Inspection on 27/05/09 for Kingsleigh Resource Centre

This inspection was carried out on 27th May 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingsleigh Resource Centre 09/10/09

Kingsleigh Resource Centre 27/02/08

Kingsleigh Resource Centre 01/12/06

Kingsleigh Resource Centre 18/11/05

Kingsleigh Resource Centre 13/06/05

Kingsleigh Resource Centre 26/08/04

Kingsleigh Resource Centre 01/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Kingsleigh Resource Centre Kingsleigh Kingfield Road Woking Surrey GU22 9EQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Vera Bulbeck     Date: 2 7 0 5 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 Resource Centre Kingsleigh Kingfield Road Woking Surrey GU22 9EQ 01483740750 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): manager.kingsleigh@careuk.com manager.burroughs@careuk.com Care UK Community Partnerships Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 67 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 67. The registered person may provide the following category 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). Date of last inspection Brief description of the care home Kingsleigh Resource Centre is run by Care UK Community Partnerships Ltd. The home caters for the needs of older people and can provide permanent and respite care for people with dementia and a day care service. Residential accommodation consists of five self-contained units, each with varying numbers of single bedrooms, some of which have en-suite facilities. Each unit also has Care Homes for Older People Page 4 of 28 Over 65 0 67 Brief description of the care home a lounge/dining room, a kitchenette, a bathroom and toilets. The home has spacious communal areas and has safe, well-maintained gardens. The home is situated near to local shops and community facilities and is approximately two miles from Woking town centre. There are car parking facilities within the grounds of the home. 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: two star good 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: This inspection of the care home was an unannounced Key Inspection. Mrs Vera Bulbeck Regulation Inspector carried out the inspection and arrived at the service on 27th May 2009 at 09.15 and was in the home for eleven hours. It was to have a thorough look at how well the service was meeting the key National Minimum Standards for Care Homes for Older People and has in this report made judgments about the standard of the service. The previous inspection was a Annual Service Review completed on the 25th February 2009. The CSCI Inspecting for Better Lives involves an Annual Quality Assurance Assessment to be completed by the service, which includes information from a variety of sources. This document was received in January 2009 and reference to the AQAA was made whilst undertaking the key inspection and developing the report. The information contained in this report was gathered from observation by the Care Homes for Older People Page 6 of 28 inspector and speaking with a number of service users and care staff. A full tour of the premises was undertaken and documents sampled during the inspection included some service users care plans, daily records and risk assessments, medication procedures, health and safety records, staff training and recruitment records, and some of the homes policies and procedures. The final part of the inspection was spent giving feedback to the manager and service manager about the findings of the visit. Three safeguarding vulnerable adult referrals remain un-concluded. The homes management advised that five complaints have been received by the home since February 2009 and one complainant has contacted the commission regarding the home. From the evidence seen by the inspector it is considered that the home would be able to provide a service to meet the needs of clients who have diverse religious, racial or cultural needs. The commission have noted that no requirements were made during the last key inspection in February 2008. The fees for the home range from three hundred and sixty five pounds to eight hundred and ninty five pounds, these fees do not include personal items. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: There is a malodour in some of the bedrooms, management stated this would be Care Homes for Older People Page 8 of 28 addressed immediately and a company would be called in to undertake this task. care planning and risk assessments in the home have been computerised and the full details are transferred onto the computer. Therefore these were not seen on this occasion. However it was noted that information regarding one service user had not been transferred to the computerised care plan and it was discussed the person may not be receiving the care they need. All mandatory training must be updated in order to ensure that the homes staff are suitably trained and competent in their duties. A number of training courses have been booked. The Environmental Health Officer visited the home on 15/11/07 and made a requirement for the ceiling in the kitchen to be cleaned and painted. On the day of inspection this work had not been undertaken. When this was pointed out to the manager and service manager they said it had been overlooked and would be dealt with immediately. The basins in the hairdressing room need to be more suitable for service users and need to be back basins, this would eradicate the water running over service users faces. The service manager stated the basins are to be changed very shortly. The control of infection needs to be reviewed to ensure peoples safety and health and welfare is promoted. This is particularly regarding the cleanliness of the home. People are consulted about their choice of social activities and the programme of activities provided by the home is available for people to see. However there is currently only one activity organiser at present and service users are not being sufficiently stimulated. Medication procedures have been reviewed and all senior staff have received medication training to ensure the safety and well being of service users receiving prescribed medicines. However it was noted that controlled medication was not kept in the appropriate CD cupboard. 