Inspection on 12/05/05 for Kingsley House

This inspection was carried out on 12th May 2005.

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

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

Other inspections for this house

Kingsley House 03/05/07

Kingsley House 24/04/06

Kingsley House 10/01/06

Kingsley House 05/11/04

Kingsley House 10/06/04

Kingsley House 12/01/04

Kingsley House 25/07/03

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

CARE HOMES FOR OLDER PEOPLE Kingsley House 115 Kingsley Avenue West Ealing London W13 0EH Lead Inspector Paula Eaton Unannounced 12 May 2005 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 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 House Version 1.10 Page 3 SERVICE INFORMATION Name of service Kingsley House Address 115 Kingsley Avenue, West Ealing, London W13 0EH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 998 9708 0208 991 5256 Mrs Margaret Nyambura Lane Mrs Margaret Nyambura Lane Care Home 7 Category(ies) of Old age, not falling within any other category registration, with number (7) of places Kingsley House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10/02/05 Brief Description of the Service: Kingsley House is a care home for seven older people. It is situated in West Ealing, in a quiet residential area. There are shopping centres at West Ealing, Greenford and Ealing Broadway that can be reached from the home. West Ealing main line station and Ealing Broadway underground station are a short distance from the home. The home is currently owned and managed by the proprietor Mrs Margaret Lane who also owns and manages a nursing home in Ealing Broadway. The house is semi-detached and accommodation is two storeys. There are four bedrooms, on the ground floor there is one shared bedroom and there are two shared bedrooms and one single bedroom on the second floor. There is no passenger lift and none of the facilities are wheelchair accessible. There is a bathroom on the first floor with a separate toilet and a small shower room and toilet on the ground floor. There is a kitchen and lounge/dining room but there is insufficient space for all seven service users to dine at the same time. There is no private space available for visitors. There is a small garden, which has outbuildings for the laundry and the food store. There are no facilities for staff such as lockers or a changing area. There is no office and the files are stored in the kitchen. Kingsley House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over four hours as part of the statutory inspection process. There were two members of staff on duty at the time of the inspection; the Registered Provider/Manager arrived at the home shortly after the Inspector arrived at the home. There were only four service users resident at the home at the time of the inspection all of which were spoken to. One member of staff was spoken to and records, policies and procedures were examined. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kingsley House Version 1.10 Page 6 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 Standards Statutory Requirements Identified During the Inspection Kingsley House Version 1.10 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home has an adequate system in place to assess the needs of service users prior to admission to ensure the home is able to meet their needs. More detail could be recorded. EVIDENCE: There had been no new admissions to the home since the last inspection took place. The home carries out a pre-admission assessment. The information contained in the assessment documentation inspected covered all areas of need for each service user. However, it was noted that some of this information could be more detailed. The home had also obtained any Care Management assessments that had been completed. The homes assessment and the Care Management assessments had been used to develop care plans for the service users. Kingsley House Version 1.10 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 There is a satisfactory care planning system in place to provide staff with information about the needs of service users. The systems for the administration of medication are satisfactory. The size of the home limits the amount of privacy service users can utilise if the home is full to capacity. EVIDENCE: Individual care plans were in place for all four individuals living at the home. These covered all areas of need and were being reviewed on a monthly basis. However, the information contained in the care plans is quite general and could contain more specific details regarding the needs of individuals. For example, more detailed information regarding service users preferences with regards to daily routines. Risk assessments had been completed for all service users with regard to falls and the risk of developing pressure ulcers. A record is maintained of any health care received and any appointments attended. One service user had recently had her needs reassessed as her health had deteriorated and as a result she will be moving on to a nursing home shortly. The medication store and records were viewed and were generally satisfactory however; the date of opening was not recorded on liquid medicines. None of Kingsley House Version 1.10 Page 9 the service users were taking any controlled drugs at the time of the inspection. One service user administers his/her own insulin whilst a member of staff is present and staff have now received training on managing Diabetes. Staff were observed knocking on service users bedroom doors before entering and treating service users respectfully. Three out of the four bedrooms in the home are double rooms. Screens are available to provide a degree of privacy however as there is not any private communal space it would be difficult for service users to see any visitors in private. Kingsley House Version 1.10 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 The home does not meet the social and leisure needs of service users. Staff encourage service users to maintain contact with family and friends. Meal provision at the home is satisfactory EVIDENCE: The daily routines of the home are fairly relaxed and allow service users a certain amount of choice. Service users are able to choose whether to take their meals in their bedroom or in the communal lounge/diner and they are able to decide whether to participate in any activities taking place in the home. The leisure and social activities available to service users in the home are very limited. There is an activities programme available on the notice board in the lounge; however, it is just written on a piece of A4 paper and is hardly noticeable. The home must review the leisure and social activity provision provided in the home, find out what service users would like to do and take action to meet these requests where possible. It was noted in the service user plans viewed that very little was recorded in the way of social interests. It is recommended that the home consider employing an activities co-ordinator. Visitors are welcomed at the home and the daily records seen showed records of visitors to the home. Kingsley House Version 1.10 Page 11 The Service Users Guide to the home provides information to service users about independent advocacy services available. It was evident from service users bedrooms that they are encouraged to bring their personal belongings into the home. A satisfactory menu was in place. On arriving at the home service users were being given a morning