Inspection on 10/11/05 for Kingsley House

This inspection was carried out on 10th November 2005.

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

The inspector 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

Kingsley House 19/09/07

Kingsley House 17/01/07

Kingsley House 13/02/06

Kingsley House 29/09/04

Kingsley House 05/05/04

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

CARE HOME ADULTS 18-65 Kingsley House 16 Dudley Road New Brighton Wallasey Wirral CH45 9JP Lead Inspector Karen Barry Unannounced Inspection 10th November 2005 10:00 Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 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 House DS0000018906.V266480.R01.S.doc Version 5.0 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 Adults 18-65. 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 House DS0000018906.V266480.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kingsley House Address 16 Dudley Road New Brighton Wallasey Wirral CH45 9JP 0151 630 3714 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) Mr David Christopher Russell Mrs Ellen Ann Crofts Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16) of places Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Only fourteen (14) adults (aged 18 - 64 years) may be accommodated. Only two (2) named older persons (aged 65 years and over) may be accommodated. 29th September 2004 Date of last inspection Brief Description of the Service: Kingsley House is a three storey, Victorian house, offering care and accommodation to 14 adults and 2 older people with mental health disorders. Situated in the centre of New Brighton, close to a variety of shops and community facilities. The home is within reach of the main waterfront, bus and rail services. Accommodation is provided in eight single and four shared bedrooms, one double room upon the ground floor has en-suite facilities. There is an additional bedroom on the ground floor, which is used by staff for sleep in duties. The homes office overlooks the front door, this helps to monitor the comings and goings from the home whilst helping the staff to greet / direct visitors as necessary. Two communal lounges are available on the ground floor. The residents have designated the smaller lounge as a no smoking area. The dining room is situated within the conservatory, which overlooks the rear garden area. The kitchen is situated in the middle of the house in between the main lounge and the conservatory. Access between the ground, first and second floor is via the main stair case. There is a stained glass window along the staircase which adds considerable character and history to the home. A passenger lift is not available in this home. The home has access to a mini bus which is registered in the proprietor. This provides various opportunities for outings / activities. Car-parking facilities are available to the front of the building Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The registered proprietor and manager had not been told that the inspector would be visiting the home. During this inspection a tour of the home was conducted, and the inspector spoke with a number of residents and staff. Various records relating to care and management of practices offered within the home were viewed. Discussion took place with both the proprietor and the manger in relation to observations made. What the service does well: What has improved since the last inspection? Following an increase in the funding supplied via the local authority the staffing levels have been increased within the home. This has provided the residents with more time to take part in social activities, whilst providing the staff with more opportunities to form, develop and maintain good working relationships with the residents. The proprietor and the manger have continued to replace worn fixtures and fittings to ensure that the home décor is kept to a safe and reasonable standard. Internet access has been provided within the homes office to assist all staff members to gaining information which will enhance their knowledge. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,& 5 The assessments carried out by the home are detailed and help ensure that the home can meet resident needs in full. There is an opportunity for residents to visit the home before making an informed decision about where to live. EVIDENCE: The inspector examined 3 of the resident’s files and found that these contained information about the resident before and after they had been admitted to the home. Information from other professionals had also been collected to make sure the care being offered would be suitable. The manager told the inspector that residents are encourage to come and try the home before a final admission date is arranged. Individual contracts are written out for each of the residents, these show what can be expected and who is responsible for meeting cost involved. Those seen had been signed by the residents and relevant professionals. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9, & 10 Care plans and risk assessments are in place which encourage decision making and independence within a group living setting. Improvements could be made to the way reviews are recorded, as these highlight when changes are required to care plans following changes in residents physical and emotional well being. Residents are encouraged to take an active part in the daily running of the home. Formal reviewing of care plans EVIDENCE: Care plans seen by the inspector gave information regarding the individuals overall aims. Further information relating to how staff members should support and assist residents in achieving these aims was seen within the various risk assessments that had been completed. A key worker system is in place and workers continue to work with individual residents to help build up a fuller picture of who they are and what they really want to achieve. It was evident from reading the daily record sheets that the staff are regularly reviewing the care plans and altering their methods of working with individual Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 10 residents however these changes did not appear to be recorded upon the main care plan. Advice was given to the manager relating to formalising some of these changes into a formal review record, to prevent them losing sight of the reason behind why changes where necessary. Residents have access to all parts of the house and are encouraged to assist with the carrying out of various daily living tasks i.e. making hot drinks and snacks for themselves, helping with the tidying of their bedrooms and doing the laundry. One residents stated “I can be involved if a I want, but I don’t have too” Discussion with other residents and staff during the lunch time meal indicated that they are regularly asked about what is happening in and outside the home, and that decisions are often made that reflect both the individual and the groups wishes as appropriate. Residents files where stored within the main office which is locked when not in use, protecting the residents rights in relation to the handling of their confidential information. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 & 17 The atmosphere within Kingsley house indicates that the resident’s views and desires are made a priority. EVIDENCE: Residents are provided with opportunities and support to move towards supported living and employment within the community. The inspector was told that one of the residents is slowly making progress towards achieving his goal of moving into supported living. It was evident throughout the inspection that staff members are very clear about their roles and that they see themselves as motivators rather than carers. Residents where observed undertaking small tasks within the kitchen and discussing various outings and activities with the staff and each other. Generally there is a good relationship between the residents within the house although mornings are described as occasionally problematic. Residents spoken to stated that if and when they had experience problems with other residents they could always find another room to go to spend time apart and that they felt comfortable discussing these matters with staff. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 12 Activities and social events in and outside the home are encouraged to ensure each person hobbies and interests are addressed. The home provides the residents with a dart board, pool table playing cards, computer and digital TV. It was noted that an outside entertainer providing a karaoke was due to visit the following evening. This social event was arranged to help celebrate the proprieties recent marriage. Residents and staff spoken to where clearly looking forward to the evening and stated that a number of their families and friends would be joining them. Many of the residents go out independently to visit the local shops, bookmakers and pubs. Visitors are welcomed at any time providing the residents wishes to receive them. Guidance regarding visiting the home is available in the signing in book in the main hallway and visitors are requested to sign that they have read this and will follow the guidance appropriately. A varied diet is provided with the resident’s preferences in mind. Residents are encouraged to prepare their own breakfast as and when they are up and about. Lunch time was noted to be flexible as it is normal a light cooked snack. On the day of the inspection residents could choose from toasted sausage sandwiches or chicken nuggets and beans with bread and butter. The main meal of the day is served during the evening. Prior to the inspection ending staff where observed preparing a lasagne, for the evening meal. Residents told the inspection the food at the home was good and that they looked forward to a weekly “chippy” treat each week. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 & 21 Staff members have a wealth of knowledge and experience of working within Kingsley house and appear to have formed very good relationships with the residents to ensure they receive the right levels of support and assistance to meet their needs. Polices and procedures relating to medication must be followed more closely to ensure the safety and well being of the residents. EVIDENCE: Care plans seen by the inspector gave staff information to think about and highlighted what areas of encouragement residents required to maintain their physical and mental health. A number of risk assessments and management plans where also seen and discussed. These plans highlighted various issues that needed to be considered whilst respecting a residents desire to remain / become independent and gave instruction to residents & staff re methods to follow to reduce any risk. The manager has recently purchased a new risk assessment template which can be used on the computer. This system provides the reader with a professional looking document which is easy to read, and has assisted a number of staff to gain further knowledge and understanding which has benefited their progression with regards to National Vocational Qualification achievements. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 14 Health & social records seen show that as and when necessary residents are seen by their GP and that staff within the home do their utmost to gain advice and direction from other professional when the need arises. The community psychiatric nurse visits most of the residents at regular intervals. All of these visits and any interaction / administration of medication by the nurse is recorded upon the residents file. Medication was stored in a suitable secured cupboard within the office. However it was noted that since the chemist had recently change the size of the nomad boxes used, space is becoming very limited. It is therefore recommended that the purchasing of another suitable storage facility be considered in the near future. Medication is delivered on weekly basis by the chemist and any unused medication is returned to them for destroying. Records are kept to show medication entering and leaving the home however the previous weeks delivery record was not available on the day of inspection. The manager stated she would address this matter with the staff immediately. Medication Administration Records (MAR) sheets used to record administration of medication where checked alongside a number of residents nomad packs these where found to be correct. Concern was raised in relation to a number of missed signatures or codes upon records relating to PRN (when required medication) The home need to follow a consistent approach to how these are to be recorded to ensure the good health and well being of the residents. Its recommended that they either only sign when PRN medication is given or stick to using a suitable single letter code on a daily basis which is stated upon the MAR sheet to show that it hasn’t been required. A couple of the Marr sheets had hand written changes or entries upon them although these had been signed by the manager the RPS recommends that such entries are signed by two suitable trained staff. As the majority of the residents medication is now delivered via nomad packs routine information slips that highlight essential information regarding what the medication is for how it should be stored and what side effects may occur are not always supplied. The inspector discussed this situation with the manager and strongly advised her to request such leaflets from the chemist and to arrange for these to be stored in a suitable ring binder so that staff can obtain the information required with easy. The staff at Kingsley house presently offer care and accommodation to two service users over the age of 65. During conversations with staff it was evident that they had an awareness of the ageing process and that they seek advice and guidance from other professional to ensure they are still able to meet the residents needs appropriately. