Inspection on 29/01/08 for Kingsland House Care Home

This inspection was carried out on 29th January 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Kingsland House Care Home 24/09/08

Kingsland House Care Home 19/07/07

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

CARE HOMES FOR OLDER PEOPLE Kingsland House Care Home Kingsland Close, off Middle Road Shoreham-by-Sea West Sussex BN43 6LT Lead Inspector Annette Campbell-Currie Key Unannounced Inspection 29th January 2008 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 Kingsland House Care Home DS0000069308.V355015.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. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsland House Care Home Address Kingsland Close, off Middle Road Shoreham-by-Sea West Sussex BN43 6LT 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) 01273 440019 01273 455625 amanda.f.davies@barchester.com www.barchester.com Barchester Healthcare Homes Ltd vacant post Care Home 71 Category(ies) of Dementia (0), Physical disability (0) registration, with number of places Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only:Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 2. Physical Disability (PD) The maximum number of service users to be accommodated is 71 Date of last inspection 19th July 2007 Brief Description of the Service: Kingsland House is registered as a care home with nursing to accommodate people with a physical disability and a dementia. The accommodation is divided into two units. The Downs Unit accommodates thirty people with a physical disability and the Memory Lane Unit accommodates forty-one people who may have a dementia and a physical disability. The property has been purpose built and is situated in a residential area of Shoreham by sea and is reasonably close to local amenities. An extension has been built and was completed in June 2007 to increase the number of rooms by fourteen. This means that there are now seventy-one beds. The operational activities of Westminster Healthcare Ltd were transferred to Barchester Healthcare Homes Ltd in February 2007. The responsible individual acting on behalf of the company is Mrs Carole Hunt. A general manager has been in post since September 2007 and is in the process of applying to be the registered manager for the home. The fees for the home range from £642.95 to £1000. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that people who use this service experience adequate quality outcomes. Annette Campbell-Currie and Jan Aston regulatory inspectors carried out this site visit for the key unannounced inspection over a period of seven hours. Five requirements had been made at the previous inspection. We looked at the action the home has taken to make sure the requirements have been met. The provider had sent an action plan in response to a request for an Improvement Plan following the previous inspection. The outcomes for people living in the home was assessed in relation to twentyfour of the thirty-eight National Minimum Standards for the care of older people, including those considered to be key standards to ensure the welfare of people living in the home. The general manager who was appointed in September assisted with the inspection; her line manager was also available during the day. The staff on duty were very helpful and all the information and paperwork needed was available. There were twenty-nine people staying in the Memory Lane unit and thirty in the Downs unit. The previous manager had returned an annual quality assurance assessment form (AQAA) about the home and this was used in the planning of the inspection. We looked at eight care plans, four fluid charts, recruitment records for two newly appointed staff, the complaints and compliments file, training records, supervision programmes, quality assurance information, monthly internal audits and other relevant information. During the day we spoke to seven residents, five staff and two relatives. An hour was spent observing the care being provided for a small group of people in the lounge of the Memory Lane unit. The outcome of the observations were discussed with the manager and used to help make an assessment of people’s experience. Three of the five requirements have been met. A requirement about the provision of suitable activities for people who have a dementia has been partially met. There were significant gaps in some of the care plans that were seen which means that some people may not be getting the care that they need, so this requirement has not yet been met. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The general manager has been carrying out all the assessments before a decision is made about whether or not the home could meet their needs. This means that prospective residents and their relatives are involved in the assessment and have the information that they need about what to expect if they decide to move in. The manager then provides a memo for all departments of the home before people move so that staff are aware of any special needs or requirements. A senior member of the nursing team with ten years experience of working in the home has been appointed to head the Memory Lane unit. A review of staffing on each unit has been carried out so that the manager can be sure that staff have the skills and attitudes they need to provide care for people who have a dementia. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 7 A review has been carried out of the people who were being cared for in bed so that more people can be involved in the daily activities if they wish. A new system has been introduced to improve the monitoring of care for people who are cared for in their rooms; staff complete a clock chart at regular intervals every hour. The lounge in the Memory Lane unit has been re-arranged so that people can sit in small groups. The television is in a corner of the room so that other activities can take place without interruption. What they could do better: It is recommended that there should be written evidence of the planning for how an individual moving to the Memory Lane unit should be supported. A record of the actual support a resident received on admission with a record of regular monitoring noting how that individual is settling into the home should also be in place. The care plans for each person in the home should be fully completed and include details of the persons interests, lifestyle and cultural needs and end of life wishes to make sure that their needs are fully understood by staff. Care plans should be individualised and specific to the needs of a person with a dementia. Risk assessments should be completed at an early stage so that staff know how to keep people safe. The way that people have been involved in their care planning and review should be made clear. Where people do not have the capacity to make choices in their lives this should be documented. A further requirement has been made about the completion of care plans for people who have a dementia. The use of fluid and nutrition charts should be reviewed to make sure they accurately reflect people’s experience. An individual programme of activities for people who have a dementia must be established to make sure that people have the opportunity to take part in activities they enjoy and receive the stimulation that they need. Please contact the provider for advice of actions taken in response to this Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 8 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. