Inspection on 12/05/09 for Kingsleigh

This inspection was carried out on 12th May 2009.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingsleigh 21/05/08

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Kingsleigh 78 Berrow Road Burnham-on-Sea Somerset TA8 2HJ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Poole     Date: 1 2 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Kingsleigh 78 Berrow Road Burnham-on-Sea Somerset TA8 2HJ 01278792768 01278783825 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Angels (Kingsleigh) Ltd care home 23 Number of places (if applicable): Under 65 Over 65 23 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is 23. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Kingsleigh is registered with the Commission for Social Care Inspection to provide care to up to 23 people over the age of 65 who require personal care. Nursing care is not provided. The home is a large, older style property located in a residential area of Burnham on Sea. Accommodation is arranged over two floors with a passenger lift between. All communal areas are located on the ground floor. Care Homes for Older People Page 4 of 28 Brief description of the care home The home has been owned by Angels (Kingsleigh) ltd since December 2007. The registered manager is Samantha Oatway. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience Adequate quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for people and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out by one inspector over a one day period. Throughout the report the term we refers to the inspector from the Care Quality Commission. Care Homes for Older People Page 6 of 28 During the inspection we, the Commission, were able to speak to people living and working at the home, observe care practises, view records and tour the building. Prior to the inspection the manager completed an Annual Quality Assurance Assessment (AQAA) this gave details about the home, their plans for the future and some numerical information. Current fees (15/05/09) range from 402 to 470 pounds per week. The following is a brief summary of the inspection findings and should be read in conjunction with the whole of the report What the care home does well: What has improved since the last inspection? What they could do better: There are two outstanding requirements from the last inspection. These are in relation to assessment and care planning. Pre admission assessments need to be more comprehensive to ensure that the home are able to evidence how they will meet individual needs and expectations. Care plans also need to be more comprehensive to enable staff to assist people in a person centred way. People living at the home appear to have limited involvement in care planning and reviews and therefore limited opportunities to express their changing needs and wishes. All care plans need to be kept up to date to ensure that they reflect the persons current needs and wishes. Some people living at the home felt there was a lack of social stimulation and meaningful activity. People said that there were very few opportunities to go out and they spent the majority of their time sat in the lounge without stimulation. The home need to find out, and record, individuals personal interests and hobbies to ensure that Care Homes for Older People Page 8 of 28 any activity programme meets the needs and expectations of everyone living at the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to move to the home receive adequate information about Kingsleigh but do not always have opportunities to visit before they move in. Pre admission assessments are basic and do not give full details about the persons wishes and expectations. Intermediate care is not provided. Evidence: Anyone wishing to move to the home receives a pack that contains a colour brochure, a copy of the statement of purpose and the last inspection report. Some people living at the home said that they had been able to visit before making a decision to move in. In addition to full residential care the home also offers day care Care Homes for Older People Page 11 of 28 Evidence: and respite stays. One person spoken with said that they had originally visited the home for day care and another said that they had had a short stay before deciding to move in on a permanent basis. Two people said that they had not seen the home before they moved in and felt that they had not had a choice. The manager stated that they assess anyone wishing to move in before offering a place at the home. One care plan of a person who had recently moved to the home was viewed. The care plan contained a very brief pre admission assessment completed by the home. No assessment undertaken by professionals outside the home had been received. This meant that there was limited information about the person, their abilities or wishes. When spoken with this person said that they had not been able to view the home and did not feel they had had a choice about where they lived. The first four weeks of any stay is considered a trial period. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have access to medical professionals according to their individual needs. Care plans give basic information about the persons needs but would benefit from being more comprehensive to ensure that they fully reflect up to date needs and wishes. Evidence: Three care plans were viewed during this inspection. All contained assessments of need, a basic plan of care and an outline of the persons preferred daily routine. One person was experiencing significant mental health difficulties and a mental health assessment had been completed. This assessment had not been dated and therefore it was difficult to tell if it presented an up to date view of the person. There was evidence that care plans were being reviewed regularly and people living at the home are asked to sign when the plan has been reviewed. We observed one person being asked to sign their care plan. The plan was not explained to them and there was no evidence that Care Homes for Older People Page 13 of 28 Evidence: the person had been involved in the review. The manager stated that one person had been reviewed by professionals outside the home but records of this review were not available in the care plan, therefore there were no details