Inspection on 24/02/06 for Kingsfield Care Centre

This inspection was carried out on 24th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Kingsfield Care Centre 26/10/07

Kingsfield Care Centre 14/09/06

Kingsfield Care Centre 12/07/05

Kingsfield Care Centre 13/03/05

Kingsfield Care Centre 19/07/04

Kingsfield Care Centre 10/03/04

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 Kingsfield Union Road Ashton-under-Lyne Tameside OL6 9JF Lead Inspector Steve Chick Unannounced Inspection 1:45 24th February and 3 March 2006 rd 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 Kingsfield DS0000005573.V280432.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. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kingsfield Address Union Road Ashton-under-Lyne Tameside OL6 9JF 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) 0161 330 1853 Tameside Care Limited Rita Shockledge Care Home 52 Category(ies) of Dementia - over 65 years of age (48), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (48), Old age, not falling within any other category (52), Physical disability over 65 years of age (18), Sensory Impairment over 65 years of age (2) Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 52 OP up to 48 DE (E) up to 48 MD (E) up to 18 PD (E) and up to 2 SI (E). 12th July 2005 Date of last inspection Brief Description of the Service: Kingsfield is a single storey, purpose built, detached property set in its own grounds. It offers accommodation for up to 52 older people, in single rooms. Kingsfield is near the town centre of Ashton under Lyne and, consequently, has good access to public transport facilities. There are also parking facilities in the vicinity. Kingsfield has two lounge/dining rooms and one small lounge, which is a dedicated smoking area, and a quiet room. The building also has a conservatory area off the main lounge and a patio area in the inner garden. Kingsfield is run by Tameside Care Limited, which also runs several other care homes in the area. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection six service users were interviewed, as were five relatives of service users. Additionally discussions took place with three staff members. The inspector also undertook a tour of the building and scrutinised a selection of service user records as well as other documentation, including staff rotas and medication records. This inspection was unannounced on the first day. The inspector returned by appointment to meet with the manager who was unavailable on the first day. Not all standards were assessed at this inspection. It is recommended that this report be read in conjunction with the report written following the previous inspection in July 2005. An additional visit was made to the home in August 2005 and a report of that visit is also available. What the service does well: What has improved since the last inspection? Some administrative and recording practices had improved, to enable better accountability regarding care practice. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 6 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. Kingsfield DS0000005573.V280432.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 Kingsfield DS0000005573.V280432.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): 1 and 6 Kingsfield makes appropriate information available to prospective service users to assist in deciding if the home is suitable for their needs. EVIDENCE: The home has produced a service user guide and statement of purpose. These documents were not scrutinised at this inspection, but have been found to contain appropriate information at previous inspections. Some relatives spoken to during the inspection were able to confirm that the service user guide had been made available to them before their relative became a resident. Kingsfield does not offer intermediate care. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 and 10. Written care plans are reviewed and updated to ensure staff are informed of the changing needs of service users, to maintain an appropriate level of care. Medication policies, procedures and practice offer a sound basis to ensure service users receive the right medication at the right time. The attitude and approach of staff seeks to maintain service users’ dignity and privacy. Service users are treated with respect. EVIDENCE: A selection of service users’ files was scrutinised. All had a written plan of care. There was also documentary evidence that the care plan was reviewed at regular intervals. This procedure was also confirmed by the senior staff on duty. Service users’ signatures provided evidence of their involvement in the care planning process. One example was seen where the assessment and care plan indicated that the service user’s mental health was such that their signature would not be a meaningful indication of their agreement with the plan. In this case a relative had signed to indicate their agreement. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 10 In files seen there was some evidence of a ‘social history’ of the service user having been obtained. More information in this context, if available, may further assist the staff to respond to service users’ individuality. Visitors who were asked confirmed that communication with the home was good, and they believed they were appropriately involved in decision making about their relative’s care. The home has appropriate policies and procedures in connection with the storage and administration of medication. These were not scrutinised at this inspection. Kingsfield used a pre dispensed monitored dosage system to administer service users’ medication. Medication was seen to be stored appropriately. A selection of medication administration records was scrutinised. These presented as being appropriately maintained. An example was seen of a minor error (a signature in the wrong date box) having been identified and appropriately amended. All service users and relatives who were asked expressed confidence in the home seeking appropriate medical support in a timely manner. All service users and relatives spoken to were positive about the approach and attitude of staff. This included being treated with respect and having their dignity maintained. One visitor made the observation that “you can see staff being nice to everyone, regardless of [whether or not they have ] visitors.” A service user said she had seen no “rudeness” from any staff. Another service user also identified the night staff as “great” , and if you have a problem, “they just sort it out”. Several service users described the staff as “very nice” and “friendly”. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 11 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): 13 Visitors are welcome to the home at any reasonable time which assists service users to maintain contacts with family and friends. EVIDENCE: Kingsfield has a written policy of welcoming visitors at any reasonable time. Visitors spoken to during this inspection all confirmed that they could visit at any reasonable time. Several visitors commented on the welcoming attitude of the staff when they do visit. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Service users or their advocates are able to make complaints and are confident they will be dealt with appropriately. Policies, procedures and staff awareness all serve to create a safe environment where service users are protected from abuse or exploitation. EVIDENCE: Kingsfield has an appropriate written complaints policy which is widely available for service users and their representatives. All service users, visitors and staff who were asked during the inspection, expressed the view that any complaint would be dealt with appropriately. Staff were described as friendly, caring and easy to talk to. One service user reported that he had “nothing to grumble about” and had been told by a staff member that it was her job to look after him. The organisation has appropriate procedures for dealing with any allegations of abuse. Staff who were spoken to indicated an understanding of the need to be vigilant about the possibility of abuse and their responsibility to ‘whistle blow’ if necessary. All service users and visitors who were asked expressed the view that service users were safe at Kingsfield. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 and 26. The building is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. This includes their own bedrooms and the indoor and outdoor communal areas. Suitable toilet and bathing facilities are available to enable service users to maintain their personal hygiene in a dignified manner. EVIDENCE: During the inspection a tour of the building was undertaken. This included a selection of service users’ bedrooms. The building presented as appropriately maintained and decorated throughout. No items requiring remedial maintenance were identified. Maintenance records were not scrutinised at this inspection. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 14 Service user’s bedrooms presented as being appropriately personalised, with individual’s personal effects. Kingsfield has appropriate toilet and bathing facilities, including adaptations and aids for service users with restricted mobility. The repairs to the roof which were in progress at the previous inspection had been completed and service users were able to use the pleasant patio area in the centre of the building. This inspection was unannounced. The home presented as clean and tidy with no unpleasant odours. Visitors, service users and staff who were asked, all confirmed that this was the usual state of the building. Records relating to the maintenance of good hygiene practices were not inspected on this occasion. Staff spoken to confirmed the continued availability and use of disposable gloves and aprons to minimise the risk of cross infection. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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. Staffing levels were predominantly provided at a level to maintain an appropriate quality of care for service users. However on some occasions this quality was compromised. EVIDENCE: The staff rota for the week ending 19/02/06 was scrutinised. This indicated that usually during the day (08:00 – 20:00) there were six or seven staff on duty. Kingsfield aimed to have four staff on duty between 20:00 and 22:00 but failed to achieve this level on three occasions in that week. Three staff are on duty between 22:00 and 08:00 the following morning. Each morning (08:00 to 13:00) had seven staff, to reflect that this is often the busiest time of the day. The rota showed that on two occasions the staffing had fallen to five for a brief period in the early afternoon. The manager’s hours are in addition to these figures. Additionally the home has cooks, domestics and access to maintenance workers. These staffing levels presented as being adequate other than the occasions when only three staff were available to cover between 20:00 – 22:00. The fourth staff member appeared to be necessary given the number of service users needing assistance to retire to bed and the layout of the building. The manager reported that she was still endeavouring to cover these shifts but was having difficulty recruiting staff for this purpose. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 16 There remained some uncertainty amongst staff regarding emergency cover during the night in circumstances where, for example, a staff member needs to leave the home to escort a service user to hospital. The manger was clear that there was a system which involved, in the first instance, seniors and herself being accessible by telephone. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 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): 33. Quality Audit systems enable service users to give feedback on the running of the home. Issues raised are addressed by the management. EVIDENCE: Kingsfield is subject to a range of Quality Monitoring and Quality Audit procedures. At least once a year this includes a questionnaire survey to service users. The results of the annual survey are published. The manager had produced a written action plan indicating how issues which had been identified were to be addressed. Minutes of service user meetings were seen which included ‘matters arising’. This provided evidence that issues raised by service users were addressed. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 2 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X X Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 19 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP27 Regulation 18 (1)(a) Requirement The registered person must ensure that sufficient staffing is provided throughout the day, including four care staff between 18:00 and 22:00. (Timescale of 11/01/06 not met) The registered person must ensure that clarification is given to staff and the Commission for Social Care Inspection about the arrangements for cover when staffing in the home falls below the minimum levels. (Timescale of 11/01/06 not met) Timescale for action 12/04/06 2. OP27 18 (1)(a) 12/04/06 Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 20 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. Refer to Standard OP7OP12 Good Practice Recommendations The registered person should ensure that as full a social history as reasonable is obtained recorded and used to identify appropriate social activities for each service user. Kingsfield DS0000005573.V280432.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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. 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