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 9 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 Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 10 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): 1, 3 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have the information that they need to make an informed choice about where to live. People have their needs assessed before a decision is made about them moving to the home. People have the opportunity to visit the home before they make a decision to move in. Intermediate care is not provided in the home. EVIDENCE: A Statement of Purpose is in place and is currently being updated to show that the home is able to provide for the needs of some people under the age of sixty. There is an admission policy and procedure for staff to follow when a prospective resident moves to the home. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 11 The general manager said that she carries out all the pre-admission assessments by visiting the person and their relatives and in this way they can be involved in the assessment process. It also enables the manager to provide comprehensive information about the home. The manager said even if the admission is at short notice the home always carries out their own assessment to make sure that the person’s needs could be provided for and that their needs are compatible with those already living in the home. There are twentyfive beds on the Downs unit that are used by the local Primary Care Trust and for people moving to these beds information is provided prior to their arrival. The manager said that people are welcome to visit the home as part of a planned admission. A daughter who was spoken with during the inspection confirmed that she had written information about the home and came to visit before her mother moved in. A new resident will have a named registered nurse and care assistant to oversee their needs on admission. A memo is sent to all departments in the home when people are due to move in so that staff know their particular needs before their arrival. From the sample of care records examined there was evidence that good information about a person’s needs had been obtained before they had moved into the home. Copies of continuing health care assessments and care managers assessments were in place that provided detailed information. The samples of case records showed that pre-assessments had been carried out and a further assessment had been carried out on admission. From the records examined in relation to two new residents admitted to the Memory Lane unit there was no written evidence of a planned admission and how members of staff had assisted a person with settling into the home. As the Memory Lane unit provides specialised care for people with a dementia it would be expected that written evidence of the planning for how an individual should be supported on admission to the unit should be in place. A record of the actual support a resident received on admission with a record of regular monitoring noting how that individual is settling into the home should also be in place. The manager agreed that this would be done in future. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 12 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): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The gaps in information on care plans and risk assessments do not ensure that members of staff provide the right support for each person. The health and personal care needs of people staying in the home are being met. People are protected by the home’s medication policies and procedures. People are treated with respect and their right to privacy upheld. EVIDENCE: The organisation has a standard format of documentation to record a person’s needs that is used in all of their homes. The standard format enables staff to record a comprehensive amount of information about each person. This includes information about a person’s needs on a daily basis, their social interests, cultural and religious wishes and an assessment of whether they are at any risk. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 13 From the sample of case records examined it was seen that where they were fully completed comprehensive information was available to staff and a good record of the needs and support provided was documented. There were nutritional assessments on the case records and it was evident that people have their weight checked each month and any changes are monitored. Contact with health professionals such as GP’s, chiropodist, physiotherapists and occupational therapists are all documented. A record is also kept of significant daily events. There is a format for risk assessments for mobility, skin integrity, nutrition and falls. It was noted that the three out of the eight care plans had been reviewed monthly. However out of the sample of eight records examined only the case records of three individuals were fully completed and reviewed. The remaining five care plans had significant gaps in the recording of information in areas of general risk, moving and handling, continence, end of life wishes, nutritional profiles and social interests, activities and life stories. It was noted that the mobility section of a care plan for a person with complex needs who had recently been admitted to the home just stated, “to improve mobility and dexterity.” This gave no guidance to staff as to how to achieve this. During the inspection a member of staff was heard saying that she was not clear about a person’s ability to stand or walk, this could have presented a risk to the person and the member of staff. Included in