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission and assessment procedures ensure that service users needs are appropriately identified prior to moving into the home, however at times these need to be more consistently implemented when accepting a person, the management need to ensure appropriate information is received regarding the service user. Evidence: An individuals care plan who had been recently admitted to the home was sampled and evidenced that an assessment had been made by a qualified person to ensure that the needs of the service user could be met by the homes staff. The manager confirmed that a senior member of staff, team leader or the deputy manager would assess a potential service user. However it was stated that at times appropriate information is not always supplied from care management or the hospital. The manager confirmed the statement of purpose and service users guide has recently been updated, these documents were not seen at this inspection. Care Homes for Older People Page 11 of 28 Evidence: The home continues to offer respite care for individuals. The home does not offer intermediate care. In the AQAA it states all potential service users are invited to view the home and spend some time in the home prior to admission. A full information pack is provided, which includes the statement of purpose and a service users guide. From the pre assessment, a concise and individual plan of care for all daily needs is created with the service user and their family. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning and medication processes in the home would benefit from improvement to ensure that service users needs are consistently met and service users rights to protection are maintained at all times. The home promotes service users dignity and respect. Evidence: Four care plans were sampled there were several files for each service user and not filed in any order, making it very difficult to view the information. In one of the care plans seen information was out of date, and according to the recording of a service users weight was last undertaken on 29/09/08. The staff are currently transferring all relevant information onto the computer. It was noted when visiting each unit that a member of staff was adding information into the computer. However when the inspector asked a member of staff about a service users needs, she was not able to tell the inspector. When asked if she read the care plans on the computer the reply was we are supposed to but time does not allow. The inspector discussed this with the registered manager and the service manager and suggested that they review the method currently used as each service user should be provided with a care plan to Care Homes for Older People Page 13 of 28 Evidence: read if they wish and all staff should have access to the care plan. The representative from the commission was shown a new person centred style care plan, which the management advised has been introduced at the home in order to benefit the service user and staff providing the service users care. The service manager stated that all Care UK homes are adopting this method. The care plans have been improved to be more person centred and to include information about the individuals maintenance of their daily living skills, their likes and dislikes, lifestyle choices for example what time they like to get up and retire at night, their previous occupation, how they like to be addressed, their spiritual, ethnicity and cultural needs and choice regarding gender specific care. The homes management and staff have an action plan to continue to work to wards ensuring that all service users care plans accurately reflect the needs of the service user in respect of their health, social and behavioural needs and the care plans will be audited by the homes manager. There was evidence to support that the new manager will be working closely with all grades of staff in order to improve staff practise and are continuing to ensure that service users or their representatives, where able, are being consulted about the information on their care plan. Care plans also need to be signed by the service user or their representative. It was observed that those service users in their bedrooms had their call bells available to them in order that they could ring for staff assistance if needed. There needs to be continuous information and records documented to evidence that appropriate health care appointments including visits by the General Practitioner had been attended. Health care visits to the home include visits from the opticians,continence advisors, dentists and chiropodists to ensure that service users health care needs continue to be met. The commission have been given assurances that the overall standard of care plans will be improved by the day to day manager and all staff members will be given support and training to improve the current care planning system for the benefit of service users receiving care and support at the home. The home has a medication policy and procedure in place and continues to use a blister pack system. There are four team leaders who are responsible for the administration of medication. All four had completed the training for administering medication. However the inspector noted that controlled medicines for four service users were not kept in the controlled medicine cupboard. The service manager who was in the home at