Inspection on 21/11/07 for Kingsfield Care Home

This inspection was carried out on 21st November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingsfield Care Home 27/05/09

Kingsfield Care Home 02/07/08

Kingsfield Care Home 26/06/07

Kingsfield Care Home 25/01/07

Kingsfield Care Home 19/04/06

Kingsfield Care Home 17/11/05

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Kingsfield Care Home 23 High Street Clay Cross Chesterfield Derbyshire S45 9DX Lead Inspector Rose Veale Unannounced Inspection 21st November 2007 09:15 Kingsfield Care Home DS0000063894.V352197.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 Kingsfield Care Home DS0000063894.V352197.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. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsfield Care Home Address 23 High Street Clay Cross Chesterfield Derbyshire S45 9DX 01246 861505 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) Kingsfield Care Homes Ltd Mr Alkesh Odedra Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th June 2007 Brief Description of the Service: Kingsfield provides personal care and accommodation for up to 9 people with learning disabilities. The home is located in the village of Clay Cross, near Chesterfield, close to local shops and amenities. The home is a converted domestic property with accommodation over two storeys. There are seven single bedrooms and one double bedroom, a large lounge and separate dining room. There are separate kitchen and laundry facilities of a domestic scale and a large attractive garden to the rear of the home with a small garden and car parking space to the front and side of the home. Information about the home, including CSCI inspection reports, is available from the provider or manager. The fees at the home are £377.85 per week. This information was provided by the registered manager on 4th December 2007. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and took place over 4 hours. The inspection visit focused on assessing compliance to requirements made at the previous inspection and on assessing all the key standards. There were 6 people accommodated in the home on the day of the inspection visit. People who live in the home and the acting manager were spoken with during the visit. The responsible individual, Mr J Sisodia, was spoken with by telephone during the inspection visit. Records were examined, including care records, staff records, maintenance, and health and safety records. The communal areas and one of the bedrooms were seen. At the last key inspection in June 2007 the overall rating for the home was poor and so the home was included in the CSCI improvement strategy. A management review was held with the inspector and regulation manager, and then a meeting with the providers of the service. The providers were required to produce an improvement plan detailing how they were going to make the necessary changes to comply with the regulations and improve outcomes for residents at the home. The improvement plan was produced in the required timescale and addressed all the requirements made. What the service does well: What has improved since the last inspection? The management arrangements had improved so that there was more support for the acting managers from the registered manager and responsible individual. The management team had worked together to improve the service and to meet requirements made at the last inspection. Care records had been reorganised and reviewed. A checklist had been introduced to ensure that staff records included all the required information and documents. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Kingsfield Care Home DS0000063894.V352197.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 Kingsfield Care Home DS0000063894.V352197.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment information was sufficient to ensure that the needs of people living in the home could be met. EVIDENCE: There had been no admissions to the home since the last inspection in June 2007. As at the last inspection, the care records included assessments by Social Services care managers, and by the staff at the home when the person first moved into the home. In the care records seen the assessment information had been reviewed and updated since the last inspection. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 9 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 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care records did not always have sufficient information to ensure that people’s needs and personal preferences were met. EVIDENCE: Since the last inspection in June 2007, the care records had been reorganised to make them easier to use. All the records seen had care plans written within the last 10 months. 1 person had a new care plan relating to a recent healthcare problem. There was some evidence that people were involved in their care plans – 1 care plan had been signed, and another 2 people asked were aware of their care plans. The care plans included some details of the person’s preferences regarding care, support and daily routines. Care plans sometimes lacked detail and did not look at all areas of the person’s life. The care records included old information that could be confusing. Daily records were detailed and informative, although one person’s records did not include information about a recent significant incident. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 10 There was evidence that people were encouraged and supported to make decisions about their daily lives. For example, 1 person wanted to find suitable daytime activities outside the home and staff had helped them to do this. Another person was pleased with the new bedroom furniture they had chosen. Notes of meetings held with people who lived in the home showed that they were consulted about meals, activities, and routines, and also kept informed of developments at the home. Risk assessments seen had been reviewed and updated since the last inspection. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 11 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, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were encouraged and supported to take part in activities in and out of the home so that the lifestyle offered met their needs and expectations. EVIDENCE: All the people living in the home attended day centres, college, or adult education classes during the week. There were records of leisure time activities that people had taken part in, such as going to the cinema, bowling, meals out, and shopping. People spoken with said they enjoyed going to the local snooker centre and going shopping. It was commented that the home’s vehicle was being used much more since the last inspection as there were more drivers available. There were 4 people at home on the day of the inspection visit. They were watching television, helping with domestic tasks, listening to music and doing Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 12 word puzzles. There was a relaxed atmosphere and obvious good rapport between staff and people living in the home. Routines were flexible around people’s needs and preferences. The care records included details of families and friends. It was seen from daily records and from talking to people that contact with family and friends was encouraged and supported. The menu for the week was displayed in the dining room. 1 person spoken with said they were able to have alternative meals if they did not like what was on the menu. People were involved in menu planning at regular meetings. People were encouraged to make their own drinks and light meals, and to help with preparation of the main meal. The dining area was pleasant and bright. People living in the home were not directly involved in shopping for food as this was ordered on-line and delivered to the home. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 13 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 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although personal and healthcare needs were generally met, the care plans lacked detail so it was not clear that individual preferences were recognised and promoted. EVIDENCE: The care plans included some details of how people preferred personal care and support to be carried out by staff. Care plans did not always include sufficient detail about all areas of support provided. Staff were knowledgeable about the needs and preferences of people living in the home. The care records included details of the visits and input of healthcare professionals, such as GP, community nurses, chiropodist and dentist. There was evidence from the daily records and from talking to people that health problems were promptly followed up. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 14 Medication in the home was stored securely and was administered by staff who had received appropriate training. Medication records seen were mostly correctly completed. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 15 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 and 23 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Although their complaints were listened to, appropriate action was not always taken and people were not fully safeguarded. EVIDENCE: Records were kept of issues raised by people living in the home, with details of the action taken. The outcome of complaints was not always recorded. The records of complaints included allegations of abuse made by people living in the home. Although the registered manager had seen these allegations, no referral had been made to Social Services and CSCI had not been informed. The registered manager had taken disciplinary action against a member of staff named in the allegations. The allegations were reported to Social Services by CSCI and by the home’s acting manager on the day of the inspection visit. An Immediate Requirement was left for the home to take urgent action to ensure people at the home were protected from abuse. A letter of serious concern was sent to the responsible individual following the inspection. A response to this letter was requested by return of post, but had not been received 2 weeks later. People spoken with said they would go to staff with any concerns or problems and were confident that action would be taken. The complaints procedure was available in a suitable format for people at the home. People had access to an advocacy service through regular meetings held at the home. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 16 Staff at the home had all received training in 2007 about safeguarding vulnerable adults. The home had a copy of the local multi-agency procedures for safeguarding adults. Although staff were aware of the correct procedures to follow if allegations of abuse were made, this had not happened after the incidents reported in the complaints book. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the home was clean and comfortable, there was a lack of progress in building and refurbishing so that the needs and expectations of people living there were not fully met. EVIDENCE: There was an extension being built to the rear of the home. As found at the last inspection, no further building work had been carried out to the extension since late 2006. There were unsightly piles of rubble, and access to the back garden was restricted. People spoken with were frustrated at the lack of progress of the new extension. As noted at previous inspections, the home was generally in need of upgrading and refurbishment. People spoken with said the furniture and carpet in the lounge needed replacing, and that a shower fitted over a bath was not Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 18 working. People spoken with were pleased with their bedrooms. The home was clean and free from offensive odours on the day of the inspection visit. At the previous 2 inspection visits requirements were made for a bedroom window to be repaired or replaced. This had not been done. The window was taped around the edges to prevent draughts, but this prevented the window from being opened. The acting manager said that quotes were being obtained for a replacement window. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 19 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): 32, 34 and 35 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Staff training and staffing levels were generally sufficient to meet the needs of people living in the home. EVIDENCE: People spoken with said that there were usually staff available when needed. On the day of the inspection visit, there was 1 care assistant on duty between 10am and 4pm as most people were out at day centres. Although this appeared sufficient to meet the needs of the people at home that day, it could limit the opportunities for activities for those people. At weekends there were 2 staff on duty during the day. Staff had received training as required in fire safety, safeguarding vulnerable adults, manual handling, health and safety, and food hygiene. Of 8 care staff, 6 had already achieved National Vocational Qualification (NVQ) in care at level 2 or above. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 20 No new staff had been recruited since the last inspection in June2007. The records of 2 staff were seen and included all the required information. Since the last inspection a checklist had been included in staff records to ensure all the required information and documents were in place. Also since the last inspection, notes had been made to complete the gaps in the employment history for 1 member of staff. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 21 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, 39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements to the temporary management arrangements had provided a more consistent and better organised service for people living in the home. EVIDENCE: Since the last inspection the management arrangements at the home were that 2 care assistants were acting managers, with the registered manager and the responsible individual coming in for 1 day per week each to provide help and support. One of the acting managers said that these arrangements were working and that both acting managers felt better supported than they had previously. The management team had worked together to make improvements and meet requirements made. The responsible individual had Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 22 produced a visit report every month since the last inspection, (as required at the last inspection). The responsible individual said that it was planned for the 2 acting managers to complete NVQ level 4 with a view to one of them becoming the registered manager. There were some quality assurance measures at the home. There were regular meetings for people living in the home and minutes showed that they were asked for their views and opinions. People also had access to a local advocacy service through meetings at the home. Some visitors to the home had completed questionnaires and the registered manager had noted the comments made. Requirements made at the last inspection regarding health and safety issues had been met. As detailed in the Complaints and Protection section of this report, the registered manager had not referred allegations of abuse on to Social Services. The responsible individual had not responded to a letter of serious concern sent following the inspection. Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 23 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 1 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 X 2 X 2 X X 2 X Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 YA23 Regulation 13(6) Requirement Any allegations of abuse made by people living in the home must be reported to Social Services as soon as possible. This will ensure that people are safeguarded. The window in the identified bedroom must be repaired or replaced to eliminate drafts and ensure the resident’s comfort. Original timescale 28/02/07 CSCI must be notified of all the specified events. This will protect residents. Original timescale 31/08/07 Residents, (and / or their representatives), must be involved in a system for evaluating the quality of services provided at the home. This will ensure that residents’ views underpin review and development at the home. Original timescale 31/03/06 Timescale for action 21/11/07 2 YA24 23(2)(b) 31/12/07 3 YA37 37 30/11/07 4 YA39 24(1)(2) 31/03/08 Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 25 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 5 Refer to Standard YA17 YA22 YA24 YA24 YA35 Good Practice Recommendations People living in the home should be actively involved in shopping for food to ensure choice and to encourage independent living skills. The outcome of complaints should be recorded so that people know their concerns are taken seriously and acted upon. The shower over the bath in the first floor bathroom should be in working order to ensure choice and convenience of facilities for people living in the home. There should be a programme of refurbishment, in consultation with people living in the home, to ensure a pleasant and comfortable environment. A staff training and development programme should be developed to ensure that staff fulfil the aims of the home and are able to meet the changing needs of people living there. There should be a permanent, full-time manager with the appropriate skills and experience to ensure effective and consistent management of the home. This would ensure that the home is run in the best interests of people who live there. 6 YA37 Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Kingsfield Care Home DS0000063894.V352197.R01.S.doc Version 5.2 Page 27 - 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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