Inspection on 13/12/05 for Kingscourt Nursing Home

This inspection was carried out on 13th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kingscourt Nursing Home 15/05/07

Kingscourt Nursing Home 20/07/06

Kingscourt Nursing Home 13/07/05

Kingscourt Nursing Home 14/02/05

Kingscourt Nursing Home 20/05/04

Kingscourt Nursing Home 26/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Kingscourt Nursing Home 12 Newton Lane Hoole Chester Cheshire CH2 3RB Lead Inspector Wendy Smith Unannounced Inspection 13th December 2005 10:15 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 Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kingscourt Nursing Home Address 12 Newton Lane Hoole Chester Cheshire CH2 3RB 01244 313201 01244 350133 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) Brookaid Limited Lindsey Elizabeth Unsworth Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home is registered for a maximum of 37 service users in the category OP (Old age, not falling within any other category) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection 13th July 2005 3. Date of last inspection Brief Description of the Service: Kingscourt Nursing Home is a purpose built three storey property situated in its own grounds on the outskirts of Chester city centre and close to local amenities in Hoole. It is convenient for the local bus service. Bedrooms are on three floors and there are 37 single rooms, 20 of which have en-suite facilities. Day space is on the ground floor and consists of a large lounge, and a dining room with a conservatory leading off. There is an enclosed garden at the rear of the property. A passenger lift provides access to all floors. Assisted bathing facilities are provided on all floors. Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three and a quarter hours on 13th December 2005 as part of the Commission for Social Care Inspection annual inspection programme. 36 residents were living at the home. Ten were receiving personal care and 26 were receiving nursing care. The home changed ownership earlier in 2005 and has a new manager and a number of new staff. A number of the key national minimum standards were inspected, and found to be met in full at the last inspection, which was carried out on 13th July 2005. A tour of the building, including communal areas and some bedrooms, was completed. Time was spent in conversation with the home manager and the deputy manager. Several residents and staff were also spoken with. The arrangements for medicines and for handling residents’ personal money were inspected. Maintenance records were reviewed. What the service does well: What has improved since the last inspection? A monitored dosage system has replaced the previous NOMAD system for medicines. There are more social activities organised for residents. A number of residents who had spent a considerable length of time confined to bed have been enabled to enjoy a fuller life. Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 6 Refurbishment of bedrooms has been ongoing. Corridors have been carpeted and decorated and this has made a great improvement in the presentation of the home. The lounge has also been carpeted. The home is generally cleaner and tidier. The nurse call system has been improved. More registered nurses have been recruited, and there are more nurses working on each shift during the day. The home has a maintenance person who carries out day to day repairs and maintenance, and health and safety checks. The standard of record keeping continues to improve. The manager has been registered with the Commission for Social Care Inspection. The manager has a new office which is adjacent to the main entrance. What they could do better: Ensure that medicines are stored, administered and recorded to comply with the Royal Pharmaceutical Society guidance. Continue with refurbishment of bedrooms. Improve the lounge to provide a pleasing and comfortable environment for residents to sit in. (Plans are in place for this.) Improve the dining room. Consider how toilet facilities on the ground floor could be improved for residents who require assistance with mobility. All staff must receive training regarding adult protection and whistleblowing. Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 7 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. Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 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 Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this visit. EVIDENCE: Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9. Each resident has a care plan that identifies their needs and how they should be met. Residents’ health needs are met in full. Medicines are not always stored, administered and recorded to the required standard. EVIDENCE: New care plans have been introduced for all residents. A sample of the new care plans was seen in use for residents and they had been completed to a good standard. At the time of the inspection two residents were very frail and were cared for in bed. These residents were clean, comfortable and appropriately dressed, and pressure relieving equipment was in place. Charts were in place to record care given. These demonstrated that fluids were given and that the residents were regularly re-positioned. Other frail residents, who were previously Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 11 confined to their beds, have been enabled to spend periods of time out of bed and to have social interactions with other residents. The manager said that two residents had pressure sores. These were superficial in nature and were being treated by the district nurses. All residents with continence difficulties have been assessed by the continence advisor and are receiving appropriate aids. These are kept in each person’s bedroom. Moving and handling equipment is provided. The home has changed to a monitored dosage system of medicine management, and at the time of the inspection arrangements were almost completed to convert the room that was formerly the manager’s office into a clinical room. A very thorough medicines audit was carried out by the home’s area manager on 23rd November 2005. This recorded a poor score against the company’s auditing tool. A number of areas of poor practice were identified and an action plan was put in place. It was disappointing to note that three weeks after this audit there were a significant number of missed signatures on the medicine administration record sheets. Requirement Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14 The social needs of residents are provided for. Residents are able to exercise choice in daily living. EVIDENCE: The home has an activities organiser and residents spoken with said that they enjoy the social activities that are now provided on a regular basis. The home has access to a minibus that is shared with another service, and this is used at least one day a week for social outings. A programme of events was in place for the Christmas period. Residents confirmed that they are able to choose their time of getting up and going to bed. Most residents spend time in the lounge during the day and there were conversations taking place between groups of residents. The planned improvements to the lounge will provide smaller sitting areas that will afford a greater degree of choice. Most residents had personalised their bedrooms with their own belongings. Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Policies and procedures are in place for the protection of vulnerable adults but not all staff have received training regarding abuse. EVIDENCE: The home has a complaints procedure. Complaints records were inspected and provided evidence that the manager dealt appropriately with any complaints received and action was taken as needed. Four complaints relating to care practices had been recorded since last inspection. Documentation showed that they had been addressed. The home has policies and procedures detailing how residents should be protected from abuse and how any allegations of abuse should be managed. New staff have received adult protection training as part of their induction programme but other staff have not all received the training. Requirement Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 and 26. Significant improvements have been made to the environment over recent months. The main lounge and dining room need to be improved. Some improvements have been made to bathrooms, but facilities provided on the ground floor do not meet the needs of all residents. Equipment is provided to meet the needs of residents. Some bedrooms have been refurbished and others are still in need of upgrading. The general standard of cleanliness and tidiness has improved. EVIDENCE: Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 15 Since the last inspection, the entrance area and the corridors on all three floors have been decorated and carpeted and this has significantly improved the appearance of the home. The lounge has also been carpeted. A new office has been constructed for the manager, which is also a very positive development. The manager said that work to improve the lounge is planned to start in January, and the dining room will also be refurbished during 2006. Recommendations Work to improve the bedrooms is ongoing and several have now been completed. This needs to continue until all residents have a bedroom that is decorated and furnished to a good standard. Recommendation On the ground floor there are two toilets for use by residents. Neither of these have much space for residents who require a wheelchair or a hoist, which means that some residents have to be taken back to their bedroom, which may be on the first or second floor, for toileting. Recommendation Moving and handling equipment, mobility aids, and pressure relieving aids were observed to be in use as needed by residents. Additional sounders have been added to the nurse call system. The home is generally cleaner and tidier and there were no unpleasant odours. Sluicing facilities are poor. New laundry equipment was installed earlier in the year. Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28. Staff are provided in appropriate numbers to meet the needs of residents. The home has not yet achieved the Department of Health target for care staff achieving an qualification, but is working towards this. EVIDENCE: The home employs eight registered nurses and 22 care staff. Staffing levels have been maintained at a higher level since the change of ownership and there are usually two nurses on duty every morning, in addition to the home manager. A deputy manager, who is a very experienced registered nurse, has been appointed. Two members of care staff are qualified to NVQ level 3, and two to NVQ level 2. Four are currently working towards level 2 and the deputy manager said that all care staff will be given the opportunity to achieve an NVQ qualification. Recommendation Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. The manager has been registered with the Commission for Social Care Inspection. Quality assurance systems are in place to ensure that the home is run in the best interests of residents. Residents’ personal money is handled appropriately. The health and safety of staff and residents is protected. EVIDENCE: A new manager was appointed earlier in 2005. She is a registered nurse with previous management experience and she has been registered with the Commission for Social Care Inspection as manager of this service. Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 18 The company that owns the home has quality assurance processes to ensure that the home is run in the best interests of the residents. A quality audit is carried out monthly by the area manager, and the score achieved by the home has gradually improved over the last six months. Unannounced visits, required by regulation 26 of the Care Homes Regulations, are carried out monthly and a candid report is sent to the Commission for Social Care Inspection. Regular meetings are held for residents and staff. The manager said that she has just started to implement the company’s satisfaction survey questionnaire. The intention is to sample three residents each month. Small amounts of personal spending money are in safekeeping for most residents. Good records of all transactions are kept, and residents’ money is in individual envelopes. This is mainly used for hairdressing, newspapers and small items of shopping. The hairdresser provides individual receipts. One resident is having appointeeship arranged through the local authority. Some residents are able to look after their own finances. Staff receive the required training in health and safety and at the time of the inspection all grades of staff were completing an infection control training programme. Maintenance records were available for inspection in a maintenance file and this provided evidence that plant and equipment had been tested, serviced and maintained. The home’s maintenance person carries out regular hot water temperature checks and makes adjustments as needed. All smoke detectors have been replaced since the last inspection. Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 19 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 2 2 3 X 2 X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement Medicines must always be stored, handled and recorded to the required standard. All staff must receive training relating to the Protection of Vulnerable Adults. Timescale for action 13/12/05 2 OP18 13(6) 31/03/06 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 OP20 OP21 OP24 OP28 Good Practice Recommendations Implement plans for the improvement of the lounge and the dining room. Consider how toilet facilities on the ground floor can be made more accessible for residents using a wheelchair or hoist. Continue with the upgrading of bedrooms. Continue working towards 50 of care staff achieving a qualification. DS0000018722.V273249.R01.S.doc Version 5.0 Page 21 Kingscourt Nursing Home Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Kingscourt Nursing Home DS0000018722.V273249.R01.S.doc Version 5.0 Page 23 - 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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