of the outcome or any recommendations. The Annual Quality Assurance Assessment states that they wish to develop the key worker system more fully. Daily records are written about each individual giving details about their day to day lives and significant events. People asked said that the home assisted them to make and attend medical appointments. All appointments are recorded in the care plan. At the time of the inspection one person was unwell and spending time in bed. The home had sought advice from professionals outside the home and appropriate pressure relieving equipment was in place. Charts seen showed that the person was being assisted to change position to relieve pressure and protect their skin. There were charts in place to show daily food and fluid intake. The care plan had not been fully up dated to reflect all changes but staff were aware of the needs of the person and were recording the care given. The person appeared comfortable. People living at the home felt that their privacy was respected. People said that they were able to spend time in communal areas or in the privacy of their room if they preferred. Staff observed during the inspection spoke to people in a friendly respectful manner. Everyone asked said that they were able to see personal or professional visitors in private. The home uses a monitored dosage system for medication. Staff who administer medication have received training to undertake this task. The Medication Administration Records (MARs) were viewed and found to be correctly signed when medication entered the home and when administered or refused. This gives a clear audit trail. It was noted that hand written entries on administration records had not been signed and witnessed in line with good practise guidelines. Currently spare medication, dressings and other medical equipment is stored in the staff toilet. To promote good infection control practises alternative storage facilities should be found. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines in the home are fairly flexible, enabling people to make choices about their day to day lives. Visitors are welcome at anytime. Evidence: People living at the home said that all routines are flexible. People said that they could choose what time they get up and when they go to bed. An activities worker is employed who supports people with activities for two hours a day.The home also has a programme of entertainment which includes live music. A representative of a local church holds holy communion every month for people who wish to attend and two people have begun to go out to a local church. Some people living at the home are able to go out without assistance and use local shops and facilities. Three people asked said that there was not much to do at the home and that it sometimes felt like a long day. One person said Not much to do, I get a bit bored Care Homes for Older People Page 15 of 28 Evidence: another said The girls are lovely but theres nothing to do so I just sit all day, it feels like a very long day. Everyone asked said that they could have visitors at anytime and some people said that they enjoyed going out with friends and family. People said that they could see visitors in communal areas or in the privacy of their rooms. People said that the food was always good and that portions were ample. There is a four week menu in place which offers a choice at every meal. We were invited to have lunch with people living at the home, food was well presented and tasty. It was observed that one person who did not like the set meals was offered a variety of alternatives. Hot drinks and biscuits are served at set times throughout the day. One person spoken with said that if they were awake at night they were always offered a hot drink to help them settle. The manager wrote on the AQAA that they could be better at personal profiling to ensure that the activities programme is appropriate to the individuals living at the home. Plans for the future include increasing the activities programme. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies and procedures in the home minimise the risks of abuse to the people who live there. People are confident that any concerns would be dealt with by the manager. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. Many staff working at the home have received training in the protection of vulnerable adults and the home has obtained an e learning package to ensure that all staff are competent in this area. Staff spoken with were aware of the ability to take serious concerns outside the home. Some staff have also received training in the Mental Capacity Act to ensure that they are able to appropriately assist anyone living at the home who may lack the capacity to make decisions for them self. No complaints have been received since the last inspection. People living at the home said that they would be comfortable to raise any concerns with the manager. People were confident that any worries would be listened to. The home does not act as a financial appointee or power of attorney for anyone. There Care Homes for Older People Page 17 of 28 Evidence: is a facility to deposit small amounts of money with the manager and clear records are kept of all monies held. Records seen correlated with money held at the time of the inspection. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Kingsleigh provides a comfortable environment for the people who live there. Standards of cleanliness in the home are good. Evidence: Kingsleigh is a large older style property located in a residential area of Burnham on Sea. Accommodation is set over two floors with a passenger lift between. A fire detection and call bell system is fitted throughout the home. Communal living space is located on the ground floor and is accessible to all. To the front of the house there is a pleasant garden with seating. All bedrooms are for single occupancy and people are able to personalise them to their own tastes. A sample of bedrooms were seen. All were well maintained and adequately furnished. Many people have bought small items of furniture and personal possessions which gives rooms an individual homely feel. 6 bedrooms have en suite facilities and there is a communal bathroom located on both floors. On the day of the inspection all areas seen were clean and fresh. Some people living at the home commented that standards of cleanliness were always good. Care Homes for Older People Page 19 of 28 Evidence: The AQAA states that plans for the future include refurbishing bathrooms and improving the garden. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are assisted by a qualified and competent staff team. Recruitment records do not fully evidence that a robust recruitment procedure is in place. Evidence: The home employs 21 care staff, 15 (71 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. All new staff undertake a comprehensive induction programme when they begin work at the home. Completed induction records were seen during the inspection. There is an ongoing training programme for staff in health and safety matters and subjects relevant to the care of the people who live at the home. An easy to read matrix is maintained to ensure that all training is kept up to date. Staff spoken with felt that there were good opportunities for training within the home. The majority of people living at the home felt that staffing levels were adequate. People said that staff came promptly if they requested assistance and were always willing to help. In the morning there are 4 care staff on duty and in the afternoon there are 3 and an activity worker for 2 hours. Overnight there are two staff on duty. Care Homes for Older People Page 21 of 28 Evidence: Three recruitment files were viewed for people who have begun work since the last inspection. An initial Protection Of Vulnerable Adults (POVA) check had been obtained and a Criminal Records Bureau (CRB) check had been applied for before each person began work. Two members of staff had begun work in the home before two written references had been received and there was no evidence that telephone references had been obtained. People living at the home said that the staff were kind, very good and lovely. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager has the qualifications and skills to manage the home. The home is well maintained ensuring the health and safety of people living and working there. Evidence: The registered manager of the home is Sam Oatway. She has completed the Registered Managers Award and NVQ level 4 in care. During the inspection the manager was able to demonstrate a good knowledge of the people living at the home. The managers office is located on the second floor away from all areas of the home. At the last inspection people felt that the manager was not always involved in the home. At this inspection staff felt that the manager was more visible and people living at the home said that they could always talk to her if they had any worries or concerns. The registered provider visits the home regularly and written reports, up to January Care Homes for Older People Page 23 of 28 Evidence: 09, were available in the home. There is always a senior member of staff on duty ensuring clear lines of accountability and responsibility. The manager and senior staff have undertaken training in the implications of the Mental Capacity Act . ( After the inspection the manager was proactive in seeking advise from local professionals about issues in relation to Deprivation of Liberty safeguards.) The home sent out quality assurance surveys earlier in the year to gauge views on the quality of care offered. Returned surveys were seen and these showed a high level of satisfaction with most aspects of the service. The Annual Quality Assurance Assessment, completed by the manager, demonstrates that areas for improvement have been identified and that the home has a commitment to ongoing improvement. As previously stated the home does not act as a power of attorney or financial appointee for anyone living at the home. There is a facility for people to deposit small amounts of money for safe keeping. Records are maintained of all transactions and a sample of records seen correlated with monies held at the time of this inspection. Staff receive training in health and safety including moving and handling, fire safety and first aid. All accidents in the home are recorded and these are analysed every three months to ensure that any trends, or signs that an individual is having a significant number of accidents, are acted upon. All areas of the home are well maintained to ensure that the building is safe for people living and working there. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 3 14 (1) The registered manager 22/06/2008 must ensure that comprehensive pre admission assessments are carried out and demonstrate how the home will meet individual needs. Care plans must give clear 22/06/2008 guidelines to enable staff to give appropriate care to individuals and to monitor healthcare needs. Care plans must be drawn up and reviewed in consultation with people living at the home or their representative. 2 7 15 (1) (2) Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 Pre admission assessments 15/07/2009 must be comprehensive. They should include full details of the persons needs, interests and wishes. To ensure that the staff have the skills and experience to care for new people moving to the home. 2 7 15 (2) The registered manager must ensure that care plans are comprehensive and reflect current needs and wishes. People living at the home should be consulted when care plans are created and reviewed. To ensure that staff have access to up to date information and to make sure that people are assisted in the manner of their choosing. 31/07/2009 3 26 19 No new staff should begin work until all information listed in Schedule 2 of the 29/05/2009 Care Homes for Older People Page 26 of 28 Care Homes Regulations 2001 has been obtained. This includes 2 written references. To minimise the risks of abuse to people who live at the home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 To minimise the risk of recording errors all hand written entries on Medication Administration Records should be signed and witnessed. To promote good infection control practises alternative storage should be sought for medical supplies. To ensure that everyone receives adequate social interaction the activities programme should be expanded. Activities should take account of individual interests and hobbies. 2 3 9 12 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!