the case records examined were records of fluid and food intake for people where due to low weight or poor eating and drinking habits this had to be recorded. The records examined for four residents on the Memory Lane unit did not demonstrate that the person was regularly consuming fluid and food; in some cases it appeared that people had been left for long periods of time with no food or fluids. A requirement was made at the last inspection as significant gaps were found in the recording of information on care plans/case records for people with a dementia on the Memory Lane Unit. Throughout the day there was evidence that jugs of fluid were available and people were being assisted with drinks and fluid so it was the recording of this information that was the issue. The manager agreed to follow this up to make sure the records accurately reflect people’s experience. The above evidence demonstrates that there are still significant gaps in information recorded on care plans and no improvement in this area has been made. The requirement therefore remains unmet as where care plans/case records do not give a comprehensive overview of a person’s health and social care needs means that the service cannot be sure that an individual’s needs are met or what support is required to meet those needs. The care plans are not individualised and specific to the needs of people with a dementia. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 14 There is no evidence that people living in the home or their relatives are involved in the compilation or review of the care plans. This means that it cannot be demonstrated that the delivery of personal care is flexible, consistent, and reliable or is in accordance with the person’s wishes. The concern about the recording of information was fully discussed with the manager who said that she has been looking at ways to make key information more readily available to staff and is committed to improving the recording process. Discussions are being held within the organisation about the standard format of care plans. Plans are in place to train members of staff in person centred planning and so far eight members of staff have undertaken this training. From speaking with people living in the home and with their relatives and from observations made during the inspection the inspectors obtained information to demonstrate that the health care needs of individuals are being met. There was evidence that a GP is called when necessary and as frequently as required. A relative who was spoken with during the inspection confirmed that her relative has seen a GP when needed and has had involvement from an occupational therapist and physiotherapist. A chiropodist visits regularly and the manager confirmed that the home has a good relationship with the community matron who works for the Health Authority within the local area and with the diabetic nurse and community physiotherapist. One case file showed that a physiotherapist had carried out a mobility assessment and provided guidance to staff. There are medication policies in place and qualified nurses administer the medication; nine of the nurses have recently attended courses on the safe handling of medication. The storage and recording of medication was seen to be in order at the previous inspection. The manager confirmed that medication rounds take place at the correct time to make sure that people receive their medication as required. The home has a good relationship with the local pharmacy that undertakes regular audits. The residents who were seen during the day were being treated with sensitivity and respect. People looked well cared for and members of staff working on the Memory Lane unit were attending quickly and appropriately to people who were becoming distressed and upset. There are some members of staff working in the home who know the residents well. A member of staff spoken with said that they had worked in the home for a number of years and understands the needs of the residents and that information provided at handover sessions is very detailed. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 15 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): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Activities are varied and organised however the needs of individuals with a dementia are not always reflected in the type of activity undertaken. People are supported to maintain contact with their relatives and friends. It is not clear how people who have a dementia are supported to make choices in their lives. People are provided with a high standard of food in pleasing surroundings. EVIDENCE: There is one full time and two part time members of staff who provide activities for people in the home. The manager said that a second full time activities coordinator is being recruited. There was a programme of activities on the notice board in the Memory Lane unit. The samples of case records seen showed that some interests and hobbies had been noted on individual care plans however information was not very detailed to enable staff to establish a stimulating programme for people who have dementia. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 16 A short observation carried out for forty-five minutes before lunch in the lounge of the Memory Lane unit showed that there were no groups or one to one activities to provide stimulation for the people sitting there. Staff were attending to people who needed help but others were sitting quietly or dosing. The people receiving attention from staff were responding well which indicates that they could be encouraged to take part in one to one or small group activities. The manager said that she is planning to reorganise the communal areas so that small group activities could be more easily arranged. The television in the large lounge in the Memory Lane unit has been moved so that people can watch in comfort without having an impact on everyone in the room. Although an additional member of staff has been employed since the last inspection to co-ordinate activities particularly for the Memory Lane unit there was no evidence that a range of one to one or small group activities have been planned to meet individual need. A programme of activities has been arranged and was available on the notice board. A requirement was made at the last inspection in respect of this as it was found that “ Although there is a varied programme of activities there was no evidence of any specific activities suitable for the needs of those residents with a dementia or severe dementia”. The requirement has been