Inspection on 25/04/06 for Kingsdowne Residential Home

This inspection was carried out on 25th April 2006.

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

Kingsdowne Residential Home 24/03/09

Kingsdowne Residential Home 15/04/08

Kingsdowne Residential Home 04/01/06

Kingsdowne Residential Home 02/08/05

Kingsdowne Residential Home 16/02/05

Kingsdowne Residential Home 23/08/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Kingsdowne Residential Home 37 Dury Road Hadley Green Barnet Hertfordshire EN5 5PU Lead Inspector Tom McKervey Key Unannounced Inspection 25th April 2006 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 Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 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. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kingsdowne Residential Home Address 37 Dury Road Hadley Green Barnet Hertfordshire EN5 5PU 020 8449 0675 020 8440 8220 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) The Kingsdowne Society Mrs Janette Maria Higham Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4th January 2006 Brief Description of the Service: Kingsdowne Residential Home is a registered care home for eighteen older people of either gender. The home is situated in the Hadley Green area within approximately a tenminute walk to shops and other amenities in Barnet High Street. The accommodation comprises of sixteen single bedrooms and one double bedroom. The home has large dining and lounge areas and a conservatory. There are extensive grounds, with a front paved garden, used as a car park for staff and visitors. There are also very attractive rear and side gardens, which are accessible via a ramp for people who use wheelchairs. There are adequate toilet and bathing facilities on the ground and first floor. Where the laundry room and the office are also situated. All indoor communal areas are accessible to service users. Besides wide stairways with handrails, a lift is provided for accessing the first floor. The staff turnover is very low and several staff have worked at the home for a number of years. The manager, Ms Janette Maria Higham, has been in post for more than eleven years. The aim of the home is “To meet residents’ expectations and achieve the greatest quality of life that is possible, whilst encouraging residents to maintain their independence”. The fees for the service are £480 per week. Following “Inspecting for Better Lives”, the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection. The process took place over a period of six hours, was carried out as part of the Commission’s inspection programme and to check compliance with the key standards. At the time of the inspection, there were thirteen residents and four vacancies. The home is considering converting a double room to a single, thereby reducing the total number of places to seventeen. The inspection included a tour of the premises, speaking to the manager, five individual residents, two visitors and several staff. The district nurse, who was visiting the home, was also spoken to. Residents’ and staff records, and documents pertaining to the running of the home were also examined. What the service does well: What has improved since the last inspection? All residents, including those who come in for respite care, are provided with contracts of the terms and conditions of the service. There are records of the frequency of residents’ baths and their care plans are being reviewed monthly. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 6 Residents who have a history of falls, have been referred for specialist advice and procedures for monitoring falls have been put in place. Amendments have been made to the medication policy regarding retention of medication for seven days following the death of a resident, and staffs’ signatures are now recorded in medication records. Specialist advice has been sought from a dietician for a specific resident regarding appropriate diet. The staff rota now clearly identifies those on duty, and staff recruitment records are now complete with references and proof of identity. This is necessary to safeguard residents. A fire door now has an appropriate device fitted for opening and closing and new electric wiring has been installed throughout the home. 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. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 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 the following standard(s): 2, 3 & 5 The quality in this outcome group is good. This judgement has been made form evidence gathered both during and before the visit to this service. Prospective service users and their representatives are able to visit the home to assess its suitability to meet their needs, and no one is admitted without a needs assessment being carried out. Residents’ contracts need to state if the fees charged are for a single or double bedroom. EVIDENCE: The case files of two new residents and one other service user were sampled. Contracts had been drawn up which included the terms and conditions of the service and the fees charged. The contracts also stated what was not covered by the fees, for example, hairdressing and chiropody. However, it was not clear whether the cost was for a single or a double room and a requirement is made to address this. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 9 The new residents had been assessed by the manager of the home and, in one case, by a care manager from the local authority, which was funding the care. The assessments covered the full range of the persons’ needs. The new residents who were spoken to, said that they were very happy with the service and referred to Kingsdowne as their home. In one case, the resident had visited the home prior to moving in, and in the other, their relatives had visited on their behalf. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 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, 9 & 10 The quality in this outcome group is adequate. This judgement has been made form evidence gathered both during and before the visit to this service. Residents are supported in their personal care in a caring and dignified manner, and their healthcare needs are met. The care plan of a specific resident does not reflect their current health status, which could result in their needs not being met. Errors in the medication records are putting residents’ safety at risk. EVIDENCE: Three care plans were examined. These included assessments, goals of care and action guidelines for staff to meet service users’ needs. There were also appropriate risk assessments recorded. However, the care plan of one resident did not reflect the recent serious deterioration in their health. A requirement is made regarding this. The person referred to above, was receiving appropriate care and their file contained records of appointments with healthcare professionals. The other case files seen, showed records of GP, chiropody dental and optician services. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 11 There were charts to monitor three residents who had a history of falls, and a person’s blood pressure was also being monitored. The District Nurse, who was attending two residents during the inspection, said that the standard of care in the home was very good. Five residents who were spoken to, said that the staff were very caring and when providing personal care, always did so privately, and in a discreet and dignified manner. The medication standard was assessed. Medication was safely stored and staff signatures for the administration of medicines were recorded. However, while there were no gaps in the administration records, one Temazepam tablet, (which is a controlled drug), was missing. At the time of the inspection, the staff were unable to account for this, and a requirement is made about this issue to safeguard residents’ wellbeing. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 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, 13, 14 & 15 The quality in this outcome group is excellent. This judgement has been made form evidence gathered both during and before the visit to this service. The residents are very happy in the home and they are able to exercise choice about their lives. Appropriate activities are provided and there is frequent contact with friends and relatives. The meals provided are nutritious and residents speak highly of the catering. EVIDENCE: Five residents were spoken to. They spoke highly of the staff and the care they received. Comments made were; “ I am very happy here. There are always staff to help me at any time of the day or night”. “ There is always a happy atmosphere”; “The food is very good”. The residents also described the choices they made about their lives, including when to rise and go to bed and about what they wanted to eat. They could also choose what activities they wished to join in. Several residents were observed reading books and newspapers. During the inspection, a piano player was entertaining a group of residents. Keep-fit sessions are held fortnightly and a clothes sale takes place every three Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 13 months. Residents said that they had been taken out for walks by staff and relatives. Religious services are held regularly in the home. The relatives of a service user, present during the inspection, said their perception was that a very good service was being provided. The visitor’s book contained records of frequent visits by friends and relatives at various times of the day and evening. The menus showed a good variety of wholesome food and special diets were also catered for. The residents said that they were consulted about their meal choices and they could have hot or cold drinks and snacks at any time. There was a record of the temperatures of the fridges and freezers and of the food actually eaten by the residents. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 14 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 & 18 The quality in this outcome group is excellent. This judgement has been made form evidence gathered both during and before the visit to this service. The residents are very satisfied with their care, and have a very good relationship with the staff. There are good systems in place to protect residents from abuse. Residents and visitors are aware of how to complain. EVIDENCE: The residents and the relatives who were spoken to, expressed a high degree of satisfaction with their care, and had no concerns. They said they were confident that complaints would be addressed promptly. The inspector saw several very complimentary letters from residents and from relatives who praised the staff for the quality of care. The complaints log had no recent entries. Since the last inspection, the log now includes response times for dealing with complaints. There were records of staff training in the subject of abuse, and the staff who were spoken to, were knowledgeable about their responsibilities regarding reporting suspected abuse. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 15 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, 24, 25 & 26 The quality in this outcome group is excellent. This judgement has been made form evidence gathered both during and before the visit to this service. The residents live in a home that is comfortable, clean and well maintained. The environment is safe and they are able to have personal possessions in their rooms. EVIDENCE: A tour of the premises was carried out. The overall appearance is very attractive and the grounds are well maintained. There is a ramp to facilitate access to the gardens by wheelchair users. Grab rails were well positioned in toilets and bathrooms for people with problems with mobility, and there were several hoists available. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 16 Residents are able to summon help with call alarms that they can wear around the neck. There are records of weekly fire alarm tests and fire drills are carried out. The service records of hoists and the lift were available for inspection. The communal lounges and dining areas are pleasant and bright with comfortable domestic-style furniture. There is a passenger lift to the upstairs bedrooms, five of which were visited. The décor of the bedrooms was very good and there were plenty of personal possessions and family photographs on display. The home employs a full-time maintenance person, and a team of cleaners. At the time of the inspection, the home was very clean, well presented, and was free of unpleasant odours. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 17 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 & 29 The quality in this outcome group is excellent. This judgement has been made form evidence gathered both during and before the visit to this service. There is a sufficient number of trained staff on duty to meet residents’ needs. Residents’ welfare and best interests are safeguarded by appropriate and safe recruitment practices EVIDENCE: The normal staffing levels are four care staff on the early shift and three on the afternoon/evening. There are two staff on waking duty at nighttime. The home also employs a maintenance person, an administrator, and cleaning and cooking staff. The rota gave an accurate record of the staff actually on duty. At the time of the inspection, there were no staff vacancies. The residents said that there were sufficient staff on duty to meet their needs. The records of three staff were examined. They contained appropriate references, proof of identity and clearances from the Criminal Records Bureau. In discussion with staff, they described various training courses they had undertaken in the past year. This included the mandatory subjects, e.g. fire, health and safety and food hygiene. Training in mental health issues had also been provided. The two staff spoken to said they had attained National Vocational Qualification level 2, and one was currently studying for Level 3. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 18 Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 19 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, 32, 34, 36 & 38 The quality in this outcome group is good. This judgement has been made form evidence gathered both during and before the visit to this service. The home is well managed by an experienced and skilled manager, who provides clear leadership for the staff in a relaxed, efficient manner. Residents’ personal finances are properly accounted for and there are good systems in place for the protection of the health and safety of service users and staff. Staff supervision needs to take place at least six times a year to support them in caring for the residents. EVIDENCE: Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 20 The registered manager holds a City and Guilds Advanced Management for care qualification and has been running the home for many years. The manager is responsible to a board of trustees. The atmosphere in the home was very relaxed. The inspector observed a good relationship between the manager, staff and residents. The staff said how much they enjoyed working at the home and this is reflected in the very low turnover of staff and the length of time people have worked there. A sample of residents’ personal financial records was examined. There was a good record of how their money was accounted for when purchases were made on their behalf for toiletries, clothes, hairdressing etc. The records included income and expenditure, for which receipts where obtained. Staff supervision records showed that although this was taking place, it was not as regular or frequent as required by the National Minimum Standards, which is six supervisions per year. A requirement is made regarding this issue. There were current service records available for fire, electric, water and gas installations and an employer’s liability certificate was on display. Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 21 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 2 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 3 X 3 X 3 Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 22 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 OP2 Regulation 5(1)(a) Requirement The registered person must ensure that the contract of terms and conditions specify whether the charge is for a single or double bedroom The registered person must ensure that residents’ care plans accurately reflect their current needs. The registered person must ensure that accurate records of medication are maintained, particularly where controlled drugs are concerned. Timescale for action 30/06/06 2. OP7 15(2)(b) 30/06/06 3. OP9 13(2) 31/05/06 Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Kingsdowne Residential Home DS0000010459.V287869.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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