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Polices and procedures are in place to safe guard residents. EVIDENCE: Appropriate procedures for dealing with allegations of abuse are available within Kingsley house, including a copy of Wirral’s Adult protection procedures. Staff receive relevant information and guidance regarding these areas as part of induction training. Further updates are given on an ongoing basis to ensure all staff are kept up to date with any changes that occur. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28 & 30 Kinsley House provides a comfortable clean environment, there are sufficient toilets and bathrooms within the property and residents bedrooms appear to suit their needs. EVIDENCE: Bedrooms viewed where personalised and tidy. All bedrooms have suitable locks to ensure privacy for the residents. Staff members can override these locks with a master key in case of emergency. Bathrooms and toilets were clean and appropriately decorated. Staff members discussed and acted upon the need to purchase a more suitable lock for the new bathroom door, as the one that was supplied by the proprietor was not suitable as staff would not be unable to unlock it from the outside should a problem occur. Bedroom 11, which was vacant, during the last inspection is now in use. A new carpet was fitted to this room prior to the resident moving in. A No smoking in bedrooms policy has been introduced to reduce risks and safe guard residents. One of the residents said “ I agree with these rule it makes it safer” Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 17 A programme of redecoration and replacement of fittings is in use within the home. Residents spoken too confirmed that they are involved in the choosing of new items and colour schemes used within the home. Communal areas are well furnished with comfortable furniture including televisions, music, computer and leisure (Dart board, pool table and cards where) facilities. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 & 36 Staffing levels appear sufficient to meet the needs of the residents. Recruitment and selection procedure are robust ensuring the safety of residents at all times. Training is provided for staff in a range of skill areas and professional training through NVQ is supported. EVIDENCE: The inspector looked at two staffing files, these confirmed that a good standard of recruitment procedures is followed prior to staff being employed. A comprehensive induction programme is in place. This ensures staff gain necessary skills and knowledge to perform their roles effectively. Improvements were noted to the staff supervision programme. The deputy and senior care staff have undertaken training and have access to video guidance regarding how to give and record such sessions. Records and discussion with staff members confirm that they are receiving regular supervision. The manager has recently arranged for staff members to have access to the internet to assist them in enriching their knowledge of relevant issues and practices within the caring profession. A number of staff employed at Kingsley house have already achieved NVQ qualification and a further 2 staff are in the process of completing this form of training. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 19 The inspector Spoke with 3 staff members who all sated they like working within Kinsley House, and that they regularly attended social functions with their families and friends in their own time. The proprietor and the manager stated that they generally have a low turn over of staff. This helps to provide continuity for the residents they care for. Residents indicated that they feel the staff team is good and that they are well supported. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38 & 42 Kingsley house residents and staff benefit from a qualified and experienced manager, who ensures the health, safety and welfare of both residents and staff is promoted and safe guarded. EVIDENCE: The registered manager is qualified to NVQ level 4 and has a number of years experience within the caring profession. She undertakes an active role within the home often working alongside staff interacting with the residents in various daily living activities. It was clear from discussion with residents, staff and management that the manager and the Registered Person have maintained an open and relaxed atmosphere at Kingsley House. Safe working practices are operated within the home. Fire safety, emergency lighting, gas and electrical maintenance records were checked and found to be up to date. Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 21 Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 3 Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 15 16 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kingsley House Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 X X X 3 x DS0000018906.V266480.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation Reg 13 (2) Requirement The registered manager must follow RPS good practice guidance to ensure any handwritten changes upon MAR are checked and signed by two members of staff. A consistent recording system must also be used to record the administration of any PRN medication, in order to reduce any risks to the residents physical well being. Timescale for action 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations Staff should use review documents to record when & why any changes to support are considered. This will ensure they have clear information to hand, on which to base decisions regarding any significant changes to the residents overall care plan / risk assessment. The registered manager should consider arranging for further secure storage space for residents medication to be kept within. DS0000018906.V266480.R01.S.doc Version 5.0 Page 24 2 YA20 Kingsley House Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingsley House DS0000018906.V266480.R01.S.doc Version 5.0 Page 25 - 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!