partially met and the manager said that she is reviewing the way that activities are provided for people who have a dementia. People are supported to maintain contact with relatives and friends. There is a visitor’s dining room in the Memory Lane unit so that people can entertain their guests for meals in a comfortable setting. A relative who had written to the home said: “Whenever we visited we were made to feel welcome”. Relatives who were spoken with during the inspection said that they felt they could visit at any time, were made welcome, found the home to be clean and were kept informed. Observation of residents contact with staff in the Memory Lane unit showed that people were being supported to make simple choices about where they wanted to sit and whether they wanted a drink or to be assisted to walk to the dining room. Some care plans showed that people’s daily choices and preferences had been noted however more detailed information about people’s preferred lifestyles would enable staff to support people in having more control in their lives. There was no evidence to show where decisions had been made for people, due to their lack of mental capacity to make decisions for themselves. There is an advocacy service for people who may need it. People living in the home who were spoken with confirmed that they choose when they wish to get up and go to bed. There are activities for them to be involved with but there is no pressure for them to do so. It was noted that residents in the Downs unit had a copy of the activities programme for the week in their rooms. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 17 The food provided is of a high standard. The menus are displayed in the main reception areas and visitors can be provided with a meal. There is a choice of menu each day and the chef said that people could choose an alternative meal or something simple like an omelette if they wish. The dining room in the Memory Lane unit was attractively set out and staff had a list of meals with the special needs of individuals noted. There are two sittings in this dining room with the people who do not need assistance eating first so that those who do need support are not hurried. People were being assisted with their food in a sensitive manner. People living in the home who were spoken with during the visit to the home said the food is excellent and they always know what food is available as there are menus around the home and on the tables, they always have a choice. A resident said, “They always bring round homemade cakes in the afternoon and everything is homemade.” Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 18 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home and their relatives can be confident that their concerns and complaints will be listened to and acted upon. There are measures in place to ensure that people are protected from abuse. EVIDENCE: The complaints policy and procedure are given to people living in the home and there is a copy in the main reception area. There is a system for recording complaints to show the detail of the complaint, the timescales of the response and the outcome. The records showed that concerns and complaints are listened to and acted upon. Four people have raised concerns about the home to the Commission and a representative of the provider has appropriately investigated these. Resident’s meetings are held so that people can discuss any issues they may have and the manager operates an open door policy so that people could raise any concerns at an early stage. Letters or cards of gratitude sent to the home are displayed on notice boards or kept on file. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 19 There are policies and a procedure regarding safeguarding adults and the home follows the West Sussex Social and Caring Services Safeguarding Adults Procedures. All newly appointed staff receive information about safeguarding procedures as part of their induction and there is an ongoing programme of training in recognising and reporting signs of abuse. Members of staff spoken with during the visit to the home confirmed that they have received recent training in safeguarding adult procedures. People are encouraged to manage their own finances and where they lack capacity to do this relatives or legal advisors assist with financial matters. People hold small amounts of money for additional services in the home or personal items; all transactions are recorded and moneys accounted for. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 20 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): 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The premises are maintained to a high standard and provide a safe and pleasant environment that suits the needs of the residents. EVIDENCE: A tour of the premises demonstrated that Kingsland House continues to provide an excellent environment for resident to live in. It is well maintained and safe. The accommodation and environment in the Memory Lane unit is of a high standard and has been designed specifically to meet the needs of people with a dementia. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 21 The decoration and furnishings provide a range of textures in cushions, wall hangings and bright pictures along corridors and on outside walls. Placed tastefully around the corridors are chests of drawers with pictures, jewellery and clothing placed on them and within the drawers for rummaging. Clothing and hats etc of 1940’s are also hanging in these areas. Bathroom and toilet doors have pictures on the outside displaying a toilet (with high cistern) and bath or shower. The doors are a different colour to the bedroom doors. Bedroom doors have a display case where photos or pictures or artwork can be displayed so residents have a meaningful sign on their doors for them to recognise. Rooms are of a good size and contain all the necessary items of furniture and equipment. The rooms can be personalised with belongings and personal furniture. All beds are adjustable in height and it was noted that pressure-relieving mattresses are in place. There is a kitchen in the dining area and in the lounge area on the Memory Lane unit. This allows baking and other activities to be undertaken by residents. There were small old style jukeboxes in each kitchen area. The home was clean throughout and it was noted that there were infection control procedures in place for laundry and protective clothing for members of staff. There is a hair salon that has been upgraded that provides suitable facilities. The annual quality assurance form (AQAA) provided evidence that all the necessary health and safety checks for the premises and equipment are up to date. The home has many outside areas for residents to use. They are well maintained and as well as providing an attractive display they also provide sensory stimulation with strong smelling plants and the growing of vegetables provides another activity for residents. A gardener has been employed to maintain the upkeep of the gardens. It was noted that the home does have a storage problem for equipment such as hoists as these were being stored in bathrooms. This made the bathrooms very crowded and not a homely environment. When the bathroom is in use the equipment is then moved into the corridors that could cause a hazard. This was discussed with the manager who confirmed that a solution to this matter is being considered. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 22 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): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff meets the needs of people living in the home. People are supported by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. EVIDENCE: The manager confirmed that the staffing of each unit has been reviewed since the last inspection. The manager has looked at the skills, experience and areas of interests of each member of staff. This reorganisation has ensured that members of staff working on the Memory Lane unit are skilled and have the interest and commitment to work on this unit. The management of the Memory Lane and Downs units has also been reviewed and is under further review. Staffing levels remain at eight care staff on each unit in the mornings and five in the afternoons. The manager confirmed that this would be reviewed on the Memory Lane unit when more residents are admitted. Members of staff spoken with confirmed that they find the staffing levels appropriate and they have time to undertake all their work. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 23 The home has not yet met the target of 50 of care staff achieving the National Vocational Qualification (NVQ) level two or above. Six people have achieved the award and five people are currently working towards it. The manager said that there is an ongoing programme to make sure that all care staff could be supported to achieve an NVQ award. Samples of recruitment records showed that the home operates a robust recruitment process and all the required checks are carried out prior to new staff starting in post. The manager explained that she is involved in the recruitment of all new care staff and ensures that the interview process is interactive so that people have the opportunity to show that they have a positive attitude to the work and have an understanding of what it entails. There is a comprehensive induction and training programme to ensure that staff have the knowledge and skills they need to do the job. Training for members of staff working on this unit have been made a priority with staff receiving “Yesterday, today and tomorrow” training. This gives staff guidance on how to work with people with a dementia and challenging behaviours. Members of staff confirmed that the organisation is good at providing training and support with NVQ training. Through the inspection it was observed that members of staff in all areas of the home were friendly, approachable, interacted with residents in a professional and caring manner. Members of staff spoken with during the inspection confirmed that they meet with the manager regularly through staff meetings and one to one meetings. They confirmed that they found the manager approachable and felt they could easily raise any issue. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 24 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): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed by a person with the knowledge and experience to do so. The quality monitoring systems do not always ensure that all areas of the home are run in the best interests of people living there. People’s financial interests are safeguarded. The health, safety and welfare of people living in the home and staff are promoted and protected. EVIDENCE: A new manager for the home was appointed three months ago. She is qualified and experienced in previous management posts and is applying to be Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 25 registered with the Commission to become the registered manager for this service. Since beginning in post she has developed an action plan and has begun to make changes in the way that care is provided to improve the experience of people living in the home. A senior nurse with ten years experience of working with people who have a dementia has been appointed to manage the Memory Lane unit. The general manager is providing additional training and keeping the management of the unit under review to ensure that the quality of care for people who have a dementia is improved. The company has a quality assurance process and the views of residents, relatives and staff are sought each year. The information received is collated and published by head office. The comments that people have made are included in the report so that any issues can be addressed. Residents meetings are held so that people who are able to can express their views and opinions about the home. There is a monthly audit carried out by the deputy manager who looks at a different aspect of the home each month. Some areas of the home are developing well however there are areas of practice particularly in the Memory Lane unit that need to be addressed. At the previous inspection it was demonstrated that annual safety inspections are undertaken on equipment and utility supplies and maintenance systems are in place to ensure the safety of residents. It was noted that accidents and incidents are recorded appropriately. A comprehensive evacuation plan has been set up in case of a fire or other emergency; equipment is in place to assist with evacuation. Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 27 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 OP7 Regulation 15 (1) (2) (a) (b) (c) Requirement Care plans should be person centred and reflect the individual needs of a person with a dementia. This requirement is outstanding from the previous inspection. Timescale for action 30/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Kingsland House Care Home DS0000069308.V355015.R01.S.doc Version 5.2 Page 29 - 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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