Inspection on 14/11/05 for Kingsgate

This inspection was carried out on 14th November 2005.

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

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

Other inspections for this house

Kingsgate 01/02/07

Kingsgate 25/01/06

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 Geraldine Allen Announced Inspection 14th November 2005 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.V249908.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 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 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.V249908.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2005 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. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place during the day of Monday 14 November 2005. Mrs Taylor completed and returned a pre-inspection questionnaire. This provided a great deal of information about arrangements at the home. Comment cards were completed and returned to the Commission. A total of 2 were received from visiting health professionals, 5 from relatives and friends and 19 from residents. During the course of the inspection, information was gained from several different sources, including talking with 8 residents, talking to staff and attending their handover meeting, looking at various records and also walking around the home. The records kept by the home in respect of the care given to residents were looked at in detail. Lunch was eaten in the dining room with the residents. The overall findings of this inspection are that this home provides very good care that is enjoyed and appreciated by the residents. What the service does well: What has improved since the last inspection? As stated above, there has been significant improvement in the environment. Those rooms seen were individualised and domestic in decoration. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 6 More people who responded to the Commissions questionnaire were aware of the complaints procedure. This was displayed prominently within the home and residents spoke confidently about being able to discuss any concerns with either Mrs Taylor or Mrs Frost. 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. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 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.V249908.R01.S.doc Version 5.0 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): 3&6 All residents have a pre-admission assessment prior to moving into the home. This home does not provide intermediate care. EVIDENCE: There was evidence of pre-admission assessment within the care plans. There was also evidence of consultation with other agencies including social services and healthcare professionals as necessary. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 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, 8 & 10 Recording within the individual care plans needs to be improved. Issues around confidentiality of recording have been raised with the home. Residents’ healthcare needs are well met. Residents stated that they are treated with respect and feel their rights are upheld. EVIDENCE: Three care plans were looked at in detail. Other records, including a “staff handover book” were also seen. Further information was also obtained by attending the staff handover before the start of the afternoon shift. Generally, the home uses care plan formats that are appropriate to the physical, social and emotional needs of the residents. There was evidence that the records need to be developed further. For example, there were significant gaps in the records relating to personal care. Where a resident declines a bath, hair wash, etc., this should be recorded accordingly to demonstrate that this had been offered. See recommendations. The home is not using the risk assessment format and there was evidence that this is a significant omission. For example, one care plan referred to the Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 10 resident’s history of falls but there was no risk assessment to ensure risk reduction measures. See recommendations. The use of the “staff handover book” is questioned. Entries were reviewed during the inspection and they were found to be more appropriate to the care plan. Despite assurances from staff, there was evidence that not all of the information was being transferred into the appropriate care plan. This process is also resulting in staff writing information twice. The content of some of the entries was not appropriate to this kind of recording format in that highly confidential information was being recorded. All the information was being written on a single sheet, making it impossible for the home to provide information to residents and their representatives when requested without disclosing confidential information about other residents. See requirements. The care plans showed timely and appropriate health care interventions. Feedback from visiting community nurses confirms that staff provide good care in accordance with their instructions. Residents were spoken to throughout the day either in a group or individually and in private. All residents felt they were well cared for and that staff treated them with respect and dignity. All those residents who returned a comment agreed with this. Residents signatures were seen on care plans, indicating their involvement in the care planning and review process. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 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): 12, 13, 14 & 15 Residents described being able to enjoy activities and interests that reflect their preferred lifestyle and needs. Residents maintain regular contact with their families, friends and representatives. Residents felt they had control over decision-making and were able to make choices about daily living. Residents receive a well-balanced and nutritious diet. EVIDENCE: A total of 8 residents were spoken to, either in a group during lunch or individually in private. They spoke about their daily living and gave many examples of how they are able to take part in activity within and outside of the home that reflects their personal taste and preference. The availability of staff to assist them with activities where necessary was discussed and the residents agreed that, generally, there were sufficient staff on duty for this to happen. Residents described the regular contact they are supported to maintain with friends, relatives and representatives. During the course of this inspection, some residents were consulting with their legal representative in private. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 12 Residents felt that their visitors were made to feel welcome and were always offered refreshments on arrival. Residents also felt they could invite their visitors to lunch if they wished. Residents described their experiences of daily living at the home and felt they had control and were able to make choices that were respected. Lunch was eaten in the dining room with residents. This enabled sociable discussion to take place. The food was well-presented and freshly prepared using fresh produce. Residents confirmed that they are offered choices at all meals and the food was described as “wonderful”. Residents can eat their meals where they wish, although the majority choose to eat in the main dining room. The dining tables appeared attractively laid and there were plenty of staff available to serve and provide assistance if needed. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home has a complaints procedure that is known to residents and visitors. Residents are protected from abuse by good recruitment practice. EVIDENCE: The home’s complaints procedure is displayed in the entrance hall and all residents spoken to were aware of the procedure and what they would do if they had concerns. All felt confident that they would be listened to and that Mrs Taylor and Mrs Frost would take their concerns seriously and act upon them. No complaints have been received by the home in the last 12-months and no complaints have been received by the Commission. All staff are due to attend adult abuse awareness training shortly. All staff are subject the Criminal Records Bureau and Protection of Vulnerable Adults checks. Records of completed disclosures were available for inspection and are kept on the individual staff files. Overseas staff have been subject to full disclosure in the country of origin and further checks have been undertaken in this country. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 & 26 The home is well maintained. Residents’ bedrooms are comfortable, with many personal possessions in evidence. The home is clean and tidy. No unpleasant odours were detected during the inspection. EVIDENCE: A brief tour of the premises was undertaken with Mr & Mrs Taylor and evidence of extensive refurbishment and redecoration was seen. The entire home has been re-roofed and new wiring to allow the installation of trip meters has been fitted. A substantial number of bedrooms have been refurbished to a high standard. All wallpaper is gradually being removed and the walls skimmed and painted. This is resulting in a much lighter environment that looks clean and bright. New carpets are also being fitted. Doorguards have been fitted to all the main doors within the home. Mr & Mrs Taylor have also identified some bedroom doors where the fitting of Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 15 Doorguards will be beneficial and these will be fitted shortly. The refurbishment will continue throughout the home. Mr Taylor has undertaken to provide updated plans of the premises. Those residents’ bedrooms seen were clean, airy and bright. Some had their own furniture and all were very personalised with pictures, ornaments and other items. New laundry equipment has been installed, including two washing machines, one of which has a sluice facility, and a new dryer. All areas of the home were clean and tidy. There were no unpleasant odours detected during the day. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The numbers and skills of staff meet the residents’ needs. EVIDENCE: A staff rota for the week of inspection was provided. The details recorded on the rota tallied with those staff on duty. The rota showed that more than 14 care hours are provided for each resident in the home at the time of inspection. This level of staff provision is in line with the no-regression agreement. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33 & 38 The service providers and registered manager are well qualified and competent to run and manage the home. The ethos and leadership of Mrs Taylor and Mrs Frost ensures an approach to care that places the residents at the centre. The home is run in the best interests of residents and their views and opinions are sought. Safe practice and staff training protect the health and safety of residents, staff and visitors to the home. EVIDENCE: Discussion with Mrs Taylor and Mrs Frost demonstrated they are both experienced and competent. Further evidence was obtained through the perusal of care plans and discussion with residents. They each have a good Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 18 understanding of the needs of older people and how they can effectively be met. Both are open to the involvement of healthcare and other professionals to ensure good and timely care. Evidence was obtained through discussion with residents and also by observation, to show that the ethos of the home places the resident at the centre of care planning. It was noted that, during staff handover, the discussion was around individual need and how it could be met. Residents also confirmed they felt involved with this process. The home operates a quality assurance process and the most recent questionnaire sent out to residents focused on food. Mrs Taylor provided details of the outcome and described how comments will influence future menu planning. During the course of the inspection, it was seen that the home is maintained to safe standards. There is a continuous programme of replacement and renewal that includes general equipment and fire safety. Safety notices were seen clearly displayed. Safety and maintenance records are maintained in accordance with regulations and relevant equipment is maintained on service contracts. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 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 3 X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X 3 Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 20 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 OP7 Regulation 12(4)(a) Requirement The registered person must ensure that all records held about residents respect the residents’ right to confidentiality Timescale for action 14/11/05 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 Refer to Standard OP7 OP7 OP7 Good Practice Recommendations It is recommended that a record is kept when a resident refuses personal or other care. It is recommended that the proper risk assessment format is used to encourage a risk reduction approach to care planning. It is recommended that the “staff handover book” is used only to record general care issues and not to refer to individual residents. Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Kingsgate DS0000027278.V249908.R01.S.doc Version 5.0 Page 22 - 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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