CARE HOMES FOR OLDER PEOPLE
Kingsley Court 28 Dorchester Road Weymouth Dorset DT4 7JU Lead Inspector
Amanda Porter Key Unannounced Inspection 10th May 2007 11:30 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 Kingsley Court DS0000026829.V336719.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. Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Kingsley Court Address 28 Dorchester Road Weymouth Dorset DT4 7JU 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) 01305 782343 01305 786800 enquiries@kfcare.co.uk www.Kfcare.co.uk Mr Michael Anthony Fry Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 24th April 2006 Brief Description of the Service: Kingsley Court has been owned and managed by Mr M Fry since 1994. It is one of two homes owned by Mr M Fry, the other being Friary House and forms part of the family business. The home is established in a large detached house, which is situated on the Dorchester Road, a short drive away from Weymouth seafront and town centre. It is also close to local shops and amenities. Kingsley Court is registered to accommodate a maximum of 18 elderly residents with single and double bedrooms available at ground and first floor level. Communal facilities include a lounge with a conservatory extension and a separate dining room. There are two assisted bathrooms in the home, one on each floor. A stair lift enables access to the first floor of the home for those residents who cannot easily use the main staircase. Three rooms are accessible up a further four stairs. The front entrance of the home comprises of a large parking area, with garden borders, while the back garden is small, enclosed and sheltered with lawns, rockery and flower borders. The home has both a web site and e-mail address where prospective residents can view details or contact the home directly for information. Copies of at least the last two Inspection Reports are displayed in the main hallway of the home and are available to visitors. Fees range from £425- £600, extra amounts are charged for chiropody services, hairdressing, daily papers /magazines. See the following website for further guidance on fees and contracts www.oft.gov.uk (Value for Money and Fair Terms in Contracts). Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 10th May 2007 over a period of approximately four hours. The purpose of the inspection was to review the requirements and recommendations made at the last inspection and assess all of the key standards. The Registered Provider/Manager, Mr Fry, and the home manager Mrs Chapman were on hand throughout to aid the inspection process. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home. • A pre-inspection questionnaire completed by the Registered Manager. • The annual quality assurance assessment completed by the home. • 5 comment cards completed by residents, 5 by relatives/visitors; 1 by a GP and 1 by a health professional. • Tour of the premises. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents and staff. Four residents and five members of staff were spoken with and asked their views on the service provided at Kingsley Court. Comments received in comment cards and through discussion included: “The service is friendly, calm, personal and caring.” “It offers a friendly and supportive environment. It does its best to avoid an institutional milieu.” “If this standard is maintained I will be very happy.” “Staff have good communicating skills with both residents and relatives. I am very happy with this friendly family run home, which is always clean, tidy and welcoming whenever we visit.” “My relative always speaks highly of the service and of the staff at Kingsley Court.” “Kingsley Court has a very homely feel and approach to things.” “I am very pleased with the staff.” All the staff and residents were welcoming and helpful. Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 6 What the service does well:
Residents and their relatives are assured that Kingsley Court is suitable for meeting their needs prior to admission when an assessment is carried out to identify care needs and other considerations. Each resident has a plan of care detailing for staff how to meet assessed care needs; care plans are reviewed with the resident. Residents’ health needs are identified and met by staff and visiting health care professionals and medicines are managed well in the home in the best interests of residents. Comments received from residents and their relatives/visitors confirmed that staff treated them with respect and were supportive and kind. The activities arranged within the home meet the expectations of the residents living there. Staff at the home support resident’s rights to privacy in care routines and residents spoken with confirmed they are able to enjoy the privacy of their rooms when they choose without interruption. Residents and relatives said that visitors to the home were always made welcome and were greeted by a friendly face. Residents like the food provided and enjoy the choices offered at each meal. “The food is very good.” The complaints procedure can reassure residents that their views are important to the home and that any complaints they raise will be properly investigated. The home is well maintained and the standard of the environment is good providing residents with an attractive and comfortable place to live. The home is clean and free from any unpleasant odours. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the needs of the residents. A thorough recruitment process is followed when employing staff, which ensures that residents are protected from risk. The home has an ongoing training programme for staff, which means that residents will be cared for by skilled staff. Mr Fry and Mrs Chapman manage the home. A competent and committed staff whose main aim is to give a good level of care to all the residents, supports them in this. Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 7 A robust quality assurance system is in place to ensure that the home is run in the best interests of the residents. Financial procedures within the home also ensure that residents’ interests are protected. The health and safety of the residents and staff are protected by the policies and procedures that the staff follow at Kingsley Court. What has improved since the last inspection? What they could do better:
As a result of this inspection five recommendations of good practice have been made. Medications are administered safely. However, there is no audit trail to establish how much medication the home holds for residents. The minimum and maximum temperature of the medication fridge should be recorded daily to ensure that it is in full working order at all times. To ensure that staff continue to protect residents in their care they should undertake training in the protection of vulnerable adults. The registered manager is making arrangements for this training to take place. To make sure that all adaptations made within Kingsley Court, to improve access for residents, are suitable the home should be assessed by a suitably qualified person for its overall disability provision. The home has an ongoing training programme for staff, which means that residents will be cared for by skilled staff. However NVQ training needs to continue so that the home reaches the target of 50 of care staff holding this award. This training would provide the home with skilled and qualified carers at all times. The Registered Manager is committed to this training.
Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 8 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kingsley Court DS0000026829.V336719.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 Kingsley Court DS0000026829.V336719.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): 3 & 5. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents move into the home having had their needs assessed and been assured that these needs will be met. Prospective residents are encouraged to visit the home to help them when choosing where to live. EVIDENCE: The care documentation for three residents was reviewed. Each care file contained details of a pre-admission assessment of each resident’s needs. The assessment was thorough and contained sufficient information so that a care plan could be compiled for staff to follow. Residents, who had recently moved into the home, confirmed that the assessment had taken place at home and they were encouraged to visit Kingsley Court before making a decision about moving in.
Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 11 Comments included in the resident and relative surveys stated: “Mum visited many times before to meet friends so knew the home and staff.” “I had visited several people in the home before I came to live here and decided that it would be the right place for me.” “This has been a good move.” Kingsley Court DS0000026829.V336719.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 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a care planning system in place to make sure that staff have the information they need to meet residents needs. The health needs of the residents are well met with evidence of good support from community health professionals. The medication at this home is well managed promoting the good health and well being of residents. Residents are treated with respect and their right to privacy upheld. EVIDENCE: The care documentation for three residents was reviewed. Files contained a variety of assessments including: • Nutrition
Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 13 • • • Mobility The risk of pressure sore development The residents preferred daily routine, including times of getting up and going to bed. The information from the assessments was used to formulate a plan of care. Plans were informative and they set out individual care needs and how they were to be met. Residents were encouraged to be involved in their care plans and any reviews that take place. It was clear from discussions with staff and residents that they have access to the health services they need. There was evidence to show that residents get support from General Practitioners, the district nurse, chiropodists, opticians and dentists. The home has an informative medicines policy and procedure including reference to self-administration and associated risk assessment and arrangements for ordering, administration and disposal. Medicines were stored securely. However there was no clear audit trail to identify how much of certain medications were held by the home. The minimum and maximum temperature of the medication fridge should be taken and recorded daily. Examination of records indicated that medicines are properly administered in accordance with the prescriber’s instructions. Staff responsible for the administration of medications had received the appropriate training. All medication administration records were signed correctly. Comments received from residents and their relatives/visitors confirmed that staff treated them with respect and were supportive and kind. “Staff are extremely caring and friendly to residents.” “I like the staff, they are so helpful and kind.” Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 14 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 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an adequate range of social opportunities available in the home, which reflects residents’ interests and preferences. There is a sense of homeliness and inclusion of family and friends in life at Kingsley Court. Residents are helped to exercise choice and control in their daily lives within their capabilities and desire to do so. The dietary needs of residents are well catered for with a balanced and varied selection of food available that meets their tastes and choices. EVIDENCE: Kingsley court employs a member of staff to organise activities. These include: • Lunch outings • Bus trips • Theme day celebrations • Bingo
Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 15 • Quizzes and games. It was clear through discussion with residents that some of them preferred to arrange their own social activities, which they were free to do and they could spend their days as they wished. Comments received included: “Residents are encouraged to take part in activities that are arranged, which always prove to be great fun, and a talking point when we visit.” “There is a good secluded garden which residents can sit in, and enjoy the fresh air, flowers and wild life.” “I enjoy some of the activities but I chose which ones I want to attend.” Residents confirmed that they could receive their visitors in private and that they were always made very welcome. One visitor commented: “When we visit the home the staff always make you welcome and give you a cup of tea, also they welcome you by name.” The menu provided choice and the cook was aware of residents’ likes and dislikes. Residents confirmed they could take their meals where they wished and some preferred to eat in their rooms and some preferred to go to the dining room. They said they liked the food offered. “Meals are very good and varied.” “The food is very good on the whole.” Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 16 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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear and accessible complaints procedure and residents confirmed they knew who to speak with if they had any concerns. The home’s adult protection policy demonstrates an understanding of abuse and of how to protect residents from it. EVIDENCE: The home has a clear complaints procedure available to everyone. Residents spoken with during the inspection said that if they had any concerns they would feel confident about talking to the managers, knowing that they would listen to them. The home has a robust policy and procedure to respond to suspicion or evidence of abuse or neglect. However staff have not received training on the subject. The Registered Manager is in the process of arranging this training. Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 17 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, 22 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within Kingsley Court is good providing residents with an attractive, homely and safe place to live. Residents have individual aids and adaptions according to their assessed need. However, the home should be assessed by a suitably qualified person for its overall disability provision. The home is kept clean and smells pleasant thereby making daily life for all in the home more pleasurable. Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 18 EVIDENCE: The home has a programme of routine maintenance and the home provides a comfortable environment in which to live. Records show that a variety of outside agencies have attended the home to undertake the routine maintenance of: • Fire safety equipment. • Gas installation. • Chair lifts. • Hoists. Refurbishment since the last inspection has included updating the kitchen; outside painting; three new front windows have been double glazed; redecoration of six bedrooms the lounge, hall, main stairs and corridors. Over the years the home has had various adaptations, such as chair lifts and ramps, added to improve access to most areas for the residents. To ensure that all adaptions are suitable and to assess whether any further are needed the home should be assessed by a suitably qualified person for its overall disability provision. A call bell system is available in every room. All areas of the home were clean and there were no unpleasant odours. The laundry was well managed and adequate supplies of clean linen were seen to be available. Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 19 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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The deployment and number of available staff is sufficient to meet the needs of the residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are experienced and competent and residents could be confident they would be well looked after. EVIDENCE: Staff rosters demonstrated that there are sufficient staff on duty at all times. During the inspection call bells were answered promptly and residents commented that staff were on hand when they needed them. The home has an ongoing training programme, which includes NVQ level 2 and 3 in care and at the time of inspection 33 of the care staff hold the minimum of a level 2 award in care. This is below the 50 recommended but the home continues to support candidates to reach the award. Records show that staff receive mandatory training on a regular basis. Staff spoken with during the inspection confirmed this.
Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 20 One staff recruitment file was reviewed. It was well ordered and contained all the information required by law. POVA first and enhanced Criminal Record Bureau checks had been obtained for all new staff. Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 21 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 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a committed and competent manager, who creates an open and positive atmosphere which supports good care practices for residents. The home regularly reviews aspects of its performance through a programme of self-review and consultations, which include seeking the views of residents and relatives. Residents are assured of sound management of their financial interests. The health and safety of the service users and staff are protected by the policies and procedures followed at Kingsley Court. Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 22 EVIDENCE: The Registered Manager has many years experience in caring for elderly people and is suitably qualified. Residents and staff confirmed they found the management style at the home open and supportive. Residents spoken with confirmed that they would happily discuss any concerns they may have with Mr Fry and Mrs Chapman. One resident said: “This is a very well run home with a kind and helpful staff.” There is an effective quality assurance and quality monitoring system in place. The home takes steps to review its performance regularly and resident surveys are conducted and results analysed and action is taken as necessary. Residents confirmed that they either deal with their own finances or have appointed a responsible representative to do so. This is frequently another family member. Records showed that staff had received recent training in fire safety and all had manual handling updates. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were recorded and analysed and appropriate action was taken as necessary. Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X 2 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 3 X 3 X 3 X X 3 Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP9 OP9 OP18 OP22 OP28 Good Practice Recommendations There should be a clear audit trail for all medications coming into and leaving the home. The minimum and maximum temperature of the medication fridge should be recorded daily. All staff should receive training in the protection of vulnerable adults. A suitably qualified person, for example an occupational therapist, should assess the home for disability provision. The home should continue to work towards at least 50 of staff achieving a minimum of an NVQ 2 award. Kingsley Court DS0000026829.V336719.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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
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