the time of the inspection to undertake a Regulation 26 visit had Care Homes for Older People Page 14 of 28 Evidence: also noted the storage problem. The staff member in charge of medication on the day was immediately informed to ensure controlled medicines are kept stored appropriately. Staff acted immediately to address this problem. It was also noted that one service user had been prescribed medication 1 - 2 tablets as directed, the staff member spoken to stated they give one tablet in the morning and one in the evening. When asked who said that was how the medication was to be administered the staff member said thats what we do. The inspector advised the management to check with the G.P to state what the dosage should be. It is not up to the staff to make judgments of how or when and what doses medication is to be administered. It would be appropriate for the team leaders to undertake further training to ensure they are clear with the procedures, and to contact the local pharmacist from whom the homes medications are dispensed in order that the concerns be rectified. The member of staff was reminded by the manager of the procedures and was not allowed to undertake medication administration until further training is been undertaken. Throughout the day the inspector observed that service users were addressed in a polite and courteous way by all staff. In the AQAA it states Individualised care plans are activity enhanced. They emphasise personal choices and preferences and are reviewed on a monthly basis or sooner if required. A varied skill mix of staff are on duty and service users have a choice of a male or female carer to attend their needs. Medication is administered, recorded and stored according to the home and company policy. Staff responsible for the administration of medication undergo full training. Care Homes for Older People Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activities provided by the home are individualised to each service user and include contact with the local community both within and outside the home. Contacts with family and friends are encouraged. Meals are well-balanced and varied with individual choices and preferences catered for. Evidence: The routines of daily living are arranged to suit individual service users preferences and choices. This was confirmed by service users spoken with. The activity programme was sampled at this visit. Activities are mainly provided in the day centre and some service users like to attend. On the day of the visit only one activity organiser was working in the home and she was covering the whole day in the day centre including the serving of lunches. The inspector asked her about her own lunch hour and was informed she does not always have time for lunch. The management have advertised for another activity organiser. The activities include arts and craft, cooking, outside musicians who visit the home to provide entertainment. The staff on each unit are supposed to provide activities for service users in the afternoon. However it would be impossible for staff to undertake activities as well as do cleaning, particularly with the staffing levels being two staff on each unit with the high number of service users who require assistance, and some require two members of staff. The Care Homes for Older People Page 16 of 28 Evidence: service users would benefit from more stimulation. Service users spoken to stated that there were always activities they could participate in. One service user commented on how much she enjoyed the old time music. Service users are able to choose which activities they attend or participate in. Some individual bedrooms were all seen to contain many personal possessions which were arranged to suit their individual wishes.There are no restrictions to visiting times and staff support and encourage service users to maintain family links and friendships inside and outside the home. Menus sampled showed that the home offers a varied and well-balanced menu, with service users able to choose alternatives if they do not want the dish that is on the menu on the day. The lunchtime meal was taking place during this visit, the food was well presented, the atmosphere in the dining rooms was pleasant and relaxed and staff available to offer help and assistance as needed. In one unit it was noted that a care assistant was standing feeding a service user. It was also noted that several units had small portions and when the staff was asked what happens if service users want seconds the response was we have to go to the kitchen for extra food. The chef stated if service users want more food he provides it. For example sausages were on the menu on the day of the inspection and the chef stated he would cook another sausage if required. In the day centre my observation was there was not enough food in the trolley to serve the number of service users who were seated for lunch, the mash potato ran out and so did the mixed vegetables and sausages. The member of staff stated the problem is when they run out of food service users have to wait, by the time staff go to the kitchen and request more food the service users have to eat their main meal while the other service user eat their sweet. There was not enough cream for the sweet and only just enough food to go round. In the AQAA, to demonstrate what the home does well, the manager stated that there is a comprehensive programme displayed of daily and weekly activities in the home and day centre. Activities are provided with one to one and group sessions by both activity co-ordinators when possible. Seasonal events are always celebrated with a summer fete, BBQ, Halloween, Easter and Christmas. Community contact is maintained with booked visiting entertainers, singers and a pantomime at Christmas. Church services are conducted in the home by the local churches. The