drink. All the service users said that the food at the home was good and there was plenty of food stored in the home at the time of the inspection. Kingsley House Version 1.10 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a satisfactory complaints system with information available to service users, staff and visitors to the home. Systems are in place for the protection of service users from abuse but more vigilance and prompt action is required to ensure the protection of service users. EVIDENCE: The home has a satisfactory complaints procedure in place that provides all of the relevant information for someone wishing to make a complaint. No complaints had been recorded since 2002. The home has satisfactory procedures in place for the protection of service users and clear guidelines for staff regarding the action they should take if they witness or suspect abuse is taking place or if an allegation is made. However, on arrival at the home a service user was observed being verbally abusive towards the service user that they share a room with. When this was discussed with the registered provider she said that this had not happened before and that she would discuss the incident with the service user later. There was no record of a history of this behaviour on the service users care plan or any evidence of previous incidents in the daily records viewed. An immediate requirement was issued requiring the home to complete a risk assessment for the two service users sharing a room. This has since been completed and forwarded to the CSCI and one of the service users has moved into a single room. Kingsley House Version 1.10 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21, 22, 24 and 26 The bathroom facilities require updating. The environment was clean, tidy and generally well maintained. Individual accommodation was satisfactory. EVIDENCE: The home is situated in a quiet residential area of West Ealing. Local shopping centres are a short journey from the home and there are good transport links. There were no maintenance issues noted at the time of the inspection. The small rear garden was looking untidy and overgrown, however someone arrived at the home during the inspection and started working on this. It was noted that the bath on the first floor was very stained. The registered provider said that she had received estimates for replacing the bath with an assisted shower facility as recommended by an Occupational Therapist who assessed the home. There are adequate grab rails in the home for the present service users. The service users bedrooms were comfortably furnished and decorated to a satisfactory standard. Individuals said that they were happy with the Kingsley House Version 1.10 Page 14 accommodation that they had been provided with and it was evident that people had brought personal possessions into the home with them. The home was clean and tidy and there was no malodour detected in the home. There are appropriate laundry facilities provided in an outbuilding in the rear garden. Kingsley House Version 1.10 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 There are satisfactory numbers of staff employed by the home. The current recruitment practices safeguard the welfare of service users. Staff receive appropriate training to do their jobs. EVIDENCE: There were two members of care staff on duty at the time of the inspection. Care staff cook and clean the home as well as care for service users. As there were only four service users living at the home at the time of the inspection this was adequate. However, staffing levels will need to be reviewed as more service users are admitted to the home. The staffing rotas seen were satisfactory. The staff employment records viewed contained all of the required information and evidence that the expected recruitment checks had taken place. A training record for each member of staff is maintained. Staff had received required mandatory training in areas such as moving and handling, fire safety and food hygiene and had also received training in managing diabetes to ensure that staff can adequately meet the needs of one particular service user in the home. Kingsley House Version 1.10 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36 and 38 There is not sufficient management cover for the home at present to ensure sufficient monitoring of the homes systems. The health and safety of service users and staff are satisfactorily protected. EVIDENCE: The Registered Provider is still the Registered Manager for the home as well as her other registered home. This is not acceptable. A requirement was made regarding this matter at the previous inspection that had not been complied with therefore an immediate requirement was issued at this inspection. The manager said that she had put an advertisement for the post in the Nursing Times however; no evidence was seen of this at the time of the inspection. The home has some self-monitoring systems in place. Service user surveys are carried out and a record of these kept in the home. Recent staff meetings and service user meetings had taken place. The registered provider said that she Kingsley House Version 1.10 Page 17 had updated the annual development plan for the home however it was not available at the time of the inspection. From the staff records viewed there was no evidence of regular staff supervision taking place. Health and safety records were up to date and in order. All other equipment was being regularly serviced. All fire safety equipment was being regularly tested and records maintained. Risk assessments were in place and there are a low number of reported accidents in the home. Kingsley House Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x 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 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 2 3 x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 1 x 3 x x 2 x 3 Kingsley House Version 1.10 Page 19 YES 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. 2. Standard 9 12 Regulation 13(2) 16(2)(m) (n) Requirement Liquid medicines must have the date of opening written on them Service users must be consulted about their social and leisure interests and the activity provision in the home reviewed in light of this information. A risk assessment must be completed for the two service users sharing a room and any necessary action taken to protect the service users. (Immediate requirement issued) The bath on the first floor must be replaced with an assisted bathing facility as recommneded in the Occupational Therapy assessment carried out for the home. Suitable management arrangements must be made for the day to day running of the home. (Previous timescale not complied with. Immediate requirement issued) Timescale for action 12/05/05 1/07/05 3. 18 13(6) 17/05/05 4. 21 23(2)(b) 23(2)(n) 1/09/05 5. 31 8(1)(a)(b) (iii) 9/06/05 6. Kingsley House Version 1.10 Page 20 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. Refer to Standard 3 7 12 Good Practice Recommendations More detailed information should be recorded in the preadmission assessment documentation. More detailed information should be recorded regarding the service users individual preferences with regard to daily living. The home should consider employing an activities coordinator. Kingsley House Version 1.10 Page 21 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing London W5 2ST 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 Version 1.10 Page 22 - 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!