Inspection on 10/08/05 for Kingshill

This inspection was carried out on 10th August 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

Kingshill 26/07/06

Kingshill 09/03/06

Kingshill 10/01/05

Kingshill 15/07/04

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

CARE HOME ADULTS 18-65 KINGSHILL Kingshill Court Standish Wigan WN6 0AR Lead Inspector Bernard Tracey Announced 10 August 2005 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 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 Stationary 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. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Kingshill Address Kingshill Court Standish Wigan WN6 0AR 01257 421332 01257 427681 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Making Space Cordelia Saint CRH Care Home only 15 Category(ies) of MD Mental disorder - 15 registration, with number MD(E) Mental disorder (over 65 years) - 15 of places KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 15 service users to include:up to 15 adults in the category of MD (Mental Disorder aged 18 - 65 years) up to 15 service users in the category of MD(E) (Mental Disorder over 65 years) 2. The service should employ a suitably qualified and experienced manager who is registered with the Comission for Social Care Inspection. Date of last inspection 10th January 2005 Brief Description of the Service: Kingshill Care Home is privately owned by the company Making Space. The Home is a purpose built home that provides accommodation and personal care and support for up to 15 adults whom suffer from an enduring mental illness. The Home is set in its own grounds in a residential area of Standish. Wigan and Standish town centres are easily accessible by public transport.The Home provides all single accommodation, no rooms offer en suite facilities.There is car parking to the front of the Home and enclosed, private gardens to the rear. The external areas of the Home are well maintained and well presented. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home had been informed that the inspection was to take place on the 10th August 2005 and had been requested to ensure that residents and relatives were aware of the inspection. The inspector also wrote to General Practitioners, Community Psychiatric Nurses and Social Workers involved in the home asking for their comments. Two doctors returned comment cards and both felt the home provided a satisfactory service. Five relatives responded to the questionnaires all expressed satisfaction with the care provided by the home. The home has recently been given a change of registration by the Commission to allow over 65 year old residents to be cared for in the home as well as residents under 65 years old. The Inspector spent time speaking to 8 residents both individually and as a group. He also spoke to 5 support staff and the manager to see how they felt the home was run and how residents were involved in the day-to-day decisionmaking. The Inspector also took the opportunity to read through records relating to how the care of residents was planned and carried out including how the residents spent their time during the day and how they were supported in taking personal responsibilities for themselves within their own capabilities. When talking with the residents they were asked what they thought of the home and had they been given enough information about the home before being admitted. They were also asked how they felt the staff looked after them What the service does well: Prior to moving into the home each individual receives a detailed assessment to determine if the home can meet his or her needs. If admission to the home is appropriate individual written plans are provided with the full involvement of the individual and the resident receives a copy of this plan. Residents and relatives felt that all of the staff were caring and committed to providing the best care they could. Relatives had written to say they were confident that the staff provided a good service. Observations made during the inspection indicated that there was a relaxed and easy relationship between residents, visitors and members of staff. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The key standard was not examined on this occasion. EVIDENCE: The key standard was not inspected on this occasion. It will be inspected at the next inspection. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 7 9 There is a clear and detailed care planning system in place that includes residents’ involvement and provides the staff with the information needed to meet the needs of the residents. EVIDENCE: KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 10 All prospective residents receive a formal assessment from a qualified member of staff, usually the home manager, using a detailed assessment format. The care management assessments and the hospital care plans are obtained prior to admission to the home, and a copy was seen in the residents’ notes that were examined during the inspection. Any potential restrictions on choice, freedom, services or facilities that become part of the residents’ daily life, had been discussed and agreed with the resident during assessment, and recorded in the care plan. Two residents spoken with confirmed that they had been given “good information about how the home is run before coming here.” The care plan is generated from the single care management assessment and the assessment provided by the home. The plan sets out how the current and anticipated needs are to be met. There is evidence that the resident together with family, friends or advocate are involved in the drawing up of the plan. Care plans examined had been reviewed on a monthly basis, which is above the necessary requirement of this standard. The review of care is conducted on a group basis that involves the resident, the key worker and the social worker or advocate, if appropriate. All of the reviews are recorded and signed by the participants. Two residents said they were aware of their own care plans and had been into the reviews with the staff. They were able to explain to the Inspector that the care plan set out “ important things about our care”. Daily records were detailed but in line with good practice guidelines these entries should be timed as well as dated. Information in respect of residents is shared within the home team and visiting professionals in the interests of the resident. In this respect it also necessary for the home to share personal identification and some medical detail with the local police when concern surrounds an individual who is absent from the home without prior arrangement and the home feels that the person may be at risk. Procedures for responding to unexplained absences and who should be notified are confirmed in a written policy. Wherever possible residents are encouraged to manage their own finances, but where the home does manage the finances for individuals, records are maintained and a recognised tool for audit is incorporated in the monthly review of finance. A newsletter has been published on a monthly basis and includes details of planned outings as well as general news items. This started as a response to a request from the residents in their regular monthly meetings with staff. The home is hoping to develop this further. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 11 In a group discussion with three residents all agreed that staff cared very well for the residents and they felt they were consulted in regards to how the home was run. Observations made during the inspection indicated that staff had developed a good rapport with residents and there were several examples of spontaneous and humorous interactions with residents and staff. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 13 14 15 16 17 Residents are supported in acquiring new skills enabling them to live more independently through access to local community and leisure facilities. The dietary needs of the residents are well catered for with a balanced and varied selection of food available that meets the residents’ tastes and choices. EVIDENCE: All of the residents spoken with during the inspection said that they were satisfied with day-to-day life in the home. Staff members were seen to support residents in the activities of daily living, which in the case of some individuals is presently fully meeting their needs, but arrangements are in place to enable residents to take up opportunities in relation to education and training activities. One resident said that he was about to start attending Sunshine House, a local mental health day centre, but that he also had special interest in maintaining the gardens and greenhouse Care staff support service users in accessing local facilities for leisure and shopping, according to the assessed needs of the individual. Several residents KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 13 spoke of group trips into the village, for a drink in the local pub, as well as visits to the garden centre. Not all activities are conducted on a group basis with ample opportunity for one to one trips out from the home. The home have recently converted a small lounge area on the first floor and equipped it to provide a relaxation area as well as Reike treatment. The inspector took the opportunity to speak with the member of staff, who is qualified as a Reike therapist, as well as two residents who said they felt the benefit of the treatment particularly as it helped them to relax. Staff members give support to residents in ensuring access to public transport as well as organised trips to places of interest and enjoyment, suggested by the residents. A photograph album has been produced to record a recent visit to Martin Mere bird sanctuary. A deputy manager has overall responsibility for day care. Along with the residents she produces a monthly newsletter which gives details of forthcoming events as well as reports and information concerning recent activities that have taken place. Four residents had recently taken a holiday in Ireland accompanied by the care staff. The manager confirmed that residents may develop and maintain intimate personal relationships with people of their own choice, and information and specialist guidance are provided to help the service user to make appropriate decisions. Each resident’s personal privacy is maintained. One resident said that staff members “always knock on your door and wait”. This was confirmed when the inspector toured the building with the manager. Staff members enter the bedrooms only with permission and in the presence of the resident. Residents are encouraged to participate in the political process through the opportunity to vote in local and general elections. The inspector took the opportunity to have a lunchtime meal with a group of residents. The meal, was well presented and appropriately served. A choice of tea or a cold drink was offered. The meal was well cooked and tasty and confirmed by residents that this is usually the case. Residents informed the inspector that the food is always good and there is always an alternative offered. Barbeques are provided for the regular theme nights that take place in the home, which are often in fancy dress. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 19 20 Committed, enthusiastic and well-trained care staff are meeting the physical and mental health needs of the residents. EVIDENCE: Individual care plans are in place for each resident. Three care plans examined were well written, with evidence of resident involvement in formulation of the plan and the review of care. Access to all NHS services is upheld and documented within the care plan. Residents are registered with a local medical practice. For all other healthcare needs residents are supported in accessing relevant community facilities such as community psychiatric nurses, dentists and opticians. Additionally where necessary, referrals would be made to specialist medical services. Care staff also provide residents with information regarding general healthcare and specific issues relating to their lifestyles and needs. The manager has policies and procedures in place for the receipt, recording, storage, handling and disposal of medicines. Currently there are no service users who self administer their own medication. All staff members that administer medication have received appropriate training. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The key standards were not examined on this occasion. EVIDENCE: The key standards were not inspected on this occasion, but they will be inspected at the next inspection. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None EVIDENCE: The key standards were not inspected on this occasion. They will be inspected at the next inspection. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None EVIDENCE: The key standards were not inspected on this occasion. They will be inspected at the next inspection. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 39 42 The manager is providing a clear vision for the home, which she has effectively communicated to the residents, care staff and relatives. The quality assurance and monitoring systems ensure the views of service users and relatives were utilised to improve the service. EVIDENCE: KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 19 The manager has recently been registered with the Commission for Social Care Inspection, following a period as acting manager of the home. The atmosphere at the time of the inspection was relaxed and homely. The staff and residents appeared happy and comfortable in the company of one another. The Inspector observed a friendly, respectful rapport between the staff and residents. The manager communicates a clear sense of direction and leadership, which staff and residents understand and are able to relate to the aims and purpose of the home. The manager ensures that effective quality assurance systems are in place, which suits the capacity of the residents. The manager or senior carer maintains daily contact with the residents. There are monthly residents meetings, a newsletter is published and relatives receive a copy. Annual satisfaction questionnaires are distributed and following consideration are implemented where appropriate. The manager has comprehensive policies and procedures in place. Staff have access to the policies at all times, and are fully involved in developing, reviewed and implementing the policies and procedures. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 KINGSHILL Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 21 NO 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 Regulation NONE 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 6 Good Practice Recommendations All daily entries in the residents care plans should be timed as well as dated, in line with good practice guidelines. KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 KINGSHILL F56 F06 S5742 Kingshill V221160 100805 Stage 4.doc Version 1.40 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!