 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. People receive the help they require with their healthcare needs, and medication systems are safe. However, although some peoples’ preferences in relation to their personal support needs are not being met, there are strategies in place to minimize risks. EVIDENCE: A recent complaint from a family has said that their relatives care needs were unmet. Through discussion with both the Manager and Director, and examination of records this has identified some areas of concern in that the home did have difficulty in addressing some areas of this person’s needs. It was evident that the funding authority were involved in decisions relating to this person’s care; however there have been conflicting views expressed by the family. Care documentation, daily records and discussion with staff demonstrated that the health care needs of those people living at the home are being met, involving both health professionals and specialist services such as speech therapists, psychologist and other appropriate agencies. Information recorded in peoples care records indicated medical visits, and appointments with dentist, optician and chiropody. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 17 Daily records gave information relating to the monitoring of peoples health, including weight gain. A staff member spoken to conveyed that the home also provides emotional and spiritual support as well as monitoring peoples physical health. It was observed that staff respect peoples privacy when they knocked on an individual’s door several times before getting a response and entering their room. Staff expect people to be up and dressed ready for their day activities by 8.00 am each morning. This is stated in the ‘The guide to living at Kings Court’. However on the day of this visit one person was having a ‘lie in’ as they were not attending their day service. They said they are treated well by staff and are happy with the care and support offered. A staff member spoken with was familiar with the information in peoples care plans, and how best to support people with their care needs. Staff are aware of the need to support people with any personal care with the appropriate staff gender, however this has not always been the case. Care files indicated that an individual required a female key worker to support them due to their personal care needs, but was originally offered a male key worker. This was changed after this was requested by the family. It was also stated in another persons care plan that a female staff is required to meet their personal support needs; it is evident that although this person has a female key worker there are occasions when their care needs are provided by a male. The home’s support plans identified agreed risk assessments that have been discussed with the funding authority. The Manager is aware of the need to recruit more female staff, in order that peoples’ preferences in relation to personal support needs are met. The home is responding by taking appropriate action through recruitment. The procedures and systems in place for administration, storage and disposal of medication were checked to monitor if the systems are safe. Medication is included in peoples care plans. There are no people who self medicate. The medication administration charts were looked at and were up to date, legible and in good order. There was a photograph of the person maintained with each record. Two staff administer medication while one staff signs medication administration charts; a record is kept of the reasons for any omissions. Staff administering medication complete in house training and ‘safe handling of medicines’ at a local college. The stock of medication held was satisfactorily organised. A record is kept of medication that is no longer required and is returned to the pharmacist. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. People are well supported to make complaints and express concerns about the service. Although the home now has appropriate procedures in place to help protect people from financial abuse, there are still some areas that are in need of being improved. EVIDENCE: The home has a complaints policy and procedure and keeps a record of complaints made with relevant correspondence in place. Discussion was had with the manager in relation to recording some of the information in a different format. A family has made a recent complaint and elements of this complaint were looked at whilst carrying out this inspection and this has been recorded in Standards 9, 18, 19, and 23. The Manager said the home highlights the complaints procedure at house meetings periodically. This is good practice and helps reinforce that people can make a complaint or express a concern and that they will be supported. The home is aware of safeguarding adults procedures and have recently referred an individual through this process. Care plans identified that for some people there are behavioural management strategies recorded. The manager said there are currently no people who have behavioural issues that may result in physical intervention from staff. Training records identified that staff are trained through Control and Restraint General Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 19 Services(CRGS) and that this is updated 12 monthly. However training records did not evidence that all staff have attended an update. The Manager explained a new proforma that is used to provide information relating to any incidents people may be involved in that presented physical challenges and that results in staff using restraint /breakaway techniques. This included triggers associated with the escalation of behaviour and how staff responded. The home informs us of any incidents relating to the safety of people with action taken. The home has a missing persons policy and individual procedures in place if people are missing from the home. People have their own bank accounts; there is one person whom is subject to Guardianship with appropriate procedures in place. Although records are kept of the management of peoples’ personal allowance, the home has never kept receipts for those people who may need support with their finances and to ensure people are kept safe from financial abuse. A recent complaint has also highlighted poor practice in relation to the recording of an individual’s finances and that the home needs to improve in areas of financial management. Through examination of financial documentation and records it is evident that the home has not practiced a robust financial practice. However the home has responded by producing a new policy and procedure that is now in place in supporting people to manage all aspects of their finances. Although the home is now keeping receipts for financial expenditure it was evident that the recording systems will be improved if all receipts are numbered to correspond with balance sheets. This practice will also ensure peoples finances can be case tracked more fully and robustly. The Manager said it is her responsibility to check peoples financial documentation monthly and although the organisations finances are audited externally there is no evidence that individuals finances is also audited externally. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 20 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, 26, 27, 28, & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a homely environment with some communal redecoration started; however people would benefit from further planned redecoration to incorporate their rooms. EVIDENCE: Kings Court is two semi-detached houses that have been converted into one property. The home is located near to local amenities, bus routes and relevant support services such as day resource centres and leisure centres. The home accommodates up to 11 people, and the bedrooms are split between the three floors. The home has recently made an application for a variation to increase the homes occupancy to 12 people. The home does not have a lift and is therefore only able to accommodate anyone with mobility impairment on the ground floor. Communal areas of the home are comfortably furnished. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 21 The home has started a redecoration programme in response to a recommendation from the previous inspection. Progress is being made to decorate the hallways and stairways through the house and although there are still areas that need to be completed, this has generally given a lighter appearance to the home. A breakfast room has also been decorated. The home has recently employed a cleaner for 10 hours a week; the home was generally clean and tidy. A tour of the home was made but only 4 peoples bedrooms were seen. All but one bedroom has a bath, wash hand basin and toilet. A bedroom on the ground floor was looked at; the room contained personal possessions and was furnished sufficiently. It was noted that the bedroom would benefit from redecoration. The ceiling and wallpaper in their en suite facility was also damaged due to an upper floor water leak and must be repaired. Another person showed their room and said there was a slight problem with the water flow in their basin and the toilet flush in their en suite facility. This was reported to the manager. They also said that their room had not been decorated since they had moved to the home. A third person’s room was seen and they stated that they were satisfied with the room provided. The Manager said she was due to meet with the director to include a planned schedule of bedroom redecoration into the homes business plan. The 4th room seen was vacant, had been decorated and was in the process of being furnished. Since the last inspection a new shower room has been located on the ground floor for easier access. It was noted that there was an area of discolouration in a corner of the tiling. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are well looked after by a caring staff team who are well supported by the manager, and are skilled and competent to undertake their role. People benefit from a robust recruitment process to ensure their safety and protection. EVIDENCE: A member of staff spoken with described their previous related experience. They had a good understanding of their role and responsibilities and related their skills and knowledge. They gave examples of relationship building with people and how they supported people with their development. Two staff are in the process of completing National Vocational Qualification Level 3, whilst 3 other staff are due to be registered to also complete this qualification. The staffing rota indicated that there are 3 staff on duty during the morning (8.00am- 10.30am). This then reverts to 2 staff until 3.00pm when there are 3 staff on duty till 10.00pm. There is a slight change at weekends. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 23 As previously recorded in the text of Standard 7, there is 1 staff member who covers sleeping in duties. However an individuals care files evidenced that the home increased staffing at night for a period when their needs changed and to ensure their safety. The Manager said agency staff are only used when permanent staff are unable to work and that usually both bank staff and the homes permanent staff team cover most vacant shifts. The Manager explained the homes recruitment practice and 4 staffing files seen indicated that all had been through interview process, having been short listed by application, and with 2 references taken up. Documentation also evidenced that staff had been police checked through the Criminal Records Bureau and that there are appropriate processes in place to ensure the safety of people living at the home. As previously recorded in the text of Standard 18 the home is in the process of recruiting 2 new staff. Staff undergo an organisational induction that includes information on the role, responsibilities, policies and procedures. This was also evidenced through discussion with a staff member who went into detail about their induction. The home uses the ‘Skills for Care’ induction standards over a 12 week period; mandatory training is also completed during this time. The Manager is an ‘ambassador’ for ‘Skills for Care’ and is involved in instructing staff in the development of their portfolios. This is good practice in supporting staff in recording their personal development. Staffing records seen identified that staff have completed updates in mandatory training such as first aid, food hygiene, manual handling, and fire safety. Several staff have also completed fire marshalling training. Staff records also indicated that other areas of training completed include sexuality, mental health awareness, assertive communication, risk assessing and autism. However some areas of staff training records need to be up updated reflecting staff training needs that have been met. Staff also have identified skills in specific areas, including sexuality, where one staff works closely and are supported by a psychologist. Another staff member is linked to mobility issues; an occupational therapist has trained staff on the use of specific equipment and in maintaining an individual’s independence. This is good practice. The Manager has successfully completed a trainers course in implementing training for staff in the Safeguarding Adults. Records evidenced that all staff have received training in this area. The Operational Manager who is currently responsible for the identified needs of staff training in the organisation was able to show a current training and development plan. Staff meeting minutes were seen and indicated fortnightly meetings take place. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 24 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, 38, 41, & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from an ‘open’ management approach with systems in place that safeguard and protect the health and safety of those living and working at the home. People benefit from the homes process where they can share their views and contribute to the management of the home. EVIDENCE: Catherine Twine is the director of the organisation Supported Independence; Jacqueline Mears is an Operational Manager organising training and implementing policies and procedures and contracts. She is also Line Manager to Nicola Stanworth, the Home Manager, and carries out monthly visits to the home reporting on all aspects of the homes management. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 25 Nicky Stanworth has completed both National Vocational Qualification level 4 and Registered Managers Award. The registered managers position is that of a shared role with the Director Catherine Twine. Both written surveys from families, and vocal feedback from professionals and families indicated that Ms Stanworth is well thought of and that she considers the best interests of the people receiving a service. Her management of the home was commended by all those people spoken. The home has processes in place to review the quality of care. The Operational Manager stated questionnaires are sent to individuals annually and that a recent SWOT (strengths, weaknesses, opportunities and threats) analysis was carried out in order to identify how the organisation can improve peoples care. Feedback is also gained from an annual strategic day, house meetings, peoples’ weekly supervision, and annual reviews. The fire logbook record showed that the range of required fire safety checks were being carried out and were up to date helping to ensure the safety of people inside the building is maintained. All staff attend both fire training and regular fire drills. Other records seen identified that service contracts were up to date including, gas and electrical services. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 26 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 x 26 2 27 2 28 3 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 x x 3 x Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 27 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. 2. Standard YA23 Regulation Sched 4 23(2) Requirement Ensure staff training records are kept up to date with current information. Repair damaged ceiling in en suite area of an individual’s room and peeling wallpaper in another persons en suite. Timescale for action 31/07/07 31/07/07 YA24 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. 4. Refer to Standard YA7 YA18 YA23 YA23 Good Practice Recommendations Review aspects of the homes ‘house rules’ in respect of maximizing peoples’ choice. Review staffing levels in relation to gender preferences. Number receipts to correspond with balance sheets so that finances can be case tracked fully. Ensure peoples’ finances are monitored through visits made to the home by the operational manager. Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Kingscourt DS0000040011.V339675.R01.S.doc Version 5.2 Page 29 - 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. 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