Inspection on 01/02/07 for Kingsgate

This inspection was carried out on 1st February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Kingsgate 25/01/06

Kingsgate 14/11/05

Kingsgate 31/01/05

Kingsgate 08/11/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 17/12/2008.

CARE HOMES FOR OLDER PEOPLE Kingsgate 25 - 27 North Street Sheringham Norfolk NR26 8LW Lead Inspector Mrs Susan Golphin Unannounced Inspection 1st March 2007 09:30 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 Kingsgate DS0000027278.V332327.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 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. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsgate Address 25 - 27 North Street Sheringham Norfolk NR26 8LW 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) 01263 823114 01263 821779 enquiries@kingsgateresidentialhome.co.uk Mr Anthony Churchill Mrs Jennifer Churchill, Mrs Virginia Taylor Mrs Lynn Frost Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: Kingsgate is a care home providing personal care and accommodation for up to 31 older people. Mr A Churchill, Mrs J Churchill and Mrs V Taylor own the care home. The home is located close to the centre of the seaside town of Sheringham, close to shops, pubs and other local amenities. The home consists of a three-storey building with 27 single and 4 double rooms on the ground, first and second floors, serviced by a shaft lift. There are a variety of communal lounges and a large dining hall where other social activities can take place. There is also a paved garden area with seating. The fees range from £339 to £432 per week. Additional charges are made for hairdressing private chiropody and personal requisites including toiletries. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups which assess how well a provider delivers the service to people. This key inspection has been carried out by using information from previous inspections, information from the providers, staff and the residents and their relatives, as well as other health care professionals. This report gives a brief overview of the service and the current judgments for each outcome group. What the service does well: What has improved since the last inspection? Areas of the home have been refurbished to a good standards including residents rooms where en-suite facilities have been installed. There is an ongoing redecoration programme in place and there are plans to upgrade one of the sitting rooms in 2007/8. The management have reviewed some of the administration procedures and recruitment and selection of staff practices to ensure clarity and good record keeping. Improvements have also been made to the quality assurance process to promote a good dialogue and openness with users of the service and other health care professionals. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 6 The registered providers continue to promote ways in which staff knowledge and skills can be developed through training opportunities and formal supervision. Daily recording on all aspects of residents care is being monitored and staff are improving and developing their skills to make certain that their reporting skills reflect the levels and standards of care as well as the lifestyle and choices of the residents. 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. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 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 Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6 The quality outcome for this group of standards is good. Pre admission documentation is in place and provides a clear care path which is tailored to meet Individual need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Good referral and pre admission documentation is in place and up to date. Three case files were seen on the day and clearly reflected the personal and social needs of the residents. During the discussions with the staff they were able to demonstrate a clear knowledge and understanding about residents assessment of need and how the needs of clients are met. Residents said that they are aware of the assessment process and are happy with the way in which their personal and social needs are met. Comment cards from relatives Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 9 and other health care professionals also expressed satisfaction with the service and high standards of care. Formal intermediate care is not offered as part of the service, however the registered providers would be able to support and assist residents who wished to work towards returning to their own homes or independent lifestyle. The referral and admission policy for the home is being updated. Currently it is combined with existing policy documentation but will be itemised as a separate process for easy reference. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9,10 The quality outcome for this group of standards is excellent. Resident’s care and health needs are well met by good practice and clear planning and recording processes. There are good systems in place for the management of medication. There is a clear process in place for the promotion of residents well being in a discreet and respectful way. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans were seen on this occasion. All were well documented and up to date. Reviews and reassessment of need had been carried out and changes in support and care indicated clearly. Care plans are established at the point of admission and based on the initial assessment and risk assessment. Residents said that they are consulted about their care and have a say in the reviews and any changes that may need to be made. Residents and relatives are also encouraged to contribute and comment. The care plans show that each resident’s healthcare needs are met with evidence of regular medical and medication reviews, and a daily record is Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 11 maintained. Residents said that the staff are very caring and attentive and that overall they are well cared for in every respect. Four residents were seen on the day and each of the residents commented positively about their own care and acknowledged that they are encouraged to be as independent as possible and that staff support is provided discreetly and in a respectful way. Excellent examples of personal kindnesses by staff and management were provided. One resident said that they would not want to live anywhere else. From the comment cards from residents and relatives they said the home offers ‘a very good standard of care’ and ‘my friend is very happy here and contented. She feels well looked after’. During the discussions with staff they were able to give good examples of care practice and to demonstrate their knowledge and understanding of the care needs of older people. The senior staff team are responsible for the management of medication and the system used is pre packed in a monitored dose system. The home has a drug management policy and the staff have attended appropriate training in the management and administration of medication. Medication administration sheets are maintained and a random check showed they were up to date and the medication issued recorded appropriately. The registered providers advised that a new monthly audit process for checking receipt of all medication is to be introduced in March 2007. This procedure will help to ensure that any errors in the delivery or ordering process will be identified quickly. All the medication is stored in a locked unit. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15 The quality outcome for this group of standards is excellent. Resident’s individual lifestyles and personal choices are respected and promoted. Resident’s are encouraged to maintain family ties and friendships. Residents receive a consistently well -balanced and nutritious diet which promotes their wellbeing. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents spoken to on the day said the routine in the home is not rigid and can be flexible to fit in with their own daily routine. Residents spoke enthusiastically about activities in and out of the home and how they are encouraged to maintain their own social interests and contacts. Residents also spoke of maintaining their family links and friendships. From the discussions on the day residents are encouraged to express their views and make their own choices about their daily lives. Residents care plans contain individual risk assessments and these have been reviewed since the last inspection. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 13 The management and staff promote an open style and inclusive atmosphere in the home and this was evidenced by the way in which families and visitors were welcomed on to the premises. Residents were very complimentary about the meals and choice of food available. One resident gave a good example of their dietary needs and favourite dishes and personal choices. The menu examples provided for the purposes of the inspection provided an attractive range of meals and interesting recipes and style of presentation. Breakfast is served from 7.30am until 9am. Coffee and biscuits mid morning and the main meal of the day is served at lunchtime between 12 and 1pm.Afternoon tea with homemade cake and gateaux is served at 3pm and high tea from 5.30pm when there is a choice of hot or cold dishes available. Hot drinks and light snacks are also available to residents at 7.30-8pm. Residents were very complimentary about the meals and especially about the cakes and pastries as well as the very popular Sunday roast. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 18 The quality outcome for this group of standards is good. There is a robust complaints procedure in place that is easily accessible to residents and their representatives. Residents are protected from abuse by the homes’ policies and procedures and robust recruitment and selection processes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a good complaints procedure in place that is easily accessible and available to residents and their representatives. Residents spoken to on the day confirmed that the management and staff are very accessible and will deal with matters quickly whatever the problems. One person said – nothing is too much trouble and I can rely on the staff to listen to my problem and help. One resident said; the staff do have time to talk to me and other residents so any little thing can be discussed before it becomes a worry or a problem. There have been no formal complaints made in the home or to the CSCI in the last year. The home has a robust recruitment and selection processes in place and there is evidence on the staff files that thorough checks on prospective staff are carried out. The criminal records disclosures for three of the staff were randomly selected and all were well documented and in place. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 15 Training for staff in adult abuse awareness and protecting vulnerable people is in place. During the discussions staff were able to demonstrate a clear understanding and knowledge in these areas. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 26, The quality outcome for this group of standards is excellent. The management process for maintaining this home is well established and ensures that residents environment is clean well maintained and offers accommodation of a high standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This home is exceptionally well maintained. A brief tour of premises was undertaken with the registered providers who were able to give a detailed account of both completed work including major upgrade of the property and refurbishment of residents rooms and the addition of en-suite facilities. The renovations are of a high standard and excellent quality. The inspector was invited to visit three resident’s rooms, all were attractively decorated and furnished to a high standard and expressed the individual and personal style of Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 17 the resident. The standard of general maintenance and cleanliness in the home is excellent, and the management and staff are to be commended for their attention to detail in maintaining such a pleasant, homely atmosphere and especially with the discreet management of continence materials and laundry. As an adapted property the owners are constantly looking at ways in which the facilities can be improved to promote residents choice of communal space and their ability to use rooms independently. The registered providers confirmed that there is a plan in place to refurbish the small sitting / television room in 2007/8. Part of the refurbishment will involve widening one of the doorways and improving the layout generally. The overall plan will offer improved facilities and better access. The refurbishment will also include redecoration and replacement carpets. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30 The quality outcome for this group of standards is excellent. The home promotes good policies and procedures for the recruitment and selection of staff. The high quality and standard of staff supervision and the training opportunities provided safeguards residents and promotes best practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two senior staff and two care staff were interviewed on the day of the inspection. One senior member of staff has specific responsibility for the management and administration of the medication. The other senior member of staff has a specific input to the induction and supervising of new and inexperienced staff. Both were able to demonstrate an up to date knowledge and understanding of their responsibilities and care role. Good examples of on the job training and supervision of practice were given with a clear understanding of residents care needs and individual choices. Residents commented positively about the staff group and were able to give good examples of care input, responses to requests and needs, and individual kindnesses shown to them. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 19 30.4 of the care staff have NVQ 2 or above and they are supported by ancillary and catering staff. Three staff files were seen and demonstrated clear recruitment processes including identity checks and CRB disclosures . Details of formal interviews with staff are now maintained on file. Information relating to staff training and supervision is well documented. Mandatory and specialist training for staff is in place and reviewed by the registered providers each year to ensure the good levels of care knowledge and competency are maintained. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31 33 35 38 The quality outcome for this group of standards is good. The residents and staff benefit from supportive management and positive leadership. There are good procedures in place to protect the health and safety of residents and staff. There are clear processes in place to safeguard the rights and interests of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As part of the long term development of the service the registered providers are looking at restructuring the management team over the next two years. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 21 This will provide better opportunities for the qualified staff to undertake specific responsibilities and roles within the home and ensure that best care processes and practice are in place. There is a Quality Assurance process is in place and residents or their representatives views on the service are sought on a regular basis The registered providers are also developing their own self assessment review document to monitor the consistency and quality of the service and service delivery. They will also be looking at ways in which the outcome of the quality assurance review can be shared with users of the service and commissioners in an easy to read format. A brief overview of the policies and procedures was carried out with the registered providers. A review of the policies and procedures will be carried out to ensure that the required documents appear under their own heading. Currently the information required to be kept is in place but in some instances appears with or within existing documentation ( see recommendation). Changes to the way the home manage residents personal monies have been made and there is an audit trail for income and expenditure and remaining balance. Any expenditure made on a resident’s behalf is recorded and either formally receipted or signed for. The process is working well but the registered providers may make some further refinements to the procedure. Kingsgate is well maintained to a high standard, and the maintenance programme and records relating to health and safety fire protection are clear,well maintained and up to date. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 22 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 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 4 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x 3 3 Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 OP37 Good Practice Recommendations It is recommended that the registered providers review the policies and procedures for the home to ensure they have separate heading and are not contained within existing documentation. Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Kingsgate DS0000027278.V332327.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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