home plans to raise funds to purchase a snooker table, male service users have made a request for this. Some service users have requested an aquarium is purchased. Care Homes for Older People Page 17 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. The home has a simple, clear and accessible complaints procedure, which includes timescales for the process. Policies and procedures are in place to protect service users from potential harm or abuse. Evidence: The home has a complaints procedure in place that is available to all service users and their relatives and is also included in the service users guide. One complainant has contacted the Commission with information regarding a complaint made to the service since the last inspection. The home has received five complaints since February 2009, all complaints seen have been appropriately dealt with. Records were seen of the outcome of the investigation and the action that had been taken. There have also been three safeguarding issues and three are still on going. All service users spoken to stated they always knew who to talk to if they were not happy, with one service user adding that: the staff are very helpful. There is a whistle blowing policy in place and the home have a copy of the latest Surrey Multi-agency Procedure for the Protection of Vulnerable Adults. Training in safeguarding adults is included in the homes staff induction and the majority of staff confirmed that they had received the training and were aware of the procedures to follow. However there are some new staff that need to complete the training and some staff who need to have up dates to their training. Care Homes for Older People Page 18 of 28 Evidence: In the AQAA, to demonstrate what the home does well, the manager stated that she has an open door policy and the manager and deputy can be easily approached for discussion with service users or relatives. There is a whistle blowing procedure in place and these procedures are displayed in the staff room. All staff have completed POVA training and are aware of Surrey Multi Agency procedures for reporting abuse. An advocacy service is available and details are displayed on the homes notice board. Care Homes for Older People Page 19 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The location and layout of the home and gardens are suitable for their stated purpose. An ongoing maintenance and redecoration programme provides the service users with generally clean, pleasant and homely surroundings in which to live. Evidence: Service users spoken with expressed their satisfaction with the accommodation provided at the home and one service user commented the home was always fresh and clean. A relative commented the home is very good, bedrooms are nice and she also stated she is very happy with the care provided in the home. The home was toured during this visit. The maintenance and redecoration programme for the home was seen to be ongoing. Since the last inspection there have been many improvements to the communal and individual areas of the home. These improvements included the refurbishment of bathrooms and the redecoration of some service users bedrooms. However there were several bedrooms with a malodour when this was discussed with the service manager and the registered manager it was agreed that the carpets need to be washed more frequently. At present with the domestic staff numbers being very low two domestic staff on duty on the day of inspection for such a large home is not appropriate. The bedrooms are not being cleaned and carpets washed as often as necessary. It was also noted the cleaning storage cupboards are also in need of a thorough clean. Care Homes for Older People Page 20 of 28 Evidence: In one of the units a drawer was missing from the kitchen, a cover was missing from an emergency light. It was also noted in the dining room that the table cloths had run out, a member of staff stated they take the cloths to the laundry after mealtimes and they are washed and ironed ready to be used again. It would be easier if there was a good supply of table cloths as extras for any accidents that my occur. Several service users were having their hair done in the specially adapted hairdressing room. One service user was not happy about having her hair washed and the water running down her face. The basins would be more comfortable if they were back wash basins so that it is not uncomfortable for service users bending forward. Laundry facilities with washing machines and tumble dryers suitable for the needs of the service users. The member of staff on duty stated between the two persons who work in the laundry on opposite shifts four hours daily, seven days a week. The member of staff stated they are able to keep on top of the amount of washing and ironing that is undertaken on a daily basis. The member of staff also confirmed that a number of service users entering the home do not have their clothes marked, which causes problems when clothes get lost. The marking of the clothes is then done by the laundry assistant, when the clothes are clean. It was also noted from the kitchen doorway that the ceiling was in a poor state, the inspector asked the chef if the Environmental Health Officer had been to the home for an inspection. The chef stated he had been some time ago. When checking the report left in the home on 15/11/07 it stated the ceiling needed to be painted. The registered manager and service manager were informed and the service manager commented it had been over looked. Immediately they arranged for the ceiling to be cleaned and painted within a few days of the inspection visit. On the day of this visit the home was found to be warm and bright with a homely atmosphere. In the AQAA, to demonstrate what the home does well, the manager stated that Maintenance of the building is constantly monitored. The gardens are well maintained. Maintenance of all electrical equipment is recorded including hot water and lighting. The on call system is maintained throughout the building and regularly serviced, all maintenance certificates seen were up to date. Care Homes for Older People Page 21 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. The skill mix of the staff meets service users needs. However the staffing levels need to be reviewed to ensure staff are able to meet the needs of service users, when the home is full there are 67 service users to care for. Domestic staff hours need to be increased to ensure the home is clean and free of malodour. The home has a comprehensive staff recruitment and training programme, which incorporates all areas needed to ensure, as far as reasonably possible, that service users are in safe hands at all times. Evidence: The staff rota was seen and it was noted that two members of the care staff are allocated to each of the five units on a daily basis, in the morning there are also two floating members of staff. There are four team leaders and the manager and deputy manager. The staff training as detailed in the AQAA states twelve staff hold a National Vocational Qualification (NVQ) level 2 and above in care. During this visit the files of three recently recruited members of staff were sampled. All files were seen to contain proof of identity, two references, a completed application form and enhanced Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (POVA) list checks had been obtained. All staff spoken to confirmed they had been supplied with a copy of the General Social Care Homes for Older People Page 22 of 28 Evidence: Care Council (GSCC) code of conduct and practise. Staff induction is in line with the new, mandatory Skills for Care common induction standards and the inspector was advised that staff are supervised until they have completed their induction. Staff are booked on additional training and updates as the courses become available. Some new staff have yet to complete some training, the deputy manager advised training has already been booked but there is a considerable time before the staff receive the training. One member of staff commented that she was very happy with the level of training provided by the home. In the AQAA, to demonstrate what the home does well, the manager stated that Kingsleigh employs a varied skill mix and use no agency staff, they use their own bank staff to cover any duties for holidays and sickness. Two team leaders have completed their train the trainers course to become in house trainers. The manager states she would like all staff to complete a NVQ qualification. Care Homes for Older People Page 23 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. Service users benefit from the clear management approach at the home providing an open, positive and inclusive atmosphere. The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the service users. Evidence: The manager has recently completed her registration with the commission, she has completed the Registered Managers award some time ago and has also completed NVQ Level 4 she is a qualified registered nurse. In addition holds a BA(Hons) degree and a legal qualification Post Graduate Diploma in Law. Therefore is experienced to manage Kingsleigh. Her management style is inclusive and the service users and staff benefit from the ethos, leadership and clear management approach of the home. The deputy manager has completed NVQ level 3 and is hoping to commence NVQ Level 4. The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the service users and their relatives. The inspector was Care Homes for Older People Page 24 of 28 Evidence: advised that the home carry out yearly service user and relative surveys, correlate the responses and then formulate an action plan to address any issues that are raised. The Regulation 26 notifications are undertaken on a regular basis and cover a wide area of the home and and its operation. These documents are informative and give a detailed assessment of the findings including a number of issue to be addressed identified. Policies and procedures are in place to protect service users financial interests. The administrator deals with the service users finances and the manager is kept informed of the process. The records containing personal information must be stored in a locked facility. Health and safety monitoring check sheets were sampled and found to be wellmaintained and up to date. All staff have received required safe working practise training and updates. Staff were observed to be following appropriate health and safety practises as they went about their work. In the AQAA, to demonstrate what the home does well, the manager stated that quality assurance audits are carried out yearly, meetings are held on a regular basis for service users and staff. Regular audits are undertaken on care plans and medication. Risk assessments have been completed and kept up to date on service users and health and safety in the home. The manager and deputy manager are on call for advice and support when required. The majority of staff have completed dementia care training. The team leaders are to be given more responsibility for training the staff and providing staff supervision on a regular basis. All interactions observed between the staff and service users were inclusive, caring and respectful. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 26 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 26 16 Keep the home free from offensive odours. Several service users bedrooms there was a malodour. 17/07/2009 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 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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. 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